In clinical practice, GC patients with mesenteric metastasis pose a significant challenge due to the scarcity of effective treatment options and generally poor outcomes. The phenomenon of anoikis resistance is a key determinant in the metastatic progression of numerous malignancies, including GC. Anoikis, a specialized form of apoptosis, is triggered when cells detach from the extracellular matrix. It represents a pivotal barrier to tumor metastasis, as cells must evade this programmed cell death to successfully colonize distant sites [26, 27]. Anoikis resistance is essential for the survival and sustained propagation of metastatic tumor cells [28]. Among the myriad of factors implicated in the induction of anoikis, the metabolic perturbations that lead to a critical surge in ROS are particularly significant. These ROS, when influenced by iron ions, have the capacity to assail the polyunsaturated fatty acids within the cell membrane. This assault initiates a cascade of lipid peroxidation events, which are diagnostic of ferroptosis. The potential interplay between anoikis and the onset of ferroptosis is a compelling avenue for further research. Decoding this nexus is crucial as it promises to deepen our comprehension of the intricate pathways of cell death and may reveal innovative therapeutic strategies for conditions marked by abnormal cell detachment and the advancement of tumors. In this study, we revealed that anchorage-independent growth of GC cells potently induced ferroptosis, which can be effectively mitigated by the ferroptosis inhibitors. Our findings substantiate that detachment from the extracellular matrix triggers ferroptosis in GC cells.
Exogenous metabolites including lipids are potent modulators of cell function and fate. Our previous study demonstrated that peritoneum-derived adipocytes induces robust lipid droplets accumulation in GC cells. However, the pathways that drive lipid droplet accumulation in GC cells and the relationship between lipid droplets and ferroptosis is complicated. Bailey et al [29] have reported that lipid droplets protected Drosophila glial cell niche and neural stem cells from damaging PUFAs peroxidation. The accumulation of excess free fatty acids (FFAs) can induce oxidative stress and mitochondrial dysfunction, resulting in the overproduction of ROS, accumulation of unsaturated fatty acids, and escalation of lipid peroxidation [30].Therefore, tumor cells should aim to minimize oxidative phosphorylation and reduce ROS production, especially during the process of metastasis.
Here, we have demonstrated that lipid drolets derived from OA treatment or coculture with adipocytes, can significantly attenuate ferroptosis in GC cells during suspension growth. This indicates that lipid drolets play a significant role in ferroptosis resistance and the development of peritoneal metastasis in GC cells.
Moving forward, our investigation is focused on identifying and characterizing the pivotal enzymes that orchestrate the biogenesis of lipid droplets in GC cells. The synthesis of triglycerides, a critical lipid class in lipid droplets, is contingent upon the availability of glycerol-3-phosphate(G3P), a key precursor that is requisite for the esterification process irrespective of the fatty acid's origin, be it exogenous or endogenous. G3P is the basic unit of various lipid metabolites, further serving as the backbone for lipid biosynthesis and different signaling molecules, participating in regulating biological processes of cell survival, energy metabolism, and oxidative stress [31, 32]. GPD1 and GPD1L share 70% of the same protein sequence and catalyze the same function. They utilize NADH as a coenzyme to catalyze the production of dihydroxyacetone phosphate derived from glucose to G3P in the cytoplasm. Interestingly, emerging evidence indicates that GPD1 plays a tumor-promoting role [33], and GPD1/GPD1L DKO in mouse kidney cancer cells inhibited lipid synthesis and in vitro/ in vivo tumor growth [34]. An observational bladder cancer study also suggested correlated increases in GPD1 and fatty acid synthetic enzyme activities in tumor tissues [35]. In our investigation, we observed that GPD1/1L utilize intracellular unsaturated fatty acids to synthesize triglycerides during the process of detachment, leading to the accumulation of these lipids within cells during the early stages of metastasis. This results in a reduction lipid peroxidation and preventing ferroptosis. Particularly, when GC cells are transferred to the adipocyte-rich peritoneal environment, the expression of cytoplasmic GPD1/1L is significantly upregulated. This upregulation lead to the accumulation of lipid droplets, potentially facilitating tumor progression. Elucidating the precise scope of GPD1's tumor-promoting roles will necessitate additional research.
The system Xc-/GSH/GPX4 axis is a GSH-dependent ferroptosis defense system and is one of the most important antioxidant systems for ferroptosis resistance [36]. However, in some cell types or cell lines, inhibition of GPX4 cannot induce ferroptosis, which indicates the presence of alternative mechanisms. Among them, the GSH-independent coenzyme Q oxidoreductase FSP1 acts in parallel with GPX4, representing another major regulator of ferroptosis [37, 38]. FSP1, as one of the main regulatory molecules of ferroptosis [39], is regulated by upstream factors, including transcription factors and noncoding RNA, and is subject to epigenetic modifications, which affect the progress of FSP1-related diseases. FSP1 is closely associated with the poor prognosis of malignant tumors and plays an important role in disease treatment [40]. Moreover, a study found that dehydroabietic acid can stimulate the upregulation of FSP1 through activating NRF2 pathway, inhibit ROS accumulation and lipid peroxidation, and mitigate nonalcoholic fatty liver disease (NAFLD) induced by a high-fat diet (HFD) [41]. In our investigation, we found that lipid droplets, when accumulated, can suppress the ubiquitination of FSP1. This observation lays the groundwork for delving into novel molecular mechanisms, particularly from the perspective of protein stability pathway.
Briefly, when exposed to a high-fat environment in the peritoneum, a large amount of fatty acids are taken up for synthesis of triglycerides, which can upregulate FSP1 to eliminate intracellular lipid ROS during metastasis. This study unveils the important relationship between lipid metabolism reorganization and ferroptosis, demonstrating that GPD1/1L regulates the accumulation of lipid droplets and that lipid droplets can confer resistance to ferroptosis through FSP1 (Fig. 7). These findings provide a novel target for the prevention and treatment of peritoneal metastasis of gastric cancer.