Mario AD, et al. Cell Reports, 2021, 35(12), 109275.
Benzethonium, a quaternary ammonium compound, has emerged as a notable negative modulator of the mitochondrial calcium uniporter (MCU), a key channel facilitating mitochondrial Ca²⁺ uptake. High-throughput screening of FDA-approved drugs identified benzethonium as a selective inhibitor of MCU, revealing its potential to influence cancer cell physiology, particularly in triple-negative breast cancer (TNBC) cell lines like MDA-MB-231.
The study demonstrated that benzethonium inhibits mitochondrial Ca²⁺ uptake without significantly affecting cytosolic Ca²⁺ levels or mitochondrial membrane potential (ΔΨm). This selective inhibition is critical, as mitochondrial Ca²⁺ uptake is pivotal in maintaining cellular energetics, driving cell proliferation, and regulating apoptosis. By suppressing mitochondrial Ca²⁺ uptake, benzethonium delays TNBC cell growth and migration. Interestingly, it also protects cells from ceramide-induced apoptosis, contrasting the pro-apoptotic effects typically associated with excessive mitochondrial Ca²⁺ entry.
Despite these promising results, benzethonium's low cell permeability presents a challenge for its therapeutic application. Additionally, it was found to modestly inhibit the Na⁺/Ca²⁺ exchanger (NCLX), complicating its role as a purely MCU-targeting agent. Nonetheless, the inhibitory effect on the MCU appears to be the dominant action at lower concentrations, where the effects on cell growth inhibition and apoptosis prevention are observed.
Benzethonium's ability to modulate mitochondrial Ca²⁺ uptake without inducing apoptosis at specific concentrations positions it as a potential candidate for cancer therapies that require precise control over mitochondrial functions. Further studies are warranted to optimize benzethonium's cellular delivery and evaluate its broader applicability across different cancer types and pathophysiological conditions.