Expression of YAP suppresses cell proliferation and elevates the sensitivity of chemotherapy in retinoblastoma cells through lipid-peroxidation induced ferroptosis

Chin Clin Oncol. 2023 Oct;12(5):52. doi: 10.21037/cco-23-97.


Background: Retinoblastoma (RB) is a retinal cancer most commonly occurred in young children. Cisplatin and etoposide had been confirmed as chemotherapy drugs in the treatment of RB, even though the phenomenon of chemotherapeutic resistance has been occurring in clinical treatment frequently. RB has been reported to be a tumor with reduced expression of yes-associated protein (YAP). However, the role of YAP protein and its correlation with the chemotherapy effect in RB still remains unknown.

Methods: Here we used human RB cell lines Y79 and RB3823 to construct YAP over-expression cell lines for exploring the specific role of YAP. In vitro, a series of techniques and methods were used to identify the biological role of YAP in RB, such as Agilent Seahorse assay, lipid peroxidation assay, intracellular reactive oxygen species (ROS) measurement, flow cytometry apoptosis assay, and other basic experimental techniques, among others.

Results: The cell growth and cytology experimental results found YAP can inhibit the proliferation of RB cells and promote their apoptosis (Y79 32.71% vs. 3.75%; RB3823 40.32% vs. 6.73%). The mitochondrial fuel flex test, lipid peroxide and ROS measurement confirmed that YAP over-expression could promote mitochondrial fatty-acids β-oxidation and lipid peroxidation in RB cells. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis for the expression of lipid peroxidation related factors imply that YAP over-expression caused ferroptosis in RB cell lines. In addition, YAP transcription specific activator PY-60 (10 µM) further improved the sensitivity of cisplatin/etoposide.

Conclusions: Our research results found the expression of YAP inhibits cell proliferation and promoted lipid peroxidation induced ferroptosis in RB. Interestingly, the mitochondrial oxidative phosphorylation shows an increased fatty acid dependency and decreased glucose dependency. As a result, this phenomenon improved the sensitivity of RB to cisplatin/etoposide chemotherapy in vitro. Our finding provides a potential therapeutic target for RB chemotherapy.

Keywords: Yes-associated protein (YAP); chemo-resistance; ferroptosis; reactive oxygen species (ROS); retinoblastoma (RB).

MeSH terms

  • Cell Line, Tumor
  • Cell Proliferation
  • Child
  • Child, Preschool
  • Cisplatin / pharmacology
  • Cisplatin / therapeutic use
  • Etoposide / pharmacology
  • Etoposide / therapeutic use
  • Ferroptosis*
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Lipid Peroxidation
  • Lipids / pharmacology
  • Lipids / therapeutic use
  • MicroRNAs* / metabolism
  • Reactive Oxygen Species / metabolism
  • Reactive Oxygen Species / pharmacology
  • Reactive Oxygen Species / therapeutic use
  • Retinal Neoplasms* / drug therapy
  • Retinal Neoplasms* / genetics
  • Retinal Neoplasms* / pathology
  • Retinoblastoma* / drug therapy
  • Retinoblastoma* / genetics
  • Retinoblastoma* / metabolism


  • Etoposide
  • Cisplatin
  • Reactive Oxygen Species
  • Lipids
  • MicroRNAs