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Repurposing screen identifies Amlodipine as an inducer of PD-L1 degradation and antitumor immunity

Abstract

Cancer cell expression of PD-L1 leads to T cells exhaustion by transducing co-inhibitory signal, and further understanding the regulation of PD-L1 in cancer cells may provide additional therapeutic strategies. Here by drug repurposing screen, we identified amlodipine as a potent inhibitor of PD-L1 expression in cancer cells. Further survey of calcium-associated pathways revealed calpain-dependent stabilization of the PD-L1 protein. Intracellular calcium delivered an operational signal to calpain-dependent Beclin-1 cleavage, blocking autophagic degradation of PD-L1 accumulated on recycling endosome (RE). Blocking calcium flux by amlodipine depleted PD-L1 expression and increased CD8+ T-cell infiltration in tumor tissues but not in myocardium, causing dose-dependent tumor suppression in vivo. Rescuing PD-L1 expression eliminated the effects of amlodipine, suggesting the PD-L1-dependent effect of amlodipine. These results reveal a calcium-dependent mechanism controlling PD-L1 degradation, and highlight calcium flux blockade as a potential strategy for combinatorial immunotherapy.

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Fig. 1: Amlodipine decreased PD-L1 expression post-translationally by blocking intracellular calcium flux.
Fig. 2: Amlodipine facilitated the autophagic degradation of PD-L1.
Fig. 3: Calpain modulated Beclin-1-dependent stabilization of PD-L1.
Fig. 4: Inactivated calpain facilitated the autophagic degradation of PD-L1 from recycling endosomes.
Fig. 5: Amlodipine suppressed PD-1 binding and growth of tumor cells.
Fig. 6: Amlodipine promoted antitumor immunity by decreasing PD-L1 expression in vivo.
Fig. 7: The calcium flux inhibitor Amlodipine induces PD-L1 degradation by promoting selective autophagy of recycling endosome.

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The authors declare that all data supporting the findings of this study are available within the paper and its Supplementary information files.

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Acknowledgements

This work was supported by National Natural Science Foundation of China (No: 82030104, 81874050, 81572326), Basic Research Projects of Shanghai Science and Technology Innovation Action Plan (20JC1410700); National Key R & D Program of China (2016YFC0906002, 2016YFC0906002), Tang Scholar (JX), and Startup Research Funding of Fudan University.

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CL, HY, and HW performed experiments and analyzed data. JYF provided supports on study resources. CL and JX wrote the paper. JX conceived the study.

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Correspondence to Jie Xu.

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Li, C., Yao, H., Wang, H. et al. Repurposing screen identifies Amlodipine as an inducer of PD-L1 degradation and antitumor immunity. Oncogene 40, 1128–1146 (2021). https://doi.org/10.1038/s41388-020-01592-6

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