Int J Biol Sci 2021; 17(3):756-767. doi:10.7150/ijbs.52927 This issue

Research Paper

AKR1B10 confers resistance to radiotherapy via FFA/TLR4/NF-κB axis in nasopharyngeal carcinoma

Xiangting Liu1*, Zheng Hu1,2*, Jiayao Qu1,2, Jia Li1, Ke Gong1, Li Wang1,2, Jing Jiang1, Xiangning Li1, Rongzhang He1, Lili Duan1, Weihao Luo1, Chenglai Xia3,4✉, Dixian Luo5,6✉

1. Translational Medicine Institute, the First People's Hospital of Chenzhou, University of South China, Hunan 432000, P.R China.
2. The First School of Clinical Medicine, Southern Medical University, Guangdong Guangzhou 51000, China.
3. South Medical University Affiliated Maternal & child Health Hospital of Foshan, Foshan 528000, P.R. China.
4. School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 520150, P.R. China.
5. Department of Laboratory Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Guangdong 518000, P.R China.
6. Center for Laboratory and Pathology, National & Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, the First People's Hospital of Chenzhou, Southern Medical University, Hunan 423000, P.R China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Liu X, Hu Z, Qu J, Li J, Gong K, Wang L, Jiang J, Li X, He R, Duan L, Luo W, Xia C, Luo D. AKR1B10 confers resistance to radiotherapy via FFA/TLR4/NF-κB axis in nasopharyngeal carcinoma. Int J Biol Sci 2021; 17(3):756-767. doi:10.7150/ijbs.52927. Available from

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Graphic abstract

Nasopharyngeal carcinoma (NPC) is one kind of human head and neck cancers with high incidence in Southern China, Southeast Asia and North Africa. In spite of great innovations in radiation and chemotherapy treatments, the 5-year survival rate is not satisfactory. One of the main reasons is resistance to radiotherapy which leads to therapy failure and recurrence of NPC. The mechanism underlying remains to be fully elucidated. Aldo-keto reductase B10 (AKR1B10) plays a role in the formation and development of carcinomas. However, its role in resistance to radiotherapy of NPC is not clear. In this research, the relationships between AKR1B10 expression and the treatment effect of NPC patients, NPC cell survival, cell apoptosis, and DNA damage repair, as well as the effect and mechanism of AKR1B10 expression on NPC radioresistance were explored. A total of 58 paraffin tissues of NPC patients received radiotherapy were collected including 30 patients with radiosensitivity and 28 patients with radioresistance. The relationships between AKR1B10 expression and the treatment effect as well as clinical characteristics were analyzed by immuno-histochemical experiments, and the roles of AKR1B10 in cell survival, apoptosis and DNA damage repair were detected using the AKR1B10 overexpressed cell models. Furthermore the mechanism of AKR1B10 in NPC radioresistance was explored. Finally, the radioresistance effect of AKR1B10 expression was evaluated by the tumor xenograft model of nude mice and the method of radiotherapy. The results showed AKR1B10 expression level was correlated with radiotherapy resistance, and AKR1B10 overexpression promoted proliferation of NPC cells, reduced apoptosis and decreased cellular DNA damage after radiotherapy. The probable molecular mechanism is that AKR1B10 expression activated FFA/TLR4/NF-κB axis in NPC cells. This was validated by using the TLR4 inhibitor TAK242 to treat NPC cells with AKR1B10 expression, which reduced the phosphorylation of NF-κB. This study suggests that AKR1B10 can induce radiotherapy resistance and promote cell survival via FFA/TLR4/NF-κB axis in NPC, which may provide a novel target to fight against radiotherapy resistance of NPC.

Keywords: nasopharyngeal carcinoma, AKR1B10, radiotherapy resistance, FFA/TLR4/NF-κB axis