Curcumin combined with arsenic trioxide in the treatment of acute myeloid leukemia: network pharmacology analysis and experimental validation.

PURPOSE

This study aimed to evaluate the effects of curcumin by co-administration of arsenic trioxide (AsO) in acute myeloid leukemia (AML) treatment, using network pharmacology and experimental validation.

METHODS

Using Pubchem database, Traditional Chinese Medicine Information Database (TCMID) database, and Swiss target prediction database to predict compound-related targets, AML-associated targets were determined using GeneCards and Online Mendelian Inheritance in Man (OMIM) databases. We identify overlapping common targets by comparing Compounds-related and AML-associated targets and using these targets to perform GO and KEGG functional enrichment analyses. Subsequently, these targets were input into the STRING database, and we used Cytoscape to construct protein-protein interaction (PPI) network. Finally, we used KG1-a cells and the AML mouse model to measure the anti-leukemia effects of curcumin and AsO and their combination.

RESULTS

Compounds and targets screening hinted that 85 intersection targets were predicted in the curcumin treatment of AML, 75 targets in the AsO treatment of AML, and 48 targets in the curcumin combined with the AsO treatment of AML. GO and KEGG analyses indicated that the top 10 enriched biological processes and top 20 pathways implicated in the therapeutic effects of curcumin and AsO on AML, respectively. In addition, network pharmacology screening revealed STAT3, TP53, EP300, MAPK1, and PIK3CA as the top five genes in PPI network of curcumin treatment of AML and TP53, MAPK3, MAPK1, STAT3, and SRC as the top five genes in PPI network of AsO treatment of AML. Moreover, the in vitro experiment demonstrated that curcumin combined with AsO inhibited proliferation and induced apoptosis in KG1-a cells, and this effect is more substantial than curcumin or AsO alone. Mechanistically, the curcumin combined with AsO significantly down-regulated the protein expression of JAK2, STAT3, and Bcl-2, and up-regulated the levels of P53, P27, and Bax. In the mouse model, the survival time of mice in each administration group was drawn out to varying degrees, with the most significant prolongation in the curcumin combined with the AsO group.

CONCLUSION

Our results suggested that curcumin and AsO combination therapy exerts more significant anti-leukemia effects in the treatment of AML than curcumin or AsO monotherapy by up-regulating p53 pathway and down-regulating the JAK2/STAT3 pathway.