Department of Pathology, Faculty of Basic Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria.
Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria.
PLoS One. 2021 Jan 19;16(1):e0245581. doi: 10.1371/journal.pone.0245581. eCollection 2021.
Evasion of apoptosis is associated with treatment resistance and metastasis in colorectal cancer (CRC). Various cellular processes are associated with evasion of apoptosis. These include overexpression of pro-apoptotic proteins (including p53 and PD-L1), anti-apoptotic proteins (BIRC7/Livin and Bcl-2), chemokine receptors (including DARC), and dysregulation of DNA mismatch repair proteins (including MSH2 and PMS2). The aim of this study was to determine the effect of folinic acid, 5-FU and oxaliplatin (FOLFOX) as a single agent and aspirin plus FOLFOX in various combinations on the aforementioned proteins in human CRC, SW480 cell line and rat models of N-Methyl-N-Nitrosourea (NMU)-induced CRC. In addition, effects of the NMU-induced CRC and chemotherapeutic regimens on haematological and biochemical parameters in the rat models were studied. Immunohistochemistry, immunofluorescence and immunoblot techniques were used to study the expression pattern of the related proteins in the human CRC cells pre- and post-treatment. Double contrast barium enema, post-mortem examination and histological analyses were used to confirm tumour growth and the effect of the treatment in vivo in rat models. Notably, we found in human mucinous CRC, a significant increase in expression of the BIRC7/Livin post-FOLFOX treatment compared with pre-treatment (p = 0.0001). This increase provides new insights into the prognostic role of BIRC7/Livin in evasion of apoptosis and facilitation of treatment resistance, local recurrence and metastasis particularly among mucinous CRCs post-FOLFOX chemotherapy. These poor prognostic features in the CRC may be further compounded by the significant suppression of DARC, PD-L1, PMS2 and overexpression of MSH2 and anti-apoptotic Bcl-2 and p53 proteins observed in our study (p < 0.05). Importantly, we found a significant reduction in expression of BIRC7/Livin and reactivation of DARC and PD-L1 with a surge in Annexin V expression in rat models of CRC cells post-treatment with a sequential dose of aspirin plus FOLFOX compared with other treatments in vivo (p <0.05). The mechanistic rational of these effects underscores the importance of expanded concept of possible aspirin combination therapy with FOLFOX sequentially in future CRC management. Validation of our findings through randomized clinical trials of aspirin plus FOLFOX sequentially in patients with CRC is therefore warranted.
细胞凋亡逃避与结直肠癌(CRC)的治疗耐药和转移有关。各种细胞过程都与细胞凋亡逃避有关。这些过程包括促凋亡蛋白(包括 p53 和 PD-L1)、抗凋亡蛋白(BIRC7/Livin 和 Bcl-2)、趋化因子受体(包括 DARC)和错配修复蛋白(包括 MSH2 和 PMS2)的失调的过度表达。本研究的目的是确定单独使用亚叶酸、5-FU 和奥沙利铂(FOLFOX)以及阿司匹林加 FOLFOX 的各种组合对人 CRC、SW480 细胞系和 N-甲基-N-亚硝基脲(NMU)诱导的 CRC 大鼠模型中上述蛋白的影响。此外,还研究了 NMU 诱导的 CRC 和化疗方案对大鼠模型血液学和生化参数的影响。免疫组织化学、免疫荧光和免疫印迹技术用于研究人 CRC 细胞治疗前后相关蛋白的表达模式。双重对比钡灌肠、尸检和组织学分析用于在大鼠模型中确认肿瘤生长和治疗效果。值得注意的是,我们发现人黏液性 CRC 中,FOLFOX 治疗后 BIRC7/Livin 的表达显著增加,与治疗前相比(p=0.0001)。这种增加为 BIRC7/Livin 在逃避凋亡和促进治疗耐药、局部复发和转移方面的预后作用提供了新的见解,特别是在接受 FOLFOX 化疗后的黏液性 CRC 中。这些 CRC 的不良预后特征可能会因我们研究中观察到的 DARC、PD-L1、PMS2 表达显著抑制以及抗凋亡 Bcl-2 和 p53 蛋白过度表达而进一步加剧(p<0.05)。重要的是,我们发现与其他体内治疗相比,CRC 细胞大鼠模型中阿司匹林加 FOLFOX 序贯治疗后 BIRC7/Livin 表达显著降低,DARC 和 PD-L1 重新激活, Annexin V 表达增加(p<0.05)。这些影响的机制合理性强调了在未来 CRC 管理中扩展阿司匹林联合 FOLFOX 序贯治疗概念的重要性。因此,有必要通过 CRC 患者中阿司匹林加 FOLFOX 序贯治疗的随机临床试验来验证我们的发现。