Introduction
Multiple myeloma (MM) as one of the lymphoid neoplasms, is characterized
by the accumulation of abnormal plasma cells in bone marrow [
1,
2].
MM is the second most common hematological malignancy, accounting for 10% of all
hematological malignancies. MM can affect various organs function in patients and
result in a series of symptoms such as bone pain, renal failure, infection and
neurological disorders [
3-
6]. It is estimated that total 14541 cases will
suffer MM in the year of 2010 and the number of incidence cases are likely to
increase to 21754 by 2020 in India [
7].
In addition, the overall survival time for patients with MM ranges from 6 months to
10 years with mean of 3 to 4 years [
8].
MM remains an incurable hematological malignancy, despite of conventional and
advanced chemotherapy.
Presently, novel therapies are urgently needed. Photodynamic therapy
(PDT) is a potential novel anticancer therapy that applied a photosensitizer and
light to produce reactive oxygen in cells [
9]. PDT can inactivate tumor cells in autologous bone marrow
grafts and shows benefits in bone marrow transplantation substantially [
10]. PDT has been applied in eradicating the
malignant cells of the autograft in the autologous bone marrow transplantation for
MM treatment [
11]. Additionally, it is
reported that PDT exerts stronger cytotoxicity in chronic myeloid leukemia (CML)
cells than normal granulocyte/macrophage progenitors and PDT can eliminate CML cells
from malignant-normal bone marrow mononuclear cells mixture [
12]. PDT is becoming a promising therapeutic
modality for hematological malignancies, such as leukemia [
13], lymphoma [
14] and MM [
11].
Hypericin, a natural polycyclic quinone, is mainly extracted from the
plants of hypericum genus [
15].
Hypericin has been regarded as a promising photosensitizing agent for its
characteristic of light-dependent antineoplastic and antiviral activity
[
16]. Hypericin-mediated PDT has
obtained increasing interests as a potential treatment for various cancers
[
17-
19]. Currently, multiple pathways have been found to involved in
the tumor cell death program induced by hypericin-mediated PDT, such as
mitochondrial pathway [
20,
21], lysosomal damage [
22], alternation of intracellular pH level
[
23,
24], Bcl-2 phosphorylation by CDK-1 [
25] as well as the increase of intracellular
Ca2+ stimulated apoptosis [
26-
28]. However, the
mechanism underlying hypericin-mediated PDT for MM suppression has been not
clarified clearly.
In this study, we explore the mechanism of MM treatment and the type of
cell death induced by PDT with hypericin by SP2/0 cells. The cellular morphology and
the cell proliferation of SP2/0 cells were investigated at different concentrations
of hypericin. The changes in the mitochondrial membrane potential and the activation
of Caspase related pathways were further assessed. The aim of the present study was
to investigate the effect and mechanism of hypericin-mediated PDT on the mouse MM
cells in vitro.
Materials and methods
Hypericin preparation and cell culture
Hypericin powder (Beijing Standard Herbs Medical Science &
Technology Development Co. LTD., Beijing, China) with purity > 98% was
determined by high-performance liquid chromatography (HPLC). A stock solution of
hypericin (10 mM) was prepared with dimethyl sulfoxide (DMSO; Sigma) and stored
at −20°C in the dark. Immediately before each experiment, the working solution
of hypericin was diluted in RPMI1640 medium without serum to obtain a final
concentration.
The mouse myeloma cell line SP2/0 (ATCC) was from American Type
Culture Collection. The cells were cultured in RPMI1640 medium supplemented with
10% calf serum, 2.2 g/l NaHCO3, 100 U/ml penicillin, and
100 g/ml streptomycin. Cells were maintained in a humidified atmosphere with 5%
CO2 at 37°C until the logarithmic growth phase based
on the cell growth curve. The adherent cells were displaced by rinsing with
0.25% trypsin. Then, the adherent and suspension cells were harvested for the
following experiments.
PDT treatment
SP2/0 cells (5 × 104 cells/ml) were
seeded on 96-well plates (100 μl/well) and incubated with hypericin at different
concentration (0.001, 0.01, 0.1, 1 and 10 μM) for 16 hours in the dark. Cells
were given external 7 cm illumination treatment on a plastic diffuser sheet
above a set of 6 yellow L18W/30 lamps (CH Lighting, Zhejiang, China) with the
maximum spectrum range of 570–620 nm. Irradiation intensity was detected to be
under 13000 lux by TES-1332A (TES, Taiwan, China). The total light doses were
determined to be 2.82, 5.64, 8.46, 11.28 and 14.10
J/cm2 by a photometer. During the illumination,
the temperature of the samples ranged from 32 to 37°C. After PDT treatment,
cells were maintained for 24 hours at 37°C in a humidified atmosphere of 95%, 5%
CO2 until further analysis.
The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT)
assay
In order to determine the optimal hypericin concentration or
irradiation dose for PDT treatment, we performed MTT assay to analyze the
proliferation of SP2/0 cells [
29].
Briefly, SP2/0 cells at a final density of 5 × 10
4
cells/ml (100 μl/well), were incubated with hypericin at a concentration
gradient from 0.001 to 10 μM for 16 hours in the dark. The cell plates were
illuminated with different light dose of 0, 2.82, 5.64, 8.46, 11.28 and 14.10
J/cm
2, and then incubated for 24 hours in the
dark. To obtain the IC
50, SP2/0 cells were treated with
indicated concentrations of hypericin (0, 0.0125, 0.025, 0.05 and 0.1 μM) for 16
hours in the dark. Subsequently, the cells were illuminated at a light dose of
11.28 J/cm
2 for 24 hours in the dark.
SP2/0 cells without any treatment were set as controls. The MTT
assay was performed for SP2/0 cells at each condition according to the
manufacturer’s instructions. In brief, 10 μl of MTT (5 mg/ml; Sigma) was added
in each well for 4 hours at 37°C. After removal of the medium, the MTT crystals
were dissolved with 100 μl DMSO for 15 min. The absorbance at 550 nm was
measured by a Multiskan Spectrum 1500 (Thermo Electron Corporation, USA). The
inhibition rate of cell proliferation was calculated as follows: (A550control −
A550treated)/A550control × 100% and the IC
50 value was
obtained by Logit method [
30].
Light and fluorescence microscopy
SP2/0 cells (1 × 105cells/ml) were
seeded into the 6-well plates (2 mL/well) and incubated with hypericin at the
final concentrations of 0.025, 0.05 or 0.1 μM for 16 hours in the dark.
Subsequently, the plates were illuminated at a light dose of 11.28
J/cm2 for 24 h. The adherent and suspension cells
were collected for the following morphological analysis according to the method
described above.
A part of cells were harvested and observed by a phase-contrast
microscopy. Some cells were collected for Hoechst 33342/propidium iodide (PI)
co-staining [
31]. SP2/0 cells were
stained with Hoechst 33342 (5 μg/ml) and PI (5 μg/ml) at room temperature for 10
min, then examined under a fluorescence microscopy (E600, Nikon, Japan) with
excitation at 360 nm [
32]. Intact
blue nuclei of viable cells, condensed/fragmented bright blue nuclei of
apoptotic (early or late) cells and pink nuclei of necrotic cells can be
observed. The number of apoptotic or necrotic cells was counted in a total of
200 cells from 5 random fields.
Transmission electron microscopy (TEM)
SP2/0 cells (1 × 10
5cells/ml, 2 mL/well)
treated with hypericin (0.025, 0.05 or 0.1 μM) and illumination (11.28
J/cm
2) were collected for TEM examination.
Samples were prepared as described previously [
33]. The cells were fixed with 2.5% glutaraldehyde, followed
by 1% OsO
4 and then dehydrated with acetone. They were
embedded in Epon812-resin mixture. Serial sections (about 50 nm) were obtained
by ultra-microtome. Sections were stained with sodium acetate and lead citrate
and then viewed by a Hitachi H-7000/STEM electron microscope (Hitachi Inc.,
Tokyo, Japan) at 75 kV.
DNA fragments
SP2/0 cells with hypericin (0.025, 0.05 and 0.1 μM) and
illumination (11.28 J/cm2) were used for this
experiment. The suspension cells and adhesive cells on the 6-well plates were
all collected for DNA extraction following the manufacturer’s instructions of
DNA Ladder Extraction Kit with Spin Column (Beyotime Institute of Biotechnology,
China). The DNA extractions (40 μg) were separated on 1.0% agarose gel
containing ethidium bromide (EB) and were visualized under UV light. Standard
molecular weight markers (Fermentas, MBI) were run on the left-hand lane of the
gel.
The 5, 5′, 6, 6′-tetrachloro-1, 1′, 3,
3′-tetraethylbenzimidazolyl-carbocyanine iodide (JC-1) staining
In order to explore the changes in the membrane potential, we
carried out JC-1 staining for SP2/0 cells intervened by hypericin (0, 0.025 and
0.05 μM) and illumination (11.28 J/cm
2). The collapse
of the mitochondrial membrane was measured using a mitochondrial membrane
potential assay kit with JC-1 (Beyotime Institute of Biotechnology, China)
[
34]. JC-1 formed aggregates in
the mitochondria at relatively high membrane potential exhibiting red-orange
fluorescent at 590 nm. The JC-1 monomers distributed in the cytoplasm of cells
with low potential and emitted a green fluorescent at 529 nm. After JC-1
staining, cells were analyzed by flow cytometry with green emission in channel 1
(FL1) and red emission in channel 2 (FL2). The relative ratio of JC-1 aggregate
(FL2, red fluorescence intensity) to monomer (FL1, green fluorescence intensity)
was calculated. A decrease in this ratio was defined as the depolarization of
the mitochondrial membrane potential.
Propidium iodide (PI) staining
To evaluate the effects of caspase inhibitors (pan-caspase
inhibitor Z-VAD-FMK or caspase-3 inhibitor Ac-DEVD-CHO) on apoptosis mediated by
hypericin with PDT, the PI staining was carried out. The caspase inhibitors were
dissolved in DMSO at a storage 20 mM concentration. SP2/0 cells were
pre-incubated with the pan-caspase inhibitor (100 μM) or caspase-3 inhibitor
(100 μM) for 1 h, and then exposed to 0.05 μM hypericin for 16 h in the dark.
Preliminary experiment indicated that 0.125% DMSO had little effect on the cell
death and proliferation. For PI staining, the caspase inhibitors were dissolved
in 0.05% DMSO that was safe for SP2/0 cells. After illuminated at 11.28
J/cm2 for 24 h, SP2/0 cells were harvested, fixed
in 70% ethanol and stored at 4°C overnight. Then, cells were stained with PBS
containing 40 μg/mL RNase and 10 μg/mL PI at room temperature for 30 min in the
dark. Cells were analyzed using an FACS-Calibur flow cytometer (Becton
Dickinson, San Jose, CA, USA). The cells during apoptosis were obtained from the
distinct sub-G1 region of the DNA distribution histograms. At least 20,000
events were counted for each sample.
Caspase-3 activity assay
SP2/0 cells at a final density of
1 × 10
5 cells/ml were grown in 6-well plates (2
mL/well) and incubated with the hypericin (0.025 and 0.05 μM) for 16 hours. The
untreated cells were defined as control. After 24 h illumination at 11.28
J/cm
2, caspase-3 activity was determined using a
caspase-3 activity kit (Beyotime, Nanjing, China) which was based on the ability
of caspase-3 to change acetyl-Asp-Glu-Val-Asp p-nitroanilide into the yellow
formazan product, p-nitroaniline. The absorbance at 405 nm was measured for
cells treated with hypericin with PDT and controls. The formula was listed as
follows:
$$ \mathrm{Activity}\ \mathrm{of}\ \mathrm{caspase}\ 3=\frac{O{D}_{405 nm}\ \mathrm{of}\ \mathrm{treated}\ \mathrm{cells}}{O{D}_{405 nm}\ \mathrm{of}\ \mathrm{controls}} $$
Western blotting
Western blot analysis was performed as previously described
[
35-
37]. Protein samples (40 μg) were separated
by 8-12% (8% for PARP-1; 10% for AIF, β-actin; 12% for Bcl-2, Bax, Cytochrome c,
Histone 2A, Caspase-3) sodium dodecyl sulfate-polyacrylamide gels
electrophoresis and transferred to polyvinylidene fluoride membrane (Immobilon
PVDF, Millipore). The membranes were blocked in 10% non-fat dried milk in TBS-T
(10 mM Tris–HCl (pH 8.0), 150 mM NaCl, and 0.1% Tween) for 2 hours at room
temperature. Then the membranes were incubated with the primary antibodies of
anti-Bcl-2 rabbit monoclonal antibody (1:1000), anti-Bax rabbit monoclonal
antibody (1:1000), anti-caspase-3 rabbit polyclonal antibody (1:1000), anti-PARP
rabbit polyclonal antibody (1:1000), anti-β-actin mouse polyclonal antibody
(1:1000), anti-cytochrome
c rabbit monoclonal
antibody (1:1000), anti-AIF rabbit monoclonal antibody (1:1000), and anti-H2AX
rabbit monoclonal antibody (1:500), respectively, overnight at 4°C. All the
antibodies were purchased from Cell Signaling Technology (Beverly, MA, USA).
Subsequently, membranes were washed three times with Tris-bufffered saline, 0.1%
Tween-20 and then incubated with the peroxidase-conjugated secondary antibodies
for 1 h. The membranes were washed three times again and developed using
enhanced chemiluminescence (ECL, Amersham Biosciences). Bands were visualized
using the ChemiDoc™ XRS+ System with Image Lab™ Software (Bio-rad, USA). Protein
expressions were quantified by densitometry analyzed using Quantity One 4.5.2
software (Bio-Rad, Hercules, USA).
Statistical analysis
All the data were displayed as mean ± standard deviation (SD). All
the statistical analysis was performed by SPSS17.0 statistical software. Differences among groups were
analyzed with S-N-K followed by One-Way ANOVA. P value < 0.01 was considered to be statistically
significant.
Discussion
MM is the most common bone marrow malignancy. It is reported that there
are 114,000 cases diagnosed with MM and 80,000 deaths resulting from MM in 2010
worldwide [
38]. MM remains an incurable
bone malignancy with severe complications and poor prognosis for MM patients. The
increasing studies for MM treatment contribute to the evolution of therapies, the
increase of survival time and the improvement of life quality for patients
[
39]. Hypericin-mediated PDT is
reported to be an attractive candidate treatment modality for human cancer cells
[
40]. The evidence of the
inhibitive effect of hypericin-mediated PDT on MM is insufficient. In this study, we
further explored the mechanism of the apoptosis of mouse myeloma SP2/0 cells induced
by hypericin-mediated PDT at different concentrations of hypericin.
Our results showed that the combination of hypericin with PDT showed
great inhibitive effects on the proliferation of SP2/0 cells and led to extensive
apoptosis. After tumor cells were incubated with different concentrations of
hypericin (0.01-10 μM) and then exposed to illumination with different light doses
(0–14.10 J/cm2), data from MTT assay revealed that hypericin or illumination
treatment alone had no obvious effect on inhibiting the proliferation of SP2/0
cells. Hypericin combined with illumination caused significant drug concentration-
and light intensity-dependent manner in the inhibition of SP2/0 cells proliferation.
The metabolic activity of SP2/0 cells was reduced significantly with the increasing
hypericin concentration and light dose. Additionally, we found that under the same
concentration of hypericin, high light dose (11.28 and 14.10
J/cm2) caused comparable effect on the cell
proliferation inhibition, and the higher concentrations of hypericin (1 and 10 μM)
caused equal inhibitory effect on the tumor cell proliferation, under the same
illumination, which indicated that there might be a saturation of photochemical dose
in PDT treatment on the MM. In order to avoid the damage caused by excess
photosensitizing drug, the optimal treatment condition leading to the appropriate
energy state results for MM patients should be further studied.
Apoptosis has been determined to be the most prominent event in the
tumor tissue destruction induced by hypericin-mediated PDT [
41,
42]. In order to assess the involvement of apoptosis in tumor
response to hypericin-mediated PDT, the hallmarks of apoptosis including DNA
fragmentation and morphological changes were investigated in this paper. Results
showed that low doses of PDT with hypericin (0.025 and 0.05 μM) induced apparent
morphological and biochemical characteristics of apoptosis in SP2/0 cells such as
cell shrinkage, chromatin condensation, formation of apoptotic bodies as well as DNA
laddering, while high dose of PDT with hypericin (0.1 μM) led to cell necrosis
(Figures
2 and
3). As outlined in previous studies, apoptosis induced by PDT can
be observed at lower hypericin concentrations and fewer light intensities, whereas
necrosis occurs at high hypericin concentrations and light intensities [
43,
44], which is consistent with our findings. The transitions from
apoptosis to necrosis in a drug and light dose-dependent manner induced by hypericin
with PDT have also been observed in HeLa cells and human epidermoid carcinoma cells
in vitro [
20,
21]. All these
showed that hypericin-mediated PDT is a potent inducer of apoptosis or necrosis in
MM SP2/0 cells depended on the dosage of PDT, despite of the factors such as the
location of the photosensitizer, the nature of photosensitizer as well as the
genetic and metabolic potential of the cell type.
It is demonstrated that the apoptosis induced by hypericin-mediated PDT
mainly resulted from the activation of apoptosis related pathways in response to the
oxidative stresss and other signals [
45]. It is reported that the apoptosis pathways induced by
hypericin-mediated PDT are involved with plasma membrane death receptors,
mitochondria, lysosomes and ER, caspases, and Bcl-2 family proteins [
46]. Bcl‑2 family proteins play key roles in the
mitochondria-mediated cell death [
47].
The expression of Bcl‑2 family proteins can induce the mitochondrial membrane
permeabilization, which causes the release of caspases or apoptosis inducing factor
(AIF) [
48]. The up-regulation of
Bax/Bcl-2 ratio is found to be associated with the decrease of mitochondrial
membrane potential that inhibits the growth of cancer cell growth [
49].
In the present study, results of western blotting suggested that the
expression of anti-apoptotic Bcl-2 protein was decreased and pro-apoptotic Bax
protein was increased induced by hypericin-mediated PDT and thus shifted the
Bax/Bcl‑2 ratio that leaded to loss of the mitochondrial membrane potential in favor
of cytochrome
c and AIF release. In the apoptosis
process, the release of cytochrome
c induced the
activation of caspase-9 and then activates caspase-3 [
50]. Caspase-3-mediated cleavage of the 116-kDa PARP protein into
89-kDa fragments is a hallmark of apoptosis [
51]. The present study also showed that caspase-3 activity was
increased that contributed to PARP cleavage and DNA degradation.
In fact, cytochrome
c-mediated
capsase dependent apoptotic pathway and AIF mediated caspase independent apoptotic
pathway are complicated but not completely independent. AIF in the cytosol could
promote cytochrome
c to be released from
mitochondria and the activated caspases also facilitate translocation of AIF from
mitochondria to the nucleus [
52].
Besides, the present study further showed that the apoptosis induced by
hypericin-mediated PDT was inhibited significantly by the pan-caspase inhibitor
zVAD-fmk or special caspase-3 inhibitor Ac-DEVD-CHO. All these indicated that AIF
release might be facilitated by casapse and hyerpicin with PDT induced apoptosis
mainly depended on caspase-mediated cell death pathways.
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Competing interests
The authors declare that they have no competing interest to
disclose.
Authors’ contributions
JZ and LS participated in the design of this study, and they both performed
the statistical analysis. CW carried out the study, together with HL, collected
important background information, and drafted the manuscript. RX conceived of this
study, and participated in the design and helped to draft the manuscript. All
authors read and approved the final manuscript.