CAMK1D activates PINK1/Parkin-dependent mitophagy to promote enzalutamide resistance in prostate cancer
Although AR-targeted therapies (e.g., enzalutamide) initially improve outcomes of prostate cancer (PCa) patients, resistance inevitably develops, driven in part by prostate cancer stem-like cells (PCSCs). However, the molecular mechanisms linking PCSCs maintenance to enzalutamide resistance (ENZR) remain incompletely characterized. The emergence and reversal of ENZR represent critical clinical challenges in PCa therapeutics. Cancer stem-like cells (CSCs) have been implicated in contributing to ENZR through multiple pathways. Here, we demonstrated that CAMK1D, a Ca²?/calmodulin-dependent kinase, is consistently upregulated in PCa with ENZR and contributes to resistance by enhancing mitophagy in PCa cells both in vitro and in vivo. Mechanistically, CAMK1D promotes the expansion of PCSCs by enhancing mitophagy through activation of the AMPK-PINK1 signaling pathway, thereby facilitating cellular adaptation. We reveal that CAMK1D interacts with AMPK, triggering lysosomal AMPK activation via metabolic stress–induced PINK1 phosphorylation. This AMPK-PINK1 cascade reprogramsmitochondrial metabolism to fuel PCSCs expansion. In patient-derived xenograft chimeras, targeting mitophagy or CAMK1D-AMPK signaling pathway suppresses tumor growth and depletes the PCSCs population. Our findings establish mitochondrial hemostasis as an important nexus between ENZR and AMPK-mediated PCSCs enrichment in PCa. CAMK1D emerges as a key regulator of ENZR by orchestrating mitophagy-dependent stemness maintenance. Therapeutically, we developed an Enz-siCAM/HNA nanoformulation that potently reverses ENZR and improves treatment responses. Overall design: In this research, We established an orthotopic PCa model in mice using RM-1 cells exclusively and collected tumor tissues from both control and enzalutamide-treated groups. These tissues were then subjected to scRNA-seq for further analysis.