A recently described phenomenon, termed immunogenic cell death (ICD)8,9, is a form of cell death that induces an immune response from the host. Ivermectin treatment ex vivo preferentially depleted this expanded CD11b+ myeloid population, normalizing the balance between myeloid and T cell compartments (Fig. Glioma stem cells promote radioresistance by preferential activation of the DNA damage response. Treatment with IP therapy alone provided some survival benefit with ~40% of animals remaining free of lethal disease. Apetoh, L. et al. Niazi M., Zakeri-Milani P., Najafi Hajivar S., Soleymani Goloujeh M., Ghobakhlou N., Shahbazi Mojarrad J., Valizadeh H. Nano-based strategies to overcome p-glycoprotein-mediated drug resistance. Gallardo treated melanoma cells with IVM and found that it could effectively inhibit melanoma activity [73]. Nat. Galluzzi L., Pietrocola F., Bravo-San Pedro J.M., Amaravadi R.K., Baehrecke E.H., Cecconi F., Codogno P., Debnath J., Gewirtz D.A., Karantza V., Kimmelman A., Kumar S., Levine B., Maiuri M.C., Martin S.J., Penninger J., Piacentini M., Rubinsztein D.C., Simon H.U., Simonsen A., Thorburn A.M., Velasco G., Ryan K.M., Kroemer G. Autophagy in malignant transformation and cancer progression. We also explored the effects of further augmenting this combination immunotherapy with interleukin-2 (IL-2). Science 348, 5661 (2015). Mastrangelo E., Pezzullo M., De Burghgraeve T., Kaptein S., Pastorino B., Dallmeier K., de Lamballerie X., Neyts J., Hanson A.M., Frick D.N., Bolognesi M., Milani M. Ivermectin is a potent inhibitor of flavivirus replication specifically targeting NS3 helicase activity: new prospects for an old drug. On the other hand, ivermectin promotes programmed cancer cell death, including apoptosis, autophagy and pyroptosis. Get what matters in cancer research, free to your inbox weekly. Approximately 40% of animals on the combination therapy become long-term survivors. The mechanism involved the inhibition by IVM of the Akt/mTOR pathway to induce autophagy and p-21-activated kinase 1(PAK1)was the target of IVM for breast cancer [32]. All untreated animals required euthanasia due to metastatic disease around day 2040 following surgical resection of primary tumor (Fig. IVM not only has strong effects on parasites but also has potential antiviral effects. Research reported in this publication includes work performed in the Biostatistics Core and Analytical Cytometry Core of City of Hope and supported by the National Cancer Institute of the National Institutes of Health under award number P30CA033572. in American Society of Clinical Oncology Educational Book. 4A). Therapeutic strategies of drug repositioning targeting autophagy to induce cancer cell death: from pathophysiology to treatment. and JavaScript. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Denkert, C. et al. The tumor and surrounding mammary fat pad was removed by blunt dissection using autoclaved surgical instruments (Braintree Scientific). A clinical trial of 476 patients found ivermectin didn't improve the recovery time in patients who had COVID-19. IVM inhibited the activation of EGFR and the downstream ERK/Akt/NF-kappa B signaling pathway to downregulate the expression of P-gp. It has a good effect on the treatment of parasitic diseases such as river blindness, elephantiasis, and scabies. Earlier, we mentioned that IVM combined with conventional chemotherapeutic drugs such as cisplatin [60], paclitaxel [59], daunorubicin and cytarabine [51], or with targeted drugs such as dasatinib [53] and dapafenib [73] shows great potential for cancer treatment. Cite this article. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. Female BALB/c mice were purchased from Charles River Laboratories at 58 weeks of age and housed in City of Hopes animal care facilities under pathogen-free conditions. Immune checkpoint inhibitors (ICIs) are effective as single agents only in a small subset of cancer patients. Crump A. Ivermectin: enigmatic multifaceted wonder drug continues to surprise and exceed expectations. Mechanisms of IVM-induced P2 4/P2 7/NLRP3-mediated pyroptosis. MDR of tumor cells is the main cause of relapses and deaths after chemotherapy [97]. Drug-resistant Drosophila indicate glutamate-gated chloride channels are targets for the antiparasitics nodulisporic acid and ivermectin. Kobayashi Y., Banno K., Kunitomi H., Tominaga E., Aoki D. Current state and outlook for drug repositioning anticipated in the field of ovarian cancer. In contrast, achieving similar reductions in CD4 or CD8 T cells required higher doses and/or longer exposure to ivermectin: observed in CD8 T cells only after 48h of 8M or 24h of 16M, and in CD4 T cells only after the maximum exposure (48h of 16M). ACS Nano 12, 1104111061 (2018). These results suggest that the IVM+IP combination treatment is effective in the neoadjuvant setting and induces potentially stronger protective anti-tumor immunity in responders. 4F). Target cells were seeded at 0.025106 cells per well. We went on to demonstrate that this novel combination is effective in the neoadjuvant, adjuvant, and metastatic settings that mimic clinical situations in which it may be used. ). In contrast, poor responses to chemotherapy in solid tumors are associated with lymphopenia19. Ivermectin has powerful antitumor effects, including the inhibition of proliferation, metastasis, and angiogenic activity, in a variety of cancer cells. OBrien C.A., Kreso A., Jamieson C.H. Localization and density of immune cells in the invasive margin of human colorectal cancer liver metastases are prognostic for response to chemotherapy. 8600 Rockville Pike Here, we reviewed the related mechanisms by which ivermectin inhibited the development of different cancers and promoted programmed cell death and discussed the prospects for the clinical application of ivermectin as an anticancer drug for neoplasm therapy. 88]. Proc. Antibiotic ivermectin preferentially targets renal cancer through inducing mitochondrial dysfunction and oxidative damage. Means.d., n=5 mice, pooled data from two independent experiments. The antiparasitic agent ivermectin induces chloride-dependent membrane hyperpolarization and cell death in leukemia cells. On the other hand, caspase-1 activated by GSDMD triggers pyroptosis independent of apoptosis. Sharmeen S., Skrtic M., Sukhai M.A., Hurren R., Gronda M., Wang X., Fonseca S.B., Sun H., Wood T.E., Ward R., Minden M.D., Batey R.A., Datti A., Wrana J., Kelley S.O., Schimmer A.D. Cancer Res. 3B), while control nave animals all developed tumors (data not shown). Our results demonstrate that treatment with ivermectin induces robust T cell infiltration into breast tumors via induction of ICD, thus turning cold tumors hot. Recurrence of primary tumor was recognized when the animals luciferase value exceeded 600,000 photons/s/cm2/steradian, a threshold chosen because it was well above the lower limit of reproducible detection (510,000) and because, in optimization experiments, 600,000 was the lowest threshold consistently followed by ever-increasing values and eventually death. Moreover, Akt can inhibit -catenin transfer into nucleus. Gasdermin D(GSDMD)is a substrate for activated caspase-1 and is considered to be a key protein in the execution of pyroptosis [86,87]. The following mouse antibodies from BioLegend (San Diego CA) were used: CD4 (GK1.5); CD8 (53-6.7); Tbet (4B10); Gata3 (16E10A23); Foxp3 (MF-14); IFN (XMG1.2); IL-10 (JES5-16E3); IL17 (TC11-18H10.1); and TGF (TW7-16B4). Galluzzi L., Green D.R. 1C, D). 4E). B Induction of protective immunity in treated mice that survived beyond day 80, then re-challenged with 4T1 cells on the contralateral mammary fat pad. Kwon Y.J., Petrie K., Leibovitch B.A., Zeng L., Mezei M., Howell L., Gil V., Christova R., Bansal N., Yang S., Sharma R., Ariztia E.V., Frankum J., Brough R., Sbirkov Y., Ashworth A., Lord C.J., Zelent A., Farias E., Zhou M.M., Waxman S. Selective Inhibition of SIN3 Corepressor with Avermectins as a Novel Therapeutic Strategy in Triple-Negative Breast Cancer. 4A). Quantification of IFN response was determined using a BD mouse IFN ELISPOT kit. An agent that induces ICD of cancer cells without suppressing immune function would be ideal for combination with checkpoint blockade. Hanafi H.A., Szumlas D.E., Fryauff D.J., El-Hossary S.S., Singer G.A., Osman S.G., Watany N., Furman B.D., Hoel D.F. Oncol. 4), but there is no specific evidence to prove this speculation. Galluzzi L., Bravo-San Pedro J.M., Demaria S., Formenti S.C., Kroemer G. Activating autophagy to potentiate immunogenic chemotherapy and radiation therapy. Current Advances in the Treatment of BRAF-Mutant Melanoma. Unlike conventional chemotherapy drugs, this agent has the added benefit of not suppressing host immune function, but rather has beneficial immunomodulatory effectsmaking it a promising and mechanistic partner for immune checkpoint blockade. Liu J., Liang H., Chen C., Wang X., Qu F., Wang H., Yang K., Wang Q., Zhao N., Meng J., Gao A. Ivermectin induces autophagy-mediated cell death through the AKT/mTOR signaling pathway in glioma cells. Renal cell carcinoma is a fatal malignant tumor of the urinary system derived from renal tubular epithelial cells. 71, 56705677 (2011). Synergistic innate and adaptive immune response to combination immunotherapy with anti-tumor antigen antibodies and extended serum half-life IL-2. In addition, IVM could reduce the metastasis of lung cancer cells by inhibiting EMT. Mice were injected with the analgesic sustained-release Buprenorphine (ZooPharm, 1mg/kg body weight) and meloxicam (2mg/kg body weight) by subcutaneous injection. Ivermectin has dual immunomodulatory and ICD-inducing effects in breast cancer, converting cold tumors hot, thus represents a rational mechanistic partner with checkpoint blockade. Ashour D.S. We explored the secondary hypothesis that addition of a recombinant albumin-IL-2 fusion with extended half-life to the ivermectin and anti-PD1 regimen (anti-PD-1+IL-2 therapy, termed IP for simplicity) can further improve the efficacy of our combined treatment. PubMedGoogle Scholar. The results demonstrated that ivermectin dose-dependently inhibited colorectal cancer SW480 and SW1116 cell growth, followed by promoting cell apoptosis 4C). Casares, N. et al. G KaplanMeier survival analysis of mice in the metastatic setting treated with ivermectin, anti-PD1, ivermectin+anti-PD1IL-2 (IP), or control; n=5 mice per group, two-tailed log-rank test; *p0.05, **p0.01, ***p0.001. Barpe, D. R., Rosa, D. D. & Froehlich, P. E. Pharmacokinetic evaluation of doxorubicin plasma levels in normal and overweight patients with breast cancer and simulation of dose adjustment by different indexes of body mass. Ginsburg O., Bray F., Coleman M.P., Vanderpuye V., Eniu A., Kotha S.R., Sarker M., Huong T.T., Allemani C., Dvaladze A., Gralow J., Yeates K., Taylor C., Oomman N., Krishnan S., Sullivan R., Kombe D., Blas M.M., Parham G., Kassami N., Conteh L. The global burden of womens cancers: a grand challenge in global health. Ivermectin (Systemic Pediatric Medication This information from Lexicomp explains what you need to know about this medication, including what its used for, how In contrast, tumors isolated from mice treated with ivermectin showed large areas of DAPI-positive cells lacking HMGB1 (Fig. The aim of this study was to clarify the mechanisms that regulate the transcription of the chicken Abcg2 gene through cloning and Franken M.G., Leeneman B., Gheorghe M., Uyl-de Groot C.A., Haanen J., van Baal P.H.M. A drug screening study of TNBC showed that IVM could be used as a SIN3-interaction domain (SID) mimic to selectively block the interaction between SID and paired a-helix2. Bao S., Wu Q., McLendon R.E., Hao Y., Shi Q., Hjelmeland A.B., Dewhirst M.W., Bigner D.D., Rich J.N. Marino G., Niso-Santano M., Baehrecke E.H., Kroemer G. Self-consumption: the interplay of autophagy and apoptosis. PAK1 can also activate pro-inflammatory pathways by facilitating nuclear activation of NF-kappa B. Opin. In addition, IVM also had a cytotoxic effect on a variety of nasopharyngeal cancer cells in vitro, and the mechanism is related to the reduction of PAK1 kinase activity to inhibit the MAPK pathway. We showed that ivermectin represents a rational mechanistic partner for immune checkpoint blockade, demonstrating bona fide synergy when neither agent worked alone. Zheng Z., Li G. Mechanisms and Therapeutic Regulation of Pyroptosis in Inflammatory Diseases and Cancer. The best survival outcome was seen with the combination of IP and ivermectin therapy, with ~75% of animals becoming long-term survivors following surgical resection (p<0.05, Fig. Gastric cancer is one of the most common malignant tumors worldwide. Splenocytes were isolated from untreated or treated mice on day 16 following to tumor re-challenge. Immunol. Genetic and molecular epidemiology of adult diffuse glioma. 87, 1328 (2011). To mimic more physiologically relevant conditions of exposure, we also treated splenocytes with lower non-cytotoxic doses of ivermectin and observed that over extended exposure, ivermectin had a significant potentiating effect on phytohemagglutinin (PHA)-stimulated T cells and augmented the ratios of both CD8+ and CD4+ Teff/Tregs (Fig. (4) IVM can enhance the sensitivity of chemotherapeutic drugs and reduce the production of resistance. S1). Antibiotic ivermectin selectively induces apoptosis in chronic myeloid leukemia through inducing mitochondrial dysfunction and oxidative stress. Early Treatment With Ivermectin and LosarTAN for Cancer Patients With COVID-19 Infection (TITAN) The safety and scientific validity of this study is the We assessed the efficacy of ivermectin, anti-PD1, and recombinant IL-2 alone or in combination as adjuvant immunotherapy after surgery. This can greatly reduce the dose of IL-2 required for therapeutic activity, enhancing both safety and efficacy24,25. IVM activates glutamate-gated chloride channels in the parasite, causing a large amount of chloride ion influx and neuronal hyperpolarization, thereby leading to the release of gamma-aminobutyric acid (GABA) to destroy nerves, and the nerve transmission of muscle cells induces the paralysis of somatic muscles to kill parasites [9,10]. Plates were wrapped in foil and incubated at 37C for 24h and developed following the manufactures protocol. J. Clin. PAK1 is at the junction of these pathways. Cancer 12, 252264 (2012). 1F) but not in untreated tumors (Fig. 9, 2100 (2018). Provided by the Springer Nature SharedIt content-sharing initiative, npj Breast Cancer (npj Breast Cancer) In vivo loss-of-function screens identify KPNB1 as a new druggable oncogene in epithelial ovarian cancer. C IFN ELISPOT analysis of 4T1-reactive splenocytes in treated animals. Article Dong J., Qin Z., Zhang W.D., Cheng G., Yehuda A.G., Ashby C.R., Jr., Chen Z.S., Cheng X.D., Qin J.J. Complete response (CR) to treatment was defined as permanent shrinkage of tumor volume to zero at any time during follow-up; no tumor that shrank to zero resumed growth. Splenocytes (SPL) were isolated from the spleens of aged-matched untreated and nave non-tumor-bearing control mice (CTRL) or untreated 4T1 tumor bearing mice (TB), 1 month post tumor inoculation, then cultured on 96-well tissue culture-treated plates in complete R10 medium for 4h48h and analyzed by flow cytometry for spontaneous and ivermectin-induced changes in various immune subpopulations. Depletion of CD11b+GR-1+ MDSCs, CD11b+GR-1 Monocytes/Macrophages, CD19+ B cells and CD3+ T cells by IVM could be reversed by an inhibitor of P2X7/CaMKII (KN62 at 10M). Science 334, 15731577 (2011). IVM has been proven to significantly inhibit the proliferation and migration of HeLa cells and promote apoptosis [56]. Ivermectin may also be used as an effective treatment for a wide range of other conditions and as a treatment of onchocerciasis, intestinal strongyloidiasis and onchocerciasis or river blindness. 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