Stein U, Walther W, Shoemaker R H
Max-Delbrück-Center for Molecular Medicine, Berlin, Federal Republic of Germany.
J Natl Cancer Inst. 1996 Oct 2;88(19):1383-92. doi: 10.1093/jnci/88.19.1383.
Multidrug resistance can be a major obstacle to successful cancer chemotherapy and is often associated with increased expression of the mdr1 (also known as P-glycoprotein) gene. Some of the proteins produced by the body's immune system, i.e., cytokines such as tumor necrosis factor-alpha (TNF) and interleukin 2 (IL-2), have been shown to modulate multidrug resistance. However, cytokines administered by the conventional intravenous method can cause severe side effects. Transduction of cytokine genes into tumor cells constitutes an alternative approach for production and release of the cytokine proteins in the local tumor microenvironment, which may reduce problems of toxicity associated with systemic administration.
In this study, we investigated the therapeutic potential of a combination of gene therapy and chemotherapy on the basis of cytokine-mediated modulation of multidrug resistance in human colon carcinoma cells.
Human colon carcinoma cell lines HCT15 and HCT116 were transduced with TNF or IL-2 carrying murine leukemia virus (MLV)-based retroviral vectors. Tumor cell clones were analyzed for cytokine expression by reverse transcriptase-polymerase chain reaction (RT-PCR) and by cytokine-specific enzyme-linked immunosorbent assays (TNF-ELISA or IL-2-ELISA). Expression of mdr1 messenger RNA (mRNA) was investigated using RT-PCR, and P-glycoprotein (Pgp) expression was determined by immunoflow cytometry with the monoclonal antibodies MRK16 and C219. The function of Pgp was analyzed by measuring accumulation of the fluorescent drug doxorubicin by flow cytometry. The XTT-(i.e., [2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)]-5-[(phenylamino)-carbon yl-2H- tetrazolium hydroxide]-colorimetric cytotoxicity assay was used to determine chemosensitivity of cytokine gene-transfected tumor cells to doxorubicin and vincristine. Statistical significance was determined by the nonparametric Mann-Whitney rank sum test for the flow cytometry experiments (Pgp detection as well as drug uptake assays) and the parametric Student's t test for the chemosensitivity assay (XTT cytotoxicity assay). All P values reported were derived from two-sided statistical tests.
Transduction and expression of human TNF and IL-2 in HCT15 and HCT116 human colon carcinoma cell lines were found to reverse multidrug resistance. Both TNF and IL-2 secretion reduced mdr1 expression on the mRNA and Pgp levels (P < .0243). This result was associated with enhancement of doxorubicin accumulation within the cells (P < .0001). The cytokine-mediated effects on mdr1 expression resulted in increased chemosensitivity of the transduced cells to doxorubicin and vincristine (P < .0460).
We show that endogenous expression of cytokine genes in tumor cells and after transduction secretion of the related proteins, such as TNF and IL-2, can modulate multidrug resistance in vitro. This modulation enhances the susceptibility of the cells to the cytotoxic drugs. Our findings suggest the potential value of combined treatment of resistant tumors with gene therapy and chemotherapy.
多药耐药性可能是癌症化疗成功的主要障碍,且常与多药耐药1基因(mdr1,也称为P-糖蛋白)表达增加有关。人体免疫系统产生的一些蛋白质,即细胞因子,如肿瘤坏死因子-α(TNF)和白细胞介素2(IL-2),已被证明可调节多药耐药性。然而,通过传统静脉注射方法给药的细胞因子会引起严重的副作用。将细胞因子基因转导至肿瘤细胞构成了在局部肿瘤微环境中产生和释放细胞因子蛋白的另一种方法,这可能会减少与全身给药相关的毒性问题。
在本研究中,我们基于细胞因子介导的对人结肠癌细胞多药耐药性的调节作用,研究了基因治疗与化疗联合应用的治疗潜力。
用携带基于鼠白血病病毒(MLV)的逆转录病毒载体的TNF或IL-2转导人结肠癌细胞系HCT15和HCT116。通过逆转录聚合酶链反应(RT-PCR)和细胞因子特异性酶联免疫吸附测定(TNF-ELISA或IL-2-ELISA)分析肿瘤细胞克隆的细胞因子表达。使用RT-PCR研究mdr1信使核糖核酸(mRNA)的表达,并通过使用单克隆抗体MRK16和C219的免疫流式细胞术测定P-糖蛋白(Pgp)的表达。通过流式细胞术测量荧光药物阿霉素的积累来分析Pgp的功能。采用XTT-(即[2,3-双(2-甲氧基-4-硝基-5-磺基苯基)]-5-[(苯氨基)-羰基-2H-四唑氢氧化合物]-比色细胞毒性测定法来确定细胞因子基因转染的肿瘤细胞对阿霉素和长春新碱的化学敏感性。对于流式细胞术实验(Pgp检测以及药物摄取测定),通过非参数曼-惠特尼秩和检验确定统计学显著性;对于化学敏感性测定(XTT细胞毒性测定),通过参数学生t检验确定统计学显著性。所有报告的P值均来自双侧统计检验。
发现在HCT15和HCT116人结肠癌细胞系中,人TNF和IL-2的转导和表达可逆转多药耐药性。TNF和IL-2的分泌均降低了mdr1在mRNA和Pgp水平上的表达(P < 0.0243)。这一结果与细胞内阿霉素积累的增加相关(P < 0.0001)。细胞因子对mdr1表达的介导作用导致转导细胞对阿霉素和长春新碱的化学敏感性增加(P < 0.0460)。
我们表明肿瘤细胞中细胞因子基因的内源性表达以及转导后相关蛋白(如TNF和IL-2)的分泌可在体外调节多药耐药性。这种调节增强了细胞对细胞毒性药物的敏感性。我们的研究结果提示了基因治疗与化疗联合治疗耐药肿瘤的潜在价值。