Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway

Abstract Background Radiodermatitis (RD) is the primary acute adverse effect experienced by patients receiving radiotherapy (RT) for head and neck cancer (HNC). This study aimed to investigate the correlation between triglyceride (TG) levels and the severity of RD, as well as the underlying mechanis...

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Main Authors: Yafang Hong, Hongdan Guan, Yunhao Chen, Yao Wang, Junjian Lin, Ying Wang, Yang Zhang, Rong Zheng, Xingchen Ding, Zihan Zhou, Benhua Xu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Lipids in Health and Disease
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Online Access:https://doi.org/10.1186/s12944-025-02553-2
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author Yafang Hong
Hongdan Guan
Yunhao Chen
Yao Wang
Junjian Lin
Ying Wang
Yang Zhang
Rong Zheng
Xingchen Ding
Zihan Zhou
Benhua Xu
author_facet Yafang Hong
Hongdan Guan
Yunhao Chen
Yao Wang
Junjian Lin
Ying Wang
Yang Zhang
Rong Zheng
Xingchen Ding
Zihan Zhou
Benhua Xu
author_sort Yafang Hong
collection DOAJ
description Abstract Background Radiodermatitis (RD) is the primary acute adverse effect experienced by patients receiving radiotherapy (RT) for head and neck cancer (HNC). This study aimed to investigate the correlation between triglyceride (TG) levels and the severity of RD, as well as the underlying mechanisms involved. Methods Data were collected from 248 patients with locally advanced HNC treated with intensity-modulated radiation therapy (IMRT). Clinical characteristics and blood profiles prior to RT were collected. After RT, RD severity was assessed. A binary logistic regression analysis was used to determine risk factors. Mouse models of RD were established by administering radiating at a dose of 9 Gy over two consecutive days. TG levels in the mice and cells were quantified using an automatic biochemical analyzer and a TG assay kit, respectively. Cell viability was detected by the Cell Counting Kit-8 (CCK-8) assay, while apoptotic cell percentages were measured via flow cytometry. Western blotting assay was used to analyze the protein levels in the cells of interest. Results The TG level was the sole independent risk factor for grade 3 or higher (grade 3+) RD. Radiation was found to increase the TG content in both mouse blood and skin cells. Skin cells with high TG contents presented more severe radiation-induced damage when the radiation dose administered was 9 Gy over two consecutive days. The administration of 200 µmol/L palmitic acid (PA) or 2 Gy radiation independently did not affect HaCaT cell proliferation or apoptosis rates. Their combination was shown to induce skin cell injury. Mechanistically, autophagy was excessively activated. Furthermore, the protein concentrations of phospho-PI3K, phospho-Akt, and phospho-mTOR were notably decreased. Conclusions TGs are crucially involved in the development of RD. Increased TG levels after radiation treatment suppress the PI3K/Akt/mTOR pathway, induce autophagy, and exacerbate RD.
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spelling doaj-art-0ddaf07f1ab2472bb51b40c75d062ac02025-08-20T02:28:11ZengBMCLipids in Health and Disease1476-511X2025-04-0124111310.1186/s12944-025-02553-2Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathwayYafang Hong0Hongdan Guan1Yunhao Chen2Yao Wang3Junjian Lin4Ying Wang5Yang Zhang6Rong Zheng7Xingchen Ding8Zihan Zhou9Benhua Xu10Department of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer ResearchDepartment of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical SciencesDepartment of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical SciencesDepartment of Radiation Oncology, Fujian Medical University Union HospitalDepartment of Radiation Oncology, Fujian Medical University Union HospitalAbstract Background Radiodermatitis (RD) is the primary acute adverse effect experienced by patients receiving radiotherapy (RT) for head and neck cancer (HNC). This study aimed to investigate the correlation between triglyceride (TG) levels and the severity of RD, as well as the underlying mechanisms involved. Methods Data were collected from 248 patients with locally advanced HNC treated with intensity-modulated radiation therapy (IMRT). Clinical characteristics and blood profiles prior to RT were collected. After RT, RD severity was assessed. A binary logistic regression analysis was used to determine risk factors. Mouse models of RD were established by administering radiating at a dose of 9 Gy over two consecutive days. TG levels in the mice and cells were quantified using an automatic biochemical analyzer and a TG assay kit, respectively. Cell viability was detected by the Cell Counting Kit-8 (CCK-8) assay, while apoptotic cell percentages were measured via flow cytometry. Western blotting assay was used to analyze the protein levels in the cells of interest. Results The TG level was the sole independent risk factor for grade 3 or higher (grade 3+) RD. Radiation was found to increase the TG content in both mouse blood and skin cells. Skin cells with high TG contents presented more severe radiation-induced damage when the radiation dose administered was 9 Gy over two consecutive days. The administration of 200 µmol/L palmitic acid (PA) or 2 Gy radiation independently did not affect HaCaT cell proliferation or apoptosis rates. Their combination was shown to induce skin cell injury. Mechanistically, autophagy was excessively activated. Furthermore, the protein concentrations of phospho-PI3K, phospho-Akt, and phospho-mTOR were notably decreased. Conclusions TGs are crucially involved in the development of RD. Increased TG levels after radiation treatment suppress the PI3K/Akt/mTOR pathway, induce autophagy, and exacerbate RD.https://doi.org/10.1186/s12944-025-02553-2Head and neck cancerRadiodermatitisTriglycerideAutophagyPI3K/Akt/mTOR pathway
spellingShingle Yafang Hong
Hongdan Guan
Yunhao Chen
Yao Wang
Junjian Lin
Ying Wang
Yang Zhang
Rong Zheng
Xingchen Ding
Zihan Zhou
Benhua Xu
Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway
Lipids in Health and Disease
Head and neck cancer
Radiodermatitis
Triglyceride
Autophagy
PI3K/Akt/mTOR pathway
title Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway
title_full Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway
title_fullStr Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway
title_full_unstemmed Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway
title_short Radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the PI3K/Akt/mTOR signaling pathway
title_sort radiation induced dermatitis by increasing triglyceride levels to induce autophagy and inhibit the pi3k akt mtor signaling pathway
topic Head and neck cancer
Radiodermatitis
Triglyceride
Autophagy
PI3K/Akt/mTOR pathway
url https://doi.org/10.1186/s12944-025-02553-2
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