Inducing oxidative stress by targeting the cholesterol biosynthesis pathway augments the efficacy of bortezomib in multiple myeloma.

Authors

Chunfan Li, Fuqiang Wang, Hongwei Peng, Meng Chen, Yafang Pu, Xiang Lin, Shuai Wang, Fei Li, Zhimin Gu

Published in

Free radical biology & medicine. Sep 21, 2026. Epub Sep 21, 2026.

Abstract

Proteasome inhibitors, particularly bortezomib (BTZ) which induces oxidative stress, remain the cornerstone of multiple myeloma (MM) therapy. However, resistance driven by metabolic reprogramming and redox adaptation limits their long-term efficacy. Here, we identify a cholesterol biosynthesis-dependent antioxidant mechanism that shields MM cells from BTZ-induced generation of reactive oxygen species (ROS). High cholesterol biosynthesis activity characterizes BTZ-nonresponsive plasma cells and correlates with poor prognosis. Genetic silencing of SREBF2, the master transcriptional regulator of cholesterol metabolism, sensitized MM cells to BTZ both in vitro and in vivo. Pharmacological inhibition of HMG-CoA reductase, the rate-limiting enzyme of cholesterol biosynthesis, with the clinically approved atorvastatin likewise enhanced the anti-myeloma activity of BTZ in vitro and in vivo. Mechanistically, the lipid raft protein FLOT1 promoted FOXO3 nuclear translocation and SREBF2 activation, thereby driving increased cholesterol biosynthesis and accumulation of the intermediate metabolite 7-dehydrocholesterol (7-DHC), a critical antioxidant that mitigated BTZ-induced cytotoxicity. Decreasing 7-DHC production by disrupting SREBF2 activation or treating with atorvastatin impaired the cellular ROS detoxification capacity and enhanced BTZ-induced cytotoxicity. Collectively, our findings identify that MM cells resist therapy-induced ROS by accumulating 7-DHC through activation of cholesterol biosynthesis, and provide preclinical evidence for repurposing statins to augment the efficacy of BTZ therapy.

PMID:
42767467
Bibliographic data and abstract were imported from PubMed on 22 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.