Division of Health Protection Technologies, Italian National Agency for Energy New Technologies and Sustainable Economic Development (ENEA), Rome, Italy.
Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy.
Int J Radiat Oncol Biol Phys. 2021 Apr 1;109(5):1495-1507. doi: 10.1016/j.ijrobp.2020.11.047. Epub 2021 Jan 25.
PURPOSE: Cancer stem cells constitute an endless reserve for the maintenance and progression of tumors, and they could be the reason for conventional therapy failure. New therapeutic strategies are necessary to specifically target them. In this context, microsecond pulsed electric fields have been selected to expose D283Med cells, a human medulloblastoma cell line resulted to be rich in cancer stem cells, and normal human astrocytes. METHODS: We analyzed in vitro different endpoints at different times after microsecond pulsed electric field exposure, such as permeabilization, reactive oxygen species generation, cell viability/proliferation, cell cycle, and clonogenicity, as well as the expression of different genes involved in cell cycle, apoptosis, and senescence. Furthermore, the response of D283Med cells exposed to microsecond pulsed electric fields was validated in vivo in a heterotopic mouse xenograft model. RESULTS: Our in vitro results showed that a specific pulse protocol (ie, 0.3 MV/m, 40 μs, 5 pulses) was able to induce irreversible membrane permeabilization and apoptosis exclusively in medulloblastoma cancer stem cells. In the surviving cells, reactive oxygen species generation was observed, together with a transitory G2/M cell-cycle arrest with a senescence-associated phenotype via the upregulation of GADD45A. In vivo results, after pulsed electric field exposure, demonstrated a significant tumor volume reduction with no eradication of tumor mass. In conjunction, we verified the efficacy of electric pulse pre-exposure followed by ionizing irradiation in vivo to enable complete inhibition of tumor growth. CONCLUSIONS: Our data reveal novel therapeutic options for the targeting of medulloblastoma cancer stem cells, indicating nonionizing pulsed electric field pre-exposure as an effective means to overcome the radioresistance of cancer stem cells.
目的:癌症干细胞构成了肿瘤维持和进展的无尽储备,并且可能是常规治疗失败的原因。有必要采用新的治疗策略来专门针对它们。在这种情况下,已选择微秒脉冲电场来暴露 D283Med 细胞,这是一种人髓母细胞瘤细胞系,其富含癌症干细胞和正常人类星形胶质细胞。
方法:我们分析了微秒脉冲电场暴露后不同时间的不同体外终点,如通透性、活性氧物种的产生、细胞活力/增殖、细胞周期和集落形成能力,以及涉及细胞周期、凋亡和衰老的不同基因的表达。此外,还在异种移植小鼠模型中验证了 D283Med 细胞暴露于微秒脉冲电场的体内反应。
结果:我们的体外结果表明,特定的脉冲方案(即 0.3 MV/m、40 μs、5 个脉冲)能够仅在髓母细胞瘤癌症干细胞中诱导不可逆的膜通透性和凋亡。在存活的细胞中,观察到活性氧物种的产生,同时通过上调 GADD45A 发生短暂的 G2/M 细胞周期停滞和衰老相关表型。体内结果表明,在暴露于脉冲电场后,肿瘤体积显著缩小,而肿瘤质量未被消除。同时,我们验证了电脉冲预暴露后进行电离辐射在体内完全抑制肿瘤生长的疗效。
结论:我们的数据揭示了针对髓母细胞瘤癌症干细胞的新治疗选择,表明非电离微秒脉冲电场预暴露是克服癌症干细胞放射抗性的有效手段。
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