Yulyana Yulyana, Tovmasyan Artak, Ho Ivy A W, Sia Kian Chuan, Newman Jennifer P, Ng Wai Hoe, Guo Chang Ming, Hui Kam Man, Batinic-Haberle Ines, Lam Paula Y P
Laboratory of Cancer Gene Therapy, Cellular and Molecular Research Division, Humphrey Oei Institute of Cancer Research, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
Department of Radiation Oncology, Duke University Medical Center, Research Drive 281b/285 MSRB I, Box 3455, Durham, NC, 27710, USA.
Stem Cell Rev Rep. 2016 Feb;12(1):140-55. doi: 10.1007/s12015-015-9628-2.
Glioblastoma multiforme is the most malignant tumor of the brain and is challenging to treat due to its highly invasive nature and heterogeneity. Malignant brain tumor displays high metabolic activity which perturbs its redox environment and in turn translates to high oxidative stress. Thus, pushing the oxidative stress level to achieve the maximum tolerable threshold that induces cell death is a potential strategy for cancer therapy. Previously, we have shown that gap junction inhibitor, carbenoxolone (CBX), is capable of enhancing tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) -induced apoptosis in glioma cells. Since CBX is known to induce oxidative stress, we hypothesized that the addition of another potent mediator of oxidative stress, powerful SOD mimic MnTnBuOE-2-PyP(5+) (MnBuOE), could further enhance TRAIL-driven therapeutic efficacy in glioma cells. Our results showed that combining TRAIL + CBX with MnBuOE significantly enhances cell death of glioma cell lines and this enhancement could be further potentiated by CBX pretreatment. MnBuOE-driven cytotoxicity is due to its ability to take advantage of oxidative stress imposed by CBX + TRAIL system, and enhance it in the presence of endogenous reductants, ascorbate and thiol, thereby producing cytotoxic H2O2, and in turn inducing death of glioma cells but not normal astrocytes. Most importantly, combination treatment significantly reduces viability of TRAIL-resistant Asian patient-derived glioma cells, thus demonstrating the potential clinical use of our therapeutic system. It was reported that H2O2 is involved in membrane depolarization-based sensitization of cancer cells toward TRAIL. MnBuOE is entering Clinical Trials as a normal brain radioprotector in glioma patients at Duke University increasing Clinical relevance of our studies.
多形性胶质母细胞瘤是最恶性的脑肿瘤,由于其高度侵袭性和异质性,治疗具有挑战性。恶性脑肿瘤表现出高代谢活性,这会扰乱其氧化还原环境,进而转化为高氧化应激。因此,将氧化应激水平提高到诱导细胞死亡的最大耐受阈值是癌症治疗的一种潜在策略。此前,我们已经表明,间隙连接抑制剂甘珀酸(CBX)能够增强肿瘤坏死因子相关凋亡诱导配体(TRAIL)诱导的胶质瘤细胞凋亡。由于已知CBX会诱导氧化应激,我们假设添加另一种强大的氧化应激介质、强大的超氧化物歧化酶模拟物MnTnBuOE-2-PyP(5+)(MnBuOE),可以进一步增强TRAIL驱动的胶质瘤细胞治疗效果。我们的结果表明,将TRAIL + CBX与MnBuOE联合使用可显著增强胶质瘤细胞系的细胞死亡,并且这种增强可通过CBX预处理进一步增强。MnBuOE驱动的细胞毒性是由于其能够利用CBX + TRAIL系统施加的氧化应激,并在内源性还原剂抗坏血酸和硫醇存在的情况下增强这种应激,从而产生细胞毒性H2O2,进而诱导胶质瘤细胞而非正常星形胶质细胞死亡。最重要的是,联合治疗显著降低了对TRAIL耐药的亚洲患者来源的胶质瘤细胞的活力,从而证明了我们治疗系统的潜在临床应用价值。据报道,H2O2参与了基于膜去极化的癌细胞对TRAIL的致敏作用。MnBuOE作为一种正常的脑辐射防护剂正在杜克大学的胶质瘤患者中进行临床试验,这增加了我们研究的临床相关性。