抗うつ薬フルオキセチンが卵巣がんの化学耐性を克服する可能性を発見(SYSU researchers identify antidepressant as potential breakthrough in overcoming ovarian cancer chemoresistance)

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2026-01-07 中山大学(SYSU)

中山大学(SYSU)中山医学院のPan Chaoyun教授らの国際共同研究は、卵巣がんの化学療法耐性を引き起こす新たな「神経―免疫―代謝軸」を解明し、抗うつ薬フルオキセチンを有望な感受性増強薬として提示した。血小板由来セロトニンがHTR7受容体を持つ腫瘍関連マクロファージを活性化し、イノシトール代謝酵素を含む細胞外小胞をがん細胞へ供給することで、DNA修復因子MRE11の機能を高め、白金製剤やPARP阻害薬への耐性を強化することが判明した。フルオキセチンは末梢セロトニンを低下させ、この経路を遮断し、再発抑制と腫瘍負荷低減を達成。低コストで実装可能な新治療戦略として臨床応用が期待される。

抗うつ薬フルオキセチンが卵巣がんの化学耐性を克服する可能性を発見(SYSU researchers identify antidepressant as potential breakthrough in overcoming ovarian cancer chemoresistance)
Working Mechanism Diagram

<関連情報>

セロトニン誘導マクロファージはイノシトール代謝を介して卵巣癌の化学療法抵抗性を増強する Serotonin-licensed macrophages potentiate chemoresistance via inositol metabolic crosstalk in ovarian cancer

Jie Li, Jingyi Lu, Cuimiao Zheng, Xi Huang, Haoyuan Li, Qiuwen Mai, Siqi Chen, Zhou Zhou, Jiayu Zhu, Tiantian Yu, Manman Xu, Hao Tan, Chun-min Zhang, Qinglei Gao, Junxiu Liu, Chaoyun Pan
Cell Metabolism  Available online: 17 December 2025
DOI:https://doi.org/10.1016/j.cmet.2025.11.011

Highlights

  • A serotonin-responding HTR7+ TAM enhances HR repair in ovarian tumors
  • The serotonin-activated TAMs secrete EVs to elevate nuclear IP4 in cancer cells
  • IP4 binds MRE11 to promote its DNA-binding activity and facilitate HR repair
  • Fluoxetine disrupts serotonin-enhanced HR repair and potentiates chemotherapy

Summary

Therapeutic resistance in solid tumors frequently stems from enhanced homologous recombination (HR) repair capacity, yet systemic regulators of this pathway remain poorly defined. Here, we identify a serotonin-sensitive tumor-associated macrophage (TAM) subpopulation that orchestrates inositol metabolic crosstalk to potentiate HR repair in cancer cells. This TAM subset exhibited marked enrichment in ovarian tumors with low response to chemotherapy. Mechanistically, peripheral serotonin activates these TAMs via serotonin receptor HTR7, triggering extracellular vesicle (EV) secretion enriched with inositol metabolic enzymes PI4K2A and ITPKC. EV-mediated transfer of these metabolic enzymes elevates nuclear inositol-1,3,4,5-tetraphosphate (IP4) in cancer cells, where IP4 directly binds MRE11 and facilitates MRE11-DNA binding and HR repair. Attenuating peripheral serotonin using fluoxetine—a selective serotonin reuptake inhibitor (SSRI) antidepressant—ablates TAM-derived EV delivering of inositol metabolic enzymes and sensitizes tumors to cisplatin/PARP inhibitor (PARPi). Our study unveils a systemic serotonin-primed metabolic crosstalk within the tumor microenvironment that potentiates chemoresistance, revealing targetable HR repair regulation beyond cancer-cell-autonomous mechanisms.

医療・健康
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