Improving the Efficacy and Expanding the Application of NQO1-Bioactivated Therapeutics

dc.contributor.advisorBrekken, Rolf A.en
dc.contributor.committeeMemberBoothman, David A.en
dc.contributor.committeeMemberScaglioni, Pier Paoloen
dc.contributor.committeeMemberGao, Jinmingen
dc.creatorMoore, Zachary Rayen
dc.date.accessioned2020-06-02T21:01:55Z
dc.date.available2020-06-02T21:01:55Z
dc.date.created2018-05
dc.date.issued2015-06-09
dc.date.submittedMay 2018
dc.date.updated2020-06-02T21:01:56Z
dc.description.abstractNADPH:quinone oxidoreductase-1 (NQO1)-bioactivated drugs, such as ß-lapachone (ß-lap), are powerful therapeutics for tumor-specific therapy. They react with NQO1, which is highly overexpressed in most solid tumors, to cause a futile redox cycle that results in devastating oxidative DNA damage and energy depletion in the form of ATP, NAD(H) and NADP(H) loss specifically in tumor cells. However, ß-lap suffers from inherent limitations shared by quinone therapeutics, most notably methemoglobinemia at high doses caused by non-specific oxidation of hemoglobin. My goal was to increase the efficacy of ß-lap at lower, well-tolerated doses without increasing normal tissue toxicity. Targeting the NAD+ synthesis pathway by inhibiting NAMPT prevented cells from surviving the metabolic stress of NAD+ and ATP depletion induced by PARP1 hyperactivation secondary to ß-lap treatment. This resulted in synergistic cancer cell death at normally sublethal doses of both ß-lap and NAMPT inhibitors, occurring through the same NAD+-Keresis mechanism as with ß-lap alone. On the other hand, synergy with PARP inhibitors occurred due to an increased accumulation of DNA double strand breaks, which was a result of inhibited repair of ß-lap-induced single strand breaks. In contrast to synergy observed with NAMPT inhibition, PARP inhibitors combined with ß-lap caused canonical caspase-mediated apoptosis. In addition to providing new treatments for further preclinical and clinical development, these studies elucidated the importance of NAD+ and ATP depletion in cell death induced by ß-lap. Furthermore, these treatment strategies increase the tumor specificity and widen the use of both NAMPT and PARP inhibitors, since in combination with ß-lap they are effective against all NQO1-overexpressing tumor cells. As a study in expanding the application of NQO1-bioactivated therapeutics, I have also demonstrated NQO1 overexpression and ß-lap sensitivity in atypical teratoid rhaboid tumors (ATRTs), a rare but deadly pediatric malignancy that can be targeted with NQO1-bioactivated therapeutics.en
dc.format.mimetypeapplication/pdfen
dc.identifier.oclc1156324529
dc.identifier.urihttps://hdl.handle.net/2152.5/8297
dc.language.isoenen
dc.subjectNAD(P)H Dehydrogenase (Quinone)en
dc.subjectNaphthoquinonesen
dc.subjectNeoplasmsen
dc.subjectNicotinamide Phosphoribosyltransferaseen
dc.subjectPoly Adenosine Diphosphate Riboseen
dc.titleImproving the Efficacy and Expanding the Application of NQO1-Bioactivated Therapeuticsen
dc.typeThesisen
dc.type.materialtexten
thesis.degree.departmentGraduate School of Biomedical Sciencesen
thesis.degree.disciplineCancer Biologyen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.levelDoctoralen
thesis.degree.nameDoctor of Philosophyen

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