We have used a murine model of breast cancer where tumour growth in syngeneic female BALB/c mice is induced by a single
s.c. injection of 1 × 10
3 4T1 cells in the right flank of the mice. The 4T1 tumour model closely resembles human breast cancer because its poor immunogenicity and ability to spontaneously metastasise to lungs, liver, bone marrow and brain [
16,
17]. This model was used to evaluate the efficacy of oral supplementation of TRF to enhance the therapeutic benefits of DC immunotherapy in treating breast cancer in a mouse model.
Our results showed that TRF on its own, in both the
in-vitro or
in-vivo methods used in this study can significantly inhibit the growth of 4T1 cells or tumours induced by these cells. This study corroborates with previous reports of other tumour models [
12,
18,
19]. In this study, we show for the first time, that the combination of using two therapeutic approaches i.e. three injections of tumour-lysate pulsed DC prior to inoculation of tumour cells and daily TRF supplementation can significantly inhibit the growth of tumour as well as improve the overall survival of mice induced with tumour.
The MTT assay showed that 2 μg/ml TRF could inhibit the proliferation of 4T1 tumour cells
in vitro. However, TRF at this concentration did not exhibit any anti-proliferative effect of DC or murine splenocytes (Fig.
3b &
3c). The IC
50 value of TRF for 4T1 cells was determined to be 8 μg/ml. Although there was a slight increase in the CD11c expression by TRF-treated DCs compared to control, this increase was not statistically significant. The DC+TL+TRF treatment yielded significantly higher production of IFN-γ by the DC. In addition, the DC pulsed with tumour lysate from 4T1 cells could enhance the productions of IFN-γ and IL-12 by T-helper-1 cells when these cells were cultured in the presence of 8 μg/ml TRF. These findings show that TRF is a potent compound that can induce the immune system to release cytokines that promote cell mediated immune response.
In the animal model, mice that were injected with DC pulsed with tumour lysate from 4T1 cells and supplemented daily with oral TRF showed marked reduction in tumour onset and growth. Previous reports by Nesaretnam and co-workers [
12,
13,
19‐
21] have shown that tocotrienol on its own can inhibit growth of human breast cancer cells
in vitro [
12,
19] as well as in athymic nude mice [
21]. The combination of tumour lysate pulsed-DC and TRF supplementation observed in this study could inhibit the growth of breast tumour in the mouse model. As shown in Fig.
5 and Table
1, the incidence of tumour in the DC+TL+TRF group showed smaller tumour burden compared to control group and DC+TL group, TRF group and DC+TRF group. The splenocytes from the DC+TL+TRF group produced the highest amount of IFN-γ (1346 pg/ml) compared to the DC+TL group (700 pg/ml), control untreated group (520 pg/ml), TRF group (760 pg/ml) or DC+TRF group (900 pg/ml). The IL-12 amount produced in splenocytes culture from experimental mice showed similar pattern as IFN-γ. There was a significant higher production of IFN-γ and IL-12, which are the two signature cytokines for Th1 response, by splenocytes from the DC+TL+TRF group which also suggest that the combination therapy has been effective in enhancing a cell-mediated immune response in these mice. Interferon-γ also promotes class-switching to IgG isotype, which is a key component of cell mediated immunity [
22]. This cytokine also upregulates the expression of class II MHC molecules and B7 co-stimulatory molecules on antigen presenting cells. For IL-12, it is expressed specifically in macrophages and dendritic cells [
17,
23] and plays a central role in mediating cell mediated immunity, promoting differentiation of CD4+ T cells to the Th1 subset and of CD8
+ T cells into mature cytotoxic T lymphocytes (CTLs) [
24]. IL-12 is also a potent stimulator of NK cells as well as enhancing cytocidal anti tumour immune responses [
25,
26]. All these actions could serve to amplify T-cell responses [
22]. Our findings are in agreement with that reported by Ramanathapuram and co-workers [
2], who showed that combination therapy using alpha-tocopheryl succinate (α-TOS) and DCs (α-TOS+DC) increased IFN-γ production by CD4
+ and CD8
+ T lymphocytes. The α-TOS is an esterified analogue of vitamin E used as an adjuvant to demonstrate the inhibitions of 3LL tumours
in vitro and in C57BL/6 mice model. In our study, we used tocotrienol-rich fraction (TRF), which contains the natural isomers of vitamin E. The TRF can be found abundantly in palm oil was used as an adjuvant to develop cancer vaccine in this study because TRF could inhibit the growth of murine mammary cancer (4T1) and human breast cancer (MCF-7 & MDA) cells. In addition, when the DC were co-cultured with TRF, there was a significant increase in the production of IFN-γ by the DC. These are important properties for an adjuvant to be used in a tumour model to have as it could promote Th1 immune responses.
Both NK cells and CD8
+ T-cells have a crucial role in the recognition and removal of tumour cells [
27‐
29]. The NK cell activation induced by tumour cells can directly promote anti-tumour responses. Although activation of CD8
+ T-cells is more complex, it is important for the development of tumour-specific memory T-cells, which is responsible for long-term protection against the same tumour [
28]. The percentages of NK cells and CD8
+ T-cells increased in the TRF supplemented group compared to the control and DC+TL only group. Thus, the combine therapy of using DC+TL and daily oral TRF supplementation can promote tumour-specific immune responses in this mouse model of breast cancer.