Abstract

Breast cancer (BC) is a malignant neoplasia with the highest incidence and mortality rates in women worldwide. Currently, therapies include surgery, radiotherapy, and chemotherapy, including targeted therapies in some cases. However, treatments are often associated with serious adverse effects. Looking for new options in BC treatment, we evaluated the therapeutic potential of cold atmospheric plasma (CAP) in two cell lines (MCF7 and HCC1806) with distinct histological features. Apoptosis seemed to be the most prevalent type of death, as corroborated by several biochemical features, including phosphatidylserine exposure, the disruption of mitochondrial membrane potential, an increase in BAX/BCL2 ratio and procaspase 3 loss. Moreover, the accumulation of cells in the G2/M phase of the cell cycle points to the loss of replication ability and decreased survival. Despite reported toxic concentrations of peroxides in culture media exposed to plasma, intracellular peroxide concentration was overall decreased accompanying a reduction in GSH levels shortly after plasma exposure in both cell lines. In HCC1806, elevated nitric oxide (NO) concentration accompanied by reduced superoxide levels suggests that these cells are capable of converting plasma-derived nitrites into NO that competes with superoxide dismutase (SOD) for superoxide to form peroxinitrite. The concomitant inhibition of the antioxidative activity of cells during CAP treatment, particularly the inhibition of cytochrome c oxidase with sodium azide, synergistically increased plasma toxicity. Thus, this in vitro research enlightens the therapeutic potential of CAP in the treatment of breast cancer, elucidating its possible mechanisms of action.

Highlights

  • Breast cancer (BC) is a heterogenous group of diseases with a high incidence rate worldwide, with 2.261.419 estimated new cases and 684.996 deaths in 2020, mostly women [1]

  • In MCF7-treated cells, this reduction in viability was followed by an increase in apoptosis, while in HCC1806-treated cells the most common type of death varied with cold atmospheric plasma (CAP) exposure time

  • Viable MCF7 cells decreased from 92.00 ± 0.84% to 72.25 ± 2.08% (p < 0.0001) after 60 s of CAP exposure and 72.88 ± 2.38% (p < 0.0001) after 120 s, while apoptosis increased

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Summary

Introduction

Breast cancer (BC) is a heterogenous group of diseases with a high incidence rate worldwide, with 2.261.419 estimated new cases and 684.996 deaths in 2020, mostly women [1] Intrinsic subtypes such as hormone-receptor-dependent (progesterone receptor (PR) and oestrogen receptor (ER)) expression), human epidermal growth factor receptor 2 (HER2) positive, and triple negative breast cancer (TNBC), which is PR, ER and HER2 negative, are clinically relevant because their therapeutic stratification depends on molecular diagnosis [2]. Poly-ADP-ribose polymerase (PARP) inhibitors are best known as a targeted treatment for BRCA1 and BRCA2 genes, and they are in clinical trials combined with chemotherapy [3,9] All these therapies are accompanied by unwanted side effects [10]. The research on new therapies is crucial, and recently, cold plasma has emerged as a novel approach for anticancer therapy with a selective potential regarding phenotypically normal cells [11,12]

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