Cancer arises from uncontrolled cell proliferation—one of the primary mechanisms of chemotherapies is to induce cell death in proliferating cells. The overexpression of 14-3-3ζ and its related isoforms in the context of cancer has long been associated with poor clinical outcomes due to increased cell survival in the face of chemotherapeutic treatment[15, 61]. Although inhibiting 14-3-3ζ triggers apoptosis in cancer cells, there are currently no approved therapeutics that target 14-3-3ζ:BAD interactions[17]. The primary aim of this study was to explore the possibility of identifying anti-CRC compounds by their capacity to interrupt 14-3-3ζ:BAD interactions, but for this to be achieved, a suitable, mechanistically-specific assay is needed and was not available. We created this required tool by innnovating a biosensor capable of detecting 14-3-3ζ:BAD PPIs. Importantly, our BRET-based biosensor was capable of detecting 14-3-3ζ:BAD PPIs in living cells, which provides physiological relevance.
In this study, a short fragment of murine BAD was used to construct the BRET sensor in place of full-length BAD. Previous research has demonstrated that BAD overexpression leads to apoptosis in various cell types[62, 63], and an advantage of using the BAD-112-136F is its inability to interact with its client BCL-2 proteins due to the lack of BH-3 domain to induce apoptosis[64]. Furthermore, it was not possible to detect BRET when the Rluc8 acceptor and mCitrine donor were fused to 14-3-3ζ and full-length BAD, respectively. Since energy transfer between Rluc8 and mCitrine requires a distance shorter than 10nm, we assumed that the inability to detect BRET was due to the distance between the fusion sites and interaction sites. In reported crystal structures, the N-terminus of 14-3-3ζ is positioned on the rear of the protein on the opposite side of the aliphatic groove and sits on the interface of the 14-3-3ζ[38]. This could potentially interfere with dimer formation and function and due to its location, Rluc8 could be blocked from interacting with the mCitrine attached to bound ligands. Additionally our modelling suggests that when full length BAD-mCitrine bound to 14-3-3ζ, mCitrine is positioned far away from from Rluc8 at the end of a flexible tether. This increased distance, and the low occupancy of any state within the BRET distance to Rluc8, predicts that there would be no meaningful BRET signal. TR-FRET, a technique where a fluorescent protein is used as an energy donor instead of luciferase, has been previously used to screen for disruptors of 14-3-3:BAD PPIs, but a limitation was the fusion of the FRET acceptor to the serine residue that mediates interactions[24]. Thus, we chose not to pursue this option as it would directly interfere with the needed binding mode and generate false positives. Instead, different truncated forms of BAD were generated to identify the optimal fusion strategy for measuring BRET efficiency between 14-3-3ζ-Rluc and BAD-truncate-mCitrine. In our modelling of BAD-112-136F-mC, we saw that the fragment could bind 14-3-3ζ with mCitrine positioned much closer to Rluc8 than in full length BAD. Although the peptide is more flexible and allows the fluorophore to move through a greater range, almost all the lowest energy conformations keep the Rluc8 and mCitrine within the necessary BRET distance, leading to a strong signal upon binding. Given that the interactions between 14-3-3ζ and BAD occur between the C-terminus of 14-3-3 and S112 or/and S136 of BAD, it was not surprising that the combination of 14-3-3ζ-Rluc8 and 112-136F-mCitrine represented the optimal combination in the constructing the BRET sensor[12, 65].
Since it was uncertain if the BAD-112-136F could represent the full-length BAD in its interactions with 14-3-3ζ, further evaluations were conducted by introducing mutations at Ser-Ala mutations at S112 and/or S136. Unlike the S112A mutation, S136A significantly disrupted the association between 14-3-3 and BAD-112-136F, as indicated by reduced BRET. This aligns with a prior study suggesting that S136, rather than S112, primarily mediates 14-3-3:BAD interactions[66]. This hypothesis is completely in line with our computational modelling as S136 on BAD’ engages in important H-bonds with R56, while S112 appears to merely form a weaker electrostatic interaction with R127 and K49 of 14-3-3ζ. We see no meaningful predicted difference in these key binding motifs between the full length BAD and the truncated versions from the in silico calculations. Additionally, in contrast to 112-136F-AA, 112-136F is specifically sequestered in the cytoplasm. This indicates that 14-3-3ζ interacts with this truncated form similarly to how it would interact with full-length BAD, but only if the serine residues crucial for 14-3-3:BAD interactions remain intact.
To assess the capacity of this sensor to discover disruptors of 14-3-3ζ:BAD PPIs, we introduced two well-known 14-3-3 inhibitors, FTY720 and I-2,5, and both compounds signficantly reduced BRET. It is worth mentioning that we did not assess if there were any differences in affinity between 14-3-3ζ:BAD and 14-3-3ζ:112-136F. Nevertheless, drugs identified to disrupt 14-3-3ζ:112-136F PPI should be effective, as this smaller fragment likely accesses the binding groove of 14-3-3ζ more readily than the full-length BAD[67]. Additionally, it is worth mentioning that the high homology among different 14-3-3 isoforms permits them to share client proteins and form homo- or hetero-dimers, suggesting that the identified PADs are highly likely to disrupt PPIs not only between BAD and 14-3-3ζ but also between BAD and other 14-3-3 isoforms[65]. An important caveat of our reporter system is that we cannot experimentally distinguish if PADs directly block or disrupt the amphipathic groove of 14-3-3ζ where PPIs occur or if PADs promote the dephosphorylation of Ser112 and Ser136F on the BAD fragment[10, 62, 63]. However, the in silico calculations strongly suggest that the hits, for the most part, do simply work through direct competitive target engagement; although additional studies, both experimental and in silico, combined with a structure-activity relationship campaign and/or confirmatory experimental structural biological data, are required to examine the mechanisms of action of each identified PAD hit.
The efficiency of utilizing HTS to develop novel anti-cancer compounds has been underscored by the discovery of sorafenib, palbociclib, and ABT-199[68–71]. However, a recognized drawback of this drug discovery approach is the increased risk of false positives and false negatives due to the lack of replication and the use of miniaturized reaction systems[72, 73]. To increase the chances of identifying potential compounds, we first ensured the robustness of our sensor by achieving a Z-factor greater than 0.5[36]. Second, to minimize false negatives, we tested each compound twice at four different concentrations in our primary screens but only recorded the highest BRET reduction for each concentration. After evaluating the capacity of identified compounds to induce cell death in NIH-3T3 fibroblasts, a group of drugs that decreased BRET by more than 34% and triggered more than 30% of cell death emerged as potential hits capable of killing target cells by disrupting 14-3-3ζ:BAD PPIs. Interestingly, this BRET reduction aligns with that caused by 112-136F-AA-mCitirine, suggesting that the ability of a compound to completely dissociate the 14-3-3ζ:112-136F complex is indicative of its potential to induce cell death. Another group of drugs that were capable of reducing BRET reduction by more than 34%, but without notable efficacy in inducing cell death in NIH-3T3 cells, arose from our screens. A possible explanation for this is that our screening is based on a cell-based assay[50], and the complex intracellular environment makes it challenging to determine whether the dissociation of 14-3-3ζ:BAD resulted from a direct inhibitory action on 14-3-3ζ or BAD, or an indirect effect on the upstream signaling pathways that promote 14-3-3ζ:BAD interactions, or possibly a general mechanism of interference of the assay through non-specifc absorption to Rluc8. Therefore, other than disrupting 14-3-3:BAD interactions, these compounds may have additional effects, such as up-regulating anti-apoptotic BCL-2 proteins, which promote cell survival[11].
Although the altered expression of 14-3-3 in CRC has been reported in several studies, the role of 14-3-3ζ:BAD in the survival of CRC cells remains unclear[17, 74, 75]. Our research provides the first evidence that disruption of 14-3-3ζ:BAD PPIs can promote CRC cell death. We used two representative CRC cell lines, Caco-2 and HT-29, to validate our assay[76–78]. Terfenadine, penfluridol, and lomitapide were advanced as the most promising hits after conducting dose-response studies with the 13 most potent compounds.
To support our experimental work, we modelled the possible binding modes of hits to 14-3-3ζ and compared them with the most likely binding modes of known inhibitors BV-02 and I,2–5. All compounds are capable of fitting the aliphatic groove but had varying docking scores, and many were predicted to only have very moderate affinity. None of the compounds were predicted to have nM affinity based on the docking scores. Compounds BV-02 and I-2,5 were designed take advantage of the phosphate binding region which contains numerous Arg and Lys residues and have their binding largely driven by the formation of hydrogen bonds and salt bridges. However, for many screened compounds, aromatic H-bonds and π-cation interactions played a significant role, especially in top compounds Penfluridol and Lomitapide. Interestingly the top two compounds experimentally, penfluridol and lomitapide, had the best docking scores. Docking scores also align well with observed Caco-2 cell death at the 48 hours mark and better docking scores correlated with higher levels of cell death. Exceptions were Azelnipidine, Bardoxolone methyl, and Saikosaponin A; however, as these did induce cell death in HT29 cells but are not predicted to have strong binding, this may be due to completely separate cytotoxic mechanisms that are independent on 14-3-3ζ and BAD[79–82]. Surprisingly, some compounds also had similar or better docking scores than known inhibitors, which suggested that they indeed bound to 14-3-3ζ. We also note that this computational model does not account for any variability in cell permeability, localization, cell-driven degradation, or more importantly off-target effects. Corrections for these features likely would improve linearity, and it must be remembered that all compounds in the assay are existing drugs with established biological activity through target engagement with other proteins. Despite these caveats, the model still shows predictive power in separating effective from less effective compounds that are all active over a tight range. This suggests that both the model is likely reasonable and that the observed cell toxicity is at least partially ascribable to this mechanism, rather than due to the known other activity of these compounds.
Additionally, we also collected data on the efficacy of all 101 compounds that were identified from the primary screen in inducing cell death in these two CRC cell types at 20uM (Supplemental Table 1). These data would be invaluable for future research exploring the different capacities of drugs to target CRC cells, and provide the essential information needed to initiate a rational drug design campaign starting from any of these hits.
To confirm that lead PADs induce apoptotic cell death by disrupting 14-3-3ζ:BAD PPIs, we further tested whether inhibiting caspase activation could mitigate lead PAD-induced cell death and if these lead PADs could promote the mitochondrial translocation of BAD. In most cases, Z-VAD-FMK treatment prevented increases in PI-positive and Annexin-V-positive cells; however, in lomitapide-treated Caco-2 cells, Z-VAD-FMK had no effect on propidium iodide incorporation, despite preventing annexin V incorporation (Fig. 8M). This is likely due to the kinetics of lomitapide in Caco-2 cells whereby the early stages of apoptosis, marked by the binding of annexin V to phosphatidylserine, is being observed, without a loss of membrane integrity that is needed for propidium iodide entry into the cell[83]. As Z-VAD-FMK cannot inhibit necroptosis, a process where cells shift to necrosis when they cannot complete apoptosis[84, 85], other forms of cell death may also be occuring. Nevertheless, confocal imaging showed that all three lead PADs trigger the mitochondria translocation of BAD, confirming apoptotic cell death.
With the variability of 14-3-3 protein expression across individuals, a personalized medicine approach could be undertaken to explore the potential of lead PADs to treat CRC by careful evaluation of tissues from people living with CRC[75]. A significant advantage of our screening strategy is our focus on repurposing drugs from PADs. Therefore, all of our identified hits have been tested for their safety in prior phase 1 clinical trials. Interestingly, penfluridol and lomitapide have been previously suggested to have potential for treating CRC, but their mechanisms were not fully defined—their designed mechanisms of action are not related to driving cell death[86–88]. Our study not only further validates their therapeutic value but also provides insight into the mechanism by which these drugs may ameliorate CRC. Nevertheless, additional in-depth pre-clinical studies in animal models are required. We recognize that PADs may also have effects in other cell types, and improving cell type specificity is clearly warranted[8]. A potential approach could also be to adopt a localized use of PADs to treat colorectal tumors, whereby intratumural drug administration might also enhance the specificity of these compounds[89].
With the use of a novel BRET-based sensor to monitor 14-3-3ζ:BAD interactions in living cells, we successfully identified terfenadine, penfluridol, and lomitapide as having the abilities to disrupt 14-3-3ζ:BAD interactions and induce apoptosis of CRC cells. Although further research is critical to validate the ability of these compounds to ameliorate CRC in animal models and in humans, these hits represent potential chemical backbones that can be modified and translated into new chemical entities for the treatment of CRC. In addition, our screening approach has shown significant potential for the discovery of novel therapeutics for the treatment of other apoptosis-related diseases.