Niclosamide Prodrug Enhances Oral Bioavailability and Targets
Vasorin-TGFβ Signaling in Hepatocellular Carcinoma
Abstract
Background and Purpose: Hepatocellular carcinoma (HCC) ranks third in
cancer-related deaths worldwide, with limited therapeutic options. While
niclosamide (NIC) has shown potential for repurposing in HCC, its poor
water solubility and low bioavailability limit its efficacy, and its
mechanisms of action are not yet fully elucidated. This study aimed to
enhance NIC’s bioavailability by developing a water-soluble prodrug salt
(NIC-PS) and to elucidate its mechanisms, paving the way for clinical
translation. Experimental Approach: We designed a water-soluble NIC
prodrug (NIC-PS) and evaluated its efficacy through in vitro and in vivo
studies, including pharmacokinetic (PK) and pharmacodynamic (PD) assays,
HCC patient-derived xenograft (PDX) models were applied in two
independent experiments and vasorin (VASN) knockout models. Combination
treatments with NIC-PS and sorafenib or anti-PD-L1 antibody in HCC
cells. Bioinformatic analyses and western blotting were used to
investigate NIC-PS’s target, VASN, and related signaling pathways. Key
Results: NIC-PS exhibited a ten-fold increase in oral bioavailability
and reduced tumor volume by over 75% in HCC PDX models. NIC-PS directly
binds and suppresses VASN, suppressing TGFβ signaling and reducing
SMAD2/3 phosphorylation. VASN inhibition led to a 50% tumor reduction,
and NIC-PS enhanced responses to sorafenib and anti-PD-L1 therapy.
Conclusion and Implications: NIC-PS, equal to 36% of NIC in molecular
weight, offers improved bioavailability, efficacy, and a novel mechanism
of action in targeting VASN, showing promise for HCC treatment alone or
in combination therapy.