Cuproptosis is a newly discovered form of RCD, characterized by lipoylation protein oligomerization and loss of Fe-S proteins, distinguishing it from other forms of RCD [1]. Nonetheless, there are still many questions remain unanswered regarding this new type of cell death. In this study, we reported that increased DNA damage is also characteristic of cuproptosis. Also, our results demonstrated that the NAD+ precursor NMN can partially rescue cuproptosis by inducing G1/S arrest, upregulating sirt2, and increasing NADPH levels.
One possible explanation for the DNA damage during cuproptosis is the generation of reactive oxygen species (ROS), which has long been reported to be involved in Es-induced cell death [14, 15], and since ROS is known to induce DNA damage, it is conceivable to detect DNA damage during cuproptosis. Also, in DDR, distinct signaling pathways involving multiple proteins/molecules are activated to deal with the different types of DNA damage, leading to either cell cycle arrest to repair the damage, or cell death, depending on the degree of the damage[12]. Interestingly, certain Fe-S proteins play important roles of in DNA replication and repair, such as POLD1[16, 17]. During the process of lipoylation, Fe-S cluster is the sulfur donor [18, 19]. Lipoylation modification of DLAT and DLST, which is essential for their acyl transfer function, is triggered by aerobic oxidation [20]. When aggregated by copper, it leads to increased consumption of Fe-S clusters as the sulfur donor for lipoic acid synthesis, ultimately resulting in Fe-S cluster depletion and the loss of Fe-S proteins. Cells that under aerobic oxidation are nearly 1000-fold more sensitive to cuproptosis than cells undergoing glycolysis [1]. These findings suggest that the aggregation of lipoylated proteins leads to the loss of Fe-S proteins. In this study we also confirmed that Es/Cu downregulated the expression of POLD1, which may further elevate the DNA damage level.
NADPH is the H and electron donor for the Fe-S cluster biosynthesis process [9]. Therefore, theoretically, by modulating NAD+ metabolism to increase cellular NADPH level, it should be able to inhibit the loss of Fe-S clusters. A recent studieshave also found that NADPH affects the sensitivity of cuproptosis [21]. The NAD+ precursor NMN has been under intensive investigation for the past decade, due to its potent anti-oxidative and anti-aging effects [11]. Recently, we have reported the strong protective effects of NMN and NR on cisplatin-induced DNA damage as well as the decrease of cell viability of HeLa cells[22], therefore, it is of interest to see whether NMN can also protect cells from Es/Cu-induced DNA damage. As expected, Es/Cu-induced DNA damage was significantly inhibited by NMN pretreatment (Fig. 2A). Furthermore, the decreased expression of the Fe-S protein POLD1 by Es/Cu was also reversed.
As stated above, G1/S cell arrest is an important event during DDR, and it has been reported that the G1/S checkpoint cyclin Dependent Kinase Inhibitor 2A (CDKN2A, also known as P16) is a cuproptosis suppressor [1], it was hypothesized that G1/S arrest might contribute to the resistance of Es/Cu-induced DNA damage. Again, we were able to show that NMN pretreatment significantly increased the ratio of G1 phase cells, just as the the copper chelator TTM did. Based on these data, we speculate that G1/S arrest may contribute to the resistance HeLa cells to cuproptosis. Nonetheless, compared to the strong protective effect on DNA damage, NMN only caused a relatively small increase of cell viability, it is believed that the NAD + metabolic pathway only plays a minor role in Es/Cu-induced cell death.
To understand how NMN elicits its protective effect on cell viability, we noticed the two lipoamidases[6, 7], with interest, as they need NAD+ as cofactor[23]. Examination of these two enzymes revealed that Es/Cu decreased Sirt2 expression, while NMN upregulated the expression of sirt2. Furthermore, overexpression of sirt2 also caused a small but significant increase of cell viability after Es/Cu treatment, just as NMN treatment, indicating that Sirt2 may play a role in the inhibition cuproptosis. Conversely, knockdown of sirt2 abolished the protective effect of NMN on cuproptosis. Together, such results suggest that NMN could inhibit cuproptosis through the regulation of Sirt2.
Since sirt2 and sirt4 have the lipoamidase activity, we were wondering whether such enzymatic activity is required for the action of NMN. The level of aggregated lipoylated proteins was evaluated by immunofluorescence assay, and our results showed that overexpression of neither sirt2 nor sirt4 affected the level of aggregation of lipoylated protein. These results suggested that Sirt2 rescued cuproptosis in a lipoamidase-independent manner. Recently, Sun reported that Sirt2 delactylates METTL16, an atypical methyltransferase, inhibiting its activity, while AGK2, a SIRT2-specific inhibitor, induces cuproptosis [24].
To further explore the mechanism of rescue cuproptosis by NMN and sirt2, we compared the function of sirt2 and sirt4. Besides its lipoamidase activity, sirt2 also serve as the controller of the pentose phosphate pathway (PPP), which is the major NADPH- producing process[10]. Sirt2 activates Glucose-6-Phosphate Dehydrogenase (G6PD) and enhances NADPH production [25, 26]. Therefore, intracellular NADH and NADPH levels were examined under different conditions. It was found that copper reduced intracellular NADH and NADPH content in HeLa cells. NMN, as expected, increased intracellular NADH and NADPH levels. In contrast, only overexpression of Sirt2 increased intracellular NADPH but not sirt4. NADK is important for the generation of NADPH, and thioNA is a NADK inhibitor [27]. Both the NADH and NADPH levels were decreased by thioNA, and NMN cannot rescue cuproptosis in thioNA pretreated cells, suggesting that either NADH or NADPH might mediate the action of NMN. To determine which one was responsible, we further knockdown NADK by si-NADK, and knockdown of NADK only decreased NADPH level. On the other hand, NMN did not affect the sensitivity of NADK-knockdown cells to cuproptosis. These data suggested that NMN and sirt2 rescue cuproptosis via elevating intracellular NADPH level. However, the detailed mechanism of how NADPH protects cells from cuproptosis needs to further investigated.
Taken together, the results demonstrate that increased DNA damage and decreased NADPH are important features of cuproptosis. G1/S arrest contributes to the resistance of cuproptosis. NMN can partially rescue cuproptosis, and its mechanism includes upregulation of POLD1 to counteract copper death-induced DNA damage, as well as upregulation of sirt2 to increase NADPH levels.