Abstract
Prostate cancer patients often have increased levels of psychological stress or anxiety, but the molecular mechanisms underlying the interaction between psychological stress and prostate cancer as well as therapy resistance have been rarely studied and remain poorly understood. Recent reports show that stress inhibits apoptosis in prostate cancer cells via epinephrine/beta2 adrenergic receptor/PKA/BAD pathway. In this study, we used experimental data on the signaling pathways that control BAD phosphorylation to build a dynamic network model of apoptosis regulation in prostate cancer cells. We then compared the predictive power of two different models with or without the role of Mcl-1, which justified the role of Mcl-1 stabilization in anti-apoptotic effects of emotional stress. Based on the selected model, we examined and quantitatively evaluated the induction of apoptosis by drug combination therapies. We predicted that the combination of PI3K inhibitor LY294002 and inhibition of BAD phosphorylation at S112 would produce the best synergistic effect among 8 interventions examined. Experimental validation confirmed the effectiveness of our predictive model. Moreover, we found that epinephrine signaling changes the synergism pattern and decreases efficacy of combination therapy. The molecular mechanisms responsible for therapeutic resistance and the switch in synergism were explored by analyzing a network model of signaling pathways affected by psychological stress. These results provide insights into the mechanisms of psychological stress signaling in therapy-resistant cancer, and indicate the potential benefit of reducing psychological stress in designing more effective therapies for prostate cancer patients.
Author Summary Psychological stress and anxiety are often experienced by prostate cancer patients, but the underlying mechanisms of interactions between psychological stress and cancer development, as well as drug resistance, are unclear. Here, we employed a systems biology approach to study interactions between stress-activated epinephrine/beta2 adrenergic receptor/protein kinase A signaling and a regulatory network that controls apoptosis in prostate cancer cells. We developed a dynamic network model of signaling pathways that control apoptosis in prostate cancer cells and quantitatively evaluated the effects of stress-activated signaling on apoptosis induced by drug combinations. Experimental data were used to guide modeling, to fit the unknown parameters and validate the model. Based on our model we found that epinephrine/beta2 adrenergic receptor/protein kinase A signaling can decrease drug efficiency, and can shift the effect of drug combination from synergy to antagonism. We also predicted that in addition to BAD phosphorylation Mcl-1 expression could be upregulated by stress/epinephrine signaling to inhibit apoptosis. This study provides insights into the mechanisms of psychological stress signaling in therapy-resistant cancer, and suggests that reducing psychological stress could help to make prostate cancer treatment more effective.