Experimental study on the mechanism of reversal of leukemia multidrug resistance by proteasome inhibitor bortezomib

Objective  

In this study, we applied multidrug resistant leukemia cell line expressing mdr1-mRNA to observe changes in mdr1-mRNA, the P-gp, cell cycle and apoptosis before and after bortezomib was used, in order to explore the mechanism of reversal of leukemia multidrug resistance by the proteasome inhibitor bortezomib.     

RNAi对白血病细胞mdr-1基因和多药耐药表型的影响

目的:探讨RNA干扰技术(RNAi)对慢性粒细胞白血病急变细胞系K562/AO2细胞mdr1基因的抑制和耐药表型的逆转作用。方法:选择合成封闭mdr-1基因的小干扰序列(si-MDR1),以1个碱基突变的si-MDR1-mut为对照序列,在脂质体介导下转染至K562/AO2细胞系。RT-PCR和Western blot检测mdr1 mRNA及P-gp蛋白水平,流式细胞术分析细胞内柔红霉素(daunorubicin,DNR)积累量,并以四甲基唑蓝快速比色法(MTT)反映K562/AO2对阿霉素、长春新碱、足叶乙甙药物敏感性的变化。结果:实验证实该序列能高效封闭K562/AO2细胞内mdr-1基因表达,增加细胞内化疗药物DNR积累量,增强K562/AO2细胞对阿霉素、长春新碱、足叶乙甙的敏感性。结论:RNAi可以通过抑制mdr1基因表达,逆转K562/AO2细胞耐药表型。     

硼替佐米作用不同时间对K562耐药细胞株核因子-κB途径的影响

 目的　观察硼替佐米（商品名：万珂,PS-341）对柔红霉素（DNR）诱导的K562耐药细胞株（K562／DNR）核因子-κB（NF-κB）、抑制蛋白κB（IκB）及P-糖蛋白（P-gp）表达的影响,探讨PS-341逆转耐药的分子机制。方法　以100 μg／ml DNR单用或联合应用4 μg／L PS-341分别作用于K562／DNR 12、24及36 h,检测不同时间点各组NF-κB、IκB及P-gp表达情况,同时测定NF-κB p65活性,检测各组细胞凋亡率。结果　Western blot结果显示：与阴性对照组相比,DNR可诱导NF-κB表达上调及活性增强、IκB表达下调、P-gp表达上调;加用PS-341可显著抑制 DNR诱导的NF-κB及P-gp表达,使IκB表达增加。加用PS-341后,NF-κB活性12 h为（15.3±1.87）%[DNR组为（23.8±2.27）%],24 h为（10.2±1.69）%[DNR组为（25.4±1.98）%],36 h为（6.08±2.53）%[DNR组为（26.9±2.58）%],与相应单用DNR组相比均有明显下降,差异有统计学意义（P值均＜0.05）。DNR与PS-341联用后,细胞凋亡率12 h为（35.23±5.15）%[DNR组为（15.56±4.12）%],24 h为（40.26±6.89）%[DNR组为（17.25±2.89）%],36 h为（43.58±7.69）%[DNR组为（22.47±4.58）%],与DNR组相比,细胞凋亡率均明显增加,差异具有统计学意义（P值均＜0.05）。上述作用呈时间依赖性。结论　PS-341可减少K562／DNR细胞NF-κB的活化,降低P-gp表达,逆转细胞耐药,促进细胞凋亡。     

硒酸酯多糖通过下调mdr1/P-gp表达逆转K562/ADM细胞凋亡抑制

目的:研究硒酸酯多糖(Kappa-selenocarrageenan,KSC)对多药耐药K562/ADM细胞的诱导凋亡效应及其分子机制。方法:以白血病多药耐药细胞K562/ADM为KSC作用的靶细胞,用MTT比色法检测细胞增殖活性,形态学、DNA片段化和流式细胞术(FCM)观察细胞凋亡;RT-PCR检测mdr1基因和Caspase-3基因mRNA的表达;FCM测定P-gp蛋白表达水平和Caspase-3活性。结果:KSC显著抑制K562/ADM细胞增殖,KSC诱导后K562/ADM细胞出现典型的凋亡形态学变化、DNA片段化和亚G1期细胞群等特征性改变。KSC下调K562/ADM细胞mdr1基因表达、抑制P-gp合成,并上调caspase-3基因表达、增强caspase-3活性。结论:KSC通过下调mdr1/P-gp表达逆转K562/ADM多药耐药细胞的凋亡抑制。     

Overexpression of glucosylceramide synthase in associated with multidrug resistance of leukemia cells

Ceramide, as a second messenger, initiates one of the major signal transduction pathways in tumor apoptosis. Glucosylceramide synthase (GCS) catalyzes glycosylation of ceramide and produces glucosylceramide. Through GCS, ceramide glycosylation allows cellular escape from ceramide-induced programmed cell death. Here we investigated the expression of GCS in human leukemia cells and an association between GCS and multidrug resistance of leukemia cells. Using RT-PCR technique the level of GCS gene was detected in 65 clinical multidrug resistance/non-resistance cases with leukemia, and in K562 and K562/A02 cell lines. AlamarBlue Assay was applied to confirm the multidrug resistant of K562/A02 cells. PPMP, which is a chemical inhibitor for GCS, was used to determine the relationship between GCS and drug-resistance in K562/A02 cells. In addition, multidrug resistance gene (mdr1), Bcl-2 and Bax mRNA was also analyzed by RT-PCR. The expression of GCS and mdr1 mRNA in clinic multidrug resistance samples exhibited significantly increased compared with clinic drug sensitive group (P<0.05). There was the positive correlation both the expression of GCS and mdr1 genes in leukemia samples (P<0.01, gamma=0.7). AlamarBlue Assay showed that the K562/A02 cell line was 115-fold more resistant to adriamycin and 36-fold more resistant to vincristine compared with drug-sensitive K562 cell line. There also was significant expression difference of GCS and mdr1 genes between K562 and K562/A02 cells. Bcl-2 gene exhibited higher expressions whatever in clinic drug-resistance samples or K562/A02 cells, whereas the expressions of Bax gene were higher in drug-sensitive samples and K562 cells. PPMP increased sensitivity to adriamycin toxicity by inhibiting GCS in K562/A02 cells. Therefore, it is suggested that a high level of GCS in leukemia is possible contributed to multidrug resistance of leukemia cells. Abnormally expressions of the genes in associated with cell apoptosis might be one of the main molecular pathology mechanisms of multidrug resistance caused by GCS gene.     

干扰素和环孢霉素A 协同逆转K562/ ADM细胞对阿霉素的耐药性

  目的 观察干扰素(α-Interleron，α-IFN)和环孢霉素A(Cyclosporine A,CsA)对白血病K562/ADM细胞耐药性的协同逆转效应。方法 以多药耐药基因／P-糖蛋白(Muhidrug resistance gene／P-glycoprotein，mdrl／P-gp)超表达的K562／ADM细胞为靶细胞，MTT比色法检测药物的细胞毒效应；流式细胞仪检测细胞P-糖蛋白(P-glycoprotein，P-gp)表达水平；激光共聚焦显微镜观察细胞内阿霉素含量变化。结果 K562／ADM细胞对阿霉素呈高度耐药性，并与柔红霉素和鬼臼乙叉甙交叉耐药，但与CsA无交叉耐药。CsA和α-IFN单独或联合应用均对K562／ADM细胞的耐药性有较强的抑制效应。流式细胞仪和激光共聚焦显微镜分析发现α-IFN和CsA单独或联合均不能下调细胞mdrl/P-gp的表达，反而应激性地刺激耐药细胞P-gp的合成增加，但可抑制P-gp的功能、增加K562／ADM细胞内阿霉素的积聚。结论 α-IFN和CsA联合可协同逆转耐药白血病细胞的耐药性，其作用机制为抑制P-gp的功能而非下调mdrl／P-gp的表达水平。     

Antitumor effects of cytosine deaminase and thymidine kinase fusion suicide gene under the control of mdr1 promoter in mdr1 positive leukemia cells

The multidrug resistance (mdr) mediated by P-glycoprotein (P-gp), the mdr1 gene product, is one of the major obstacles in leukemia treatment. The present study was designed to explore a suicide gene therapy approach targeting mdr1 for reversal of P-gp-mediated mdr in the mdr positive K562/A02 cells. To study targeted killing effects of cytosine deaminase (CD)-thymidine kinase (TK) fusion suicide gene on multi-drug resistant leukemia, the CD-TK fusion suicide gene expression vector driven by mdr1 promoter was constructed and transferred into K562 and K562/A02 cells using lipofectintrade mark 2000. RT-PCR was used to demonstrate that there were CD and TK genes expression in K562/A02 cells, but not in K562 cells. MTT analysis showed that, compared with that in K562/CDTK, the survival rate of K562/A02-CDTK cells decreased and at the same time the apoptotic rate increased after treatment with GCV and 5-FC (P < 0.05). In vivo studies showed that the tumor volume in the prodrug treated K562/A02-CDTK groups was significantly less than that in the NS-control and K562-CDTK groups (P < 0.05). These findings show that the CD and TK fusion suicide gene expression driven by mdr1 promoter is effective in killing multidrug resistant K562/A02 cells.     

Reversal of P-glycoprotein-mediated multidrug resistance with small interference RNA (siRNA) in leukemia cells

The multidrug resistance (MDR) mediated by P-glycoprotein (P-gp), the MDR1 gene product, is one of the major obstacles in leukemia treatment. The present study was designed to explore a MDR1-targeted small interfering RNA (si-MDR1) approach for reversal of P-gp-mediated MDR in the MDR human leukemia cell line k562/A02. It was found that si-MDR1 significantly inhibited MDR1 expression at both mRNA and protein levels. Depletion of MDR1 by si-MDR1 correlated with the increased sensitivity of the cells to cytotoxic agents and with the enhanced intracellular retention of daunorubicin (DNR). One base-pair mutated control (si-MDR1-Mut) lost the effect of si-MDR1 on both the degradation of mdr1 mRNA and the reduction of P-gp expression. These findings indicate that siRNA specifically and efficiently interferes with the expression of mdr1 and could be used as a molecularly defined therapeutic approach for MDR in the treatment of leukemia.     

槲皮素恢复柔红霉素在白血病耐药细胞K562/ADM和HL-60/ADM中的分布

背景与目的：槲皮素是一种天然黄酮类中药成分,儿有多种生理活性,最近发现其有逆转白血病细胞耐药的作用,本研究旨在探讨槲皮素恢复柔红霉素在白血病耐药细胞的分布从而达到逆转耐药的机制：方法：通过MTT体外药敏法检测槲皮素对柔红霉素的增敏作用并确定逆转的浓度范围,作用于K562／ADM、HL-60／ADM细胞及相应敏感株K562和HL-60,借助激光共聚焦显微镜观察槲皮素怍用前后柔红霉素在亚细胞水平的分布变化：结果：20～40μmol／L槲皮素在体外能日月显提高柔红霉素对K562／ADM和HL-60／ADM的敏感性,恢复柔红霉素在亚细胞水平的分布,使其回归细胞核内,从而逆转多药耐药。结论：黄酬类中药槲皮素能够成为蒽环类药物治疗白血病中有效的化疗增敏剂。     

NF-κB信号通路的激活对白血病细胞K562／A02多药耐药的影响

 目的　研究K562细胞株及其耐药细胞株K562／A02 NF-κB活性的差异性表达,探讨白血病多药耐药（MDR）发病机制。方法　用MTT法检测K562／A02的耐药倍数,观察细胞生长的形态学变化,PI单染法检测K562／S、K562／A02细胞周期分布,并用RT-PCR 方法检测mRNA的表达、流式细胞仪检测P糖蛋白（P-gp）表达及其功能,Western blotting方法检测细胞核NF-κB p65表达,比较K562与K562／A02白血病耐药细胞株之间的差异性。结果　与K562细胞不同,耐药细胞株K562／A02细胞生长特性发生改变,呈半贴壁生长,与K562／S细胞相比,K562／A02细胞的 G0／G1期、S期比例增高,G2／M期细胞比例减低,差异有统计学意义（P＜0.05）,凋亡细胞比例差异无统计学意义（P＞0.05）,且检测到mdr1 mRNA及细胞膜P-gp表达增高以及细胞核内NF-κB p65表达明显增加。结论　NF-κB信号通路的激活即NF-κB p65细胞核内转位可能参与了白血病MDR的形成。     

P13-K抑制剂LY294002逆转P-gP介导的白血病和胃癌细胞耐药

背景与目的：磷脂酰肌醇3-激酶／蛋白激酶B[phosphatidylinositol-3-kinase（P13-K）／proteinkinaseB（Akt）,P13-K／Aktl通路是调控细胞生存的重要信号转导通路之一。本研究旨在探讨P13-K抑制剂LY294002对P-gP过表达的人类白血病K562／DNR和胃癌SGC7901／ADR细胞多药耐药性的逆转作用。方法：将细胞分为单纯药物组和LY294002预处理组,单纯药物组分别以柔红霉素（daunorubicin,DNR）、阿霉素（adriamycin,ADR）、长春新碱（vincristine,VCR）和依托泊甙（etoposide,VP-16）处理,LY294002预处理组在加药前以LY294002进行预处理。用台盼蓝拒染法及MTT法检测药物敏感性及LY294002对细胞耐药性的影响。Westernblot检测K562／DNR和SGC7901／ADR细胞中P．gP及p-Akt的表达。流式细胞术检测细胞内药物浓度。结果：2．5μmol／LLY294002预处理显著降低DNR、ADR、VCR和VP-16对K562／DNR细胞的IC50,相对逆转效率分别为72．4％、64．9％、60．4％和52．8％。此外,LY294002部分逆转SGC7901／ADR对ADR的耐药性,相对逆转效率为31．0％。LY294002预处理可部分抑制p-Akt和P-gP的表达。随着处理时间的延长．K562／DNR、SGC7901／ADR细胞内DNR、ADR的蓄积效应有增强的趋势。结论：LY294002通过抑制P13-K／Akt信号转导通路,部分逆转P-gp介导的白血病和胃癌细胞的多药耐药。     

Valproic acid inhibits proliferation and induces apoptosis in acute myeloid leukemia cells expressing P-gp and MRP1.

The multidrug resistance (MDR) phenotype, induced by the overexpression of several ABC transporters or by antiapoptotic mechanisms, has been identified as the major cause of drug resistance in the treatment of patients with acute myeloid leukemia (AML). In this study, we have shown that valproic acid (VPA) (a histone deacetylase inhibitor) can inhibit the proliferation of both P-glycoprotein (P-gp)- and MDR-associated protein 1 (MRP1)-positive and -negative cells. VPA also induced apoptosis of P-gp-positive cells. VPA induced apoptosis in K562 cells led to decrease in Flip (FLICE/caspase-8 inhibitory protein) expression with Flip cleavage, which could not be observed in HL60 cells. In HL60/MRP cell line, which proved to be resistant to apoptosis by VPA, we observed an abnormal expression of apoptotic regulatory proteins, overexpression of Bcl-2 and absence of Bax. Also, the Bcl-2 antagonist HA14-1 rapidly restored apoptosis in this cell line. Cotreatment with cytosine arabinoside induced very strong apoptosis in both K562/DOX and HL60/DNR cell lines. VPA also induced apoptosis in AML patient cells expressing P-gp and/or MRP1. Our findings show VPA as an interesting drug that should be tested in clinical trials for overcoming the MDR phenotype in AML patients.     

斑蝥酸钠逆转K562/AO2细胞多药耐药的机制初探

目的 观察斑蝥酸钠(SCA)对多药耐药的白血病细胞(K562/AO2)细胞是否有逆转作用,并初步探讨其逆转机制.方法 应用 MTT测定多柔比星(阿霉素,ADM)对K562/AO2细胞的半数抑制浓度(IC50);应用逆转录聚合酶链式反应(RT-PCR)检测K562、K562/AO2细胞表达mdr1基因水平;用流式细胞术(FCM)检测其P-gp蛋白表达的水平.结果 MTT结果显示,无毒剂量的SCA与ADM联合应用比单纯加ADM(同等剂量)对K562/AO2细胞的IC50降低了1.51倍;耐药细胞(K562/AO2)经SCA处理后mdr1基因与P-gp蛋白表达均下降(P＜0.05).结论 SCA对K562/AO2有一定的逆转作用,其机制可能与下调mdr1基因和P-gp蛋白表达有关.     

siRNA抑制K562/ADM细胞mdr1基因表达并逆转其耐药性

背景与目的：白血病耐药性是白血病治疗中的难点，RNAi技术具有特异、高效、毒性小的特点，可高效、特异地抑制特定基因的过度表达。本文研究小干扰RNA分子（siRNA）对白血病多药耐药K562／ADM细胞mdr1基因表达和耐药性的影响。方法：设计、筛选和合成针对mdr1基因的siRNAs（si—mdrl—1，si—mdr1—2），脂质体介导转染K562／ADM细胞；RT—PCR法检测mdr1 mRNA的转录；流式细胞术测定P-糖蛋白（P—gP）表达水平；MTT法检测K562／ADM细胞对多柔比星（阿霉素，ADM）的敏感性。结果：si—mdr1—1、si-mdr1-2转染24h和48h，si—mdr1—1的抑制率分别为55．5％和22．5％，而si—mdr1—2则分别为16．0％和57．6％。si—mdr1—1和si—mdr1—2作用72h时，P—gP的表达强度分别下降74％和85％。si—mdr1—1和si—mdr1—2均可提高K562／ADM细胞对多柔比星的敏感性、逆转其耐药性，逆转倍数分别为2．52倍和1．96倍。结论：siRNA可特异性地沉默mdr1基因的表达，逆转P—gP介导的白血病细胞耐药性。     

环孢菌素A逆转白血病多药耐药机制的实验研究

目的：研究环孢菌素A（CsA)持续作用7天后,K562／AO2细胞多药耐药性的变化及其变化机制,方法：细胞毒性试验采用MTTI地,细胞内柔红霉素（DNR）浓度用流式细胞术检测,多药耐药基因（mdrl)的表达水平用RT－PCR方法检测,结果：K562／AO2耐药性降低2．2倍,K562／AO2细胞内DNR浓度明显升高,mdrl表达降低,佛伯酯（TPA）可拮抗CsA升高细胞的DNR浓度的作用,结论：CsA可下调mdrl的表达和细胞内DNR浓度进而逆转MDR,其作用可能与CsA抑制蛋白激酶D（PKC）活性有关。     

环孢素A对白血病耐药细胞化疗药物敏感性的研究

目的 研究环孢素A对K562/DOX细胞多药耐药的逆转作用.方法 用流式细胞仪和MTT法观察了CsA对K562/DOX细胞P-糖蛋白的抑制作用及对阿霉素(doxorubicin,DOX)、长春新碱(vincristine,VCR)耐药的逆转作用.结果 CsA能剂量相关性地增加K562/DOX细胞内罗丹明123(rhodamine123,Rh123)的累积,明显抑制P-gp介导的Rh123外排,显著增强DOX、VCR的细胞毒作用,增加VCR诱导的细胞凋亡和G2/M期细胞百分率.结论 CsA能显著抑制P-gp的外排功能,逆转K562/DOX细胞的多药耐药性.     

硼替佐米联合伊马替尼诱导K562细胞凋亡机制的研究

目的研究硼替佐米（BOR）单独或联合伊马替尼（IM）对慢性粒细胞性白血病（CML）急变期细胞株K562凋亡的影响并探讨其可能的机制。方法不同浓度的BOR、IM处理K562细胞,于12、48、72h分别采用四甲基偶氮唑蓝比色法（MTT）检测细胞增生活性;流式细胞仪检测细胞凋亡;反转录聚合酶链反应（RT—PCR）法检测LivinmRNA的表达。结果MTT和流式细胞仪结果显示BOR单药可以抑制K562细胞增生,诱导其凋亡,并且能够增强IM对细胞的杀伤作用。RT-PCR结果显示BOR或IM可以下调LivinmRNA的表达,联合作用后,LivinmRNA的水平明显降低。结论BOR单药或联合IM可以诱导K562细胞的凋亡,其机制可能与下调LivinmRNA的表达有关,两药联合具有协同作用。     

Targeting P-glycoprotein expression and cancer cell energy metabolism: combination of metformin and 2-deoxyglucose reverses the multidrug resistance of K562/Dox cells to doxorubicin

P-glycoprotein (P-gp) is one of the major obstacles to efficiency of cancer chemotherapy. Here, we investigated whether combination of metformin and 2-deoxyglucose reverses the multidrug resistance (MDR) of K562/Dox cells and tried to elucidate the possible mechanisms. The combination of metformin and 2-deoxyglucose selectively enhanced the cytotoxicity of doxorubicin against K562/Dox cells. Metformin was not a substrate of P-gp but suppressed the elevated level of P-gp in K562/Dox cells. The downregulation of P-gp may be partly attributed to the inhibition of extracellular signal-regulated kinase pathway. The addition of 2-deoxyglucose to metformin initiated a strong metabolic stress in both K562 and K562/Dox cells. Combination of metformin and 2-deoxyglucose inhibited glucose uptake and lactate production in K562 and K562/Dox cells leading to a severe depletion in ATP and a enhanced autophagy. Above all, P-gp substrate selectively aggravated this ATP depletion effect and increased cell apoptosis in K562/Dox cells. In conclusion, metformin decreases P-gp expression in K562/Dox cells via blocking phosphorylation of extracellular signal-regulated kinase. P-gp substrate increases K562/Dox cell apoptosis via aggravating ATP depletion induced by combination of metformin and 2-deoxyglucose. Our observations highlight the importance of combination of metformin and 2-deoxyglucose in reversing multidrug resistance.     

K562多药耐药细胞系中肿瘤干细胞样细胞对伊马替尼耐药机制的初步研究

 目的 进一步阐明一些高表达P-糖蛋白（P-gp）的慢性粒细胞白血病细胞对伊马替尼耐药的机制。方法 经过对K562细胞系长期的足叶乙苷（VP16）诱导和克隆筛选,建立一株耐药细胞系K562／VP16;利用干细胞高效能将Hoechst 33342 荧光染料泵出细胞的特性,采用流式细胞术,从K562／VP16细胞系中分选出一小群细胞,即边缘细胞（SP）,称为K562／VP16 SP细胞,并初步探讨其抗伊马替尼的机制。结果 bcr／abl和abl 蛋白在K562细胞、K562／VP16 SP细胞及非K562／VP16 SP细胞（non-SP K562／VP16）中的表达水平差异无统计学意义;P-gp在K562细胞中不表达,在K562／VP16 SP及non-SP K562／VP16细胞中均高表达且表达水平一致;与non-SP K562／VP16细胞比较,K562／VP16 SP细胞对伊马替尼的耐药性更强,并且这种抗性几乎不能被多种多药耐药逆转剂逆转;另外,体内外实验显示,K562／VP16细胞的致瘤性几乎全部来源于K562／VP16 SP细胞。结论 bcr／abl基因的扩增、过度表达和多药耐药基因及其蛋白表达产物P-gp的高表达,可能不是白血病细胞产生对伊马替尼临床耐药的重要机制;白血病细胞对伊马替尼具有一定的抗性,可能与数量极少的白血病干细胞有直接的关系。因此,这类数量极少的干细胞样的肿瘤细胞应当成为有效治疗肿瘤的靶细胞。     

K562／Adm多药耐药细胞株生物学特性的进一步研究

采用流式细胞仪及逆转录－多聚酶链式反应技术对所建立的Ｋ５６２／Ａｄｍ细胞株生物学特性进一步研究。结果表明该耐药细胞对化疗药物的摄取能力明显降低，细胞跨膜糖蛋白Ｐ－１７０及编码该蛋白的ｍｄｒ－１ｍＲＮＡ具有过度表达。细胞酶学研究发现耐药细胞Ｇ６ＰＤ及６ＰＧＤ活性明显升高，尤以Ｇ６ＰＤ为著。该细胞为多药耐药性及其相关机制的研究提供一良好模型。