Microarray experiments were focussed on a TRD concentration of 250 μM. We have recently shown in a study analysing TRD effects by FACS analysis in five cell lines identical with the current study (HT29, Chang Liver, HT1080, AsPC-1 and BxPC-3) that TRD inhibits cell viability over a broad range of concentrations (100 μM, 250 μM and 1000 μM) [
26]. In the latter study, TRD 250 μM was the lowest concentration that significantly inhibited cell viability in all cell lines [
26]. This fact is now supported by the current study, since TRD 250 μM significantly induced apoptotic cell death in our experiments - as measured by FACS analysis (figure
2+
3). Furthermore, TRD 250 μM was the lowest concentration that significantly inhibited proliferation in all cell lines as measured by BrdU assay (figure
1). The effectiveness of TRD 250 μM as powerful anti-neoplastic concentration in cell culture experiments is consistent with several studies that evaluated the anti-proliferative and cell death inducing activity of TRD over a broad range of concentrations (50 μM - 2000 μM) in different cell lines using proliferation assays [
37,
38,
11,
39,
10,
16] or quantitative FACS analysis [
16,
14,
13,
11]. As indicated in figure
1 and
2, our results showed quite distinct and cell line specific differences in susceptibility towards TRD induced cell death. One can only speculate about the differences in the anti-neoplastic activity of TRD. However, none of the cell lines tested in our study was resistent to TRD induced cell death.
Using cRNA Microarray assay combined with
Ingenuity pathways analysis we identified several TRD regulated genes that might represent potential target genes for TRD in malignant cells. Among the 21 genes with ≥ 4 fold expressional change (table
1), we focussed in our validation experiments on 5 genes, that represent - in our eyes - genes of special interest: the transcription factors (TFs) EGR1 and ATF3, the ER-stress response gene PPP1R15A, the pro-apoptotic mitochondrial protein PMAIP1 and the E3 ubiquitin ligase TRAF6. EGR1 (early growth response 1) representing the gene exhibiting the strongest induction upon TRD treatment was confirmed by qRT-PCR. EGR1 belongs to the EGR zinc-finger family of TFs [
29] which can provide anti-neoplastic activity in numerous tumour cell lines by inducing tumour suppressors like PTEN, TGFβ1, p53, fibronectin or ATF3 [
40,
30,
41]. Furthermore, several anti-neoplastic or chemopreventive agents have recently been shown to target EGR1 expression and EGR1 driven pathways in colorectal cancer [
42‐
44]. Furthermore, our microarray analyses revealed a strong up-regulation of the pro-apoptotic transcription factor ATF3 (table
1), whereas other EGR1 target genes with tumour suppressor function like PTEN, TGFβ1, p53 and fibronectin did not show any significant regulation (additional file
2, table S2). The common induction of of EGR1 and ATF3 expression in all lines tested might indicate that activation of the EGR1/ATF3 signalling axis is an important mode of regulation how TRD mediates its growth suppressive action and/or apoptosis induction. The importance of EGR1/ATF3 axis in death signalling is supported by recent studies that described an EGR1 driven activation of the pro-apoptotic transcription factor ATF3 in colorectal cancer cells following treatment with anti-neoplastic substances [
44,
45]. ATF3 itself belongs to the CREB family of transcription factors and is regarded as a stress-inducible gene due to its activation by variety of stimuli e.g. radiation [
31], chemotherapeutic agents [
46,
47] oxidative stress [
48,
49] or ER stress [
50]. Although the physiologic functions of ATF3 are not well understood, there is some evidence that ATF3 functions as a pro-apoptotic gene in cancer cells. ATF3 has been shown to enhance the apoptotic effect of curcumin in squamous cell carcinoma cells [
51] and to mediate nitric oxide-induced apoptosis in pancreatic beta cells [
52]. Furthermore, ATF3 has been shown to promote UV induced apoptosis and cell cycle arrest in fibroblasts by binding the promoter and repressing the transcription of cyclin D1 -a key regulator of the G1-S checkpoint [
53]. We can only speculate about the TRD driven stimulation of ATF3, but oxidative stress provides a possible pathway. Previous studies have presented first evidence for involvement of TRD mediated reactive oxygen species (ROS) production in malignant cells [
7,
25,
26] and cell death induced by TRD has been shown to be reversible by application of radical scavengers like N-Acetylcysteine [
7,
54,
25,
10,
26]. Another possible cell death associated pathway resulting in activation of ATF3 by TRD is the ER stress response pathway [
55,
56], since TRD has been reported to inhibit protein translation in tumour cells at an early stage [
37]. Together with the above mentioned production of ROS, this might result in disturbance of ER homeostasis leading to ER stress response. Indicative of an involvement of the ER stress response pathway, we identified two genes that were up-regulated by TRD and known to be activated during ER stress, e.g. PPP1R15A (syn. GADD34) and the above mentioned ATF3. PPP1R15A represents an interesting potential TRD target gene, since PPP1R15A confers both apoptotic signalling [
32,
33] and inhibition of the translational silencing during ER stress via binding the catalytic subunit of protein phosphatase 1 leading to dephosphorylation of eIF2α [
57,
58]. Another strongly TRD regulated gene is PMAIP1 (syn. NOXA), a pro-apoptotic member of the BH3-only protein family, which is known to be involved in the
intrinsic mitochondrial apoptotic pathway [
34]. PMAIP1 exerts its pro-apoptotic function mainly by neutralizing anti-apoptotic members of the Bcl2 family through direct interaction, which has been proven for Bcl-2 related protein A1 (BCL2A1) and myeloid cell leukemia sequence 1 (MCL1) [
59,
60]. Interestingly, besides Bcl-2 like protein 11 (BCL2L11), which was 3-fold down-regulated, none of the remaining Bcl-2 family members (including MCL1 and BCL2A1) revealed a significant expressional change after TRD treatment in our experiments (additional file
2, table S2). Among the genes that were significantly down-regulated following TRD treatment, TRAF6 was considered as an especially important candidate gene. TRAF6 represents a member of the TRAF family of proteins that is involved in both the TNF receptor and the interleukin-1 receptor (IL-1R)/Toll-like receptor (TLR) superfamily signal transduction and is referred to innate and adaptive immunity, bone metabolism and developmental pathways [
61,
62]. Recently it has been shown that TRAF6 possesses an ubiquitin ligase activity domain (E3 ligase) that confers a site specific (Lys63) ubiquitination of different target proteins [
35,
36]. Interestingly, the protein kinase AKT - activated and transmitting survival signals in many tumours - has also been reported to be an ubiquitination target of TRAF6. Ubiquitination of AKT by TRAF6 is essential for its membrane recruitment and phosphorylation following growth factor activation [
63]. Furthermore, inhibition of AKT phosphorylation has been described following TRD application in mesothelioma cells [
11]. Although we did not find significant changes in the expression of AKT (additional file
2, table S2) and did not analyse AKT phosphorylation, the reduced expression of TRAF6 in our experiments provides a potential hint to the inhibition of the oncogenic AKT pathway by TRD. However, the involvement of the above mentioned pathways in TRD mediated cell death has to be addressed in further studies.