高三尖杉酯碱白血病多药耐药细胞系K562/HHT的诱导及米非司酮逆转耐药的研究

目的: 研究高三尖杉酯碱（HHT）诱导的白血病多药耐药细胞株耐药机制以及米非司酮(RU486)逆转其耐药效应。方法：采用反复短期暴露并逐渐增加HHT浓度的方法建立白血病多药耐药细胞系K562/HHT，MTT法检测K562/HHT细胞对化疗药物的敏感性及RU486对该细胞的细胞毒效应，RT-PCR法检测细胞MDR1基因、葡萄糖神经酰胺合成酶（GCS）基因的表达，流式细胞术检测细胞P-糖蛋白的表达和柔红霉素积累量，免疫组化法检测细胞Bcl-2、Bax、caspase-3的表达状况。结果： 成功诱导出多药耐药细胞系K562/HHT，K562/HHT较其亲代细胞K562对HHT、阿霉素、长春新碱、依托泊苷的耐药性分别提高462.6、2.8、1 183.4、2.6倍，K562/HHT细胞MDR1基因、GCS基因、P-糖蛋白和Bcl-2/Bax比值明显高于K562细胞（P<0.05），caspase-3表达、柔红霉素积累量明显低于K562细胞（P<0.05）。10 μmol/L的RU486对K562/HHT细胞无明显杀伤（存活率94.67%±2.48%），该浓度RU486可不同程度地逆转K562/HHT细胞对上述化疗药物的耐药性，RU486作用后K562/HHT细胞caspase-3表达、柔红霉素积累量明显高于作用前（P<0.05），Bcl-2/Bax比值明显低于作用前（P<0.05）。结论： 白血病细胞系K562在HHT的作用下可形成多药耐药细胞系K562/HHT，其耐药性的形成与P-糖蛋白、GCS、Bcl-2/Bax比值及caspase-3等机制有关，RU486可通过提高细胞内药物积累、调节Bcl-2/Bax比值和caspase-3的表达逆转此细胞的耐药性。

Study of establishment of K562/HHT cell line and reversal of multidrug resistance by antiprogestin drug mifepristone

AIM: To study the mechanism of multidrug resistance (MDR) of leukemia cells induced by homoharringtonine (HHT) and the reversal effect of mifepristone on MDR.METHODS: Human leukemia cell line K562 was induced into MDR cell line by intermittent administration of high dose of HHT.MTT assay was used to detect the sensitivity of these MDR cells to all sorts of chemotherapeutic agents with or without mifepristone.The cytotoxicity of mifepristone was also observed.RT-PCR was used to detect the expression of MDR1 gene and glucosylceramide synthase (GCS) gene.Flow cytometry was used to detect the expression of P-glucoprotein and the accumulative value of intracellular daunorubicin (DNR) in these MDR cells with or without mifepristone.Immunohistochemistry was used to detect the expression of Bcl-2,Bax and caspase-3 in these MDR cells with or without mifepristone.RESULTS: MDR cell line K562/HHT was acquired after induced by HHT for 2 months.This MDR cell line possessed the ability of 462.6 fold resistance to HHT and cross-resistance to adriamycin,vincristine and etoposide.The expression of MDR1 gene,GCS gene,P-glucoprotein and Bcl-2/Bax ratio in K562/HHT cells were significantly higher than those in K562 cells (P<0.05).The caspase-3 expression and the accumulative value of intracellular DNR in K562/HHT cells were significantly lower than those in K562 cells (P<0.05).10 μmol/L mifepristone reversed the resistance of K562/HHT cells to HHT,adriamycin,vincristine and etoposide at different levels.The Bcl-2/Bax ratio,caspase-3 expression and accumulative value of intracellular DNR in K562/HHT cells treated with RU486 were significantly different compared with K562/HHT cells without RU486 treatment (P<0.05).CONCLUSIONS: Leukemia cell line K562 can be induced into MDR cell line K562/HHT by HHT.P-glucoprotein,GCS,Bcl-2/Bax ratio and caspase-3 may play an important role in K562/HHT cells.Mifepristone can reverse MDR in K562/HHT cells by decreasing the accumulative value of intracellular drug and regulating the expression of Bcl-2,Bax and caspase-3.