Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Mol Cancer Ther. 2010 Nov;9(11):2879-92. doi: 10.1158/1535-7163.MCT-10-0504. Epub 2010 Nov 9.
Head and neck squamous cell carcinoma (HNSCC) is a prevalent cancer worldwide. Signal transducers and activators of transcription 3 (STAT3) signaling is reported to promote tumor malignancy and recurrence in HNSCC. Cucurbitacins, triterpenoid derivatives, are strong STAT3 inhibitors with anticancer properties. Recent studies have shown aldehyde dehydrogenase 1 (ALDH1) to be a marker of cancer stem cells (CSC) in HNSCC. The aim of this study was to investigate the therapeutic effect of cucurbitacin I in HNSCC-derived CSCs. Using immunohistochemical analysis, we firstly showed that CD44, ALDH1, and phosphorylated STAT3 (p-STAT3) were higher in high-grade HNSCCs, and that triple positivity for CD44/ALDH1/p-STAT3 indicated a worse prognosis for HNSCC patients. Secondly, CD44(+)ALDH1(+) cells isolated from seven HNSCC patients showed greater tumorigenicity, radioresistance, and high expression of stemness (Bmi-1/Oct-4/Nanog) and epithelial-mesenchymal-transitional (Snail/Twist) genes as p-STAT3 level increased. Furthermore, we found that cucurbitacin I (JSI-124) can effectively inhibit the expression of p-STAT3 and capacities for tumorigenicity, sphere formation, and radioresistance in HNSCC-CD44(+)ALDH1(+). Notably, 150 nmol/L cucurbitacin I effectively blocked STAT3 signaling and downstream survivin and Bcl-2 expression, and it induced apoptosis in HNSCC-CD44(+)ALDH1(+). Moreover, microarray data indicated that 100 nmol/L cucurbitacin I facilitated CD44(+)ALDH1(+) cells to differentiate into CD44⁻ALDH1⁻ and enhanced the radiosensitivity of HNSCC-CD44(+)ALDH1(+). Xenotransplant experiments revealed that cucurbitacin I combined with radiotherapy significantly suppressed tumorigenesis and lung metastasis and further improved the survival rate in HNSCC-CD44(+)ALDH1(+)-transplanted immunocompromised mice. Taken together, our data show that cucurbitacin I, STAT3 inhibitor, reduces radioresistant, distant-metastatic, and CSC-like properties of HNSCC-CD44(+)ALDH1(+) cells. The potential of cucurbitacin I as a radiosensitizer should be verified in future anti-CSC therapy.
头颈部鳞状细胞癌(HNSCC)是一种常见的癌症。据报道,信号转导和转录激活因子 3(STAT3)信号通路可促进 HNSCC 肿瘤的恶性程度和复发。葫芦素是一种三萜类衍生物,是一种具有抗癌特性的强效 STAT3 抑制剂。最近的研究表明,醛脱氢酶 1(ALDH1)是 HNSCC 中癌症干细胞(CSC)的标志物。本研究旨在探讨葫芦素 I 对 HNSCC 衍生的 CSCs 的治疗作用。通过免疫组织化学分析,我们首先表明,在高级别 HNSCC 中,CD44、ALDH1 和磷酸化 STAT3(p-STAT3)表达更高,CD44/ALDH1/p-STAT3 三重阳性提示 HNSCC 患者预后更差。其次,从七名 HNSCC 患者中分离出的 CD44(+)ALDH1(+)细胞显示出更强的致瘤性、放射抗性和高表达干性(Bmi-1/Oct-4/Nanog)和上皮-间充质转化(Snail/Twist)基因,随着 p-STAT3 水平的升高。此外,我们发现葫芦素 I(JSI-124)可有效抑制 HNSCC-CD44(+)ALDH1(+)中 p-STAT3 的表达和致瘤性、球体形成和放射抗性。值得注意的是,150nmol/L 葫芦素 I 可有效阻断 STAT3 信号及其下游存活素和 Bcl-2 的表达,并诱导 HNSCC-CD44(+)ALDH1(+)细胞凋亡。此外,微阵列数据表明,100nmol/L 葫芦素 I 促进 CD44(+)ALDH1(+)细胞向 CD44(-)ALDH1(-)分化,并增强 HNSCC-CD44(+)ALDH1(+)的放射敏感性。异种移植实验表明,葫芦素 I 联合放疗显著抑制肿瘤发生和肺转移,并进一步提高 HNSCC-CD44(+)ALDH1(+)移植免疫缺陷小鼠的存活率。综上所述,我们的数据表明,STAT3 抑制剂葫芦素 I 降低了 HNSCC-CD44(+)ALDH1(+)细胞的放射抗性、远处转移和 CSC 样特性。葫芦素 I 作为放射增敏剂的潜力应在未来的抗 CSC 治疗中得到验证。