Abstract

Oral cancer (OC) is a serious health problem. Surgery is the best method to treat the disease but might reduce the quality of life of patients. Photodynamic therapy (PDT) may enhance quality of life but with some limitations. Therefore, the development of a new strategy to facilitate PDT effectiveness has become crucial. ATP-binding cassette G2 (ABCG2) is a membrane protein-associated drug resistance and stemness in cancers. Here, we examined whether ABCG2 plays an important role in regulating the treatment efficacy of PDT and whether ABCG2 inhibition by natural compounds can promote the effect of PDT in OC cells. Several head and neck cancer cells were utilized in this study. OECM1 and SAS cells were selected to investigate the relationship between ABCG2 expression and protoporphyrin IX (PpIX) accumulation. Western blot analysis, flow cytometry analysis, and survival probability were performed to determine PDT efficacy and cellular stemness upon treatment of different dietary compounds, including epigallocatechin gallate (EGCG) and curcumin. In this study, we found that ABCG2 expression varied in OC cells. Hypoglycemic culture for SAS cells enhanced ABCG2 expression as higher ABCG2 expression was associated with lower PpIX accumulation and cellular stemness in OC cells. In contrast, suppression of ABCG2 expression by curcumin and tea polyphenol EGCG led to greater PpIX accumulation and enhanced PDT treatment efficiency in OC cells. In conclusion, ABCG2 plays an important role in regulating the effect of PDT. Change in glucose concentration and treatment with natural compounds modulated ABCG2 expression, resulting in altered PDT efficacy for OC cells. These modulations raise a potential new treatment strategy for early-stage OCs.

Highlights

  • Oral cancer (OC) is the sixth most prevalent cancer in the world [1]

  • protoporphyrin IX (PpIX) accumulation was lower in SAS cells cultured in low glucose condition in a time-course manner (Figure 1D), suggesting a potential association between ATP-binding cassette G2 (ABCG2) expression and intracellular PpIX levels in OC cells

  • The results showed that gefitinib, an EGFR inhibitor, curcumin, and tea polyphenol epigallocatechin gallate (EGCG) significantly inhibited ABCG2 levels compared with the untreated group

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Summary

Introduction

Oral cancer (OC) is the sixth most prevalent cancer in the world [1]. The optimal treatment of oral cancer is radical surgery, which is combined with radiotherapy and/or chemotherapy in advanced cancer. Photodynamic therapy (PDT) is new for head and neck cancer (HNC) [2,3,4]. Successful outcomes were reached by 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for treatment of variant oral potentially malignant disorders [5,6,7,8,9,10,11] and oral cancer [12]. While topical ALA application showed a beneficial effect for treatment of oral mucosa lesions, the molecular cues to determine the treatment effect of ALA-PDT in oral premalignant or malignant lesions remains unknown

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