HO-1 up-regulation: A key point in high-risk neuroblastoma resistance to bortezomib

Anna Lisa Furfaro, Sabrina Piras, Mario Passalacqua, Cinzia Domenicotti, Alessia Parodi, Daniela Fenoglio, Maria Adelaide Pronzato, Umberto Maria Marinari, Lorenzo Moretta, Nicola Traverso, Mariapaola Nitti

Research output: Contribution to journalArticlepeer-review


High-risk neuroblastoma (NB) is characterized by the development of chemoresistance, and bortezomib (BTZ), a selective inhibitor of proteasome, has been proposed in order to overcome drug resistance. Considering the involvement of the nuclear factor-erythroid-derived 2-like 2 (Nrf2) and heme oxygenase-1 (HO-1) in the antioxidant and detoxifying ability of cancer cells, in this study we have investigated their role in differently aggressive NB cell lines treated with BTZ, focusing on the modulation of HO-1 to improve sensitivity to therapy. We have shown that MYCN amplified HTLA-230 cells were slightly sensitive to BTZ treatment, due to the activation of Nrf2 that led to an impressive up-regulation of HO-1. BTZ-treated HTLA-230 cells down-regulated p53 and up-regulated p21, favoring cell survival. The inhibition of HO-1 activity obtained by Zinc (II) protoprophyrin IX (ZnPPIX) was able to significantly increase the pro-apoptotic effect of BTZ in a p53- and p21-independent way. However, MYCN non-amplified SH-SY5Y cells showed a greater sensitivity to BTZ in relation to their inability to up-regulate HO-1.Therefore, we have shown that HO-1 inhibition improves the sensitivity of aggressive NB to proteasome inhibition-based therapy, suggesting that HO-1 up-regulation can be used as a marker of chemoresistance in NB. These results open up a new scenario in developing a combined therapy to overcome chemoresistance in high-risk neuroblastoma.

Original languageEnglish
Pages (from-to)613-622
Number of pages10
JournalBiochimica et Biophysica Acta - Molecular Basis of Disease
Issue number4
Publication statusPublished - Apr 2014


  • Chemoresistance
  • Heme oxygenase-1
  • Neuroblastoma
  • Redox signaling

ASJC Scopus subject areas

  • Molecular Biology
  • Molecular Medicine


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