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Heme oxygenase 1 (HO-1) is a drug target for reversing cisplatin resistance in non-small cell lung cancer.

Jie Mei·Hui-Xiang Tian·Xiao-Ye Zhang·Yuan-Shen Chen·Lei-Yun Wang·Zhao Zhang·Yu-Long Zhang·Ding-Chao Rong·Jun Zeng·Min Dong·Yang Gao·Ji-Ye Yin·Hai-Jun Wu·Peng-Yuan Wang·Wei Zhang
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Abstract

INTRODUCTION: Platinum-based drugs, the most widely used chemotherapeutic drugs in clinical oncology, have long faced the problem of drug resistance, which is urgently in need of resolution. Identifying biomarkers of drug resistance may help reduce platinum resistance and improve therapeutic efficacy. OBJECTIVES: This study aims to identify potential biomarkers associated with the development of cisplatin resistance in non-small cell lung cancer (NSCLC) and explore mechanisms to overcome chemoresistance. METHODS: NSCLC cisplatin resistance cell lines were constructed, and transcriptome sequencing was performed. Results were validated using Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Molecular docking, proteomics sequencing, and in vitro and in vivo experiments were conducted to evaluate the role of Heme Oxygenase 1 (HO-1) in cisplatin resistance. RESULTS: NSCLC cisplatin resistance cell lines, GEO and TCGA data identified HMOX1, downstream of Nrf2, as a key drug resistance gene induced by cisplatin. Activation of the Nrf2/HO-1 pathway was found to induce ferroptosis resistance, a critical mechanism of cisplatin resistance. Candidate compounds SB 202190 and Nordihydroguaiaretic acid (NDGA) effectively reactivated ferroptosis by inhibiting HO-1, thereby increasing cisplatin sensitivity. CONCLUSION: The Nrf2/HO-1 pathway is a significant contributor to cisplatin resistance in NSCLC. Targeting HO-1 with SB 202190 and NDGA presents a promising strategy to overcome resistance and improve chemotherapy outcomes.

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CisplatinHumansCarcinoma, Non-Small-Cell LungHeme Oxygenase-1Drug Resistance, NeoplasmLung NeoplasmsAnimalsMiceNF-E2-Related Factor 2Cell Line, TumorAntineoplastic AgentsXenograft Model Antitumor AssaysMolecular Docking SimulationMice, NudeGene Expression Regulation, NeoplasticFerroptosisDrug resistanceHO-1NSCLCNrf2 pathwayJournal ArticleResearch Support, Non-U.S. Gov't

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Jie Mei, Hui-Xiang Tian, Xiao-Ye Zhang, Yuan-Shen Chen, Lei-Yun Wang, Zhao Zhang, Yu-Long Zhang, Ding-Chao Rong, Jun Zeng, Min Dong, Yang Gao, Ji-Ye Yin, Hai-Jun Wu, Peng-Yuan Wang, Wei Zhang. 2025-05-17. Heme oxygenase 1 (HO-1) is a drug target for reversing cisplatin resistance in non-small cell lung cancer.. https://doi.org/10.1016/j.jare.2025.05.033

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