Abstract

Chemoresistance in cancer therapy is an unfavorable prognostic factor in non-small cell lung cancer (NSCLC). Elevation of intracellular calcium level in multidrug resistant (MDR) sublines leads to sensitization of MDR sublines to cell death. We demonstrated that a fungal protein from Ganoderma microsporum, GMI, elevates the intracellular calcium level and reduces the growth of MDR subline via autophagy and apoptosis, regardless of p-glycoprotein (P-gp) overexpression, in mice xenograft tumors. In addition, we examined the roles of autophagy in the death of MDR A549 lung cancer sublines by GMI, thapsigargin (TG) and tunicamycin (TM) in vitro. Cytotoxicity of TG was inhibited by overexpressed P-gp. However, TM-induced death of MDR sublines was independent of P-gp level. Combinations of TG and TM with either docetaxel or vincristine showed no additional cytotoxic effects on MDR sublines. TG- and TM-mediated apoptosis of MDR sublines was demonstrated on Annexin-V assay and Western blot and repressed by pan-caspase inhibitor (Z-VAD-FMK). Treatment of MDR sublines with TG and TM also augmented autophagy with accumulation of LC3-II proteins, breakdown of p62 and formation of acidic vesicular organelles (AVOs). Inhibition of ATG5 by shRNA silencing significantly reduced autophagy and cell death but not apoptosis following TG or TM treatment. GMI treatment inhibited the phosphorylation of Akt/S473 and p70S6K/T389. Interestingly, the phosphorylation of ERK was not associated with GMI-induced autophagy. We conclude that autophagy plays a pro-death role in acquired MDR and upregulation of autophagy by GMI via Akt/mTOR inhibition provides a potential strategy for overcoming MDR in the treatment of lung cancers.

Highlights

  • Lung cancer is the most common malignancy among men and women

  • We have shown that multidrug resistant (MDR) of A549/D16 subline is mediated by ABC transporters and MDR of A549/V16 subline is mediated by non-ABC transporter-associated factors [8]

  • We hypothesized that the mechanism of the L-type calcium channel blockers in reversing tubulin binding agents (TBA) sensitivity of drug resistant cells is associated with the alteration of intracellular calcium homeostasis

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Summary

Introduction

Lung cancer is the most common malignancy among men and women. Chemotherapy is the suggested treatment for advanced non-small cell lung cancer (NSCLC), most patients develop cross-resistance to a diversity of chemotherapeutic drugs (multiple drug resistance, MDR) [1]. P-glycoprotein (P-gp), the product of the human MDR-1 gene, is a member of the large ATP-binding cassette family of membrane proteins [2]. P-gp, if overexpressed in cancer cells, can pump anticancer drugs out of the cells. Novel drugs and strategies are needed to overcome MDR to obtain better prognoses. To improve the efficacy of chemotherapy, use of Chinese herbal medicines as MDR reversing agents [3], MDR modulators of ATP-binding cassette transporters [4] and nanomedical solutions for circumventing MDR has been discussed extensively [5]

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