The synthetic retinoid fenretinide inhibits vitamin A formation and
regulates carotenoid levels in mice
Abstract
Fenretinide, a synthetic retinoid with pleiotropic benefits for human
health, is currently utilized in clinical trials for cancer, cystic
fibrosis, and COVID-19. However, fenretinide reduces plasma vitamin A
levels by interacting with retinol-binding protein 4 (RBP4), which often
results in reversible night blindness in patients. Cell culture and in
vitro studies show that fenretinide binds and inhibits the activity of
β-carotene oxygenase 1 (BCO1), the enzyme responsible for endogenous
vitamin A formation. Whether fenretinide inhibits vitamin A synthesis in
mammals, however, remains unknown. The goal of this study was to
determine if the inhibition of BCO1 by fenretinide affects vitamin A
formation in mice fed β-carotene. Our results show that wild-type mice
treated with fenretinide for ten days had a reduction in tissue vitamin
A stores accompanied by a two-fold increase in β-carotene in plasma (P
< 0.01) and several tissues. These effects persisted in
RBP4-deficient mice and were independent of changes in intestinal
β-carotene absorption, suggesting that fenretinide inhibits vitamin A
synthesis in mice. Using Bco1−/− and Bco2−/− mice we also show that
fenretinide regulates intestinal carotenoid and vitamin E uptake by
activating vitamin A signaling during short-term vitamin A deficiency.
This study provides a deeper understanding of the impact of fenretinide
on vitamin A, carotenoid, and vitamin E homeostasis, which is crucial
for the pharmacological utilization of this retinoid.