# Miltirone promotes pyroptosis via increasing pyroptosis-related protein NLRP3 and AIM2 in kidney renal clear cell carcinoma

**Authors:** Tao Huang, Qinghai Wang, Yang Gao, Hongyang Wang, Chen Guo, Lixia Song, Pingli He, Jinzhen Cai

PMC · DOI: 10.3389/fimmu.2026.1702901 · Frontiers in Immunology · 2026-02-23

## TL;DR

This study shows that miltirone can trigger pyroptosis in kidney cancer cells by boosting specific proteins, offering a new treatment approach.

## Contribution

The study identifies miltirone's novel role in inducing pyroptosis in kidney renal clear cell carcinoma via NLRP3 and AIM2.

## Key findings

- Miltirone treatment induced pyroptosis and inhibited KIRC cell proliferation.
- NLRP3 and AIM2 are associated with immune infiltration and poor prognosis in KIRC.
- Pyroptosis was enhanced through the NLRP3/AIM2/GSDMD axis in KIRC cells.

## Abstract

Pyroptosis, a type of programmed cell death, exerts direct influence on inflammatory processes and immune response. A previous study suggests that miltirone exhibits notable anti-tumor activities and has been shown to induce tumor cell pyroptosis. Nevertheless, the therapeutic value of miltirone in kidney renal clear cell carcinoma (KIRC) remains underexplored.

Using TCGA pan-cancer data, we uncovered widely expressed pyroptosis-related genes (NLRP3 and AIM2). Mechanistically, the genomic amplification alteration and high CNV percentages in pan-cancer induced an abnormal expression. StromalScore analysis suggested that NLRP3 and AIM2 were activated by the tumor immune microenvironment in KIRC. Enrichment analysis indicated that NLRP3 and AIM2 regulated the inflammatory response and were related to immune infiltration in KIRC. Furthermore, Kaplan–Meier curve and ROC analysis indicated that a high expression of AIM2 was associated with a worse prognosis of KIRC patients. MTT assays and flow cytometry revealed that miltirone treatment induced KIRC cell pyroptosis and inhibited cell proliferation, with changes in the expression level of NLPR3, AIM2, caspase-3, and GSDMD. The enhancement of cell pyroptosis and the release of IL-1β and IL-18 cytokines were reversed by pretreatment with the pyroptosis inhibitor VX-765.

Our study revealed the prognostic value of NLRP3 and AIM2 in KIRC. Miltirone treatment inhibited KIRC cell proliferation and enhanced cell pyroptosis via the NLRP3/AIM2/GSDMD axis. This study provides a novel molecular mechanism and potential therapeutic targets in KIRC progression.

## Linked entities

- **Genes:** NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548], AIM2 (absent in melanoma 2) [NCBI Gene 9447], GSDMD (gasdermin D) [NCBI Gene 79792], Casp3 (caspase 3) [NCBI Gene 12367]
- **Chemicals:** miltirone (PubChem CID 160142), VX-765 (PubChem CID 11398092)

## Full-text entities

- **Genes:** CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, NLRC4 (NLR family CARD domain containing 4) [NCBI Gene 58484] {aka AIFEC, CARD12, CLAN, CLAN1, CLANA, CLANB}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, BRCA1 (BRCA1 DNA repair associated) [NCBI Gene 672] {aka BRCAI, BRCC1, BROVCA1, FANCS, IRIS, PNCA4}, GSDMA (gasdermin A) [NCBI Gene 284110] {aka FKSG9, GSDM, GSDM1}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}, CASP1 (caspase 1) [NCBI Gene 834] {aka ICE, IL1BC, P45}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, PYCARD (PYD and CARD domain containing) [NCBI Gene 29108] {aka ASC, CARD5, TMS, TMS-1, TMS1}, AIM2 (absent in melanoma 2) [NCBI Gene 9447] {aka PYHIN4}, POTEF (POTE ankyrin domain family member F) [NCBI Gene 728378] {aka A26C1B, POTE2alpha, POTEACTIN}, CASP3 (caspase 3) [NCBI Gene 836] {aka CPP32, CPP32B, SCA-1}, ANXA5 (annexin A5) [NCBI Gene 308] {aka ANX5, CPB-I, ENX2, HEL-S-7, PP4, RPRGL3}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, GSDMD (gasdermin D) [NCBI Gene 79792] {aka DF5L, DFNA5L, FKSG10, GSDMDC1}, IL18 (interleukin 18) [NCBI Gene 3606] {aka IGIF, IL-18, IL-1g, IL1F4}, BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}
- **Diseases:** hepatocellular carcinoma (MESH:D006528), KIRC (MESH:D002292), cancers of the genitourinary system (MESH:D014565), metastasis (MESH:D009362), colon cancer (MESH:D015179), cytotoxicity (MESH:D064420), tumorigenesis (MESH:D063646), pan (MESH:C537931), melanoma (MESH:D008545), glioma (MESH:D005910), chronic inflammation (MESH:D007249), Tumor (MESH:D009369), lung cancer (MESH:D008175), NLR (MESH:D020191), para-carcinoma (MESH:D002277)
- **Chemicals:** CO2 (MESH:D002245), BCA (MESH:C047117), PVDF (MESH:C024865), PBS (MESH:D007854), Tween 20 (MESH:D011136), Miltirone (MESH:C068880), glucose (MESH:D005947), DMSO (MESH:D004121), C19H22O2 (-), cisplatin (MESH:D002945), propidium iodide (MESH:D011419), MTT (MESH:C070243), isopropyl alcohol (MESH:D019840), SDS (MESH:D012967), saline (MESH:D012965), FITC (MESH:D016650), VX-765 (MESH:C520022)
- **Species:** Homo sapiens (human, species) [taxon 9606], Mus musculus (house mouse, species) [taxon 10090]
- **Cell lines:** A498 — Homo sapiens (Human), Renal cell carcinoma, Cancer cell line (CVCL_1056), Caki-2 — Homo sapiens (Human), Papillary renal cell carcinoma, Cancer cell line (CVCL_0235), ACHN — Homo sapiens (Human), Papillary renal cell carcinoma, Cancer cell line (CVCL_1067), 786-O — Homo sapiens (Human), Renal cell carcinoma, Cancer cell line (CVCL_1051), KIRC — Mus musculus (Mouse), Mouse kidney carcinoma, Cancer cell line (CVCL_2174)

## Full text

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## Figures

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## References

33 references — full list in the complete paper: https://tomesphere.com/paper/PMC12967976/full.md

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Source: https://tomesphere.com/paper/PMC12967976