Endoplasmic Reticulum Stress-Induced JNK Activation Is a Critical Event Leading to Mitochondria-Mediated Cell Death Caused by β-Lapachone Treatment

Background: beta-lapachone (beta-lap) is a bioreductive agent that is activated by the two-electron reductase NAD(P)H quinone oxidoreductase 1 (NQO1). Although beta-lap has been reported to induce apoptosis in various cancer types in an NQO1-dependent manner, the signaling pathways by which beta-lap causes apoptosis are poorly understood. Methodology/Principal Findings: beta-lap-induced apoptosis and related molecular signaling pathways in NQO1-negative and NQO1-overexpressing MDA-MB-231 cells were investigated. Pharmacological inhibitors or siRNAs against factors involved in beta-lap-induced apoptosis were used to clarify the roles played by such factors in beta-lap-activated apoptotic signaling pathways. beta-lap leads to clonogenic cell death and apoptosis in an NQO1-dependent manner. Treatment of NQO1-overexpressing MDA-MB-231 cells with beta-lap causes rapid disruption of mitochondrial membrane potential, nuclear translocation of AIF and Endo G from mitochondria, and subsequent caspase-independent apoptotic cell death. siRNAs targeting AIF and Endo G effectively attenuate beta-lap-induced clonogenic and apoptotic cell death. Moreover, beta-lap induces cleavage of Bax, which accumulates in mitochondria, coinciding with the observed changes in mitochondria membrane potential. Pretreatment with Salubrinal (Sal), an endoplasmic reticulum (ER) stress inhibitor, efficiently attenuates JNK activation caused by beta-lap, and subsequent mitochondria-mediated cell death. In addition, beta-lap-induced generation and mitochondrial translocation of cleaved Bax are efficiently blocked by JNK inhibition. Conclusions/Significance: Our results indicate that b-lap triggers induction of endoplasmic reticulum (ER) stress, thereby leading to JNK activation and mitochondria-mediated apoptosis. The signaling pathways that we revealed in this study may significantly contribute to an improvement of NQO1-directed tumor therapies.