Abstract

Conventional adjuvant chemotherapies for bladder transitional cell carcinomas (TCCs) may cause strong systemic toxicity and local irritation. Non-toxic resveratrol inhibits TCC cell growth but its feasibility in clinical management of TCCs remains obscure. This study aimed to evaluate the safety and anti-TCC efficacy of resveratrol, using the experimental models closer to the clinical treatment condition. Human TCC EJ cells were exposed to 100 ยตM, 150 ยตM and 200 ยตM resveratrol respectively for 1 hour and 2 hours to mimic intravesical drug instillation and the cell responses were analyzed by multiple experimental approaches. An orthotopic TCC nude mouse model was established by injecting EJ cells into the sub-urothelial layer and used for short-term intravesical resveratrol instillation. The safety of resveratrol instillation was evaluated and compared with that of MCC. The results revealed that 2 h 150 ยตM or 200 ยตM resveratrol treatment leaded to remarkable S phase arrest and apoptosis at 72 h time-point, accompanied with attenuated phosphorylation, nuclear translocation and transcription of STAT3, down-regulation of STAT3 downstream genes (survivin, cyclinD1, c-Myc and VEGF) and nuclear translocations of Sirt1 and p53. The importance of STAT3 signaling in cell growth was confirmed by treating EJ cells with JAK2 inhibitor tyrphostin AG490. The efficacy and safety of resveratrol instillation were proved by the findings from nude mouse orthotopic xenograft models, because this treatment caused growth suppression, distinctive apoptosis and STAT3 inactivation of the transplanted tumors without affecting normal urothelium. Our results thus suggest for the first time the practical values of resveratrol as a safe and effective agent in the post-operative treatment of TCCs.

Highlights

  • Bladder cancer is the commonest malignancy of the urinary tract, of which 90% is transitional cell carcinoma (TCC)

  • Since resveratrol is non-toxic [5] and exerts inhibitory effects on TCC cells [9,10,11,12], it would be an alternative candidate for the management of TCCs if its anti-TCC capacity can be further proved under the experimental conditions closer to the clinical statuses

  • To mimic intravesical drug instillation, the cultured EJ TCC cells were treated with 100 mM, 150 mM or 200 mM resveratrol transiently instead of constantly

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Summary

Introduction

Bladder cancer is the commonest malignancy of the urinary tract, of which 90% is transitional cell carcinoma (TCC). Transurethral resection followed by intravesical chemotherapy is the standard care of TCC patients [1]. Recurrence is the leading risk of TCC patients because of the difficulty to radically remove the aggressive tumors [2]. Adjuvant intravesical chemotherapies become the major approaches to prevent TCC relapse. Bacillus Calmette-Guerin, interferon-a, cisplatin, mitomycin C (MMC) and their combinations are conventionally used in clinical practice, while their efficacies are variable [3,4] and usually cause strong systemic toxicity and local complications such as hemorrhagic cystitis [2].

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