CHRM1-mediated acetylcholine signaling protects prostate cancer cells from the chemotherapy agent docetaxel

Background: Chemotherapy-resistant prostate cancer (PCa) remains a leading cause of cancer-related deaths in advanced PCa patients. The current study investigates the role of acetylcholine (ACh) signaling in the development and maintenance of chemotherapy resistance in PCa. Methods: Human PCa cell cultures were used to harvest total RNA and protein for qPCR and Western blot analyses, respectively. The chemotherapy drug docetaxel’s (DTX) ability to induce apoptosis was measured with crystal violet survival assays and Western blot analysis of pro-apoptotic proteins. Results: Treatment of the androgen-independent human PCa cell lines 22Rv1 and DU145 with a low concentration of DTX at 1 nM increases the expression of the key ACh production and secretion enzymes choline acetyltransferase (ChAT), vesicular acetylcholine transporter (VAChT), and the high-affinity choline transporter 1 (CHT1), which is accompanied by a 4-fold increase in ACh secretion. These genes also show increased expression in DTX-resistant 22Rv1 cells. The muscarinic receptor system further shows alterations in gene expression with low-concentration DTX treatment and acquired DTX resistance. Specifically, across all 5 muscarinic cholinergic receptors (CHRM1-5), the expression of CHRM1 is increased in both circumstances. Treatment of both DTX-sensitive and -resistant cell lines with a combination of DTX and the CHRM1 antagonist dicyclomine decreases cell survival, lowers DTX IC50 values (DU145: 62%; 22Rv1: 48%; DTX-resistant 22Rv1: 23%), and enhances the expression of the pro-apoptotic proteins cleaved caspase-3 and cleaved PARP1 compared to treatment with DTX alone. This is paralleled by the observations that treatment with the ACh mimetic carbachol (CCh) protects cells from DTX treatment. Mechanistically, ACh signaling protects PCa cells from DTX through activation of the extracellular signal-regulated kinase / cAMP response element binding protein 1 (ERK/CREB) pathway. Treatment of 22Rv1 cells with CCh increases levels of the active phosphorylated forms of both ERK1/2 and CREB within 30 min. This increase is inhibited by the pan muscarinic receptor antagonist atropine and is not affected by the pan nicotinic receptor antagonist tubocurarine. Treatment of 22Rv1 cells with a combination of DTX and either the ERK inhibitor UO-126 or the CREB inhibitor 666-15 decreases cell survival in a synergistic manner. Conclusion: DTX induces an enhancement of ACh signaling in PCa cells, which may contribute to the development and maintenance of DTX resistance through CHRM1 and the downstream ERK/CREB pathway. Antagonism of CHRM1 and its downstream effectors may be useful in preventing and reverting chemotherapy resistance in PCa. Citation Format: Tyler Bland, Karen Vo, Baron Bechtold, Boyang Wu. CHRM1-mediated acetylcholine signaling protects prostate cancer cells from the chemotherapy agent docetaxel [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2064.