Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany.
BMC Cancer. 2021 May 28;21(1):629. doi: 10.1186/s12885-021-08354-x.
Despite considerable medical proceedings, cancer is still a leading cause of death. Major problems for tumor therapy are chemoresistance as well as toxic side effects. In recent years, the additional treatment with the antidiabetic drug metformin during chemotherapy showed promising results in some cases. The aim of this study was to develop an in vitro tumor therapy model in order to further investigate the potential of a combined chemotherapy with metformin.
Cytotoxic effects of a combined treatment on BALB/c fibroblasts were proven by the resazurin assay. Based on the BALB/c cell transformation assay, the BALB/c tumor therapy model was established successfully with four different and widely used chemotherapeutics from different categories. Namely, Doxorubicin as a type-II isomerase inhibitor, Docetaxel as a spindle toxin, Mitomycin C as an alkylating agent and 5-Fluorouracil as an antimetabolite. Moreover, glucose consumption in the medium supernatant was measured and protein expressions were determined by Western Blotting.
Initial tests for the combined treatment with metformin indicated unexpected results as metformin could partly mitigate the cytotoxic effects of the chemotherapeutic agents. These results were further confirmed as metformin induced resistance to some of the drugs when applied simultaneously in the tumor therapy model. Mechanistically, an increased glucose consumption was observed in non-transformed cells as well as in the mixed population of malignant transformed cell foci and non-transformed monolayer cells, suggesting that metformin could also increase glucose consumption in transformed cells.
In conclusion, this study suggests a cautious use of metformin during chemotherapy. Moreover, the BALB/c tumor therapy model offers a potent tool for further mechanistic studies of drug-drug interactions during cancer therapy.
尽管有大量的医学治疗方法,癌症仍然是主要的死亡原因。肿瘤治疗的主要问题是化疗耐药性和毒性副作用。近年来,在化疗中额外使用抗糖尿病药物二甲双胍在某些情况下显示出了有希望的结果。本研究的目的是开发一种体外肿瘤治疗模型,以便进一步研究联合化疗与二甲双胍的潜力。
通过 Resazurin 测定法证明了联合治疗对 BALB/c 成纤维细胞的细胞毒性作用。基于 BALB/c 细胞转化试验,成功建立了四种不同类型的广泛使用的化疗药物的 BALB/c 肿瘤治疗模型。即多柔比星作为 II 型异构酶抑制剂,多西他赛作为纺锤体毒素,丝裂霉素 C 作为烷化剂和 5-氟尿嘧啶作为抗代谢物。此外,还通过 Western Blotting 测定法测量了培养基上清液中的葡萄糖消耗和蛋白质表达。
最初的联合二甲双胍治疗试验显示出意外的结果,因为二甲双胍可以部分减轻化疗药物的细胞毒性作用。这些结果进一步得到证实,因为当二甲双胍同时应用于肿瘤治疗模型时,它会诱导某些药物的耐药性。从机制上讲,在未转化的细胞以及恶性转化细胞灶和未转化单层细胞的混合群体中观察到葡萄糖消耗增加,表明二甲双胍也可以增加转化细胞的葡萄糖消耗。
总之,本研究提示在化疗期间谨慎使用二甲双胍。此外,BALB/c 肿瘤治疗模型为进一步研究癌症治疗期间药物相互作用的机制提供了有力的工具。