Hypoxia can cause cell cycle arrest. However, reversible cell cycle arrest is not yet irreversible senescence.1 Indeed, hypoxia did not cause senescence in several cell lines tested by us, and we did not find well-documented reports of hypoxia-induced senescence. This may seem puzzling given that hypoxia activates hypoxia-inducible factor (HIF) and HIF-dependent secretion of VEGF, PAI, IGF-I and other cytokines. And hyper-secretory phenotype or senescence-associated secretory phenotype (SASP) is one of the hallmarks of cellular senescence.2-5
Possibly, while inducing some manifestations of senescence such as secretory phenotype, hypoxia suppresses the underlying senescence-driving (gerogenic) process. Thus, a senescent program (conversion from cell cycle arrest to senescence or geroconversion) depends in part on the nutrient-sensing and growth-promoting mTOR (target of rapamycin) pathway. Activation of the mTOR pathway is involved in secretion of numerous cytokines as a part of hypersecretory phenotype of senescent cells.6-8 Importantly, the mTOR pathway is responsible for a large-cell morphology and irreversible loss of regenerative (replicative) potential. Rapamycin suppresses geroconversion during cell cycle arrest.9-17 Hypoxia inhibits mTOR.18-27 This may not only explain why hypoxia does not cause senescence, but also why it suppresses geroconversion caused by senescence-inducing agents. For example, induction of ectopic p21 by IPTG causes cell cycle arrest without inhibiting mTOR, thus leading to senescence in HT-p21 cells.28 These cells acquired a large-flat morphology and lost regenerative (replicative) potential, becoming unable to resume proliferation after p21 is switched off. If p21 was induced under hypoxia, cells were arrested but did not become large and retained regenerative (replicative) potential, forming colonies upon IPTG removal.28 Using several inducers of senescence, we demonstrated this phenomenon in a variety of cell lines. In all cases, suppression of geroconversion coincided with the inhibition of mTOR by hypoxia. It was independent from p53, HIF-1 and AMPK. Although hypoxia exerted multiple other effects, it seems that inhibition of mTOR was sufficient to suppress senescence, because rapamycin was even more effective than hypoxia as a gerosuppressor (in the same cell lines) and did not have additive effects with hypoxia.28 Here we further showed that, at least in HT-p21 cells, the inhibition of mTOR was required for gerosuppression. We infected these cells with lentivirus expressing shRNA for TSC2 (shTSC2), which decreased levels of TSC2, a negative regulator of mTOR (Fig. 1A). TSC2 knockout prevented inhibition of mTOR by hypoxia, as evidenced by persistent phosphorylation of S6K and S6 (downstream targets of mTOR complex 1) and Akt (a downstream target of mTORC2) under hypoxia (Fig. 1A). Notably, both inhibition of pS6 phosphorylation28 and Akt phosphorylation (Fig. 2A) were HIF-1 independent. In contrast, rapamycin increased Akt phosphorylation in the same cell line10 (Fig. 2B and C). Hypoxia partially prevented loss of replicative/regenerative potential (RP), meaning that some cells could resume proliferation after IPTG was washed out (Fig. 1B). In contrast, hypoxia failed to prevent loss of RP in HT-p21 cells with depleted TSC2, indicating that inhibition of mTOR is required for gerosuppression by hypoxia at least in these cells.
Furthermore, we have previously identified cell lines in which hypoxia did not inhibit mTOR and geroconversion.28 This is reminiscent of the effect of non-genotoxic induction of p53 by nutlin-3a. Nutlin-3a inhibited mTOR and suppressed geroconversion during p21-induced arrest in HT-p21 cells and in normal cells.29,30 Yet, it did not inhibit mTOR in some cancer cell lines and MEFs.31,30 Next, we chose cell lines (A549 and MCF-7) in which low concentrations of nutlin-3 did not inhibit mTOR (Fig. 3). These cells become senescent following treatment with nutlin-3a (Figs. 4 and 5). Unlike rapamycin, hypoxia did not inhibit mTOR in A549 and MCF-7 cells (Fig. 3). In agreement, hypoxia did not suppress morphological senescence caused by nutlin-3a, whereas rapamycin did (Figs. 4 and 5). Thus, inhibition of mTOR by hypoxia seems to be a prerequisite of gerosuppression by hypoxia.
Our studies can explain abrogation of replicative senescence by hypoxia in mouse embryonic fibroblasts (MEFs) observed by Campisi and coworkers.32 In fact, hypoxia inhibits mTOR in MEF cells.20 Rapamycin can also suppress senescence in MEFs; however, its effect is limited by its cytostatic effect.33 We can speculate that mild hypoxia slightly inhibited mTOR without inhibiting cell proliferation, thus creating a condition for avoidance of mTOR-dependent senescence. Since hypoxia is a normal physiological condition inside an organism, this may explain why geroconversion of normal cells may take decades in humans.
Our study has one startling implication. Thousands of experiments with oxygen and hypoxia were interpreted as the evidence for the free radical theory of aging. Yet, these data can have alternative explanations. Instead of accumulation of random damage caused by free radicals, oxygen can activate oxygen-sensing pathways such as TOR (Fig. 6). Interestingly, NAC (the most commonly used agent to decrease free radicals) turned out to inhibit the mTOR pathway in some cells too.34 In our experiments, the gerosuppressive effect of hypoxia depended on whether it inhibited the mTOR pathway. Slight genetic alterations, differences between cell lines and levels of oxygen may determine the effect of oxygen on geroconversion. This is difficult to reconcile with the free radical theory. Also free radical theory of aging does not fit observations in model organisms.35-48 In agreement, inhibition of TOR prolongs lifespan in model organisms,49-61 supporting the notion that mTOR-driven cellular hyper-functions (cellular aging) lead to age-related diseases and organismal death.62-65
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