Recent studies have indicated that
cancer stem-like cells (CSCs) exhibit a high resistance to current therapeutic strategies, including
photodynamic therapy (
PDT), leading to the recurrence and progression of
colorectal cancer (CRC). In
cancer, autophagy acts as both a
tumor suppressor and a
tumor promoter. However, the role of autophagy in the resistance of CSCs to
PDT has not been reported. In this study, CSCs were isolated from
colorectal cancer cells using PROM1/CD133 (
prominin 1) expression, which is a surface marker commonly found on stem cells of various tissues. We demonstrated that
PpIX-mediated
PDT induced the formation of autophagosomes in PROM1/CD133(+) cells, accompanied by the upregulation of
autophagy-related proteins ATG3, ATG5, ATG7, and ATG12. The inhibition of
PDT-induced autophagy by pharmacological inhibitors and silencing of the ATG5 gene substantially triggered apoptosis of PROM1/CD133(+) cells and decreased the ability of colonosphere formation in vitro and tumorigenicity in vivo. In conclusion, our results revealed a protective role played by autophagy against
PDT in CSCs and indicated that targeting autophagy could be used to elevate the
PDT sensitivity of CSCs. These findings would aid in the development of novel therapeutic approaches for CSC treatment.