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Ginsenoside Rg5 overcomes chemotherapeutic multidrug resistance mediated by ABCB1 transporter: in vitro and in vivo study

  • Feng, Sen-Ling (State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology) ;
  • Luo, Hai-Bin (School of Pharmaceutical Science, Sun Yat-sen University) ;
  • Cai, Liang (State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology) ;
  • Zhang, Jie (State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology) ;
  • Wang, Dan (Xiamen Ginposome Pharmaceutical Co., Ltd.) ;
  • Chen, Ying-Jiang (Xiamen Ginposome Pharmaceutical Co., Ltd.) ;
  • Zhan, Huan-Xing (Xiamen Ginposome Pharmaceutical Co., Ltd.) ;
  • Jiang, Zhi-Hong (State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology) ;
  • Xie, Ying (State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology)
  • Received : 2018.07.19
  • Accepted : 2018.10.31
  • Published : 2020.03.15

Abstract

Background: Multidrug resistance (MDR) to chemotherapy drugs remains a major challenge in clinical cancer treatment. Here we investigated whether and how ginsenoside Rg5 overcomes the MDR mediated by ABCB1 transporter in vitro and in vivo. Methods: Cytotoxicity and colon formation as well as the intracellular accumulation of ABCB1 substrates were carried out in MDR cancer cells A2780/T and A549/T for evaluating the reversal effects of Rg5. The expressions of ABCB1 and Nrf2/AKT pathway were determined by Western blotting. An A549/T cell xenograft model was established to investigate the MDR reversal activity of Rg5 in vivo. Results: Rg5 significantly reversed ABCB1-mediated MDR by increasing the intracellular accumulation of ABCB1 substrates without altering protein expression of ABCB1. Moreover, Rg5 activated ABCB1 ATPase and reduced verapamil-stimulated ATPase activity, suggesting a high affinity of Rg5 to ABCB1 binding site which was further demonstrated by molecular docking analysis. In addition, co-treatment of Rg5 and docetaxel (TXT) suppressed the expression of Nrf2 and phosphorylation of AKT, indicating that sensitizing effect of Rg5 associated with AKT/Nrf2 pathway. In nude mice bearing A549/T tumor, Rg5 and TXT treatment significantly suppressed the growth of drug-resistant tumors without increase in toxicity when compared to TXT given alone at same dose. Conclusion: Therefore, combination therapy of Rg5 and chemotherapy drugs is a strategy for the adjuvant chemotherapy, which encourages further pharmacokinetic and clinical studies.

Keywords

References

  1. Alfarouk KO, Stock C-M, Taylor S, Walsh M, Muddathir AK, Verduzco D, Bashir AHH, Mohammed OY, Elhassan GO, Harguindey S, et al. Resistance to cancer chemotherapy: failure in drug response from ADME to P-gp. Cancer Cell Int 2015;15:71. https://doi.org/10.1186/s12935-015-0221-1
  2. Baguley BC. Multidrug resistance in cancer. Methods Mol Biol 2010;596:1-14. https://doi.org/10.1007/978-1-60761-416-6_1
  3. Gillet JP, Gottesman MM. Mechanisms of multidrug resistance in cancer. Methods Mol Biol 2010;596:47-76. https://doi.org/10.1007/978-1-60761-416-6_4
  4. Coley HM. Overcoming multidrug resistance in cancer: clinical studies of pglycoprotein inhibitors. Methods Mol Biol 2010;596:341-58. https://doi.org/10.1007/978-1-60761-416-6_15
  5. Yu M, Ocana A, Tannock IF. Reversal of ATP-binding cassette drug transporter activity to modulate chemoresistance: why has it failed to provide clinical benefit? Cancer Metastasis Rev 2013 Jun;32(1-2):211-27. https://doi.org/10.1007/s10555-012-9402-8
  6. Wang J, Seebacher N, Shi H, Kan Q, Duan Z. Novel strategies to prevent the development of multidrug resistance (MDR) in cancer. Oncotarget 2017;8(48):84559-71. https://doi.org/10.18632/oncotarget.19187
  7. Ramos P, Bentires-Alj M. Mechanism-based cancer therapy: resistance to therapy, therapy for resistance. Oncogene 2015;34(28):3617-26. https://doi.org/10.1038/onc.2014.314
  8. Dinic J, Podolski-Renic A, Stankovic T, Bankovic J, Pesic M. New approaches with natural product drugs for overcoming multidrug resistance in cancer. Curr Pharmaceut Des 2015;21(38):5589-604. https://doi.org/10.2174/1381612821666151002113546
  9. Wu C-P, Ohnuma S, Ambudkar SV. Discovering natural product modulators to overcome multidrug resistance in cancer chemotherapy. Curr Pharmaceut Biotechnol 2011;12(4):609-20. https://doi.org/10.2174/138920111795163887
  10. Dennis T, Fanous M, Mousa S. Natural products for chemopreventive and adjunctive therapy in oncologic disease. Nutr Cancer 2009;61(5):587-97. https://doi.org/10.1080/01635580902825530
  11. Mir IA, Tiku AB. Chemopreventive and therapeutic potential of "naringenin," a flavanone present in citrus fruits. Nutr Cancer 2015;67(1):27-42. https://doi.org/10.1080/01635581.2015.976320
  12. Zhou S, Lim LY, Chowbay B. Herbal modulation of P-glycoprotein. Drug Metabol Rev 2004 Feb;36(1):57-104. https://doi.org/10.1081/DMR-120028427
  13. Zhang J, Zhou F, Niu F, Lu M, Wu X, Sun J, Wang G. Stereoselective regulations of P-glycoprotein by ginsenoside Rh2 epimers and the potential mechanisms from the view of pharmacokinetics. PLoS One 2012;7(4), e35768. https://doi.org/10.1371/journal.pone.0035768
  14. Zhang J, Zhou F, Wu X, Zhang X, Chen Y, Zha BS, Niu F, Lu M, Hao G, Sun Y, et al. Cellular pharmacokinetic mechanisms of adriamycin resistance and its modulation by 20(S)-ginsenoside Rh2 in MCF-7/Adr cells. Br J Pharmacol 2012 Jan;165(1):120-34. https://doi.org/10.1111/j.1476-5381.2011.01505.x
  15. Yang LQ, Wang B, Gan H, Fu ST, Zhu XX, Wu ZN, Zhan DW, Gu RL, Dou GF, Meng ZY. Enhanced oral bioavailability and anti-tumour effect of paclitaxel by 20(s)-ginsenoside Rg3 in vivo. Biopharmaceut Drug Dispos 2012 Nov;33(8):425-36. https://doi.org/10.1002/bdd.1806
  16. Bai L, Gao J, Wei F, Zhao J, Wang D, Wei J. Therapeutic potential of ginsenosides as an adjuvant treatment for diabetes. Front Pharmacol 2018;9:423. https://doi.org/10.3389/fphar.2018.00423
  17. Kim JH, Yi YS, Kim MY, Cho JY. Role of ginsenosides, the main active components of Panax ginseng, in inflammatory responses and diseases. J Ginseng Res 2017 Oct;41(4):435-43. https://doi.org/10.1016/j.jgr.2016.08.004
  18. Lawler M, Alsina D, Adams RA, Anderson AS, Brown G, Fearnhead NS, Fenwick SW, Halloran SP. Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer. Gut 2018 Jan;67(1):179-93. https://doi.org/10.1136/gutjnl-2017-315333
  19. van Tonder A, Joubert AM, Cromarty AD. Limitations of the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay when compared to three commonly used cell enumeration assays. BMC Res Notes 2015 Feb 20;8:47. https://doi.org/10.1186/s13104-015-1000-8
  20. Ma W, Feng S, Yao X, Yuan Z, Liu L, Xie Y. Nobiletin enhances the efficacy of chemotherapeutic agents in ABCB1 overexpression cancer cells. Sci Rep 2015 Dec 22;5:18789. https://doi.org/10.1038/srep18789
  21. Ashton JC. Drug combination studies and their synergy quantification using the Chou-Talalay method-letter. Cancer Res 2015 Jun 1;75(11):2400. https://doi.org/10.1158/0008-5472.CAN-14-3763
  22. Chou TC. Drug combination studies and their synergy quantification using the Chou-Talalay method. Cancer Res 2010 Jan 15;70(2):440-6. https://doi.org/10.1158/0008-5472.CAN-09-1947
  23. Yuan ZW, Li YZ, Liu ZQ, Feng SL, Zhou H, Liu CX, Liu L, Xie Y. Role of tangeretin as a potential bioavailability enhancer for silybin: pharmacokinetic and pharmacological studies. Pharmacol Res 2018 Feb;128:153-66. https://doi.org/10.1016/j.phrs.2017.09.019
  24. Coxon A, Ziegler B, Kaufman S, Xu M, Wang H, Weishuhn D, Schmidt J, Sweet H, Starnes C, Saffran D, et al. Antitumor activity of motesanib alone and in combination with cisplatin or docetaxel in multiple human nonesmall-cell lung cancer xenograft models. Mol Cancer 2012 September 19;11(1):70. https://doi.org/10.1186/1476-4598-11-70
  25. Kim SJ, Kim AK. Anti-breast cancer activity of Fine Black ginseng (Panax ginseng Meyer) and ginsenoside Rg5. J Ginseng Res 2015 Apr;39(2):125-34. https://doi.org/10.1016/j.jgr.2014.09.003
  26. Lin X, Skolnik S, Chen X, Wang J. Attenuation of intestinal absorption by major efflux transporters: quantitative tools and strategies using a Caco-2 model. Drug Metab Dispos 2011 Feb;39(2):265-74. https://doi.org/10.1124/dmd.110.034629
  27. Rozengurt E, Soares HP, Sinnet-Smith J. Suppression of feedback loops mediated by PI3K/mTOR induces multiple overactivation of compensatory pathways: an unintended consequence leading to drug resistance. Mol Cancer Ther 2014 Nov;13(11):2477-88. https://doi.org/10.1158/1535-7163.MCT-14-0330
  28. Furfaro AL, Traverso N, Domenicotti C, Piras S, Moretta L, Marinari UM, Pronzato MA, Nitti M. The Nrf2/HO-1 axis in cancer cell growth and chemoresistance. Oxidative Med Cell Longev 2016;2016, 1958174. https://doi.org/10.1155/2016/1958174
  29. Jeddi F, Soozangar N, Sadeghi MR, Somi MH, Samadi N. Contradictory roles of Nrf2/Keap1 signaling pathway in cancer prevention/promotion and chemoresistance. DNA Repair 2017 Jun;54:13-21. https://doi.org/10.1016/j.dnarep.2017.03.008
  30. McCubrey JA, Steelman LS, Chappell WH, Abrams SL, Franklin RA, Montalto G, Cervello M, Libra M, Candido S, Malaponte G, et al. Ras/Raf/MEK/ERK and PI3K/PTEN/Akt/mTOR cascade inhibitors: how mutations can result in therapy resistance and how to overcome resistance. Oncotarget 2012 Oct;3(10):1068-111. https://doi.org/10.18632/oncotarget.659
  31. Gao A-M, Ke Z-P, Wang J-N, Yang J-Y, Chen S-Y, Chen H. Apigenin sensitizes doxorubicin-resistant hepatocellular carcinoma BEL-7402/ADM cells to doxorubicin via inhibiting PI3K/Akt/Nrf2 pathway. Carcinogenesis 2013;34(8):1806-14. https://doi.org/10.1093/carcin/bgt108
  32. Roh J-L, Kim EH, Jang H, Shin D. Nrf2 inhibition reverses the resistance of cisplatin-resistant head and neck cancer cells to artesunate-induced ferroptosis. Redox Biol 2017;11:254-62. https://doi.org/10.1016/j.redox.2016.12.010
  33. Wang X-J, Sun Z, Villeneuve NF, Zhang S, Zhao F, Li Y, Chen W, Yi X, Zheng W, Wondrak GT, et al. Nrf2 enhances resistance of cancer cells to chemotherapeutic drugs, the dark side of Nrf2. Carcinogenesis 2008;29(6):1235-43. https://doi.org/10.1093/carcin/bgn095
  34. Qi W, Cooke LS, Liu X, Rimsza L, Roe DJ, Manziolli A, Persky DO, Miller TP, Mahadevan D. Aurora inhibitor MLN8237 in combination with docetaxel enhances apoptosis and anti-tumor activity in mantle cell lymphoma. Biochem Pharmacol 2011 Apr 1;81(7):881-90. https://doi.org/10.1016/j.bcp.2011.01.017
  35. Hejazi E, Nasrollahzadeh J, Fatemi R, Barzegar-Yar Mohamadi L, Saliminejad K, Amiri Z, Kimiagar M, Houshyari M, Tavakoli M, Idali F. Effects of combined soy isoflavone extract and docetaxel treatment on murine 4T1 breast tumor model. Avicenna J Med Biotechnol 2015 Jan-Mar;7(1):16-21.
  36. Li W, Yan MH, Liu Y, Liu Z, Wang Z, Chen C, Zhang J, Sun YS. Ginsenoside Rg5 ameliorates cisplatin-induced nephrotoxicity in mice through inhibition of inflammation, oxidative stress, and apoptosis. Nutrients 2016 Sep 13;8(9).
  37. Fan H, Xiao-ling S, Yaliu S, Ming-ming L, Xue F, Xian-sheng M, Li F. Comparative pharmacokinetics of ginsenoside Rg(3) and ginsenoside Rh(2) after oral administration of ginsenoside Rg(3) in normal and walker 256 tumor-bearing Rats. Phcog Mag 2016 Jan-Mar;12(45):21-4.
  38. Newman MJ, Rodarte JC, Benbatoul KD, Romano SJ, Zhang C, Krane S, Moran EJ, Uyeda RT, Dixon R, Guns ES, et al. Discovery and characterization of OC144-093, a novel inhibitor of P-glycoprotein-mediated multidrug resistance. Cancer Res 2000 Jun 01;60(11):2964-72.
  39. Dantzig AH, Shepard RL, Cao J, Law KL, Ehlhardt WJ, Baughman TM, Bumol TF, Starling JJ. Reversal of P-glycoprotein-mediated multidrug resistance by a potent cyclopropyldibenzosuberane modulator, LY335979. Cancer Res 1996 Sep 15;56(18):4171-9.
  40. Hewage SRKM, Piao MJ, Kang KA, Ryu YS, Fernando PMDJ, Oh MC, Park JE, Shilnikova K, Moon YJ, Shin DO, et al. Galangin activates the ERK/AKT-driven Nrf2 signaling pathway to increase the level of reduced glutathione in human keratinocytes. Biomol Ther 2017;25(4):427-33. https://doi.org/10.4062/biomolther.2016.112
  41. Sayin VI, LeBoeuf SE, Singh SX, Davidson SM, Biancur D, Guzelhan BS, Alvarez SW, Wu WL, Karakousi TR, Zavitsanou AM, et al. Activation of the NRF2 antioxidant program generates an imbalance in central carbon metabolism in cancer. eLife 2017;6, e28083. https://doi.org/10.7554/elife.28083
  42. Chio IIC, Jafarnejad SM, Ponz-Sarvise M, Park Y, Rivera K, Palm W, Wilson J, Sangar V, Hao Y, Ohlund D, et al. NRF2 promotes tumor maintenance by modulating mRNA translation in pancreatic cancer. Cell 2016 Aug 11;166(4):963-76. https://doi.org/10.1016/j.cell.2016.06.056
  43. No JH, Kim YB, Song YS. Targeting nrf2 signaling to combat chemoresistance. J Cancer Prevent 2014 Jun;19(2):111-7. https://doi.org/10.15430/JCP.2014.19.2.111
  44. Chen Q, Li W, Wan Y, Xia X, Wu Q, Chen Y, Lai Z, Yu C, Li W. Amplified in breast cancer 1 enhances human cholangiocarcinoma growth and chemoresistance by simultaneous activation of Akt and Nrf2 pathways. Hepatology (Baltimore, Md) 2012 Jun;55(6):1820-9. https://doi.org/10.1002/hep.25549
  45. Singh A, Wu H, Zhang P, Happel C, Ma J, Biswal S. Expression of ABCG2 (BCRP) is regulated by Nrf2 in cancer cells that confers side population and chemoresistance phenotype. Mol Cancer Ther 2010;9(8):2365-76. https://doi.org/10.1158/1535-7163.MCT-10-0108
  46. Sadeghi MR, Jeddi F, Soozangar N, Somi MH, Shirmohamadi M, Khaze V, Samadi N. Nrf2/P-glycoprotein axis is associated with clinicopathological characteristics in colorectal cancer. Biomed Pharmacother = Biomedecine & Pharmacotherapie 2018 Aug;104:458-64. https://doi.org/10.1016/j.biopha.2018.05.062
  47. Jeddi F, Soozangar N, Sadeghi MR, Somi MH, Shirmohamadi M, Eftekhar- Sadat AT, Samadi N. Nrf2 overexpression is associated with P-glycoprotein upregulation in gastric cancer. Biomed Pharmacother = Biomedecine & Pharmacotherapie 2018 Jan;97:286-92. https://doi.org/10.1016/j.biopha.2017.10.129

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