[Mechanism of Killing Effect of Thioridazine on Human Lung Cancer PC9 Cells]

Repurposing Antipsychotics for Cancer Treatment

Cancer is a leading cause of death worldwide, with approximately 19 million new cases each year. Lately, several novel chemotherapeutic drugs have been introduced, efficiently inhibiting tumor growth and proliferation. However, developing a new drug is a time- and money-consuming process, requiring around 1 billion dollars and nearly ten years, with only a minority of the initially effective anti-cancer drugs experimentally finally being efficient in human clinical trials. Drug repurposing for cancer treatment is an optimal alternative as the safety of these drugs has been previously tested, and thus, in case of successful preclinical studies, can be introduced faster and with a lower cost into phase 3 clinical trials. Antipsychotic drugs are associated with anti-cancer properties and, lately, there has been an increasing interest in their role in cancer treatment. In the present review, we discussed in detail the in-vitro and in-vivo properties of the most common typical and atypical antipsychotics, along with their mechanism of action.

[Thioridazine Sensitizes Apoptotic Effect of TRAIL in Human Lung Cancer PC9 Cells Through ER Stress Mediated Up-regulation of DR5]

背景与目的

肿瘤坏死因子相关凋亡诱导配体（tumor necrosis factor-related apoptosis-inducting ligand, TRAIL）可诱导肿瘤细胞发生凋亡，然而相当数量的肿瘤细胞可耐受TRAIL诱导的凋亡而得以存活。本实验观察硫利达嗪（thioridazine, THZ）通过诱导内质网应激（endoplasmic reticulum stress, ER stress）介导的死亡受体5（death receptor 5, DR5）表达上调，继而增敏TRAIL对肺腺癌细胞PC9的生长抑制及凋亡诱导效应，探讨其机制。

方法

不同浓度硫利达嗪及TRAIL单独或联合处理PC9细胞，MTT法检测细胞活性变化，流式细胞术检测细胞表面DR5表达及细胞凋亡率，Western blotting检测内质网应激相关蛋白GRP78（glucose regulated protein 78）、C/EBP环磷酸腺苷反应元件结合转录因子同源蛋白（C/EBP homologous protein, CHOP）、p-PERK（PKR-like ER kinase）、p-eIF2α（eukaryotic initiation factor-2α, eIF2α）、ATF4（activating transcription factor 4, ATF4）及凋亡相关蛋白Caspase-3、Caspase-9、Caspase-8、PARP、DR5表达变化。

结果

硫利达嗪对PC9细胞的增殖抑制效应呈浓度依赖性（P < 0.05），硫利达嗪可增加TRAIL对PC9细胞的抑制作用及凋亡诱导作用且可上调PC9细胞表面DR5表达水平，流式细胞术结果显示：TRAIL联合硫利达嗪组细胞凋亡率较单独TRAIL组显著增加（P < 0.05），Western blotting结果显示：TRAIL联合硫利达嗪组细胞Cleaved-caspase-8、Cleaved-PARP、DR5表达水平较单独TRAIL组明显上调。DR5表达上调及促凋亡效应是通过诱导内质网应激发生，并伴随着GRP78及CHOP表达上调发生的，且该效应可被4-苯基丁酸（4-phenylbutyric acid, 4-PBA）可抑制（P < 0.05）。

结论

硫利达嗪增敏TRAIL对PC9细胞的增殖抑制效应显著，其机制可能与硫利达嗪内质网应激介导的DR5上调有关。