dicumarol and Urinary-Bladder-Neoplasms

To investigate the effectiveness of a combined treatment of 3-30-methylene-bis[4-hydroxycoumarin] (dicoumarol) with doxorubicin for the treatment of urothelial cancer, as doxorubicin is a common chemotherapeutic agent but its therapeutic efficacy is limited.. The synergistic effect of dicoumarol with chemotherapeutic agents such as cisplatin, doxorubicin and paclitaxel was evaluated in RT112 urothelial cancer cells. Then, dicoumarol-mediated enhancement of doxorubicin-induced cytotoxicity was screened in urothelial cancer cell lines with different p53 statuses or RT112 stable transfectants with a dominant-negative mutant of p53 (p53DN). To clarify the importance of the modification of p53 function by dicoumarol to enhance doxorubicin toxicity, the change in the p53-p21 pathway and mitogen-activated protein kinase (MAPK)-mitochondria pathway by the combined treatment were elucidated by Western blot analysis. Finally, the effect of p21 knockdown in the susceptibility to doxorubicin was examined with RT112 stable transfectants with short hairpin RNA (shRNA) of p21.. Dicoumarol significantly increased the susceptibility of RT112 cells to cisplatin and doxorubicin, but not to paclitaxel in RT112 cells. Dicoumarol (100 microm) also enhanced the cytotoxicity of doxorubicin in other bladder cancer cell lines with wild-type p53 (wt-p53; three times in 253J and 13 times in KK47), but not in those with mutant-type p53 (TCCsup, J82 and EJ) or in RT112 p53DN. The combined treatment with dicoumarol suppressed p53/p21 induction by doxorubicin and resulted in sequential p38 MAPK activation, myeloid cell leukaemia 1 suppression and caspase cleavage. The synergistic effect of doxorubicin/dicoumarol was suppressed by the p38 MAPK inhibitor SB202190 and, furthermore, p21 knockdown with shRNA transfection made RT112 cells six times more susceptible to doxorubicin with p38 MAPK activation.. These results suggest that concomitant use of dicoumarol could enhance the cytotoxicity of doxorubicin in urothelial cancer cells with wt-p53 through the p53/p21/p38 MAPK pathways. This combined treatment may provide a new therapeutic option to overcome chemoresistance in bladder cancer.

Topics: Antineoplastic Combined Chemotherapy Protocols; Cell Line, Tumor; Cisplatin; Dicumarol; Doxorubicin; Drug Resistance, Neoplasm; Drug Synergism; Humans; Immunoblotting; p38 Mitogen-Activated Protein Kinases; Paclitaxel; Signal Transduction; Tumor Suppressor Protein p53; Urinary Bladder Neoplasms; Urothelium

3-3'-Methylene-bis [4-hydroxycoumarin] (dicoumarol), an inhibitor of NADPH:quinone oxidoreductase 1, has been reported to possess potential antineoplastic effects and the ability to abrogate p53 protein. In the present study, we investigated the cytotoxic effects of dicoumarol in combination with cisplatin (CDDP), using four bladder (RT112, 253J, J82 and UMUC3) and two prostate (LNCap and PC3) cancer cell lines. Single treatment with 100 microM dicoumarol suppressed cell proliferation but did not induce apoptosis at 24 h in all cell lines examined. On the other hand, pretreatment with dicoumarol enhanced cytotoxicity of CDDP in three cell lines with wild type of p53 (RT112, 253J and LNCap), but not in three other cell lines with mutant p53 or in RT112 stable transfectants with a dominant-negative mutant of p53. In RT112 and LNCap, CDDP induced p53 and p21 expression, while pretreatment of dicoumarol suppressed induction of p53/p21 and resulted in sequential activation of c-Jun N-terminal kinase (JNK) in a time-dependent manner. Furthermore, inhibition of JNK, using SP600125, completely suppressed activity of caspases and poly-(ADP-ribose) polymerase cleavage, leading to suppression of enhancement of CDDP-mediated apoptosis by dicoumarol. These results suggested that dicoumarol could enhance cytotoxicity of CDDP in urogenital cancer cells with wild-type p53 through the p53/p21/JNK pathways.

Topics: Antineoplastic Agents; Apoptosis; Caspases; Cisplatin; Dicumarol; Drug Therapy, Combination; Enzyme Inhibitors; Humans; JNK Mitogen-Activated Protein Kinases; Male; Poly(ADP-ribose) Polymerases; Prostatic Neoplasms; Tumor Suppressor Protein p53; Urinary Bladder Neoplasms

The distribution of NADPH-dependent quinone reductase and NADPH-cytochrome P-450 reductase activities was determined in the urinary bladders of male and female rabbits. In urinary bladder transitional epithelium (UBTE) and in urinary bladder non-transitional tissue (UBNT) microsomal quinone reductases demonstrated significant (P less than 0.05) sex-dependent differences in the case of both dicoumarol-insensitive (male greater than female) and dicoumarol-sensitive or DT-diaphorase (female greater than male) activities. Microsomal NADPH-cytochrome P-450 reductase activities in UBTE and in UBNT were found to be similar in male and female rabbits. The activities of microsomal and cytosolic quinone reductases and the activity of microsomal NADPH-cytochrome P-450 reductase in UBNT were much lower than those in UBTE. NADPH-cytochrome P-450 reductase and similar flavo-enzymes activate quinones via one-electron reduction into semiquinone free radicals, which then react with molecular oxygen, forming superoxide anions. DT-diaphorase acts as a detoxifying enzyme by converting many quinones via a unique two-electron reduction into less reactive hydroquinones, enabling their excretion as water-soluble conjugates. Since UBTE contains substantial activities of prostaglandin H synthase (PHS) and NADPH-cytochrome P-450 reductase, unlike UBNT, the toxicity and carcinogenicity of xenobiotics which are either quinones or form quinones in situ through the mediation of PHS would be high in UBTE. The risk of carcinogenicity of quinones in UBTE would be higher in male rabbits than in female rabbits due to sex-dependent differences in the relative proportions of the one-electron reduction pathway, represented by NADPH-cytochrome P-450 reductase, and the two-electron reduction pathway, represented by DT-diaphorase (female greater than male).

Topics: Animals; Dicumarol; Female; Male; NAD(P)H Dehydrogenase (Quinone); NADPH-Ferrihemoprotein Reductase; Quinone Reductases; Rabbits; Sex Factors; Urinary Bladder; Urinary Bladder Neoplasms