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5-Azacytidine engages an IRE1α-EGFR-ERK1/2 signaling pathway that stabilizes the LDL receptor mRNA
Abstract
Hepatic low-density lipoprotein receptor (LDLR) is the primary conduit for the clearance of plasma LDL-cholesterol and increasing its expression represents a central goal for treating cardiovascular disease. However, LDLR mRNA is unstable and undergoes rapid turnover mainly due to the three AU-rich elements (ARE) in its proximal 3'-untranslated region (3'-UTR). Herein, our data revealed that 5-azacytidine (5-AzaC), an antimetabolite used in the treatment of myelodysplastic syndrome, stabilizes the LDLR mRNA through a previously unrecognized signaling pathway resulting in a strong increase of its protein level in human hepatocytes in culture. 5-AzaC caused a sustained activation of the inositol-requiring enzyme 1α (IRE1α) kinase domain and c-Jun N-terminal kinase (JNK) independently of endoplasmic reticulum stress. This resulted in activation of the epidermal growth factor receptor (EGFR) and extracellular signal-regulated kinase1/2 (ERK1/2) that, in turn, stabilized LDLR mRNA. Systematic mutation of the AREs (ARE1-3) in the LDLR 3'UTR and expression of each mutant coupled to a luciferase reporter in Huh7 cells demonstrated that ARE1 is required for rapid LDLR mRNA decay and 5-AzaC-induced mRNA stabilization via the IRE1α-EGFR-ERK1/2 signaling cascade. The characterization of this pathway will help to reveal potential targets to enhance plasma LDL clearance and novel cholesterol-lowering therapeutic strategies.
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Different research groups have identified more than ten different compounds that enhance LDLR mRNA stability and subsequently increase LDLR protein levels, although the mechanisms and specificity are not fully understood.
“Adding to the complexity of LDLR mRNA regulation, different research groups have identified more than ten different compounds that enhance LDLR mRNA stability and subsequently increase LDLR protein levels, although the mechanism(s) behind these effects and how specific they are is not yet fully understood [19,21,24,32,[35][36][37][38][39][40][41].”
From The low-density lipoprotein receptor: Emerging post-transcriptional regulatory mechanisms (2025) · cites this paper as [24]
The LDLR mRNA features four UCAU sequences located between ARE1 and ARE2 within its 3′UTR.
“The LDLR mRNA features four such UCAU sequences located between ARE1 and ARE2 within its 3′UTR [24,32].”
From The low-density lipoprotein receptor: Emerging post-transcriptional regulatory mechanisms (2025) · cites this paper as [24]
Some studies suggest that the increase in LDLR mRNA stability may depend on the presence of ARE1, the UCAU sequences, and the RBP HuR.
“Some studies suggest that this increase may depend on the presence of ARE1, the UCAU sequences, and the RBP HuR [24,40].”
From The low-density lipoprotein receptor: Emerging post-transcriptional regulatory mechanisms (2025) · cites this paper as [24]
Triciribine shares with berberine and 5-AzaC the traits of inhibition of DNA synthesis, induction of ERK activity, stabilization of LDLR mRNA, and inhibition of PCSK9 expression.
“Interestingly, triciribine shares a number of similar traits with berberine and 5-AzaC: 1) inhibition of DNA synthesis, 2) induction of ERK activity, 3) stabilization of LDLR mRNA and 4) inhibition of PCSK9 expression11,34,35,49–51.”
From Triciribine increases LDLR expression and LDL uptake through stabilization of LDLR mRNA (2018) · cites this paper as [34]
The effects of triciribine on LDLR mRNA stability and PCSK9 levels were reminiscent of those elicited by berberine and 5-Azacytidine (5-AzaC).
“The effects of triciribine on LDLR mRNA stability and PCSK9 levels were reminiscent of those elicited by berberine and 5-Azacytidine (5-AzaC)11,34,35.”
From Triciribine increases LDLR expression and LDL uptake through stabilization of LDLR mRNA (2018) · cites this paper as [34]
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ZFP36L1 and ZFP36L2 control LDLR mRNA stability via the ERK–RSK pathway
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GRP94 Regulates Circulating Cholesterol Levels through Blockade of PCSK9-Induced LDLR Degradation
Poirier, S., Mamarbachi, M., Chen, W.-T., Lee, A. S., & Mayer, G. (2015) · Cell Reports · doi:10.1016/j.celrep.2015.11.006 · Cited by 86
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Triciribine increases LDLR expression and LDL uptake through stabilization of LDLR mRNA
Bjune, K., Wierød, L., & Naderi, S. (2018) · Scientific Reports · doi:10.1038/s41598-018-34237-6 · Cited by 36
The low-density lipoprotein receptor: Emerging post-transcriptional regulatory mechanisms
Ndoj, K., Meurs, A., Papaioannou, D., Bjune, K., & Zelcer, N. (2025) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2024.119082 · Cited by 17
Metadata
- Authors
- Mnasri, N., Mamarbachi, M., Allen, B. G., & Mayer, G.
- Venue
- Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 1861
- Issue
- 1
- Pages
- 29-40
- ISSN
- 1874-9399
- Cited by
- 12
- References
- 5
- Language
- en
- Funders
- Canadian Institutes of Health Research (MOP133598)
- FRQS (32877)
- Montreal Heart Institute Foundation
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