We have identified an evolutionarily conserved apoptotic process distinct from the mitochondrial and death-receptor axes. This ATM/ATR-caspase-2 pathway is triggered by DNA damage in cells in which Chk1 activity is simultaneously compromised. The pathway is insensitive to p53 loss and BCL2/XL gain—two of the most common genetic abnormalities in human cancers—can be targeted with Chk1 inhibitors and assessed on the basis of caspase-2 cleavage.
The ATM/ATR-caspase-2 pathway is triggered by the combined effects of IR and Chk1 inhibition, but not by either stimulus alone. Our data show increased levels of γH2A.X and synergistic activation of ATM and ATR in irradiated cells lacking Chk1, indicating that Chk1 acts upstream of ATM and ATR to moderate the accumulation of DNA damage. This might suggest that increasing IR doses would eventually substitute for Chk1 inhibitor treatment by matching a DNA-damage threshold necessary for caspase-2 activation. However, even very high levels of DNA damage induced by IR doses of up to 150 Gy (Gray) did not robustly induce apoptosis in zebrafish
p53 mutants with functional Chk1 (
Figure S10). Thus, the ATM/ATR-caspase-2 pathway cannot mount a nonspecific response to excess damage, but rather is obligatorily tied to Chk1 activity. An involvement of Chk1’s essential or damage-dependent checkpoint functions during DNA replication (
Bartek et al., 2004;
Lam et al., 2004;
Sorensen et al., 2003;
Syljuasen et al., 2005) seems likely given the sustained rise in S phase apoptosis observed in IR + Chk1 inhibitor-treated HeLa cells. A role for replication stress in triggering the ATM/ATR-caspase-2 pathway gains support from observations that Chk1-depleted cells exposed to replication inhibitors undergo p53- and Chk2-independent apoptosis during S phase (
Rodríguez and Meuth, 2006). Also, caspase-2 is the sole caspase whose proform resides in the nucleus (
Zhivotovsky et al., 1999), where it is stabilized by cyclin D3, a positive regulator of the G1/S transition (
Mendelsohn et al., 2002). We propose that tight control of the ATM/ATR-caspase-2 pathway by Chk1 contributes to the decision to live (arrest and repair) or die in replicating cells suffering DNA damage.
ATM and ATR, while both necessary for activation of the Chk1-suppressed pathway, are individually insufficient for this function (). ATM and ATR might phosphorylate different substrates, each being essential for caspase-2 activation and susceptible to Chk1 regulation. However, neither caspase-2 nor its proposed activators, including PIDDosome components PIDD (p53-induced protein with death domain) and RAIDD (RIP-associated ICH-1/CED-3 homologous protein with a death domain) (
Tinel and Tschopp, 2004), belong to the list of 700 potential ATM/ATR substrates (
Matsuoka et al., 2007). A more likely interpretation is that ATM and ATR serve different sensory functions, with ATM responding primarily to IR-induced double-strand breaks while ATR predominantly senses signals resulting from reduced Chk1 activity, such as replication stress (
Cuadrado et al., 2006;
Syljuasen et al., 2005).
The ATM/ATR-caspase-2 pathway may serve as a mechanism that ensures the demise of cells carrying potentially harmful DNA lesions in the absence of proper genome-surveillance activity (as provided by Chk1) (
Lam et al., 2004). Such a function might help explain why
CHK1 mutations, despite fueling genomic instability (
Lam et al., 2004), are paradoxically rare in human cancers (
Bartek and Lukas, 2003). Our demonstration that the Chk1-suppressed pathway can operate in both the absence and presence of p53, as revealed in irradiated
p53+/+;chk1MO;bcl-xl embryos and in irradiated
p53+/+;Tg(rag2:EGFP-bcl-2) larvae treated with Gö6976, disqualifies it as a “backup” program (
Roos and Kaina, 2006) operating only in cells that lack p53. Rather, we propose that it constitutes an alternative, perhaps primitive, response to DNA injury that evolved independently of the p53 network. Intriguingly, however,
TP53+/+ and
TP53−/− HCT116 cells differed in their response to IR + Gö6976 treatment, in that caspase-2 but not caspase-3 cleavage was actively inhibited in the
TP53+/+ cells, via an apparent downregulation of procaspase-2 levels (; see also
Baptiste-Okoh et al., 2008). Thus, a form of crosstalk might have evolved to link these p53-dependent and -independent apoptotic pathways, similar to that described for caspase-dependent and -independent pathways (
Colell et al., 2007).
Chk1 inhibitors can radio/chemosensitize
p53-deficient human tumor cells in vitro, leading to clinical trials of their activity in cancer patients (
Kawabe, 2004;
Tse et al., 2007;
Zhou and Bartek, 2004). Because of the embryonic lethality of
Chk1−/− mice, however, it has remained unclear whether the potency and selectivity of radio/chemosensitization observed in vitro will apply in vivo. Our findings in zebrafish using the Chk1 inhibitor Gö6976 and
chk1 morphants, which retain residual levels of Chk1 activity, indicate that levels of Chk1 inhibition not toxic to normal cells are sufficient to sensitize
p53 mutant cells to IR-induced apoptosis within a living vertebrate. Our results also identify cleavage of caspase-2 as a candidate biomarker for Chk1-targeting treatments. The isolation of such specific biomarkers remains a pressing challenge in the development and optimal use of targeted cancer therapeutics (
Cully et al., 2006;
Tse et al., 2007). Finally, our results unexpectedly predict that in addition to tumors with altered p53 activity, those with other types of prosurvival alterations that block mitochondrial signaling downstream of p53, such as
BCL2-expressing follicular lymphomas, would respond favorably to combination therapy with Chk1 inhibitors.