Sanguinarine triggers apoptosis and ferroptosis synchronously by directly binding BiP in lung squamous cell carcinoma

Weidan Tan , Xinyu Wei , Changsheng Li , Huilan Wei , Fei Yu , Xiaoju Shen , Xiaoxiang Mo , Meifen Wei , Shangping Xing , Zhuo Luo , Jie Yang

Chinese Journal of Natural Medicines ›› 2026, Vol. 24 ›› Issue (4) : 427 -439.

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Chinese Journal of Natural Medicines ›› 2026, Vol. 24 ›› Issue (4) :427 -439. DOI: 10.1016/S1875-5364(26)61115-6
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Sanguinarine triggers apoptosis and ferroptosis synchronously by directly binding BiP in lung squamous cell carcinoma
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Abstract

Lung squamous cell carcinoma (LUSC) is a prevalent and aggressive form of lung cancer with limited therapeutic options. Sanguinarine (SAG), a prominent benzophenanthridine alkaloid derived from Zanthoxylum nitidum (Roxb.) DC, exhibits established anti-tumor activity; however, its molecular mechanisms in LUSC remain incompletely defined. In this study, the anti-cancer effects and underlying mechanisms of SAG were systematically investigated in vitro and in vivo. Cell viability and death were evaluated using methyl thiazolyl tetrazolium (MTT) assays, colony formation assays, flow cytometry, transmission electron microscopy (TEM), and Western blotting (WB). Drug affinity responsive target stability (DARTS) combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS), molecular docking, cellular thermal shift assay (CETSA), and surface plasmon resonance (SPR) were employed to identify and validate molecular targets of SAG. The results demonstrated that SAG simultaneously induces apoptosis and ferroptosis in LUSC cells by directly targeting the endoplasmic reticulum (ER) chaperone binding immunoglobulin protein (BiP). Silencing of BiP markedly attenuated SAG-induced apoptosis and ferroptosis, confirming its essential role in this process. Mechanistically, SAG up-regulates BiP expression and activates the protein kinase R-like endoplasmic reticulum kinase (PERK)/eIF2α/C/EBP homologous protein (CHOP)/GADD34 signaling axis of ER stress (ERS), ultimately leading to dual induction of apoptosis and ferroptosis in vitro and in vivo.

Keywords

Lung squamous cell carcinoma / Sanguinarine / Apoptosis / Ferroptosis / BiP

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Weidan Tan, Xinyu Wei, Changsheng Li, Huilan Wei, Fei Yu, Xiaoju Shen, Xiaoxiang Mo, Meifen Wei, Shangping Xing, Zhuo Luo, Jie Yang. Sanguinarine triggers apoptosis and ferroptosis synchronously by directly binding BiP in lung squamous cell carcinoma. Chinese Journal of Natural Medicines, 2026, 24(4): 427-439 DOI:10.1016/S1875-5364(26)61115-6

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Funding

This work was supported by the National Natural Science Foundation of China (Nos. U25A20166, 82374093 and 82460718), the Joint Project on Regional High-Incidence Diseases Research of Guangxi Natural Science Foundation (No. 2023GXNSFDA026026), and the Natural Science Foundation of Guangxi Province (No. 2023GXNSFAA026224).

Acknowledgements

We express our gratitude to the research team of Prof. Huaxin Hou and Prof. Danrong Li, along with Dr. Li Li, who provided countless help and patience during experiment process.

Declaration of competing interest

These authors declare no conflict of interest.

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