Different ISR-inducing stresses converge on DR5 activation
To investigate whether all ISR sensor kinases converge on DR5 expression, we treated H4 neuroglioma cells with various ISR inducers. We chose a neural cell line because a dysregulated ISR has been observed in numerous neuropathologies14. To induce ER stress and activate PERK, we treated cells with the ER calcium reuptake inhibitor thapsigargin15,16. To induce dsRNA stress and activate PKR, we transfected cells with the dsRNA mimetic polyinosinic-polycytidylic acid (poly I:C)17. To induce mitochondrial stress and activate HRI, we treated cells with the ATP synthase inhibitor oligomycin18. Finally, to mimic nutritional deficit and activate GCN2, we treated cells with L-histidinol, a histidine analog alcohol that prevents histidyl-tRNA charging19. We next measured DR5 mRNA levels by qRT-PCR after exposing cells to these different ISR inducers for 18 hours, which we reasoned would be sufficient to initiate a terminal response based on previous observations20 (Fig. 1A). These analyses revealed an approximately 4-fold upregulation of the DR5 mRNA in response to ER stress elicited by thapsigargin (Fig. 1A), which is consistent with the upregulation of DR5 mRNA observed in colon cancer cells subjected to persistent ER stress11. Poly I:C, oligomycin, and L-histidinol also elevated the levels of the DR5 mRNA, albeit less potently (approximately 2-fold, poly I:C and oligomycin; 3-fold, L-histidinol). We did not detect the mRNA encoding the death receptor DR4, another TRAIL receptor10, in cells treated with any of the ISR inducers (Fig.S1A), suggesting that DR5 upregulation is ISR-specific.
The increase in DR5 mRNA elicited by ISR inducers we used was mirrored at the protein level (Fig. 1B,C). As observed for the DR5 mRNA, thapsigargin treatment led to the largest effect at the protein level compared to the other ISR inducers (Fig. 1A-C). TRAIL binding to DR5’s ED promotes DR5 trimerization and recruitment of the adaptor protein FADD and procaspase-8 on the cytosolic leaflet of the membrane to nucleate the Death-Inducing Signaling Complex (DISC), which processes procaspase-8 into active caspase-810. The upregulation of DR5 was accompanied by the processing of procaspase-8, activation of caspase-3, and cleavage of the canonical apoptosis marker PARP1 (Fig. 1B), all of which are consistent with DR5’s pro-apoptotic activity. These changes tracked with canonical activation of the ISR, as evidenced by self-phosphorylation of PERK, PKR, and GCN2, phosphorylation of eIF2α, and induction of ATF4 and CHOP (Fig. 1B; S1B). We could not detect HRI auto-phosphorylation in cells treated with oligomycin since no commercial phospho-HRI antibodies are available, and the detection of phosphorylated HRI by electrophoretic mobility shift proved unreliable.
Given that CHOP induces DR59,21, our results suggest that the cell death decision is relayed to terminal effectors by eIF2α phosphorylation. If this is the case, inhibition of the ISR should suppress, at least in part, DR5 accumulation and apoptosis. To test this notion, we co-treated cells with the different ISR inducers and the small molecule ISR inhibitor ISRIB, which renders cells insensitive to the effects of eIF2α phosphorylation22. ISRIB modestly yet consistently inhibited the upregulation of DR5 mRNA measured by qRT-PCR (Fig. 1D), partially restored cell viability, measured by ATP levels (Fig. 1E, S1C), reduced cell death, measured by propidium iodide (PI) staining (Fig. 1F), and shifted the dose-response curve of thapsigargin (Fig. 1E, S1C; EC70 Tg = 0.4 µM, EC70 Tg + ISRIB = 0.9 µM) and the more potent oxidative stressor and HRI activator sodium arsenite (SA) (Fig. S1C, EC70 SA = 3.0 µM, EC70 SA + ISRIB = 20.1 µM). These observations indicate that cell-death signals can be bypassed to some extent in ISRIB-treated cells and substantiate the notion that the cell-death decision is relayed, at least in part, by the ISR core to terminal effectors.
We reasoned that the incomplete protection by ISRIB we observed in the experiments above stems from the pleiotropic effects of the ISR inducers we employed, which all are potent poisons. To rule out potential confounding effects, we employed a genetics-based approach in which we force-expressed eIF2αS51D, a phosphomimetic point mutant of eIF2α, under the control of a tetracycline-regulatable promoter. eIF2αS51D expression led to a robust time-dependent accumulation of DR5 mRNA, starting at 8 hours after induction and reaching an approximate 5.5-fold saturation level at 16 hours (Fig. 1G), which corresponds with the levels of DR5 we observed in thapsigargin treated cells (Fig. 1A). This time frame is consistent with the expression of eIF2αS51D and consequent ISR activity as measured by immunoblot and qRT-PCR of ISR markers (Fig. S1D-F). Together, these results indicate that DR5 is induced by the different ISR kinases downstream of phosphorylated eIF2α.
Stress-free activation of the ISR induces DR5 and apoptosis
Our observations that DR5 is induced by activation of any of the ISR kinases beg the question of whether a general molecular circuit controls the terminal ISR. To dissect the molecular determinants exclusive to the terminal ISR and avoid the pleiotropic effects of stress-inducing agents, we employed a validated chemical-genetics approach consisting of an engineered ISR sensor kinase, FKBP-PKR, which can be activated with a small molecule ligand to actuate canonical ISR signaling independently of stress23. FKBP-PKR-driven ISR actuation is fast, reversible, and engages GADD34 (compare Fig. S1D-F to Fig. 3 in23). By contrast, the forced expression of eIF2αS51D, which is not reversible by GADD34 and requires transcription and translation and resulting in a lag time. Thus, FKBP-PKR allows a rapid, stress-free activation of a “pure” ISR.
FKBP-PKR activation led to a time-dependent accumulation of DR5 mRNA, with a greater than 4-fold induction at later time points, and peaked levels at 16 hours after FKBP-PKR activation (Fig. 2A). These observations are consistent with our results in cells treated with thapsigargin and in cells expressing eIF2αS51D (Fig. 1F). The rise in DR5 mRNA levels was mirrored by a time-dependent accumulation of DR5 protein after FKBP-PKR activation (Fig. 2B,C), which once again aligned with results we obtained using ISR-inducing drugs. These increases in DR5 mRNA and protein levels were accompanied by the processing of procaspase-8 and cleavage of PARP1 upon FKBP-PKR activation (Fig. 2D,E). Together, these results indicate that DR5 can be induced in a stress-input agnostic manner to initiate cell-autonomous apoptosis downstream of the ISR.
Cell death downstream of the ISR requires DR5
To test the dependence of the ISR cell death program on DR5, we knocked down DR5 using CRISPR interference (CRISPRi) in H4 cells in cells expressing FKBP-PKR (> 80% DR5 knockdown efficiency; Fig. S3A-C) and monitored apoptosis upon FKBP-PKR activation. In these experiments, CRISPRi-mediated depletion of DR5 resulted in a substantial decrease in the activation of caspase-8 and caspase-3 (Fig. 3A, note the reduction in the levels of the cleaved form of each caspase, compare lanes 2 and 4), substantiating the notion that DR5 is a primary determinant of ISR-induced apoptosis.
Apoptosis is controlled by extrinsic (death-receptor-dependent) and intrinsic (mitochondria-permeabilization-dependent) interconnected signaling pathways that converge on the activation of executioner caspases. The pro-apoptotic protein BID, cleaved by caspase-8, bridges the extrinsic and intrinsic pathways24. The active, truncated form of BID, tBID, promotes mitochondrial membrane permeabilization and cytochrome c release. To test whether the terminal ISR engages the intrinsic pathway, we stably overexpressed the pro-survival protein BCL-XL, which inhibits mitochondrial membrane permeabilization26 in cells expressing FKBP-PKR. Forced expression of BCL-XL completely blocked cell death elicited by FKBP-PKR activation as measured by PI staining (Fig. 3B), indicating that cell death signals in the terminal ISR are channeled to the intrinsic apoptosis pathway.
Expectedly, and attesting to ISR involvement, treatment of cells in which we activated FKBP-PKR with ISRIB restored cell viability almost completely, as did treatment with the pan-caspase inhibitor Z-VAD-FMK (approximately 28% cell death down to 12% Fig. 3C compare column 1 to columns 3 and 4, respectively), corroborating ISR and caspase involvement. Notably, the genetic depletion of DR5 by CRISPRi fully restored cell viability in cells in which we activated FKBP-PKR to levels that mirrored those of the untreated controls (approximately 28% cell death down to 8% Fig. 3C compare columns 1 and 6). Moreover, the depletion of DR5 alone had no effects on cell viability (Fig. 3C, compare columns 1 and 5). Notably, the knockdown of DR5 modestly yet consistently restored cell viability in H4 cells treated with pharmacological ISR inducers (Fig. 3D), further substantiating the notion that DR5 is required to induce apoptosis in the terminal ISR. We surmise that the effect of DR5 knockdown shown in Fig. 3D was only observed at modest levels because of the pleiotropic effects associated with the potent toxicity of the drug ISR inducers used.
Stress-free activation of the ISR leads to intracellular activation of DR5
As mentioned above, during persistent ER stress, DR5 activates intracellularly independently of its ligand TRAIL20,27. Two non-mutually exclusive models for DR5 activation upon unmitigated ER stress have been proposed: unfolded proteins accumulating in the secretory pathway acting as DR5 activating ligands13 and rearrangement of disulfide bonds in DR5’s ED12. Building on these findings, we investigated whether DR5 accumulates intracellularly and signals similarly when the ISR is induced synthetically.
To this end, we first measured the levels of TRAIL mRNA by RT-PCR in FKBP-PKR-activated and thapsigargin-treated cells and found that TRAIL mRNA levels decrease upon FKBP-PKR activation (Fig. 4A). It is likely that this drop in TRAIL mRNA levels, which is mirrored by a drop in 28S rRNA levels, results from cell death, as the timing is consistent with caspase activity (Fig. 2D, E). Next, we measured intra and extra-cellular TRAIL protein levels in FKBP-PKR activated cells and found no detectable secreted TRAIL (Fig. 4B). To corroborate that H4 cells are susceptible to killing by TRAIL, we tested the ability of recombinant TRAIL to induce cell death in H4 FKBP-PKR cells. Expectedly, treatment with recombinant TRAIL in cells where FKBP-PKR is not active led to a dose-dependent loss in cell viability, indicating engagement of plasma-membrane death receptors (Fig. S4A, blue trace). FKBP-PKR activation by itself led to a drop of ~ 80% in cell viability at 24 h (Fig. 4C; first point, no TRAIL), which was enhanced when recombinant TRAIL was introduced at concentrations higher than 4.7 ng/ml, which far exceeded what has been observed in human plasma28 (Fig. S4A, red trace). Collectively, these findings suggest that TRAIL is not necessary for the activation of DR5 in the terminal ISR.
To test whether plasma membrane-localized DR5 signals apoptosis in cells undergoing a terminal ISR—a condition to which H4 cells are susceptible (Fig. 4C)—we exposed cells in which we activated FKBP-PKR to a DR5-neutralizing Fc antibody fragment (FcDR5). Treatment with FcDR5 did not prevent the activation of caspases-3 and − 8, or cleavage or PARP1 (Fig. 4C-D), nor did it block cell death (Fig. 4E) in response to FKBP-PKR activation, indicating that plasma membrane DR5 is not required for transducing death signals upon activation of a terminal ISR.
Finally, we examined the subcellular localization of DR5 upon induction of a stress-free ISR. Activation of FKBP-PKR cells led to an accumulation of DR5 in the cis-Golgi apparatus, as evidenced by immunofluorescence analyses (Fig. 4F). Strikingly, the intracellular localization of DR5 to the cis-Golgi apparatus elicited by stress-free activation of the ISR was virtually indistinguishable from that caused by ER stress-inducing agents (Fig. 4F and20,27).
Together, the observations that (i) TRAIL is not induced, (ii) plasma-membrane DR5 is not required for enforcing the ISR kill switch, and (iii) accumulation of DR5 in the cis-Golgi apparatus all occur upon synthetic ISR activation suggest that the terminal ISR engages an intrinsic, generalized, unconventional, cell-autonomous apoptosis mechanism. Moreover, these results indicate that the ISR kill switch is hard-wired and that it does not require the molecular damage induced by bona fide ISR-activating stresses.
DR5 activation does not require its ED
The results above indicate that ISR activation—synthetic or driven by ISR-inducers—increases an intracellular pool of DR5 that signals independently of TRAIL to elicit cell-autonomous apoptosis. Therefore, it is possible that high levels of DR5 and intracellular molecular crowding trigger mass-action-driven signaling, which would not require cognate ligands (i.e., TRAIL or unfolded proteins) or rearrangement of disulfide bonds. To test this hypothesis, we generated cell lines expressing epitope-tagged full-length DR5 and a mutant version lacking the ED under the control of a tetracycline-inducible promoter to titrate their expression. We co-expressed mCherry from the same construct using a constitutive promoter to select cell populations with similar expression levels using fluorescence-activated cell sorting (FACS) and corroborated DR5 expression levels by immunoblot (Fig. 5A-C, S5A). Overexpression of either form of DR5 led to a significant and equivalent, dose-dependent, decrease in cell viability (Fig. 5D). Moreover, both proteins activated the DR5 downstream molecular cascade with similar amplitude, indicated by comparable levels of cleaved caspase-8, caspase-3, and PARP1 (Fig. 5E). Overexpression of neither DR5 transgenic protein was sufficient to induce the UPR, measured by qRT-PCR of the ISR- and UPR-induced genes (BiP, DNAJB9, CHOP and GADD34), and splicing of the XBP1 mRNA, a signature of UPR activation (Fig. S5B,C), indicating that the phenotype we observed is unlikely due to ER stress induced by forced expression of these DR5 variants.
Strikingly, both DR5 transgenic proteins accumulated in the cis-Golgi apparatus upon induction and co-localized with caspase-8 (Fig. 5F-G). Moreover, collapsing the Golgi apparatus onto the ER with brefeldin A in cells expressing these DR5 variants partially protected them from cell death (Figs. 5H, S5D), indicating that signaling-competent DR5 pools localize to the Golgi apparatus. Together, these results suggest that increasing DR5 levels—by ISR induction or otherwise—is sufficient to assemble the DISC in-situ at the Golgi apparatus membrane to stimulate an intracellular, DR5-dependent cell-autonomous apoptosis program. These findings indicate that DR5 expression alone is enough to engage a cell-autonomous ISR kill switch that does not require intracellular ligands.