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Published in: Cancer Cell International 1/2020

01-12-2020 | Lung Cancer | Primary research

Fuzheng Kang-Ai decoction enhances the effect of Gefitinib-induced cell apoptosis in lung cancer through mitochondrial pathway

Authors: Sumei Wang, Zhiwei Peng, Wenjuan Li, Shunqin Long, Shujing Xiao, Wanyin Wu

Published in: Cancer Cell International | Issue 1/2020

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Abstract

Background

Our previous clinical study has shown that Chinese herbal medicine (CHM) Fuzheng Kang-Ai (FZKA) decoction is effective in treating advanced lung cancer patients through prolonging the drug resistance to Gefitinib (GFTN). Our basic study found that FZKA decoction could enhance the inhibition effect of GFTN in lung cancer by inactivating PI3K/Akt pathway. Moreover, our recent work showed that FZKA induced lung cancer cell apoptosis via STAT3/Bcl-2/Caspase-3 pathway. Thus in this study, we aim to elucidate how FZKA enhances the effect of GFTN in lung cancer from the perspective of cell apoptosis.

Methods

Cell proliferation and colony formation assay were performed to detect the cell growth inhibition. Flow cytometry and TUNEL assay were carried out to test the cell apoptosis. Mitochondrial membrane potential (MMP) assay was done to measure the alteration of MMP. Caspase-3/-9 activity assay was used to test the activity of caspase-3/-9. Western blot and qRT-PCR were done to detect the expression of STAT3 and Bcl-2 family as well as Caspase-3/-9 and Cyt-C at protein and mRNA levels, respectively. Transient transfection was performed to silence STAT3 using siSTAT3. Animal model was done to validate the molecular mechanisms in vivo and immunohistochemistry was done to detect the expression of Bax and Caspase-3.

Results

Firstly, our results showed that FZKA enhanced the inhibition effect of GFTN in lung cancer both in vitro and in vivo. Secondly, cell apoptosis was enhanced when treating lung cancer cells with both FZKA and GFTN, a process involving the mitochondria and the Bcl-2 family. And Bcl-2 family was involved in this process. Interestingly, STAT3 plays a critical role on mediating the above process. Last but not the least, the enhanced effect of cell apoptosis induction of GFTN by FZKA was validated in animal model.

Conclusion

Our findings conclude that Fuzheng Kang-Ai decoction enhances the effect of GFTN-induced cell apoptosis in lung cancer through the mitochondrial pathway, providing a novel molecular mechanism by which FZKA sensitizes to GFTN by delaying drug resistance in treating lung cancer patients.
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Literature
1.
go back to reference Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30.CrossRef Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30.CrossRef
2.
go back to reference Hong QY, Wu GM, Qian GS, Hu CP, Zhou JY, Chen LA, Li WM, Li SY, Wang K, Wang Q, et al. Prevention and management of lung cancer in China. Cancer. 2015;121(Suppl 17):3080–8.CrossRef Hong QY, Wu GM, Qian GS, Hu CP, Zhou JY, Chen LA, Li WM, Li SY, Wang K, Wang Q, et al. Prevention and management of lung cancer in China. Cancer. 2015;121(Suppl 17):3080–8.CrossRef
3.
go back to reference Rawluk J, Waller CF. Gefitinib. Recent results in cancer research Fortschritte der Krebsforschung Progres dans les recherches sur le cancer. 2018;211:235–46.PubMed Rawluk J, Waller CF. Gefitinib. Recent results in cancer research Fortschritte der Krebsforschung Progres dans les recherches sur le cancer. 2018;211:235–46.PubMed
4.
go back to reference Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, Sunpaweravong P, Han B, Margono B, Ichinose Y, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361(10):947–57.CrossRef Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, Sunpaweravong P, Han B, Margono B, Ichinose Y, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361(10):947–57.CrossRef
5.
go back to reference Kobayashi S, Boggon TJ, Dayaram T, Janne PA, Kocher O, Meyerson M, Johnson BE, Eck MJ, Tenen DG, Halmos B. EGFR mutation and resistance of non-small-cell lung cancer to gefitinib. N Engl J Med. 2005;352(8):786–92.CrossRef Kobayashi S, Boggon TJ, Dayaram T, Janne PA, Kocher O, Meyerson M, Johnson BE, Eck MJ, Tenen DG, Halmos B. EGFR mutation and resistance of non-small-cell lung cancer to gefitinib. N Engl J Med. 2005;352(8):786–92.CrossRef
6.
go back to reference Han Y, Wang H, Xu W, Cao B, Han L, Jia L, Xu Y, Zhang Q, Wang X, Zhang G, et al. Chinese herbal medicine as maintenance therapy for improving the quality of life for advanced non-small cell lung cancer patients. Complement Ther Med. 2016;24:81–9.CrossRef Han Y, Wang H, Xu W, Cao B, Han L, Jia L, Xu Y, Zhang Q, Wang X, Zhang G, et al. Chinese herbal medicine as maintenance therapy for improving the quality of life for advanced non-small cell lung cancer patients. Complement Ther Med. 2016;24:81–9.CrossRef
7.
go back to reference Yang XB, Wu WY, Long SQ, Deng H, Pan ZQ, He WF, Zhou YS, Liao GY, Li QP, Xiao SJ, et al. Fuzheng Kang’ai decoction combined with gefitinib in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutations: study protocol for a randomized controlled trial. Trials. 2015;16:146.CrossRef Yang XB, Wu WY, Long SQ, Deng H, Pan ZQ, He WF, Zhou YS, Liao GY, Li QP, Xiao SJ, et al. Fuzheng Kang’ai decoction combined with gefitinib in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutations: study protocol for a randomized controlled trial. Trials. 2015;16:146.CrossRef
8.
go back to reference Yang XB, Chai XS, Wu WY, Long SQ, Deng H, Pan ZQ, He WF, Zhou YS, Liao GY, Xiao SJ. Gefitinib plus Fuzheng Kang’ai Formula () in patients with advanced non-small cell lung cancer with epidermal growth factor receptor mutation: a randomized controlled trial. Chin J Integr Med. 2018;24(10):734–40.CrossRef Yang XB, Chai XS, Wu WY, Long SQ, Deng H, Pan ZQ, He WF, Zhou YS, Liao GY, Xiao SJ. Gefitinib plus Fuzheng Kang’ai Formula () in patients with advanced non-small cell lung cancer with epidermal growth factor receptor mutation: a randomized controlled trial. Chin J Integr Med. 2018;24(10):734–40.CrossRef
9.
go back to reference Wu WY, Yang XB, Deng H, Long SQ, Sun LS, He WF, Zhou YS, Liao GY, Chan SM, Shan SP. Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine. Chin J Integr Med. 2010;16(5):406–10.CrossRef Wu WY, Yang XB, Deng H, Long SQ, Sun LS, He WF, Zhou YS, Liao GY, Chan SM, Shan SP. Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine. Chin J Integr Med. 2010;16(5):406–10.CrossRef
10.
go back to reference Yang XB, Wu WY, Long SQ, Deng H, Pan ZQ. Effect of gefitinib plus Chinese herbal medicine (CHM) in patients with advanced non-small-cell lung cancer: a retrospective case-control study. Complement Ther Med. 2014;22(6):1010–8.CrossRef Yang XB, Wu WY, Long SQ, Deng H, Pan ZQ. Effect of gefitinib plus Chinese herbal medicine (CHM) in patients with advanced non-small-cell lung cancer: a retrospective case-control study. Complement Ther Med. 2014;22(6):1010–8.CrossRef
11.
go back to reference Zheng F, Wu J, Li X, Tang Q, Yang L, Yang X, Wu W, Hann SS. Chinese herbal medicine Fuzheng Kang-Ai decoction inhibited lung cancer cell growth through AMPKalpha-mediated induction and interplay of IGFBP1 and FOXO3a. Evid Based Complement Altern Med eCAM. 2016;2016:5060757. Zheng F, Wu J, Li X, Tang Q, Yang L, Yang X, Wu W, Hann SS. Chinese herbal medicine Fuzheng Kang-Ai decoction inhibited lung cancer cell growth through AMPKalpha-mediated induction and interplay of IGFBP1 and FOXO3a. Evid Based Complement Altern Med eCAM. 2016;2016:5060757.
12.
go back to reference Li L, Wang S, Zheng F, Wu W, Hann SS. Chinese herbal medicine Fuzheng Kang-Ai decoction sensitized the effect of gefitinib on inhibition of human lung cancer cells through inactivating PI3-K/Akt-mediated suppressing MUC1 expression. J Ethnopharmacol. 2016;194:918–29.CrossRef Li L, Wang S, Zheng F, Wu W, Hann SS. Chinese herbal medicine Fuzheng Kang-Ai decoction sensitized the effect of gefitinib on inhibition of human lung cancer cells through inactivating PI3-K/Akt-mediated suppressing MUC1 expression. J Ethnopharmacol. 2016;194:918–29.CrossRef
13.
go back to reference Wang S, Long S, Xiao S, Wu W, Hann SS. Decoction of chinese herbal medicine Fuzheng Kang-Ai induces lung cancer cell apoptosis via STAT3/Bcl-2/Caspase-3 pathway. Evid Based Complement Altern Med eCAM. 2018;2018:8567905. Wang S, Long S, Xiao S, Wu W, Hann SS. Decoction of chinese herbal medicine Fuzheng Kang-Ai induces lung cancer cell apoptosis via STAT3/Bcl-2/Caspase-3 pathway. Evid Based Complement Altern Med eCAM. 2018;2018:8567905.
14.
go back to reference McCarty KS Jr, Szabo E, Flowers JL, Cox EB, Leight GS, Miller L, Konrath J, Soper JT, Budwit DA, Creasman WT, et al. Use of a monoclonal anti-estrogen receptor antibody in the immunohistochemical evaluation of human tumors. Cancer Res. 1986;46(8 Suppl):4244s–8s.PubMed McCarty KS Jr, Szabo E, Flowers JL, Cox EB, Leight GS, Miller L, Konrath J, Soper JT, Budwit DA, Creasman WT, et al. Use of a monoclonal anti-estrogen receptor antibody in the immunohistochemical evaluation of human tumors. Cancer Res. 1986;46(8 Suppl):4244s–8s.PubMed
15.
go back to reference Cotter TG. Apoptosis and cancer: the genesis of a research field. Nat Rev Cancer. 2009;9(7):501–7.CrossRef Cotter TG. Apoptosis and cancer: the genesis of a research field. Nat Rev Cancer. 2009;9(7):501–7.CrossRef
16.
go back to reference Shen SJ, Zhang YH, Gu XX, Jiang SJ, Xu LJ. Yangfei Kongliu Formula, a compound Chinese herbal medicine, combined with cisplatin, inhibits growth of lung cancer cells through transforming growth factor-beta1 signaling pathway. J Integr Med. 2017;15(3):242–51.CrossRef Shen SJ, Zhang YH, Gu XX, Jiang SJ, Xu LJ. Yangfei Kongliu Formula, a compound Chinese herbal medicine, combined with cisplatin, inhibits growth of lung cancer cells through transforming growth factor-beta1 signaling pathway. J Integr Med. 2017;15(3):242–51.CrossRef
17.
go back to reference Mondal J, Samadder A, Khuda-Bukhsh AR. Psorinum 6 x triggers apoptosis signals in human lung cancer cells. J Integr Med. 2016;14(2):143–53.CrossRef Mondal J, Samadder A, Khuda-Bukhsh AR. Psorinum 6 x triggers apoptosis signals in human lung cancer cells. J Integr Med. 2016;14(2):143–53.CrossRef
18.
go back to reference Chi X, Kale J, Leber B, Andrews DW. Regulating cell death at, on, and in membranes. Biochem Biophys Acta. 2014;1843(9):2100–13.CrossRef Chi X, Kale J, Leber B, Andrews DW. Regulating cell death at, on, and in membranes. Biochem Biophys Acta. 2014;1843(9):2100–13.CrossRef
19.
go back to reference Fulda S. Targeting apoptosis for anticancer therapy. Semin Cancer Biol. 2015;31:84–8.CrossRef Fulda S. Targeting apoptosis for anticancer therapy. Semin Cancer Biol. 2015;31:84–8.CrossRef
20.
go back to reference Tait SW, Green DR. Mitochondrial regulation of cell death. Cold Spring Harbor Perspect Biol. 2013;5(9):a008706.CrossRef Tait SW, Green DR. Mitochondrial regulation of cell death. Cold Spring Harbor Perspect Biol. 2013;5(9):a008706.CrossRef
21.
go back to reference Frenzel A, Grespi F, Chmelewskij W, Villunger A. Bcl2 family proteins in carcinogenesis and the treatment of cancer. Apoptosis Int J Program Cell Death. 2009;14(4):584–96.CrossRef Frenzel A, Grespi F, Chmelewskij W, Villunger A. Bcl2 family proteins in carcinogenesis and the treatment of cancer. Apoptosis Int J Program Cell Death. 2009;14(4):584–96.CrossRef
22.
go back to reference Ly JD, Grubb DR, Lawen A. The mitochondrial membrane potential (deltapsi(m)) in apoptosis; an update. Apoptosis Int J Program Cell Death. 2003;8(2):115–28.CrossRef Ly JD, Grubb DR, Lawen A. The mitochondrial membrane potential (deltapsi(m)) in apoptosis; an update. Apoptosis Int J Program Cell Death. 2003;8(2):115–28.CrossRef
23.
go back to reference Green DR, Reed JC. Mitochondria and apoptosis. Science. 1998;281(5381):1309–12.CrossRef Green DR, Reed JC. Mitochondria and apoptosis. Science. 1998;281(5381):1309–12.CrossRef
24.
go back to reference Zou W, Niu C, Fu Z, Gong C. PNS-R1 inhibits Dex-induced bronchial epithelial cells apoptosis in asthma through mitochondrial apoptotic pathway. Cell Biosci. 2019;9:18.CrossRef Zou W, Niu C, Fu Z, Gong C. PNS-R1 inhibits Dex-induced bronchial epithelial cells apoptosis in asthma through mitochondrial apoptotic pathway. Cell Biosci. 2019;9:18.CrossRef
25.
go back to reference Grivennikov SI, Karin M. Dangerous liaisons: STAT3 and NF-kappaB collaboration and crosstalk in cancer. Cytokine Growth Factor Rev. 2010;21(1):11–9.CrossRef Grivennikov SI, Karin M. Dangerous liaisons: STAT3 and NF-kappaB collaboration and crosstalk in cancer. Cytokine Growth Factor Rev. 2010;21(1):11–9.CrossRef
26.
go back to reference Hart JR, Liao L, Yates JR 3rd, Vogt PK. Essential role of Stat3 in PI3K-induced oncogenic transformation. Proc Natl Acad Sci USA. 2011;108(32):13247–52.CrossRef Hart JR, Liao L, Yates JR 3rd, Vogt PK. Essential role of Stat3 in PI3K-induced oncogenic transformation. Proc Natl Acad Sci USA. 2011;108(32):13247–52.CrossRef
27.
go back to reference Wang Y, Wu C, Zhang C, Li Z, Zhu T, Chen J, Ren Y, Wang X, Zhang L, Zhou X. TGF-beta-induced STAT3 overexpression promotes human head and neck squamous cell carcinoma invasion and metastasis through malat1/miR-30a interactions. Cancer Lett. 2018;436:52–62.CrossRef Wang Y, Wu C, Zhang C, Li Z, Zhu T, Chen J, Ren Y, Wang X, Zhang L, Zhou X. TGF-beta-induced STAT3 overexpression promotes human head and neck squamous cell carcinoma invasion and metastasis through malat1/miR-30a interactions. Cancer Lett. 2018;436:52–62.CrossRef
Metadata
Title
Fuzheng Kang-Ai decoction enhances the effect of Gefitinib-induced cell apoptosis in lung cancer through mitochondrial pathway
Authors
Sumei Wang
Zhiwei Peng
Wenjuan Li
Shunqin Long
Shujing Xiao
Wanyin Wu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Cancer Cell International / Issue 1/2020
Electronic ISSN: 1475-2867
DOI
https://doi.org/10.1186/s12935-020-01270-3

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