Introduction
Lung cancer is the leading cause of cancer death worldwide with poor 5-year survival rate [
1,
2]. Current treatments for patients with advanced lung cancer result in rarely curative, and the relapse often occur, which highlights the large need development of novel therapeutic agents against this type of malignancy. Traditional Chinese Medicine (TCM) plays an important role in protecting cancer patients against suffering from complications, assisting in supportive and palliative care by reducing side-effects of conventional treatment and improving quality of life [
3] However, the molecular mechanisms by which there herbs in enhancing the therapeutic efficiency against the lung malignancies remain poorly understood.
Berberine (BBR) is a benzylisoquinoline alkaloid extracted from many kinds of medicinal plants that has been extensively used as a TCM and exhibits a wide spectrum of pharmacological activities [
4]. Recently, BBR has been reported to have anti-tumor effects on many types of cancer cells [
5], and present studies supplied evidence that BBR can inhibit proliferation of non small cell lung cancer (NSCLC) cells, and have no cytotoxic effects on normal human bronchial epithelial cells [
6]. However, the detailed mechanism of its anti-cancer activity has not been well elucidated.
The tumor suppressor p53, a sequence-specific transcription factor that activates the expression of genes involved in apoptosis, cell cycle arrest and senescence, has a wide range of functions covering cell cycle control, apoptosis, genome integrity maintenance, metabolism, fertility, cellular reprogramming and autophagy [
7‐
10]. Although different underlying mechanisms for p53 regulation have been proposed for decades, none of them is conclusive. Forkhead homeobox type O3a (FOXO3a, FKHRL1) is also a transcription factor with known tumor suppressor activity and belongs to the family of mammalian forkhead transcription factors, which are regulated by growth factor receptor-induced activation of the phosphatidylinositol 3-kinase (PI3-K)/Akt (or protein kinase B) signaling pathway [
11]. Studies in mammalian cells have shown that activation of FOXO3a stimulated the expression of proteins that are involved in apoptosis [
11] and cell cycle arrest [
12] in different types of cells. FOXO3a was implicated with tumor suppression and inhibition of FOXO3a expression promoted cell transformation, tumor progression and angiogenesis [
13]. The cyclin-dependent kinase inhibitors p21 (CIP1/WAF1) has been shown to be involved in the cell cycle control, DNA replication, cell differentiation and apoptosis [
14]. Studies demonstrated the link of p53, FOXO3a and p21 signaling in control of cancer cell growth [
15‐
17]. However, the detailed mechanism by these interactions is still inconclusive.
In this report, we show that BBR inhibits growth and induces apoptosis of lung adenocarcinoma cells through activation of p38 mitogen activated protein kinase alpha (p38α MAPK). This, in turn, leads to increase the expressions and protein interactions of p53 and FOXO3a, followed by the induction of cell cycle inhibitor p21 (CIP1/WAF1).
Materials and methods
Reagents
Monoclonal antibodies specific for cyclinD1, p38 MAPK isoforms α, extracellular signal-regulated kinase 1/2 (ERK1/2) and their phosphor-forms were purchased from Cell Signaling Technology (Beverly, MA, USA). p38 MAPK isoforms β was ordered from AVIVA System Biology (San Diego, CA, USA). The cyclin D1, p21, p53, FOXO3a and phosphor-form p53 antibodies were abstained from Epitomics (Burlingame, CA, USA). PD98059 (a special inhibitor of ERK1/2), SB203580 (a special inhibitor of p38 MAPK) were purchased from Merck Millipore (Darmstadt, Germany), MTT powder and Pifithrin-α (PFT-α) were purchased from Sigma Aldrich (St. Louis, MO, USA). p38 MAPK isoforms α and β, p53 and FOXO3a small interfering RNAs (siRNAs) were obtained from Santa Cruz (California, CA, USA). Lipofectamine 2000 reagent was purchased from Invitrogen (Carlsbad, CA, USA). The FOXO3a-GFP and N1-GFP plasmids were kindly provided by Dr. Frank M. J. Jacobs (Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, the Netherland) and was reported previously [
18]. Berberine was purchased from Chengdu Must Biotechnology (Chengdu, China).
Cell culture
The NSCLC cell lines (A549, PC9, H1650 and H1299) were obtained from the Chinese Academy of Sciences Cell Bank of Type Culture Collection (Beijing, China) and the Cell Line Bank at the Laboratory Animal Center of Sun Yat-sen University starting March 2012 (Guangzhou, China) and grown in RPMI-1640 medium supplemented with 10% heat-inactivated FBS, HEPES buffer, 50 IU/mL penicillin/streptomycin, and 1 μg amphotericin (complete medium). All cell lines have been tested and authenticated for absence of Mycoplasma, genotypes, drug response, and morphology using a commercial available kit (Invitrogen, Shanghai, China) in the Laboratory and in the Animal Center at Sun Yat-sen University. The BBR was dissolved in a small amount of dimethylsulfoxide [DMSO, maximum concentration, 0.1% (v/v)], which was then added to complete cell culture medium prior to addition to sub confluent cells. Cells treated with vehicle only (DMSO, 0.1% in media) was served as control.
Cell viability assay
NSCLC cells were seeded in 96-well plates at 5 × 103 cells/well, and incubated at 37°C in complete medium for 24 h before the treatment. NSCLC cells were treated with SB203580, PD98059, or pifithrin-α for 2 h or were transfected with control, or p53 and FOXO3a siRNAs for 24 h before exposure of the cells to BBR for an additional 24 h. Afterwards, cell viability were measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay according to the instruction from the provider.
Cell cycle analysis
NSCLC cells were cultured in 6-well plates at 2 × 105 cells/well and treated with increased doses of BBR for 24 h or with SB203580, PD98059, or pifithrin-α for 2 h, followed by BBR for an additional 24 h. Afterwards, the cells were harvested, washed twice with phosphate-buffered saline (PBS), and resuspended in 500 μL of cold PBS and ethanol (1.5 mL) for 2 h at 4°C. The fixed cells were incubated in 1 mL of 0.1% sodium citrate containing propidium iodide (PI) 0.05 mg and 50 μg RNase for 30 min at room temperature (RT) in the dark. The cell cycle analysis was detected by flow cytometry (FC500, Beckman Coulter, FL, USA), and the proportion (percentage) of cells within the G1, S, and G2/M phases of the cell cycle were analyzed using the MultiCycle AV DNA Analysis software (Phoenix Flow Systems).
Western blot analysis
NSCLC cells were harvested, washed and lysed with 1 × RAPI buffer. Protein concentrations were determined by the Thermo BCA protein assay Kit. Equal amounts of protein from cell lysates were separated on 10% and 12% SDS polyacrylamide gels, and transferred onto polyvinylidene fluoride membranes. Membranes were blocked with 5% non-fat milk in TBST and incubated with primary antibodies against p38 MAPK (including p38 α and β isoforms), ERK1/2 and their phosphor-forms, FOXO3a, p53, p21 and cyclinD1 at 4°C overnight. Afterwards, the membranes were washed and incubated with a secondary antibody against rabbit or mouse IgG conjugated to horseradish peroxidase (Cell Signaling, MA, USA) for 1 h, followed by washing and transferring into ECL solution (Millipore, Darmstadt, Germany), and exposed to X-ray film.
For the transfection procedure, cells were seeded in 6-well or 96-well culture plates in RPMI 1640 medium containing 10% FBS (no antibodies), grown to 60% confluence, and p38 MAPK isoforms α, β, p53, FOXO3a and control siRNAs were transfected using the lipofectamine 2000 reagent according to the manufacturer’s instructions. Briefly, Lipofectamine 2000 was incubated with Opti-MEM medium (Invitrogen, CA, USA) for 5 min, mixed with siRNA (up to 70 nM), and incubated for 20 min at RT before the mixture was added to cells. After culturing for up to 30 h, the cells were washed and resuspended in fresh media in the presence or absence of BBR for an additional 24 h for all other experiments.
Cell apoptosis assays
Cell apoptosis was analyzed with Annexin V-FITC/PI Apoptosis Detection Kit (BestBio, Shanghai, China) according to instructions from the manufacturer. Briefly, after treated with BBR for 24 h, the apoptotic cells were harvested by Trypsin (no EDTA) and washed with PBS, then resuspended the cells in 500 μL binding buffer, 5 μL Annexin V-FITC regent and 10 μL PI regents and incubated for 5 min at RT in the dark, followed by detecting cell apoptosis by flow cytometry.
In parallel experiment, Hoechst 33258 staining was used to further analyze cell apoptosis. Cells were cultured in 12-well culture plates and treated with berberine for 24 h. Afterwards, the cells were washed with PBS, and incubated with 500 μL 4% methanal for 10 min, followed by staining with Hoechst 33258 (Sigma, St. Louis, MO, USA) at RT for 10 min, then observed with filters for blue fluorescence under fluorescence microscopy.
Electroporated transfection assays
NSCLC cells (1 × 107 cells/mL) were washed and centrifuged at 1200 rpm for 5 min, followed by removing the medium and PBS. Afterwards, the cells in the tubes were added Bio-Rad Gene Pulser electroporation buffer. After resuspending the cells, the desired N1-GFP or FoxO3a-GFP plasmid DNA (10 μg/mL) were added and the electroporation plate were put in the MXcell plate chamber and closed the lid in Gene Pulser II Electroporation System (Bio-Rad, CA, USA). The electroporation conditions on the plates to deliver 150 V/5 ms square wave were adjusted until reaching the optimal one. Once the condition has been set and then press “Pulse” to electroporate the cells. After electroporation was completed, the cells were transferred to a tissue culture plate. We typically transfer each 150 μL electroporation sample into a 6-well culture plate containing 2 mL RPMI1640. Cells were incubated for 48 h at 37°C, then treated with BBR for an additional 24 h.
Statistical analysis
All data were expressed as mean ± SD of three independent experiments, and analyzed by one-way ANOVA followed by post hoc testing or two-way ANOVA followed by Tukey’s Multiple Comparison Test for multiple comparison involved. These analyses were performed using GraphPad Prism software version 5.0 (GraphPad Software, CA, USA). Asterisks showed in the figures indicate significant differences of experimental groups in comparison with the corresponding control condition. P-values <0.05 were considered statistically significant.
Discussion
Berberine (BBR), a promising phytochemical drug and isoquinoline alkaloid in nature, has been shown to exhibit anti-proliferation or cytotoxic effects against cancer cells of different origins, especially in lung cancer [
19‐
21]. However, the mechanisms by this drug in control of NSCLC cell growth have not been well elucidated. In this study, we confirmed that BBR inhibited NSCLC cell proliferation and induced apoptosis. Moreover, BBR can arrest cell cycle in G0/G1 phase in A549 cells. The concentrations of BBR used here were consistent with or even lower then those reported by others demonstrating significant growth inhibition in different cell systems [
21‐
23]. We realized that a higher dose was needed to inhibit different cancer cell growth, but this was within the range of those reported by others and showed no toxicity [
21,
22,
24].
Induction of cell cycle arrest and apoptosis is regulated by a large number of molecules. In our study, we found that activation of p38α MAPK, but not ERK1/2, was mediated the effect of BBR on cell cycle arrest and induction of p53 and FOXO3a protein expression. Of notes, we demonstrated the unique role of p38α isoform played in this process, whether other p38 isoforms, such as p38γ or p38δ MAPK were also involved in this response required to be determined in the future studies. Consistent with this, the role of p38 MAPK pathway in mediating the cancer cell growth inhibition and induction of apoptosis has been established and reported [
25‐
27]. The p38 MAPK pathway negatively regulated cell proliferation and tumorigenesis. Inactivation of the p38 pathway enhanced cellular transformation and rendered mice prone to tumor development with concurrent disruption of the induction of senescence. Conversely, persistent activation of p38 inhibited tumorigenesis, suggesting a tumor-suppressing function of the p38 pathway [
25]. Our results suggested that activation of p38 MAPK was required in mediating the effect of BBR on induction of tumor suppressors p53 and FOXO3a, and lung cancer cell cycle arrest. Note that activation of ERK/12 by BBR played no role in this process, which were different or even opposite reported by others [
28,
29]. The discrepancy remained unclear; different cell lines and culture conditions may account for this, which needs to be determined with more experiments in the future. The cross-talk between ERK and p38 signaling pathways was reported in other studies [
30,
31]. However, in this study we have not observed this link. Thus, more experiments may require to confirm this.
In this study, we demonstrated the important role of tumor suppressor p53 in mediating the effect of BBR on cell proliferation and cell cycle arrest, which were consistent with other studies [
24,
32] suggesting that a p53-dependent pathway was required in this process. Tumor suppressor p53 plays a significant role in the regulation of cell growth, cell cycle arrest, and apoptosis in various cancers [
33,
34]. p53 controls both the G2/M and the G1 cell cycle checkpoints and mediates reversible growth arrest in human fibroblasts [
35]. Increased expression of wild-type p53 arrested cells late in the G1 stage of the cell cycle by stimulating the synthesis of inhibitors of cyclin-dependent kinase p21 (CIP1/WAF1) [
35]. Consistent with this, we found that BBR increased p21 protein expression in human lung cancer A549 cells, which was eliminated (not observed) in cells silencing of p53 gene. This suggested that BBR-induced p21 (CIP1/WAF1) was through p53-dependent pathway. P21 (CIP1/WAF1) is a direct target of p53 [
36], thus, p53 mediated induction of p21 (CIP1/WAF1) at least contributed to the inhibitory effect of BBR on cell proliferation and cell cycle arrest.
On the other hand, our results suggested that activation of p38 MAPK mediated the BBR-induced FOXO3a protein expression and the latter also contributed to the BBR-inhibited cell growth and -induced apoptosis. It is possible that the inhibition of proliferation can be in part a consequence of increased cell apoptosis or
vise versa. The FOXO3a is an important tumor suppressor and is under-expressed in many cancers. There are a number of parallels between FOXO3a and p53, both play a pivotal role in regulating the cellular response to stress and damage signals, inducing cell cycle arrest, apoptosis, and DNA repair [
37]. Several studies showed that FOXO3a interacts with p53, and that FOXO3a is a p53 target gene [
15,
38]. In this study, we demonstrated that the potential interaction and mutually exclusive events of p53 and FOXO3a may contribute to enhance BBR-induced apoptosis and -inhibited cell proliferation. However, the detailed mechanism underlining the regulation of these transcriptional networks in mediating the effect of BBR on the control of lung cancer cell survival needs to be elucidated.
Our results also demonstrated a causative role of FOXO3a in mediated the effect of BBR on p21 (CIP1/WAF1) expression. We showed that the knockdown of FOXO3a blocked, while overexpression of FOXO3a augmented the increase in p21 (CIP1/WAF1) protein expression in BBR-treated cells. These, together with the observation from silencing of p53 experiments indicated that p21 (CIP1/WAF1) is not only the direct target of p53 but also function as FOXO3a downstream effector, which may be through the p53-independent way [
17]. p53 and FOXO3a share similar target genes including p21(CIP1/WAF1), FOXO factors bind to the promoter of p21 to induce cell cycle arrest at the G1/S transition [
39]. Given the fact that p21 (CIP1/WAF1) is involved in regulation of fundamental cellular processes, such as cell proliferation, differentiation, regulation of gene transcription and apoptosis [
40,
41]. BBR-induced FOXO3a expression may contribute to induce cell apoptosis, which could be in part a consequence of inhibition of NSCLC cell growth. Of note, the dual function of p21 (Cip1/Waf1) was observed in cancerogenesis. On the one hand, p21 (Cip1/Waf1) acts as a tumor suppressor; on the other hand, it prevents apoptosis and acts as an oncogene [
40,
42]. Therefore, precise understanding the role of p21 (Cip1/Waf1) and relevant signaling pathways involved would help to develop better cancer-treatment strategies.
Study showed that activation of p38 MAPK reduced protein expression of cyclin D1, another cell cycle regulator [
43]. Cyclin D1 actives cyclin dependent kinase 4 and 6 (Cdk4/6) and this active complex is essential for the transition to S-phase and further stimulates cell proliferation [
44]. In our study, we showed that BBR decreased the cyclin D1 protein expression, but this was not through the p53- or FOXO3a-dependent pathway, which consistent with other studies [
45] although opposite results were observed [
12,
46]. Thus, more studies are required to elucidate the truly connections and precise mechanism underlining this. In addition, whether the BBR-induced pro-apoptotic signaling by p38 MAPK is also activated and the functions of FOXO3a are regulated by p38 MAPK in cells silencing of p53 need to be determined. This may further elucidate pleiotropic anti-cancer mechanisms of this medicinal phyto-chemical compound.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
SH is fully responsible for the study designing, experiment adjustment and drafting the manuscript. FZ performed most of the experiments involved. QT carried out transfection assays and some protein measurement by Western blot and statistical analysis. SYZ conducted the densitometry, statistical analysis and participated in coordination manuscript. JJW executed the MTT assays, FOXO3a overexpression experiments and statistical analysis. ZYL fulfilled MTT and Western Blot analysis. LLL and WYW coordinated and provided important suggestions including some agents, and critical read the manuscript. All authors read and approved the final manuscript.