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During the last years, chemopreventive activity of NSAIDs against a great variety of tumors was highly investigated. COX-2 seemingly plays a major part in tumorigensis and tumor development, underlined by several studies in animals and humans. At first, NSAIDs were thought to accomplish chemoprevention by inhibition of COX-2 as their so far known mode of action comprises unselective inhbition of COX-enzymes. However, further studies revealed COX-independent mechanisms. Sulindac is known as a well established drug used to treat inflammation and pain exerting the most prominent chemopreventive action, mainly in colorectal cancer or FAP and can be classified into the group of NSAIDs inhibting both COX-isoformes. As interference with the AA metabolism is evident, it was speculated whether Ssi has targets other than COX-enzymes providing evidence and explanation of its beneficial side effect profile and its ability to reduce tumor growth. 5-LO is another master enzyme in the AA cascade which produces inflammatory lipid mediators (LTs) upon stimulation in inflamed tissues. The present work should answer the question if Ssi targets the 5-LO pathway and should examine the molecular mechanisms behind Ssi-mediated 5-LO inhibiton. As COX-2 is upregulated during carcinogenesis and is inhibited by Ssi, further investigations should show regulatory effects of Ssi on 5-LO gene expression in MM6-cells and whether Sp1 as a common transcriptional factor is involved in such a regulation. As the use of NO-NSAIDs seem to be a promising strategy concerning their chemopreventive and gastroprotective effects compared to the parent NSAIDs, a possible interaction with the 5-LO pathway as a second, potent target should additionally be elucidated. In the first section it was demonstrated that the pharmacologically active metabolite of sulindac, Ssi, targets 5-LO. Ssi inhibited 5-LO in ionophore A23187- and LPS/fMLP-stimulated human PMNL (IC50 ≈ 8 -10 μM). Importantly, Ssi efficiently suppressed 5-LO in human whole blood at clinically relevant plasma levels (IC50 = 18.7 μM). Ssi was 5-LO-selective as no inhibition of related lipoxygenases (12-LO, 15-LO) was observed. The sulindac prodrug and the other metabolite, sulindac sulfone, failed to inhibit 5-LO. Mechanistic analysis demonstrated that Ssi directly suppresses 5-LO with an IC50 of 20 μM. Together, these findings may provide a novel molecular basis to explain the COX-independent pharmacological effects of sulindac under therapy. In the second part of the work dealing with the analysis of Ssi’s inhibitory mechanism on 5-LO it was presented that Ssi shows a lack of potency in cellular systems where membrane constituents are existent. The addition of microsomal fractions of PMNLto crude 5-LO enzyme were able to recover enzyme activity to ~ 100 %. Selectively 5-LO activity stimulating lipids like PC, participating in 5-LO membrane interactions within the regulatory C2-like domain of 5-LO, counteracted the Ssimediated inhibition on 5-LO-wt in a concentration-dependent manner. Lastly, a protein mutant lacking three trp resudies essential for linking the enzyme to nuclear membranes and deploying catalytic activity was not influenced by Ssi and shows enzyme activity in a cell-free assay. Ssi displays the first 5-LO inhibitor on the market interacting with the C2-like domain of the enzyme and therfore can stand for a novel lead structure of 5-LO inhibitors. An influence on 5-LO gene expression by Ssi could be detected in differentiated MM6-cells, described in the results chapter 3 (4.3). Ssi downregulated the 5-LO mRNA level after 72 hrs of incubation in differentiated MM6-cells to ~ 20 % of output control at concentrations of 10 μM. Concomitantly, mRNA levels of Sp1 were suppressed. Reporter gene studies revealed Sp1 most probably as a regulating agent involved in the Ssi-mediated 5-LO mRNA downregulation as co-transfection of increasing amounts of Sp1 could abrogate the effect. A ChIP assay could identify Sp1 as a critical transcriptional factor as Sp1 binding to the 5-LO promoter decreased in presence of Ssi. Lastly, three NO-NSADIs (NO-sulindac, NOnaproxen, NO-aspirin) were tested for the ability of 5-LO product inhibition. In intact PMNL, all compounds showed effective inhibition of 5-LO activity and NO-sulindac was most potent with an IC50 value of ~ 3 μM. NO-ASA inhibited 5-LO with IC50 values of ~ 30 μM and showed a non-competitive mode of action in cell-based assays. On human recombinant 5-LO all compounds again showed inhibitory potency whereas NO-sulindac again suppressed LT biosynthesis with an IC50 vaue comparable to intact cellular systems. Unfortunately, all inhibitors showed a loss of potency when tested for inhibition of 5-LO product synthesis in human whole blood as higher concentrations up to 100 μM were needed to reach at least 55 % enzyme inhibition. However, this strategy of 5-LO inhibition seems promising and needs further experimental approaches to gain more insight into the mechanism of 5-LO inhibition by NONSAIDs.
Leukotrienes constitute a group of bioactive lipids generated by the 5-lipoxygenase (5-LO) pathway. An increasing body of evidence supports an acute role for 5-LO products already during the earliest stages of pancreatic, prostate, and colorectal carcinogenesis. Several pieces of experimental data form the basis for this hypothesis and suggest a correlation between 5-LO expression and tumor cell viability. First, several independent studies documented an overexpression of 5-LO in primary tumor cells as well as in established cancer cell lines. Second, addition of 5-LO products to cultured tumor cells also led to increased cell proliferation and activation of anti-apoptotic signaling pathways. 5-LO antisense technology approaches demonstrated impaired tumor cell growth due to reduction of 5-LO expression. Lastly, pharmacological inhibition of 5-LO potently suppressed tumor cell growth by inducing cell cycle arrest and triggering cell death via the intrinsic apoptotic pathway. However, the documented strong cytotoxic off-target effects of 5-LO inhibitors, in combination with the relatively high concentrations of 5-LO products needed to achieve mitogenic effects in cell culture assays, raise concern over the assignment of the cause, and question the relationship between 5-LO products and tumorigenesis. Keywords: leukotriene, apoptosis, cell proliferation, mitogenic effects, cytotoxicity
5-Lipoxygenase (5-LO) is the key enzyme in the formation of pro-inflammatory leukotrienes (LT) which play an important role in a number of inflammatory diseases. Accordingly, 5-LO inhibitors are frequently used to study the role of 5-LO and LT in models of inflammation and cancer. Interestingly, the therapeutic efficacy of these inhibitors is highly variable. Here we show that the frequently used 5-LO inhibitors AA-861, BWA4C, C06, CJ-13,610 and the FDA approved compound zileuton as well as the pan-LO inhibitor nordihydroguaiaretic acid interfere with prostaglandin E2 (PGE2) release into the supernatants of cytokine-stimulated (TNFα/IL-1β) HeLa cervix carcinoma, A549 lung cancer as well as HCA-7 colon carcinoma cells with similar potencies compared to their LT inhibitory activities (IC50 values ranging from 0.1–9.1 µM). In addition, AA-861, BWA4C, CJ-13,610 and zileuton concentration-dependently inhibited bacterial lipopolysaccharide triggered prostaglandin (PG) release into human whole blood. Western Blot analysis revealed that inhibition of expression of enzymes involved in PG synthesis was not part of the underlying mechanism. Also, liberation of arachidonic acid which is the substrate for PG synthesis as well as PGH2 and PGE2 formation were not impaired by the compounds. However, accumulation of intracellular PGE2 was found in the inhibitor treated HeLa cells suggesting inhibition of PG export as major mechanism. Further, experiments showed that the PG exporter ATP-binding cassette transporter multidrug resistance protein 4 (MRP-4) is targeted by the inhibitors and may be involved in the 5-LO inhibitor-mediated PGE2 inhibition. In conclusion, the pharmacological effects of a number of 5-LO inhibitors are compound-specific and involve the potent inhibition of PGE2 export. Results from experimental models on the role of 5-LO in inflammation and pain using 5-LO inhibitors may be misleading and their use as pharmacological tools in experimental models has to be revisited. In addition, 5-LO inhibitors may serve as new scaffolds for the development of potent prostaglandin export inhibitors.