Abstract
BackgroundThe use of temozolomide (TMZ) has improved the prognosis for glioblastoma multiforme patients. However, TMZ resistance may be one of the main reasons why treatment fails. Although this resistance has frequently been linked to the expression of O6-methylguanine-DNA methyltransferase (MGMT) it seems that this enzyme is not the only molecular mechanism that may account for the appearance of drug resistance in glioblastoma multiforme patients as the mismatch repair (MMR) complex, P-glycoprotein, and/or the presence of cancer stem cells may also be implicated.MethodsFour nervous system tumor cell lines were used to analyze the modulation of MGMT expression and MGMT promoter methylation by TMZ treatment. Furthermore, 5-aza-2’-deoxycytidine was used to demethylate the MGMT promoter and O(6)-benzylguanine to block GMT activity. In addition, MMR complex and P-glycoprotein expression were studied before and after TMZ exposure and correlated with MGMT expression. Finally, the effect of TMZ exposure on CD133 expression was analyzed.ResultsOur results showed two clearly differentiated groups of tumor cells characterized by low (A172 and LN229) and high (SF268 and SK-N-SH) basal MGMT expression. Interestingly, cell lines with no MGMT expression and low TMZ IC50 showed a high MMR complex expression, whereas cell lines with high MGMT expression and high TMZ IC50 did not express the MMR complex. In addition, modulation of MGMT expression in A172 and LN229 cell lines was accompanied by a significant increase in the TMZ IC50, whereas no differences were observed in SF268 and SK-N-SH cell lines. In contrast, P-glycoprotein and CD133 was found to be unrelated to TMZ resistance in these cell lines.ConclusionsThese results may be relevant in understanding the phenomenon of TMZ resistance, especially in glioblastoma multiforme patients laking MGMT expression, and may also aid in the design of new therapeutic strategies to improve the efficacy of TMZ in glioblastoma multiforme patients.
Highlights
Glioblastoma multiforme (GBM), the most common astrocytic tumor, representing about 65% of all adult nervous system tumors, is characterized by a high aggressiveness, with an average survival period of less than 15 months [1,2,3,4]
Our results showed two clearly differentiated groups of tumor cells characterized by low (A172 and LN229) and high (SF268 and SK-N-SH) basal methylguanineDNA methyltransferase (MGMT) expression
P-glycoprotein and CD133 was found to be unrelated to TMZ resistance in these cell lines
Summary
Glioblastoma multiforme (GBM), the most common astrocytic tumor, representing about 65% of all adult nervous system tumors, is characterized by a high aggressiveness, with an average survival period of less than 15 months [1,2,3,4]. Current treatment options, including surgery, radiation therapy, and chemotherapy [2], shows a limited response due to blood-brain barrier (BBB) protection, the absence of a lymphatic drainage system, and development of drug resistance [5]. In this context, a better understanding of GBM resistance mechanisms may lead to the development of new therapeutic strategies. TMZ resistance may be one of the main reasons why treatment fails This resistance has frequently been linked to the expression of O6-methylguanineDNA methyltransferase (MGMT) it seems that this enzyme is not the only molecular mechanism that may account for the appearance of drug resistance in glioblastoma multiforme patients as the mismatch repair (MMR) complex, P-glycoprotein, and/or the presence of cancer stem cells may be implicated
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