Contribution of LAT1-4F2hc: History
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Subjects: Oncology
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LAT1-4F2hc complex is an important amino acid transporter. It mainly transports specific amino acids through the cell membrane, provides nutrition for cells, and participates in a variety of metabolic pathways. LAT1 plays a role in transporting essential amino acids including leucine, which regulates the mTOR signaling pathway. 

  • LAT1-4F2hc
  • cancer
  • Urology
  • Prostate Cancer
  • Renal Cancer
  • Bladder Cancer

1. Introduction

Continuous proliferative signaling is the main feature of malignant tumors [1]. These signals trigger tumor cells to divide, causing tumor cells to grow rapidly in an uncontrollable way. Among all of these nutrients, Eagle discovered in 1955 that essential amino acids (EAA) were required for cell growth in vitro [2]. Later, studies found that the uptake of EAA in malignant tumor cells was higher than in normal tissues [3][4][5]. After being delivered into the cells, these amino acids were utilized to make proteins, nucleic acids, lipids, and ATP. Cancer cells have higher up-regulated transporters that facilitate the entrance of exogenous amino acids into cells, compared to normal cells, and the steady acquisition of amino acids by cancer cells is important for cancer growth [6]. HATs (heteromeric amino acid transporters) are a special type of solute transporter. They are made up of two subunits, one heavy and one light, that are linked by a conserved disulfide bond [7]. The heavy subunit is a member of the SLC3 family, whereas the light subunit belongs to the SLC7 family.
The SLC3 family now includes two glycoproteins (rBAT (SLC3A1)) and 4F2hc (SLC3A2, also known as CD98) [7]. Heavy subunits of the SLC3 family, such as 4F2hc, were discovered in 1998 and are necessary for the proper trafficking of the heterodimer to the plasma membrane [8].
Regarding the SLC7 family, Kanai first isolated a cDNA from rat C6 glioma cells through expression cloning in 1998. The cDNA encodes a new Na +-independent neutral amino acid transporter called LAT1 [9]. In 1999, Kanai’s team further isolated a cDNA from the rat small intestine, which encodes another transporter called LAT2 [10]. The former two proteins belong to the solute carrier family 7 (SLC7). After that, LAT3 [11] and LAT4 [12] were gradually discovered. These two belong to the SLC43 family. The L-type amino acid transporter, which consists of all former four subunits (LAT1-4), is an important pathway for EAA to enter the cell. Subsequently, Wang found that (18) F-labeled fluoroalkyl phenylalanine derivatives as PET tracers were more likely to bind to LAT1 in tumors, and the specific accumulation of this tracer in tumor cells suggested that LAT1 was expressed in a large number of malignant tumors, thus preliminarily revealing the close relationship between LAT1 and malignant tumors [13].

2. LAT1/4F2hc and Human Diseases (Pain & Inflammation)

Existing studies have found that LAT1-4F2hc complex is widely associated with human diseases, such as inflammation, pain, hypoxia, and tumors [14][15][16].
Inhibition of LAT1 eliminated mTORC1 activation, plasmablast differentiation, and CpG (toll-like receptor TLR9 ligand)-stimulated B cell production of IgG and inflammatory cytokines. The influx of L-leucine through LAT1 regulates the activity of mTORC1 and the immune response of human B cells [15][16]. Among the most common nociceptive pathways, LAT1 may be a feasible new target for pain. LAT1 expression and regulation link it to key cell types and pathways related to pain. LAT1 regulates the Wnt/frizzled/β-catenin signal transduction pathway. The LAT1-4F2hc complex may also be involved in pain pathways related to T cells and B cells. The expression of LAT1 induces the activation of the mammalian target of rapamycin (mTOR) signal axis, which is related to inflammation and neuropathic pain. Similarly, hypoxia and tumors can induce the activation of hypoxia-inducible factor 2α, which not only promotes the expression of LAT1 but also promotes the activation of mTORC1 [14]. As the common node of the T cell, B cell, and mTOR pathway, LAT1-4F2hc plays a vital role in human diseases. It has also received increasing attention as an important target for autoimmune diseases, chronic pain diseases, and tumors.

3. LAT1/4F2hc and Tumors

Many tumor cells lines [17][18][19] and human malignancies, such as breast, prostate, lung, colorectal, and gliomas [20][21][22][23][24][25], have high levels of LAT1 expression. In these tumors, LAT1 plays an important role in growth and survival. RNA interference (RNAi) [22][26][27][28][29] and genetic disruption by zinc fingers nucleases-mediated [30] LAT1-knockout in cancer cells caused that leucine absorption and cell proliferation were both inhibited. As a result, LAT1 is being evaluated as a potential therapeutic target for reducing cancer cell growth and proliferation [31][32].
Similarly, in human neoplasms such as prostate cancer, gastric cancer, lung pleomorphic carcinoma, and neuroendocrine carcinoma, 4F2hc expression is upregulated [33][34][19][35]. Increased 4F2hc expression is linked to a worse chance of survival, cell proliferation, and metastasis [36]. Since 4F2hc binds with LAT1 on the membranous surface of cancer cells, these results are not difficult to understand.
The LAT1-4F2hc complex is also closely related to tumor glutamine metabolism. The amount of glutamine required by cancer cells exceeds the supply produced by endogenous synthesis, resulting in the up-regulation of glutamine metabolism in many carcinogenic changes. LAT1-4F2hc complex controls the flux of glutamine and other amino acids involved in glutaminolysis and glutamine-regulated homeostasis [37]. LAT1-4F2hc complex exchanges Gln for leucine and other amino acids, which can lead to mTOR activation.
By influencing the mammalian target protein of rapamycin complex 1 (mTORC1), the amino acid leucine has been demonstrated to increase protein synthesis and accelerate cell development, whereas LAT1 has been linked to mTORC1 signaling and, as a result, cancer progression [6][38].
In cancer cells, however, LAT1 not only boosts mTORC1 activity but also enhances MYC and EZH2 signaling. Through the AKT, MAPK, and cell-cycle related P21 and P27 signal pathways, 4F2hc has been demonstrated to affect cancer cell proliferation. The expression of 4F2hc and LAT1 is reportedly codependent, and the downregulation of either subunit destabilizes the partner [8]. (Figure 1, Table 1).
Figure 1. The Major Signaling Pathways Affected by LAT1-4F2hc Complex: The LAT1-4F2HC complex not only enhances mTORC1 activity but also enhances MYC and EZH2 signaling pathways. Moreover, it can affect the proliferation of cancer cells through AKT, MAPK and cell cycle-related P21 and P27 signaling pathways.
Table 1. LAT1-4F2hc and Common Tumors.
  Cancer Types Cell Lines Downstream Effects of LAT1/4F2hc Other Related Factors References
LAT1-4F2hc Complex NSCLC A549,
H1299
Mice with smaller tumors, lower leucine absorption, lower mTORC1 activity, amino acid stress, lower proliferation, and lower EZH2 expression and activity Ki-67, VEGF,
CD31, CD34,
HIF-1a, mTOR,
ASCT2
[34][30][39][40][41][42][43][44]
Gastric cancer SGC-7901,
MKN-45,
MGC-803,
CRL-5974
Deceases in proliferation, migration and invasion Ki-67 [45][46][47][48][49][50][51]
Pancreatic cancer MIA,
Paca-2
Reductions in mTORC1 activity, decreases in proliferation and angiogenesis Ki-67, VEGF,
c-Myc, CD147
[28][52][53][54][55][56]
Biliary tract cancer KKU-M055, KKU-M213 JPH203 first in human phase I clinical trial. Well-tolerated. Ki-67 [57][58][59][60][61][62][63]
Ovarian cancer SKOV3,
IGROV1,
A2780,
OVCAR-3
Decreases in proliferation ASCT2, SN2,
p70S6K, LAT2
[64][65][66][67]
Breast cancer & TNBC MCF-7,
ZR-75,
MDA-MB-232
Decreases in proliferation ADS, HER2,
TN, Ki-67,
ER, PgR
[23][68][69][70][71][72]

4. Inhibitors of LAT1/4F2hc and Targeted Therapy

Due to its own transport characteristics of the SLC family, the LAT1-4F2hc complex often plays a key role in drug absorption, distribution and toxicity by mediating drug transmembrane transport [37]. However, only a small number of SLCs have been locked by drugs or chemical probes till now. Three main factors hinder the development of new chemical entities that can regulate SLC activity. First, most studies on this super population are relatively insufficient, and the biological functions or substrates of many SLCs are still unclear. Second, there is a lack of high-quality biological tools, specific, and reliable reagents and special databases. Finally, the number of functional analyses required to study such diverse objectives is still limited [73]. It is reported radioligand uptake assays have been widely employed to study LAT1 [74], but the radioligand uptake assays cannot distinguish inhibitors from substrates. The LAT1-4F2hc complex is overexpressed in many cancer cells and is thought to be a viable anticancer therapeutic target since inhibiting it reduces cancer cell viability dramatically.
BCH and JPH203 are LAT1-4F2hc complex inhibitors that have been studied extensively. BCH is a non-metabolic leucine analogue. In 2006, Baniasadi [75] found that BCH has an impact on the expression of many genes involved in cell survival and physiological activity. These data help to understand the intracellular signal transduction of cell growth inhibition induced by LAT1 inhibitors and can be used as a candidate for anticancer drug therapy [75]. Later studies proposed the use of N-butyl-N- (4-hydroxybutyl) nitrosamine (BBN) treatment to induce high expression of LAT1/4F2hc in rat bladder cancer cells [76] and proposed some directions for anti-LAT1/4F2hc drugs. JPH203 was discovered by Oda in 2010 and was originally known as KYT-0353 [77]. JHP203 is a highly selective LAT1 inhibitor produced by synthetic chemistry and in vitro screening based on triiodothyronine (T3). JPH203 showed excellent selective inhibition of LAT1 and showed potential as a novel antitumor agent. JPH203 interferes with constitutive activation of mTORC1 and Akt, reduces c-MyC expression, and triggers a folding protein response mediated by CHOP transcription factors associated with cell death [78]. Since then, several studies have confirmed that JPH203 has an impressive inhibitory effect on the growth of common tumor cells, such as colon cancer [77][79], gastric carcinoma [46], medulloblastoma [80], osteosarcoma [81], thyroid cancer [82][83], endocrine-resistant breast cancer [84], pituitary tumor [85], head and neck cancer cells [86], and T-cell Acute lymphoblastic leukemia (T-ALL)/lymphoma (T-LL) cells [78], etc.
In terms of urinary tumors, Maimaiti [87] found that in bladder cancer cells JPH203 inhibits the absorption of leucine by >90%. JPH203 inhibits the phosphorylation of MAPK/Erk, AKT, p70S6K, and 4EBP-1. JPH203 inhibits IGF-mediated igfb5 expression and AKT phosphorylation [87].
In the area of RCC, Higuchi [88] has tested the effects of JPH203 on RCC-derived Caki-1 and ACHN cells. JPH203 suppressed the proliferation of various cell types in a dose-dependent manner. According to the findings, the migration and invasion operations were stifled by JPH203 [88].
In the area of PCa, Otsuki [89] found that LAT1 was primarily expressed in DU145 and PC-3 cells. BCH or JPH203 inhibited leucine uptake and cell proliferation in a dose-dependent manner [89]. A Phase I clinical study found that JPH203 was well-tolerated and provided promising activity against biliary tract cancer [90]. The authors are currently planning Phase I and II study of JPH203 in CRPC [90].
These studies also show the potential of JPH203 for the treatment of urological cancers.
In 2021, Yan [91] synthesized three LAT1 inhibitors, JX-075, JX-078, and JX-119, and used cryo-EM to solve the inhibitors’ complex structures with the LAT1-4F2hc complex. They also solved the LAT1-4F2hc complex coupled with Diiodo-Tyr’s cryo-EM structure. LAT1 is found in an outward-occluded conformation in all the combinations of these complexes. These structures might reflect two distinct inhibitory processes, giving significant information for medication development in the future [91].
Of particular interest is the first Phase I clinical trial of JPH203 [90]. Although several studies have demonstrated that JPH203 can inhibit leucine uptake by tumor cells and show concentration-dependent cytotoxicity in vitro or good results in transplanted tumor models, Phase I clinical trial in humans is a milestone. Okano assessed dose-limiting toxicity in the first cycle using the 3 + 3 design. Seventeen Japanese patients with advanced solid tumors were enrolled and treated daily with JPH203 intravenously for 7 days. The maximum safe tolerated dose of JPH203 was defined as 60 mg/m2. The suitable RP2D is 25 mg/m2. Partial response was observed in one biliary tract cancer (BTC) patient at 12 mg/m2, and disease control was achieved in three of the six BTC patients at both the 12 mg/m2 and 25 mg/m2 levels. The disease control rate of BTC was 60%. The JPH203 molecule is predominantly metabolized into Nac-JPH203 by N-acetyltransferase 2 in liver cells [92]. Patients’ N-acetyltransferase 2 phenotype (rapid/non-rapid) was found to predict the safety and efficacy of JPH203. A lower Nac-JPH203/JPH203 ratio is critical for maximizing the anti-tumor effect of JPH203 [90].
Of course, there are still some deficiencies and limitations in the study of urinary tumors and LAT1-4F2hc complexes mentioned above.
In BBN-induced bladder cancer, LAT1-4F2hc was not expressed by porous endothelial cells. Whether LAT1-4F2hc expression depends on endothelial cell structure is unclear. Fenestration of microvascular endothelial cells is not a stable event, because endothelial cells with fenestration in BBN-induced rat bladder cancer were transformed into endothelial cells without fenestration 5 min after injection of VEGF inhibitor, and fenestration recovered 30 min later [76]. The molecular mechanisms of amino acid transport in normal and tumor microvascular endothelial cells need further study. However, the LAT1-4F2hc complex is closely related to angiogenesis [19][53][63][76][93][94][95][96][97]. This makes it possible for the LAT1-4F2hc complex to improve the effectiveness of cancer immunotherapy by improving immune vascular crosstalk [98].
In prostate cancer-related experiments, although downregulation of LAT1 and LAT3 in tumor cells inhibits the growth of prostate cancer cells, it remains to be determined what other mechanisms of prostate cancer resistance can be triggered by targeting LAT1 (such as activation of ATF4).
Most of the studies were conducted in vitro, not in vivo. Although the phase I clinical trial of JPH203 against biliary tract cancer has achieved good results, the clinical trial has not yet involved any urinary tumors. In addition, the number of patients included in some studies is relatively small, or the follow-up time is not long, and the prognostic impact of LAT1 inhibition on tumor patients with different stages has not been thoroughly solved. Most of the specimens studied are in vitro tumor specimens after surgery, and the expression of LAT1-4F2hc in early tumors and its influence on tumors are also a key link that needs to be studied.
Finally, targeted therapy of LAT1-4F2hc does not directly kill cancer cells, but blocks amino acid transport, resulting in loss of nutritional basis and self-apoptosis of cancer cells. This has led some investigators to suggest that targeting LAT1-4F2hc is more suitable for slow-progressing tumors. Therefore, further studies are needed to obtain more evidence that LAT1-4F2HC therapy is also suitable for highly aggressive and rapidly progressing tumors.

This entry is adapted from the peer-reviewed paper 10.3390/cancers14010229

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