Lipid droplets accumulate and delay regulated cell death execution

Abstract

Normal and cancer cells accumulate lipid droplets (LDs) under stress to buffer lipotoxicity, but their role in regulated cell death (RCD) remains incompletely understood. Here, we explored LD accumulation across multiple apoptotic and non-apoptotic RCD modalities in human cancer cells and Drosophila germ cells. We found that LD accumulation arises from de novo LD biogenesis, whereas LD lipolysis remains active--or even enhanced--in dying germ cells and cancer cells, respectively. In Drosophila, LD accumulation in ATGL/Bmm lipase loss of function mutant inhibited germ cell death, supporting a protective role of LDs. Proteomic and imaging analyses revealed a broad redistribution of LD-associated proteins, encompassing lipid metabolism and stress response factors, as well as the pro-apoptotic effector Bax in human cancer cells during cell death. Enhanced LD-mitochondria contacts promoted the translocation of conformationally active Bax from mitochondria to LDs, thereby delaying apoptosis execution. Consistently, LD depletion sensitizes cells to Bax-dependent apoptosis, whereas LD accumulation confers resistance. Collectively, these findings define LD accumulation during cell death as a delaying mechanism in which LDs sequester mitochondrial cell death regulators, attenuating their pro-death activity and revealing potential therapeutic implications for apoptosis-resistant cancers.