Combination therapy with gossypol reveals synergism against gemcitabine resistance in cancer cells with high BCL-2 expression

PLoS One. 2012;7(12):e50786. doi: 10.1371/journal.pone.0050786. Epub 2012 Dec 4.

Abstract

Although gemcitabine is highly active in several cancer types, intrinsic and acquired drug resistance remains a major challenge. Overexpression of Bcl-2 has been associated with gemcitabine resistance. The aim of this study is to determine whether gossypol can overcome gemcitabine resistance in cell lines with high level of Bcl-2 expression in combination drug therapy. Our study demonstrated that in 10 cell lines derived from different cancers, high Bcl-2 baseline expression was observed in cell lines that were resistant to gemcitabine (GEM-R). Furthermore, synergistic effect of combination therapy was observed in gemcitabine-resistant (GEM-R) cell lines with high Bcl-2 expression, but not in a gemcitabine-sensitive (GEM-S) cell lines regardless of Bcl-2 expression. Gossypol treatment resulted in the decrease of anti-apoptotic genes such as Bcl-2 and Bcl-xl and an upregulation of the pro-apoptotic gene, Noxa. Furthermore, the addition of gossypol to gemcitabine resulted in lower expressions of anti-apoptotic genes compared to gemcitabine alone. Gene expression profiling in GEM-R and GEM-S cell lines suggest that anti-apoptotic genes such as pAkt and PI3KR2 may play important role in gemcitabine resistance, while pro-apoptotic Bcl-2 related genes (Bad, Caspase-6 and Calpain-1) may regulate synergistic interaction in combination therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Apoptosis / drug effects
  • Apoptosis / genetics
  • Cell Line, Tumor
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / pharmacology
  • Deoxycytidine / therapeutic use
  • Down-Regulation / drug effects
  • Down-Regulation / genetics
  • Drug Interactions
  • Drug Resistance, Neoplasm* / drug effects
  • Drug Synergism
  • Gemcitabine
  • Gene Expression Regulation, Neoplastic / drug effects
  • Gossypol / analogs & derivatives
  • Gossypol / pharmacology
  • Gossypol / therapeutic use*
  • Humans
  • Inhibitory Concentration 50
  • Multigene Family / genetics
  • Neoplasms / drug therapy*
  • Neoplasms / genetics*
  • Proto-Oncogene Proteins c-bcl-2 / genetics
  • Proto-Oncogene Proteins c-bcl-2 / metabolism*
  • Reproducibility of Results
  • Signal Transduction / drug effects
  • Signal Transduction / genetics
  • Up-Regulation / drug effects
  • Up-Regulation / genetics
  • bcl-X Protein / genetics
  • bcl-X Protein / metabolism

Substances

  • PMAIP1 protein, human
  • Proto-Oncogene Proteins c-bcl-2
  • bcl-X Protein
  • Deoxycytidine
  • Gossypol
  • gossypol acetic acid
  • Gemcitabine

Grants and funding

This work is supported by grant NMRC/TCR/001-NUH/2007 from National Medical Research Council, Singapore. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.