Viral Infection and Cancer: The NF-κB/Snail/RKIP Loop Regulates Target Cell Sensitivity to Apoptosis by Cytotoxic Lymphocytes

The anti-viral/tumor cytotoxic T cells exert their killing mechanisms by the granzyme-perforin and death ligand-induced necrosis and apoptosis. These death ligands include TNF-alpha (tumor-necrosis factor-alpha), FasL (Fas ligand), and TRAIL (TNF-related apoptosis-inducing ligand). However, many target cells resist killing by the cytotoxic T cells. This review discusses potential novel underlying mechanisms of resistance and implicate an NF-kappa B (nuclear factor kappa beta)-Snail (SNAI-1)-RKIP (Raf-1 kinase inhibitor protein) circuitry in resistant targets. TRAIL-mediated killing of a tumor cell line is used as an example to illustrate the circuitry. Tumor cells resistant to TRAIL-mediated apoptosis can be sensitized by NF-kappa B inhibitors. Inhibition of NF-kappa B results in the induction of RKIP. RKIP overexpression sensitizes the cells to TRAIL. RKIP is induced following inhibition of the RKIP transcription repressor, Snail, downstream of NF-kappa B. Snail siRNA reverses resistance to TRAIL. Because RKIP negatively regulates NF-kappa B, we propose that the resistant cell phenotype could be maintained through Snail-mediated RKIP suppression which supports the constitutive NF-kappa B activation. This review introduces a new paradigm, namely, that the cytotoxic T-cell response to viral infection and/or cancer may be compromised by the target cells expressing the resistant NF-kappa B-Snail-RKIP phenotype. Alternative therapeutic interventions, such as various inhibitors, NF-kappa B inhibitors, and siRNAs, are presented.