Mouse lung fibroblasts are highly susceptible to necroptosis in a reactive oxygen species-dependent manner

Mouse lung fibroblasts are highly susceptible to necroptosis in a reactive oxygen species-dependent manner

Accepted Manuscript Mouse lung fibroblasts are highly susceptible to necroptosis in a reactive oxygen species-dependent manner Muadh Hussain, Vanessa ...

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Accepted Manuscript Mouse lung fibroblasts are highly susceptible to necroptosis in a reactive oxygen species-dependent manner Muadh Hussain, Vanessa Zimmermann, Sjoerd J.L. van Wijk, Simone Fulda PII: DOI: Reference:

S0006-2952(18)30025-X https://doi.org/10.1016/j.bcp.2018.01.025 BCP 13019

To appear in:

Biochemical Pharmacology

Received Date: Accepted Date:

16 December 2017 9 January 2018

Please cite this article as: M. Hussain, V. Zimmermann, S.J.L. van Wijk, S. Fulda, Mouse lung fibroblasts are highly susceptible to necroptosis in a reactive oxygen species-dependent manner, Biochemical Pharmacology (2018), doi: https://doi.org/10.1016/j.bcp.2018.01.025

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1

Mouse lung fibroblasts are highly susceptible to necroptosis in a reactive oxygen speciesdependent manner

Muadh Hussain1§, Vanessa Zimmermann1§, Sjoerd J. L. van Wijk1*, Simone Fulda1-3*

1

Institute for Experimental Cancer Research in Pediatrics, Goethe-University, Frankfurt, Germany 2 German Cancer Consortium (DKTK), Partner Site Frankfurt, Germany 3 German Cancer Research Center (DKFZ), Heidelberg, Germany

Running title: Necroptosis in MLFs

§

shared first authorship * shared senior authorship

To whom correspondence and reprint requests should be addressed: Prof. Dr. Simone Fulda Institute for Experimental Cancer Research in Pediatrics Goethe-University Frankfurt Komturstrasse 3a 60528 Frankfurt Email: [email protected] Tel.: +49 69 67866557 Fax: + 49 69 6786659157

2 Abstract Mouse embryonic fibroblasts (MEFs) have extensively been used to study necroptosis, a recently identified form of programmed cell death. However, very little is yet known about the role of necroptosis and its regulation by reactive oxygen species (ROS) in cell types naturally exposed to high oxygen levels such as mouse lung fibroblasts (MLFs). Here, we discover that MLFs are highly susceptible to undergo necroptosis in a ROS-dependent manner upon exposure to a prototypic death receptor-mediated necroptotic stimulus, i.e. cotreatment with TNFα, Smac mimetic and the caspase inhibitor zVAD.fmk (TSZ). Kinetic analysis revealed that TSZ rapidly induces cell death in MLFs. Pharmacological inhibition of receptor-interacting protein kinase (RIPK)1 by necrostatin-1 (Nec-1) or RIPK3 by GSK’872 significantly rescues TSZ-stimulated cell death. Also, genetic silencing of RIPK3 or mixed lineage kinase domain-like pseudokinase (MLKL) significantly protects MLFs from TSZ-mediated cell death. Prior to cell death, TSZ significantly increases production of ROS. Importantly, addition of radical scavengers such as butylated hydroxyanisole (BHA) or α-Tocopherol (α-Toc) significantly suppresses TSZ-induced cell death in parallel with a significant reduction of ROS generation. Consistently, BHA prevented TSZ-triggered phosphorylation of MLKL similar to the addition of GSK’872. Thus, our study demonstrates for the first time that MLFs are prone to undergo necroptosis in response to a prototypic necroptotic stimulus and identifies ROS as important mediators of TSZ-triggered necroptosis.

Keywords: cell death, necroptosis, ROS, mouse lung fibroblasts

3 1. Introduction Necroptosis is a form of programmed cell death that is increasingly being recognized to play pivotal roles in various physiological and pathological conditions, like cancer, inflammation and infections [1-4]. A prototypic signaling pathway of necroptosis is triggered by the death receptor ligand tumor necrosis factor receptor (TNF)α [1]. TNFα can engage necroptosis under certain conditions, in particular when cIAP proteins are neutralized. Small-molecule inhibitors of IAP proteins, such as Smac mimetics, induce autoubiquitination and proteasomal degradation of cIAP proteins and favor TNFαstimulated cell death while shutting off TNFα-induced nuclear factor-kappaB (NF-κB)mediated pro-survival signaling [1]. In addition, blockage of apoptosis, for example by caspase inhibition, can shift the type of programmed cell death from apoptosis to necroptosis [1]. The binding of TNFα to TNF receptor (TNFR)1 in the absence of cIAP1/2 combined with caspase inhibition triggers the formation of the so-called necrosome complex, composed of the serine/threonine kinases RIPK1 and RIPK3 [1]. Necrosome formation induces RIPK3 activation through phosphorylation which in turn phosphorylates MLKL [1]. Upon activation, MLKL translocates to the plasma membrane and disrupts its integrity via pore formation [1]. ROS can regulate various cellular signaling events and have also been implicated in the control of necroptosis [5]. We previously reported that ROS promote Smac mimetic/TNFαinduced necroptotic signaling and cell death in acute leukemia cells via a positive feedback loop [6]. On the one side, ROS foster signaling events to necroptotic cell death as shown by MLKL phosphorylation, and on the other side, necroptotic signaling components control ROS production [6]. It is well appreciated that the interplay between ROS and programmed forms of cell death including necroptosis is regulated in a context-dependent manner, e.g. depending on the cell type or tissue (see for example [7]). Cell death and survival signaling pathways in cell

4 types that are naturally exposed to high levels of endogenous and exogenous oxidative damage, like the lung epithelium, might be particular dependent on ROS [8-10]. Indeed, the maintenance of a functional antioxidant balance in these cell types has been reported to contribute to prevent lung diseases like chronic obstructive pulmonary disease, cancer and infections, in which programmed cell death plays prominent roles (see for example [11]). Understanding the interplay of oxidative responses and necroptosis in lung cells is therefore essential to comprehend the pathogenesis of lung diseases and to support the development of novel therapies. While MEFs have extensively been used as models to study necroptosis [12-16], very little is yet known about the role of necroptosis in cell types naturally exposed to high oxygen levels, such as MLFs. In the present study, we therefore investigated necroptosis and its regulation by ROS in MLFs, using TNFα-induced necroptosis as a prototypic model.

5 2. Materials and Methods 2.1 Cell culture and chemicals Wildtype and MLKL knockout MEFs were kindly provided by Jiahuai Han (Xiamen, China) and MLFs by Harald von Melchner (Frankfurt, Germany). Cells were cultured in DMEM medium (LIFE TECHNOLOGIES, Inc., Eggenstein, Germany) supplemented with 10% fetal calf serum (FCS; BIOCHROM, Berlin, Germany), 1% penicillin/streptomycin (INVITROGEN, Karlsruhe, Germany) and 1 mM Sodium Pyruvate (INVITROGEN). The Smac mimetic BV6, which neutralizes XIAP, cIAP1 and cIAP2 [17], was kindly provided by GENENTECH, Inc. (South San Francisco, CA, USA). BHA and α-Toc were purchased by SIGMA-ALDRICH (Steinheim, Germany), human recombinant TNFα by BIOCHROM, Nec1 by BIOMOL (Hamburg, Germany), zVAD.fmk by BACHEM (Heidelberg, Germany), GSK’872 by MERCK (Darmstadt, Germany). Suitable drug concentrations of BV6, TNFα or inhibitors were chosen on the basis of pilot dose response experiments (data not shown). Chemicals were purchased by SIGMA-ALDRICH or CARL ROTH (Karlsruhe, Germany) unless indicated otherwise. Cells were preincubated for 30 minutes with BV6 and zVAD.fmk in the presence of absence of inhibitors prior to stimulation with TNFα.

2.2 RNA interference Gene silencing by small interfering RNA (siRNA) was performed using Lipofectamine RNAiMAX (INVITROGEN) following the manufacturer's instructions. Briefly, cells were transfected with 40 nM of each sequence of Silencer® Select siRNAs (INVITROGEN) against RIPK3 (#1: s80754, #2: s80755, #3 s80756), MLKL (#1: s92950, #2: s92951, #3 s92952) or non-targeting control siRNA (s4390843). 48 hours after transfection with siRNAs cells were subjected to necroptosis induction.

2.3 Western blot analysis Western blot analysis was performed as described previously [18] using the following

6 antibodies: rabbit anti-RIPK3 (PROSCI, Poway, CA, USA), rabbit anti-MLKL (SIGMAALDRICH), rabbit anti-phospho-MLKL (ABCAM, Cambridge, UK), mouse anti-Vinculin (SIGMA-ALDRICH). Goat anti-mouse IgG or goat anti-rabbit IgG conjugated to horseradish peroxidase (SANTA CRUZ BIOTECHNOLOGY, Inc., Santa Cruz, CA) and enhanced chemiluminescence (AMERSHAM BIOSCIENCES, Freiburg, Germany) were used for detection. Representative blots of at least two independent experiments are shown.

2.4 Determination of cell death and ROS production Cell death was assessed by propidium iodide (PI) or PI/Hoechst (both SIGMA-ALDRICH) staining to determine plasma membrane permeability using flow cytometry or ImageXpress® Micro XLS system (MOLECULAR DEVICES, Biberach an der Riss, Germany) according to the manufacturer's instructions. To analyze ROS production cells were incubated with 5 µM CM-H2DCFDA (INVITROGEN) for 30 minutes at 37°C, put on ice and immediately analyzed by flow cytometry.

2.5 Statistical analysis Statistical significance was assessed by Student's t-test (two-tailed distribution, twosample, equal variance) using Microsoft Excel (MICROSOFT, Redmond, WA, USA). Quantitative data are shown as mean and standard deviation (SD) of at least three independent and separate experiments performed in triplicate unless indicated otherwise.

7 3. Results 3.1 MLFs are susceptible to TSZ-induced necroptosis To investigate whether MLFs are susceptible to necroptotic cell death, we treated MLFs with a combination of the death receptor ligand TNFα, the Smac mimetic BV6 and the broad-range caspase inhibitor zVAD.fmk as a prototypic necroptotic stimulus. Kinetic analysis showed that TSZ rapidly triggered cell death in MLFs (Fig. 1A). MEFs that are known as a prototypic model of necroptosis were used as positive control for TSZ-induced necroptosis (Fig. 1B). To determine whether cells die through necroptosis, we used pharmacological inhibitors to block key components of the necroptosis pathway. Of note, the RIP1 kinase inhibitor Nec-1 completely protected MLFs as well as MEFs from TSZinduced cell death (Fig. 1C, 1D). Similarly, addition of the RIPK3 kinase inhibitor GSK’872 abolished TSZ-mediated cell death (Fig. 1C, 1D). This set of experiments demonstrates that MLFs are highly susceptible to TSZ-induced necroptosis.

3.2 RIPK3 and MLKL are required for TSZ-induced necroptosis in MLFs In addition to pharmacological approaches, we genetically silenced RIPK3 and MLKL to confirm that necroptotic cell death in MLFs is dependent on RIPK3 and MLKL. Western blot analysis showed that three independent siRNA sequences directed against murine RIPK3 or MLKL efficiently silenced RIPK3 (Fig. 2A) and MLKL (Fig. 2C). Intriguingly, knockdown of RIPK3 significantly reduced TSZ-induced cell death (Fig. 2B). Also, silencing of MLKL significantly rescued MLFs from cell death upon exposure to TSZ (Fig. 2D). Furthermore, we used MLKL knockout MEFs to confirm the requirement of MLKL for the induction of cell death. Of note, TSZ-mediated cell death was abolished in MLKL knockout MEFs compared to wildtype MEFs (Fig. 2E, 2F). Thus, RIPK3 and MLKL are required for TSZ-induced necroptosis of MLFs.

3.3 TSZ-induced necroptosis in MLFs depends on ROS production

8 ROS have been reported to regulate necroptosis in a context-dependent manner [5]. Since certain cell types including MLFs are physiologically exposed to high oxygen levels and oxidative damage, we next asked whether ROS are involved in mediating necroptotic cell death of MLFs. To address this question we assessed ROS production upon exposure of MLFs to TSZ. Of note, treatment of MLFs with TSZ caused a significant raise in ROS generation as measured by the ROS-sensitive dye CM-H2DCFDA and flow cytometry (Fig. 3A). Similarly, the production of ROS was significantly increased by treating MEFs with TSZ (Fig. 3B), although this occurred at later time points. To test whether ROS are required for the induction of cell death, we used different radical scavengers to neutralize ROS, i.e. the free radical scavenger BHA and the lipophilic antioxidant α-Toc. Consistent with the radical scavenging properties of these antioxidants, control experiments confirmed that BHA and α-Toc significantly reduced TSZ-stimulated ROS production in MLFs and MEFs (Fig. 3A-D). Importantly, BHA and α-Toc significantly decreased TSZtriggered cell death in both MLFs (Fig. 3E) and MEFs (Fig. 3F). These experiments demonstrate that ROS are indeed being generated and are required for TSZ-induced necroptosis of MLFs.

3.4 ROS are required for TSZ-stimulated phosphorylation of MLKL Activation of MLKL represents a critical event during necroptosis, as MLKL is an essential effector molecule of necroptosis [19]. Therefore, we next examined the phosphorylation status of MLKL as a marker of its activation upon exposure to TSZ. Notably, treatment of MLFs and MEFs with TSZ led to a marked increase in MLKL phosphorylation as revealed by Western blot analysis using a phospho-specific MLKL antibody (Fig. 4), without affecting total MLKL amounts. To determine if ROS are required for this TSZ-stimulated phosphorylation of MLKL, we treated cells with the ROS scavenger BHA. Intriguingly, TSZ-triggered MLKL phosphorylation was prevented in the presence of BHA (Fig. 4). Similarly, addition of GSK’872 prevented MLKL phosphorylation (Fig. 4), in line with the

9 notion that MLKL is phosphorylated in a RIPK3-dependent manner during TNFαstimulated necroptosis [20]. These findings indicate that ROS are required for TSZstimulated MLKL phosphorylation.

3.5 RIPK1 and RIPK3 contribute to TSZ-stimulated ROS generation To investigate if key components of necroptosis signaling control TSZ-triggered ROS production, we monitored ROS generation in response to TSZ upon inhibition of RIPK1 or RIPK3. Interestingly, addition of Nec-1 or GSK’872 significantly reduced TSZ-stimulated ROS production in MLFs and MEFs (Fig. 3C, 3D). These findings indicate that RIPK1 and RIPK3 contribute to TSZ-stimulated ROS generation.

10 4. Discussion In the present study, we demonstrate for the first time that MLFs are highly susceptible to undergo necroptosis in a ROS-dependent manner upon exposure to a prototypic death receptor-mediated necroptotic stimulus, i.e. TSZ cotreatment. This conclusion is supported by several independent pieces of experimental evidence. First, TSZ rapidly triggered necroptosis in MLFs. Second, pharmacological as well as genetic inhibition of (essential) core elements of the necroptosis pathway, such as RIPK1, RIPK3 or MLKL, rescued TSZstimulated necroptosis. Third, preventing TSZ-stimulated ROS production by ROS scavenging agents also strongly attenuated the induction of necroptosis, emphasizing that ROS are required for TSZ-induced necroptosis. Thus, our study not only demonstrates that MLFs are prone to undergo necroptosis in response to a prototypic necroptotic stimulus, but also identifies ROS as important mediators of TSZ-triggered necroptosis. The notion that lung-derived cell types, like lung epithelial cells, can die through necroptotic cell death dependent on RIPK1, RIPK3 and MLKL [21, 22] is in agreement with our observations. Due to the continuous exposure to endogenous (like OXPHOS metabolism [22]) or exogenous sources (such as oxygen and bacterial infections) of oxidative damage, necroptosis might be of particular relevance in pathophysiological conditions of lung injury [11]. Furthermore, our data are consistent with a model of a ROS-driven amplification loop of necroptosis signaling. ROS may well act both upstream and downstream of MLKL activation, as on the one hand ROS scavengers attenuated MLKL phosphorylation, a key event in the course of necroptosis. On the other hand, inhibition of central necroptosis signaling proteins such as RIPK1 and RIPK3 partly rescued ROS production. In line with these data, we previously reported that the generation of ROS in the course of TNFα/Smac mimetic-triggered necroptosis in Fas-Associated Death Domain (FADD)deficient Jurkat leukemia cells involves a ROS-dependent positive feedback loop [6]. Also, both RIPK1 and RIPK3 have been implicated in regulating downstream ROS production.

11 Comparing MEFs deficient in RIPK1 to their wildtype counterparts, RIPK1 has been reported to be necessary for TNFα-induced ROS production as well as non-apoptotic cell death in MEFs [13]. Also, TNFα-induced ROS accumulation and cell death have been described in wildtype, but not in RIPK3-deficient MEFs [23]. Our observations emphasize the intricate relationship existing between ROS generation and necroptosis in cell types that are naturally exposed to high oxygen levels such as those derived from lung tissue. ROS-dependent control of necroptosis is known to be regulated in a highly context-related fashion and often depends on the cell type. This highlights the need to study necroptosis signaling and its dependence on ROS in the cell type(s) of interest. Further investigation of the oxidative metabolism in caspase-independent programmed cell death will open new avenues in understanding the role of necroptosis in the pathophysiology of chronic lung diseases and cancer.

5. Acknowledgements We thank D. Vucic (GENENTECH Inc., South San Francisco, CA, USA) for providing Smac Mimetic, Jiahuai Han (Xiamen, China) for providing wildtype and MLKL knockout MEFs, Harald von Melchner (Frankfurt, Germany) for providing MLFs and C. Hugenberg for expert secretarial assistance. This work has been partially supported by the Deutsche Forschungsgemeinschaft (SFB815) and the BMBF (to S.F.).

6. Conflict of interest The authors declare that there is no conflict of interest.

12 7. References [1] Vanden Berghe, T, A Linkermann, S Jouan-Lanhouet, H Walczak, P Vandenabeele, Regulated necrosis: the expanding network of non-apoptotic cell death pathways. Nat. Rev. Mol. Cell Biol. 2014; 15(2) 135-47. [2] Zhao, H, T Jaffer, S Eguchi, Z Wang, A Linkermann, D Ma, Role of necroptosis in the pathogenesis of solid organ injury. Cell Death Dis 2015; 6 e1975. [3] Kitur, K, S Wachtel, A Brown, M Wickersham, F Paulino, HF Penaloza, et al., Necroptosis Promotes Staphylococcus aureus Clearance by Inhibiting Excessive Inflammatory Signaling. Cell reports 2016; 16(8) 2219-30. [4] Newton, K, G Manning, Necroptosis and Inflammation. Annu. Rev. Biochem. 2016; 85 743-63. [5] Fulda, S, Regulation of necroptosis signaling and cell death by reactive oxygen species. Biol. Chem. 2016; 397(7) 657-60. [6] Schenk, B, S Fulda, Reactive oxygen species regulate Smac mimetic/TNFalphainduced necroptotic signaling and cell death. Oncogene 2015; 34(47) 5796-806. [7] Zhou, W, J Yuan, SnapShot: Necroptosis. Cell 2014; 158(2) 464- e1. [8] Rahman, I, SK Biswas, A Kode, Oxidant and antioxidant balance in the airways and airway diseases. Eur J Pharmacol 2006; 533(1-3) 222-39. [9] Kinnula, VL, K Vuorinen, H Ilumets, P Rytila, M Myllarniemi, Thiol proteins, redox modulation and parenchymal lung disease. Curr. Med. Chem. 2007; 14(2) 213-22. [10] Bargagli, E, C Olivieri, D Bennett, A Prasse, J Muller-Quernheim, P Rottoli, Oxidative stress in the pathogenesis of diffuse lung diseases: a review. Respir Med 2009; 103(9) 1245-56. [11] Mizumura, K, S Maruoka, Y Gon, AM Choi, S Hashimoto, The role of necroptosis in pulmonary diseases. Respir Investig 2016; 54(6) 407-12.

13 [12] Zhang, DW, M Zheng, J Zhao, YY Li, Z Huang, Z Li, et al., Multiple death pathways in TNF-treated fibroblasts: RIP3- and RIP1-dependent and independent routes. Cell Res. 2011; 21(2) 368-71. [13] Lin, Y, S Choksi, HM Shen, QF Yang, GM Hur, YS Kim, et al., Tumor necrosis factorinduced nonapoptotic cell death requires receptor-interacting protein-mediated cellular reactive oxygen species accumulation. J. Biol. Chem. 2004; 279(11) 10822-8. [14] Vanlangenakker, N, T Vanden Berghe, P Bogaert, B Laukens, K Zobel, K Deshayes, et al., cIAP1 and TAK1 protect cells from TNF-induced necrosis by preventing RIP1/RIP3dependent reactive oxygen species production. Cell Death Differ. 2011; 18(4) 656-65. [15] Tischner, D, C Manzl, C Soratroi, A Villunger, G Krumschnabel, Necrosis-like death can engage multiple pro-apoptotic Bcl-2 protein family members. Apoptosis 2012; 17(11) 1197-209. [16] Rohde, K, L Kleinesudeik, S Roesler, O Lowe, J Heidler, K Schroder, et al., A Bakdependent mitochondrial amplification step contributes to Smac mimetic/glucocorticoidinduced necroptosis. Cell Death Differ. 2017; 24(1) 83-97. [17] Varfolomeev, E, JW Blankenship, SM Wayson, AV Fedorova, N Kayagaki, P Garg, et al., IAP antagonists induce autoubiquitination of c-IAPs, NF-kappaB activation, and TNFalpha-dependent apoptosis. Cell 2007; 131(4) 669-81. [18] Fulda, S, G Strauss, E Meyer, KM Debatin, Functional CD95 ligand and CD95 deathinducing signaling complex in activation-induced cell death and doxorubicin-induced apoptosis in leukemic T cells. Blood 2000; 95(1) 301-8. [19] Sun, L, H Wang, Z Wang, S He, S Chen, D Liao, et al., Mixed lineage kinase domainlike protein mediates necrosis signaling downstream of RIP3 kinase. Cell 2012; 148(1-2) 213-27. [20] Wang, H, L Sun, L Su, J Rizo, L Liu, LF Wang, et al., Mixed lineage kinase domainlike protein MLKL causes necrotic membrane disruption upon phosphorylation by RIP3. Mol. Cell 2014; 54(1) 133-46.

14 [21] Gonzalez-Juarbe, N, KM Bradley, AT Shenoy, RP Gilley, LF Reyes, CA Hinojosa, et al., Pore-forming toxin-mediated ion dysregulation leads to death receptor-independent necroptosis of lung epithelial cells during bacterial pneumonia. Cell Death Differ. 2017; 24(5) 917-28. [22] Koo, MJ, KT Rooney, ME Choi, SW Ryter, AM Choi, JS Moon, Impaired oxidative phosphorylation regulates necroptosis in human lung epithelial cells. Biochem. Biophys. Res. Commun. 2015; 464(3) 875-80. [23] Cho, YS, S Challa, D Moquin, R Genga, TD Ray, M Guildford, et al., Phosphorylationdriven assembly of the RIP1-RIP3 complex regulates programmed necrosis and virusinduced inflammation. Cell 2009; 137(6) 1112-23.

15 8. Figure Legends Figure 1. MLFs are susceptible to TSZ-induced necroptosis A, MLFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for the indicated times. Cell death was assessed by PI/Hoechst staining using high-content microscopy. B, MEFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for the indicated times. Cell death was assessed by PI/Hoechst staining using high-content microscopy. C, MLFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 2 hours in the presence or absence of 25 µM Nec-1 or 5 µM GSK’872. Cell death was assessed by PI/Hoechst staining using high-content microscopy. D, MEFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 24 hours in the presence or absence of 25 µM Nec-1 or 5 µM GSK’872. Cell death was assessed by PI/Hoechst staining using high-content microscopy. Data are shown as mean and SD of at least three (all values except one) or two (24 hour time point in B) independent experiments performed in triplicate; ***P<0.001.

Figure 2. RIPK3 and MLKL are required for TSZ-induced necroptosis in MLFs. A-D, MLFs were transiently transfected with non-silencing control siRNA (siCtrl) or siRNA targeting RIPK3 (A, B) or MLKL (C, D). RIPK3 (A) and MLKL (C) protein expression was determined by Western blotting; Vinculin was used as loading control. MLFs transfected with RIPK3 siRNA (B) or MLKL siRNA (D) were treated 48 hours after transfection with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 2 hours and cell death was assessed by PI/Hoechst staining using high-content microscopy. E, MLKL knockout and wildtype MEFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 24 hours. Cell death was assessed by PI staining and flow cytometry. In (C-E), data are shown as mean and SD of at least three independent experiments

16 performed in triplicate; **P<0.01; ***P<0.001.

Figure 3. TSZ-induced necroptosis in MLFs depends on ROS production A, MLFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 1 hour in the presence or absence of 50 µM α−Toc. ROS production was determined by the ROSsensitive dye CM-H2DCFDA and flow cytometry. B, MEFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 6 hours in the presence or absence of 50 µM α−Toc. ROS production was determined by the ROSsensitive dye CM-H2DCFDA and flow cytometry. C, MLFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 1 hour in the presence or absence of 50 µM BHA, 25 µM Nec-1 or 5 µM GSK’872. ROS production was determined by the ROS-sensitive dye CM-H2DCFDA and flow cytometry. D, MEFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 6 hours in the presence or absence of 50 µM BHA, 25 µM Nec-1 or 5 µM GSK’872. ROS production was determined by the ROS-sensitive dye CM-H2DCFDA and flow cytometry. E, MLFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 2 hours in the presence or absence of 50 µM BHA or 50 µM α−Toc. Cell death was assessed by PI/Hoechst staining using high-content microscopy. F, MEFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 24 hours in the presence or absence of 50 µM BHA or 50 µM α−Toc. Cell death was assessed by PI/Hoechst staining using high-content microscopy. Data are shown as mean and SD of at least three independent experiments performed in triplicate; *P<0.05; **P<0.01; ***P<0.001.

Figure 4. ROS are required for TSZ-stimulated phosphorylation of MLKL. MLFs were treated with 10 ng/ml TNFα, 5 µM BV6 and 20 µM zVAD.fmk for 1 hour in the

17 presence or absence of 50 µM BHA or 50 µM GSK’782, MEFs were treated for 6 hours. Protein expression and phosphorylation of MLKL was determined by Western blotting; vinculin served as loading control.

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