Low Density Lipoprotein Receptor-Mediated Lipidome-Transcriptome Reprogramming Impulses to Cisplatin Insensitivity

Background: Platinum-based therapy remains the cornerstone for cancer therapy; however, efficacy varies. The role of tumor macroenvironmental lipid entry via lipoprotein receptors has been reported. Yet, the roles and mechanism of low-density lipoprotein receptor (LDLR) in chemo-sensitivities are in large.   Method: Patient study: Single cohort or public database cDNA microarray to associate LDLR expressions of epithelial ovarian carcinomas (EOCs) with disease prognosis. Laboratory study: In vitro and in vivo add-in/silencing LDLR were introduced to determines cisplatin sensitivity. Transcriptome-Lipidome Trans-omics  and bioinformatic analyses to model molecular mechanism. Translation study: LDLR-lipidome was implemented to formulate efficacy boosting liposome. Findings: The LDLR expression is associate with platin-based chemotherapy patients prognosis. The LDLR abundance in EOC subtypes is associated with cisplatin sensitivity. Knocked-down or overexpressed LDLR in EOC could reversed the chemosensitivity pattern in vitro and in vivo. Trans-omics analyses elucidated the LDLR→LPC (Lyso-PhosphotidylCholine)→FAM83B (phospholipase-related)→FGFRs (cisplatin sensitivity and phospholipase-related) regulatory axis in cisplatin insensitivity. Implementing LPC-liposome encapsulated cisplatin facilitated DNA-adduct formation via lipid droplets (LDs) delivery. Bioinformatics analyses found that the LDL/R-route alters LD homeostasis, which is critical for therapeutic prognosis. Lastly, using LPCliposome could improve multiple cancer types of cisplatin insensitive cells. Interpretation: The LDL/R-route as tumor macroenvironmental lipid entry which impulses platinum insensitivity and disease outcome. The drug specific lipidome for liposome manufacture might be an efficienct pharmaceutics strategy for chemoagents.   Funding Statement: This study was supported by Taiwan Ministry of Science and Technology (MOST104-2628-B-039-001-MY4; MOST106-2221-E-039-011-MY3); National Health Research Institute (NHRI-EX107-10705BI); and China Medical University/Hospital (CMU107-S-05; CMU107-TC-02; DMR-108-080; DMR-CELL-17014; DMR-CELL-1806; DMR-108-079). Declaration of Interests: All the authors in this work claimed no interests conflict. Ethics Approval Statement: Access to the tissue samples was approved by the Internal Review Board of China Medical University Hospital (DMR101-IRB2-276; and CMU105-REC3-122(CR1)). All the animal studies were performed under the supervision and guidelines of the China Medical University Animal Care and Use Committee (#CMOIACUC-2018-089).