Perego P, Romanelli S, Carenini N, Magnani I, Leone R, Bonetti A, Paolicchi A, Zunino F
Oncologia Sperimentale B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Ann Oncol. 1998 Apr;9(4):423-30. doi: 10.1023/a:1008265012435.
Alteration in apoptosis pathways (in particular mutations of p53 gene) may result in resistance of ovarian carcinoma to cisplatin. However, cisplatin resistance is likely to be multifactorial. An understanding of the molecular alterations associated with the development of resistance may be of considerable relevance in an attempt to optimize the therapeutic approach.
Two cisplatin-resistant sublines (IGROV-1/Pt0.5 and IGROV-1/Pt1), both characterized by mutant p53 (Cancer Res 1996; 56: 556-62), but with different degree of resistance were studied in terms of pattern of cross-resistance, susceptibility to drug-induced apoptosis, expression of gluthathione-dependent system, cellular pharmacokinetics, drug-induced DNA damage. The resistance index (ratio between the IC50 of resistant and sensitive cells) after a 96-hour drug exposure was 10 for IGROV-1/Pt0.5 and 14 for IGROV-1/Pt1 cells.
Resistant cells were cross-resistant to DNA-damaging agents and, interestingly, they had a collateral sensitivity to Taxol. The cellular response to Taxol paralleled the drug ability to induce apoptosis. The intracellular glutathione level was significantly increased in IGROV-1/Pt cells compared to the sensitive counterpart. In contrast, glutathione S-transferase level was consistently reduced in both sublines. gamma-Glutamyl transpeptidase activity, which was lower in resistant than in sensitive cells, was not directly correlated with glutathione level, thus suggesting a complex regulation of cellular glutathione content. In the resistant cells with the highest glutathione content, a reduced level of cisplatin-induced cross-link was found. Analysis of DNA platination revealed a slight decrease of DNA-bound platinum only in IGROV-1/Pt1 cells. Again, this reduction is consistent with a protective role for glutathione. The expression of metallothionein IIa was increased in both resistant variants.
Multiple changes are involved in acquired resistance of ovarian carcinoma cells including reduced susceptibility to apoptosis as consequence of inactivation of p53 and expression of defence mechanisms. The relative contribution is related to the degree of drug resistance. In particular, the glutathione-dependent system could have a role only in the development of a high degree of resistance. Finally, the finding that Taxol was very effective in inducing apoptosis in resistant sublines with p53 mutation supports the expression of an intact p53-independent pathway of apoptosis and suggests the pharmacological interest of Taxol in the treatment of p53-mutated tumors.
凋亡途径的改变(特别是p53基因的突变)可能导致卵巢癌对顺铂产生耐药性。然而,顺铂耐药性可能是多因素的。了解与耐药性发展相关的分子改变对于优化治疗方法可能具有相当重要的意义。
研究了两个顺铂耐药亚系(IGROV-1/Pt0.5和IGROV-1/Pt1),二者均以p53突变(《癌症研究》1996年;56:556 - 62)为特征,但耐药程度不同,涉及交叉耐药模式、对药物诱导凋亡的敏感性、谷胱甘肽依赖性系统的表达、细胞药代动力学、药物诱导的DNA损伤等方面。药物暴露96小时后的耐药指数(耐药细胞与敏感细胞IC50的比值),IGROV-1/Pt0.5细胞为10,IGROV-1/Pt1细胞为14。
耐药细胞对DNA损伤剂具有交叉耐药性,有趣的是,它们对紫杉醇具有协同敏感性。细胞对紫杉醇的反应与药物诱导凋亡的能力平行。与敏感细胞相比,IGROV-1/Pt细胞内谷胱甘肽水平显著升高。相反,两个亚系中的谷胱甘肽S-转移酶水平持续降低。耐药细胞中γ-谷氨酰转肽酶活性低于敏感细胞,且与谷胱甘肽水平无直接相关性,这表明细胞内谷胱甘肽含量存在复杂的调控机制。在谷胱甘肽含量最高的耐药细胞中,发现顺铂诱导的交联水平降低。DNA铂化分析显示,仅在IGROV-1/Pt1细胞中与DNA结合的铂含量略有下降。同样,这种下降与谷胱甘肽的保护作用一致。两种耐药变体中金属硫蛋白IIa的表达均增加。
卵巢癌细胞获得性耐药涉及多种变化,包括由于p53失活和防御机制表达导致的对凋亡的敏感性降低。相对贡献与耐药程度有关。特别是,谷胱甘肽依赖性系统可能仅在高度耐药的发展中起作用。最后,紫杉醇在诱导p53突变的耐药亚系凋亡方面非常有效的这一发现支持了完整的非p53依赖性凋亡途径的表达,并表明紫杉醇在治疗p53突变肿瘤方面具有药理学意义。