Efficacy of aroylhydrazone chelators in cancer cells
Previous work showed that AHCs (often referred to as iron-chelators due to initial studies on high Fe chelation efficacy in cell lines and
in vivo models) [
45] exert anti-proliferative and/or cytotoxic effects in neoplastic cells including cell lines derived from bladder carcinoma, rat hepatoma, T-cell leukemia, neuroblastoma, melanoma and leukemia [
34,
35,
45‐
47]. To date no studies on the effect of
AHC compounds in ovarian cancer models, neither
in vitro nor
in vivo, have been published, and their mechanism of action leading to cell death remains unknown.
The present study shows that novel compound
HNTMB in its cytotoxic capacity (IC
50 between 200-400 nM depending on the ovarian cancer cell line) is superior to other
AHC compounds (oVtBBH, HNtBBH, StBBH/206, HNTh2H/315 and HNI/311 and
HNTMB) (IC
50 0.8-6 μM) as well as to deferoxamine (DFO) (IC
50 12-25 μM) which was included as a reference. StBBH/206, HNTh2H/315 and HNI/311 in previous studies displayed anti-proliferative effects in neuroblastoma cell lines (IC
50 = 0.2-1.2 μM), melanoma cells (IC
50 0.8-1.0 μM) and leukemia cells (IC
50 0.4-1.3 μM) [
34,
35]. Two of the three AHC (HNTh2H/315 and HNI/311) and
HNTMB possess a 2-hydroxy-1-naphthylaldehyde moiety. The high lipophilicity of this aldehydic moiety when compared to
AHC compounds with a less lipophilic pyridoxal or salicylaldehyde group is correlated to increased anti-proliferative effects [
34] and likely contributes to the effectiveness of the novel
HNTMB studied here.
HNTMB, apart from a hydroxy-1-naphthylaldehyde moiety and unlike the other structurally-related
AHCs studied here (HNI/311, HNTh2H/315, HNtBBH), possesses a trimethoxybenzene moiety, which is found in a large number of biologically active compounds, including anti-cancer drugs such as combretastatin. The trimethoxybenzene moiety in
HNTMB may be associated with the further improvement of its cytotoxicity in comparison to the structurally-related chelators without such a functional group. However, further studies must be conducted to prove whether this moiety is directly responsible for the high degree of cytotoxicity produced by
HNTMB. The control compound DFO, structurally unrelated to
AHCs, is a naturally occurring hexadentate iron-chelator that has been used as a therapeutic agent against ovarian [
20] and other cancer cells [
48‐
53]. However, the hydrophilic property of DFO limits its membrane-permeability and efficacy to target the intracellular trace metal pool including iron [
54] or affect other intracellular processes. In contrast to DFO, compounds such as
HNTMB display a greater potency because of their better membrane-permeability profiles.
The observation to cytotoxic effects of
HNTMB on SKOV-3, OVCAR-3 and NUTU-19 ovarian cancer cells led to a screen performed by the NCI-DTP against a panel of cell lines
http://dtp.nci.nih.gov/screening.html derived from human tumors of different origin. It became apparent that
HNTMB displayed potent cell line-specific but not tumor type-specific cytotoxicity with GI
50 values in a 240-fold range (between 10 nM and 2.4 μM depending on the cell line studied). Thus, cell death, depending on the target tumor or cancer cell line, can be induced by
HNTMB at concentrations in the nanomolar range. At these concentrations
AHCs may not exert their effects by critical depletion of the pool of intracellular iron but by binding to other trace metals such as copper (see discussion below).
In vivo experiments have shown that effective treatment of tumors with related thiosemicarbazone Dp44mT, which reduced growth in melanoma xenografts in nude mice by 92%, required low doses that did not cause iron depletion [
55]. It is noteworthy that no direct correlation between the anti-proliferative activity of
AHCs with their abilities to prevent iron-uptake or mobilization in neuroblastoma cells was reported [
34] suggesting that interference with iron metabolism may not be responsible for the effect of
AHCs on cell viability. Early studies examined the use of copper complexes of aroylhydrazone derivatives as therapeutic agents; Cu(II) complexation of SBH not only increased the compounds cytotoxicity but administration of this complex in mice was well tolerated [
46]. The present study revealed that
HNTMB at 400 nM when complexed with Cu(I) or Cu(II) displayed a high cytotoxicity correlated with massive generation of ROS. In contrast,
HNTMB complexed with Fe(II) or Fe(III) lost its cytotoxicity and did not alter basal levels of ROS in SKOV-3 cells. Non-complexed
HNTMB displayed partial cytotoxicity and by binding to various trace metals is likely to disturb a multitude of functions important for cell proliferation and survival. HNTMB, as a tridentate coordinating ligand, has the ability to bind copper or iron in a stochiometric ratio of 1:1. Its IC50 determined for ovarian cancer cell lines is 200-400 nM (75-150 μg/L) and the assay concentration of non-complexed HNTMB that we used was 150 μg/L which is a fraction of the total iron or copper content of cells. Ovarian cancer tissues contain 0.3-0.7 mg/kg copper and 15-17 mg/kg iron content [
10]. By binding intracellular copper HNTMB can create a toxic ROS-generating complex, while intracellular iron-chelation by
HNTMB depending on its concentration may lead to a variety of cellular consequences previously described for aroylhydrazone chelators [
31]. These include ribonucleotide-reductase/RR inhibition, redox-activity leading to the hydroxylation of benzoate and the degradation of DNA in the presence of Fe(II) and H
2O
2, down-regulation of cell cycle regulators, and activation of WAF (mediator of p53 tumor suppression) among other genes.
Response mechanism of cancer cells to HNTMB treatment
Through various experimental approaches the present study suggests that the mode of action of
HNTMB in SKOV-3 cells relies on a variety of inter-dependent processes such as generation of ROS, DNA degradation, induction of apoptosis, and arrest of cell cycle progression through G2/M phase. ROS are generated in SKOV-3 when treated with a copper/
HNTMB complex but not when an iron/
HNTMB complex was used. Thus, ROS generation observed after treatment with non-complexed
HNTMB is, at least, partially due to the drug binding intracellular copper (possibly by binding to other trace metals with a similar result). Production of ROS results in apoptosis and/or necrosis and can be used for selective targeting of tumor cells which possess higher oxidative stress level and display alteration of antioxidant enzymes (catalase, SOD) as compared to normal cells. Apparently, the Cu/
HNTMB complex, as suggested for other chemotherapeutic drugs, may be used in oxidation therapy by elevating H
2O
2 and superoxide radical in tumor cells above the survival/death threshold (see introduction) [
17,
56]. Even though excess copper is known to be a potent oxidant causing the generation of ROS, we ruled out that unbound copper present in the sample of the Cu/
HNTMB complex could be responsible for ROS generation. In controls, neither Cu(I) nor Cu(II) alone, at concentrations of 1.6 μM, resulted in cytotoxicity or ROS production during treatment. Previously, we determined that treatment with non-chelated copper does not affect the viability of ovarian cancer cell at or below a concentration of 30 μM [
41]. Therefore, we suggest that future studies should focus on the mechanistic responses of tumor cells to treatment with copper/
AHCs complexes in general and specifically with a Cu/
HNTMB complex in ovarian cancer models. The mechanism(s) by which the copper-HNTMB complex generates elevated ROS levels remains under investigation but may include targeting of cellular thiol-containing anti-oxidant molecules such as glutathione (GSH) as this has been shown for other copper complexes such as CuNG [
57]. Even upon treatment with non-complexed
HNTMB intracellular copper-chelation by
HNTMB might selectively be used to cause ROS-mediated cell death in certain tumors because a higher copper level is apparent both in serum and tumors of cancer patients including those suffering from breast and ovarian cancer [
8‐
10]. Reference values determined by Yaman
et al. [
10] showed an average copper content in malignant ovarian tissue of 0.7 mg/kg copper versus 0.3 mg/kg in benign ovarian tissue. Interestingly, in these tissues the iron content for cancerous and non-cancerous conditions is comparable (15-17 mg/kg) [
10]. Thus, the iron/copper ratio decreases by a factor of 2 from benign to malignant ovarian tissues and may represent a target for chelation therapy.
In the present study, apart from ROS generation by ovarian cancer cells upon treatment with
HNTMB, we observed other cellular responses of SKOV-3 cells to this chelator such as DNA degradation, arrest of cell cycle progression in G2/M phase and activation of apoptotic signaling. Cell cycle regulation is known to be a target of chelating agents and has been attributed to the depletion of intracellular iron. Chelators of the
AHC class can regulate the expression of various proteins involved in cell-cycle control such as CDK2, cyclins A, B1, D1, D2, D3,
WAF1 (inhibitor of CDKs) as shown for HNI/311 in neuroblastoma and an erythroleukemia cell line. While chelators such as HNI/311 or DFO generally block G1/S phase transition, effects on the G2/M transition during the cell cycle has also been implicated [
58,
59]. For DFO and a 3-hydroxypyridin-4-one iron-chelator, it has been shown in K562 erythroleukemia cells that at higher concentrations these cells undergo arrest in G1/S while at lower drug concentrations they accumulated in G2 and M phase without an effect on DNA synthesis [
60]. Thus, cell cycle regulation through iron-chelators may depend on the dose and the cell line studied.
HNTMB at 600 nM lead to an accumulation of SKOV-3 primarily in G2/M phase. Future studies, beyond the scope of the present work, could focus on cell cycle checkpoints affected by
HNTMB treatment in synchronized cancer cells and verify the general concept that iron-chelation (and not depletion of other intracellular metals) is responsible for these effects. Generally, targeting cell cycle key regulators has been suggested as a supplemental approach to anti-cancer therapies [
61‐
64]. In addition, it is noteworthy that cells are most radiosensitive in the G2/M phase [
65]. Based on this and our findings,
HNTMB could be used as a radiosensitizer.
Drug treatment leading to programmed cell death (Apoptosis) results in the activation of
initiator caspases which upon activation subsequently activate downstream
effector caspases that are responsible for the cleavage of many intracellular proteins, leading to the morphological and biochemical changes associated with apoptosis [
66,
67].
HNTMB treatment of SKOV-3 cells resulted in strong activation/cleavage of
initiator caspase-8 and -9 and of
effector caspase-3 and-7, while PARP-1 (involved in DNA repair) [
68] was inactivated/cleaved following drug treatment. It is noteworthy that
HNTMB down-regulated expression of the X-linked inhibitor of apoptosis (XIAP). Down-regulation of XIAP expression in ovarian cancer cells results in apoptosis
in vitro and prolonged survival of ovarian cancer-bearing mice, which indicate that XIAP may be a valuable therapeutic target in ovarian cancers [
69]. Interestingly, cisplatin-resistance in human ovarian surface epithelial (hOSE) cancer cells is correlated with the inability of cisplatin to down-regulate XIAP expression [
70].
HNTMB may be an alternative apoptosis inducing drug in certain platinum-resistant cancers via XIAP reduction as shown to occur in SKOV-3 ovarian cancer cells used in the present study.
HNTMB induced both major signaling pathways (
intrinsic, extrinsic) as evidenced by the activation of initiator caspases similar to the effect of other iron chelators such as tachpyridine, DFO, and dipyridyl [
71].
Intrinsic pathway activation may have mitochondrial damage as a pre-requisite, leading to the activation of pro-apoptotic members of the Bcl-2 family and/or inactivation of anti-apoptotic Bcl-2 and results in the mitochondrial release of cytochrome C which in turn activates
initiator caspase-9 [
72] as seen in SKOV-3 cells following
HNTMB treatment. It has previously been suggested that the mitochondrial pathway takes a center-role in iron chelator-mediated cell death since over-expression of anti-apoptotic Bcl-2 and Bcl-XL promotes cell (in HeLa cervix carcinoma cells) survival and chelator-mediated cell death can be blocked by a dominant-negative caspase 9 and Bcl-XL over-expression [
71]. We show here that the exclusive down-regulation of Bcl-2 expression (in contrast to unmodified Bcl-XL or Bid) takes a center role in the pro-apoptotic response of SKOV-3 cells to treatment with
HNTMB. Similarly, other
AHC compounds and their iron complexes cause apoptosis via the mitochondrial pathway (in Jurkat T cells and K562 leukemia) which could be counteracted by Bcl-2 overexpression [
73]. Because anti-apoptotic Bcl-2 is highly expressed in various human cancers, this feature of
HNTMB increases its potential as an alternative anti-tumor drug. Bcl-2 also mediates the resistance of cancers to conventional therapies such as radio- and chemo-therapy. Thus, the blockage of Bcl-2 protein expression by
HNTMB treatment could be useful to sensitize cancer cells to conventional therapies [
74]. A COMPARE analysis using the NCI's anticancer drug screen database suggested the involvement of Bcl-2 protein as a putative target of
HNTMB. in its mechanism of action. The COMPARE computer program utilizes cytotoxicity data derived from screening compounds against 60 human cancer cell lines to calculate the Pearson correlation coefficient (positive correlation of 0.45 for
HNTMB), between the data for the seed compound and those for past agents in the database to identify similar molecular targets or similar mechanisms of resistance [
75‐
79].
Induction of apoptosis by chelating agents, including representatives of
AHCs, has been primarily associated to their capability to bind/deplete intracellular iron [
73]. These properties may be especially relevant for cancer treatment because (i) the intracellular concentration of iron is generally higher than that of copper and (ii) it can be significantly elevated in both serum and tumor tissue of cancer patients with endometrial or breast cancer [
9,
10]. The pro-apoptotic effects of non-complexed
HNTMB at higher concentrations may be partially linked to its capacity to bind/deplete intracellular iron. However, it is apparent that a copper/
HNTMB complex at a concentration of 0.4 μl strongly induces apoptosis, while an iron/
HNTMB complex has no such effects. Observations related to the role of organocopper complexes in apoptotic events include disruption of the peroxide and thiol metabolism with subsequent up-regulation of pro-apoptotic Bcl-2 family members (Bak/Bax in melanoma and epithelial carcinoma cells) [
80]. Previous studies have revealed that in the presence of complexed copper (Cu-NTA) the expression of anti-apoptotic Bcl-2 and Bcl-XL can be down-regulated (HL-60 cells) [
81]. Accordingly, the pro-apoptotic activity of
HNTMB may include direct effects on Bcl-2 regulation when complexed with copper in contrast to the postulated indirect pro-apoptotic effects linked to intracellular iron depletion. We conclude that non-complexed
HNTMB exerts cytotoxicity on ovarian cancer cells in a dual function by binding copper [Cu(I) and Cu(II)] present in the human body [
82] and the intracellular iron present in the Fe(II) and Fe(III) states [
31].