Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Research Article

Elemene Injection Overcomes Paclitaxel Resistance in Breast Cancer through AR/RUNX1 Signal: Network Pharmacology and Experimental Validation

Author(s): Xidong Gu, Leilai Xu, Yuanyuan Fu, Shuyao Fan, Tianjian Huang, Jiangting Yu, Jiaying Chen, Xinbing Sui* and Xiaohong Xie*

Volume 30, Issue 29, 2024

Published on: 24 June, 2024

Page: [2313 - 2324] Pages: 12

DOI: 10.2174/0113816128315677240620052444

Price: $65

Abstract

Background: Paclitaxel (PTX) is a cornerstone chemotherapy for Breast Cancer (BC), yet its impact is limited by emerging resistance. Elemene Injection (EI) has shown potential in overcoming chemotherapy resistance. However, the efficacy by which EI restores PTX sensitivity in BC and the implicated molecular mechanism remain uncharted.

Methods: Network pharmacology and bioinformatic analysis were conducted to investigate the targets and mechanisms of EI in overcoming PTX resistance. A paclitaxel-resistant MCF-7 cell line (MCF-7PR) was established. The efficacy of EI and/or PTX in inhibiting cell viability was evaluated using sulforhodamine B assay, while cell proliferation was assessed using EdU staining. Furthermore, protein and gene expression analysis was performed through Western blotting and qPCR.

Results: The EI containing three active components exhibited a multifaceted impact by targeting an extensive repertoire of 122 potential molecular targets. By intersecting with 761 differentially expressed genes, we successfully identified 9 genes that displayed a direct association with resistance to PTX in BC, presenting promising potential as therapeutic targets for the EI to effectively counteract PTX resistance. Enrichment analysis indicated a significant correlation between these identified targets and critical biological processes, particularly DNA damage response and cell cycle regulation. This correlation was further substantiated through meticulous analysis of single-cell datasets. Molecular docking analysis revealed robust binding affinities between the active components of the EI and the identified molecular targets. Subsequently, in vitro experiments unequivocally demonstrated the dose- and time-dependent inhibitory effects of the EI on both PTX-resistant and sensitive BC cell lines, effectively mitigating the resistance phenotype associated with PTX administration. Furthermore, our findings have indicated EI to effectively suppress the protein expression levels of AR and RUNX1 in MCF-7 and MCF-7PR cells under PTX treatment, as well as downregulate the mRNA expression levels of stem-like properties’ markers, KLF4 and OCT4, in these cell lines.

Conclusion: Elemene Injection (EI) application has exhibited a significant capability to mitigate PTX resistance in BC, which has been achieved through targeted suppression of the AR/RUNX1 axis, revealing a key strategy to overcome chemotherapeutic resistance.

[1]
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71(3): 209-49.
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[2]
Loibl S, Poortmans P, Morrow M, Denkert C, Curigliano G. Breast cancer. Lancet 2021; 397(10286): 1750-69.
[http://dx.doi.org/10.1016/S0140-6736(20)32381-3] [PMID: 33812473]
[3]
Johnston SRD, Hegg R, Im SA, et al. Phase III, Randomized study of dual human epidermal growth factor receptor 2 (HER2) blockade with lapatinib plus trastuzumab in combination with an aromatase inhibitor in postmenopausal women with HER2-positive, hormone receptor–positive metastatic breast cancer: Updated results of alternative. J Clin Oncol 2021; 39(1): 79-89.
[http://dx.doi.org/10.1200/JCO.20.01894] [PMID: 32822287]
[4]
Curigliano G, Dent R, Earle H, et al. Open questions, current challenges, and future perspectives in targeting human epidermal growth factor receptor 2-low breast cancer. ESMO Open 2024; 9(4): 102989.
[http://dx.doi.org/10.1016/j.esmoop.2024.102989] [PMID: 38613914]
[5]
Rizzo A, Cusmai A, Acquafredda S, Rinaldi L, Palmiotti G. Ladiratuzumab vedotin for metastatic triple negative cancer: Preliminary results, key challenges, and clinical potential. Expert Opin Investig Drugs 2022; 31(6): 495-8.
[http://dx.doi.org/10.1080/13543784.2022.2042252] [PMID: 35171746]
[6]
Guven DC, Sahin TK, Erul E, et al. The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Front Mol Biosci 2022; 9: 1039121.
[http://dx.doi.org/10.3389/fmolb.2022.1039121] [PMID: 36533070]
[7]
Rizzo A, Ricci AD, Lanotte L, et al. Immune-based combinations for metastatic triple negative breast cancer in clinical trials: Current knowledge and therapeutic prospects. Expert Opin Investig Drugs 2022; 31(6): 557-65.
[http://dx.doi.org/10.1080/13543784.2022.2009456] [PMID: 34802383]
[8]
Rizzo A, Mollica V, Tateo V, et al. Hypertransaminasemia in cancer patients receiving immunotherapy and immune-based combinations: the MOUSEION-05 study. Cancer Immunol Immunother 2023; 72(6): 1381-94.
[http://dx.doi.org/10.1007/s00262-023-03366-x] [PMID: 36695827]
[9]
Miles D, Gligorov J, André F, et al. Primary results from IMpassion131, a double-blind, placebo-controlled, randomised phase III trial of first-line paclitaxel with or without atezolizumab for unresectable locally advanced/metastatic triple-negative breast cancer. Ann Oncol 2021; 32(8): 994-1004.
[http://dx.doi.org/10.1016/j.annonc.2021.05.801] [PMID: 34219000]
[10]
Rivera E, Gomez H. Chemotherapy resistance in metastatic breast cancer: The evolving role of ixabepilone. Breast Cancer Res 2010; 12(Suppl 2): S2.
[http://dx.doi.org/10.1186/bcr2573]
[11]
Yardley DA. Drug resistance and the role of combination chemotherapy in improving patient outcomes. Int J Breast Cancer 2013; 2013: 1-15.
[http://dx.doi.org/10.1155/2013/137414] [PMID: 23864953]
[12]
Efferth T, Li PCH, Konkimalla VSB, Kaina B. From traditional Chinese medicine to rational cancer therapy. Trends Mol Med 2007; 13(8): 353-61.
[http://dx.doi.org/10.1016/j.molmed.2007.07.001] [PMID: 17644431]
[13]
Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. JAMA 1998; 280(18): 1569-75.
[http://dx.doi.org/10.1001/jama.280.18.1569] [PMID: 9820257]
[14]
Liu J, Zhang Y, Qu J, et al. β-elemene-induced autophagy protects human gastric cancer cells from undergoing apoptosis. BMC Cancer 2011; 11(1): 183.
[http://dx.doi.org/10.1186/1471-2407-11-183] [PMID: 21595977]
[15]
Jiang X, Hidru TH, Zhang Z, Bai Y, Kong L, Li X. Evidence of elemene injection combined radiotherapy in lung cancer treatment among patients with brain metastases. Medicine 2017; 96(21): e6963.
[http://dx.doi.org/10.1097/MD.0000000000006963] [PMID: 28538391]
[16]
Tan W, Lu J, Huang M, et al. Anti-cancer natural products isolated from chinese medicinal herbs. Chin Med 2011; 6(1): 27.
[http://dx.doi.org/10.1186/1749-8546-6-27] [PMID: 21777476]
[17]
Pan Y, Wang W, Huang S, et al. Beta-elemene inhibits breast cancer metastasis through blocking pyruvate kinase M2 dimerization and nuclear translocation. J Cell Mol Med 2019; 23(10): 6846-58.
[http://dx.doi.org/10.1111/jcmm.14568] [PMID: 31343107]
[18]
Yao C, Jiang J, Tu Y, Ye S, Du H, Zhang Y. β-elemene reverses the drug resistance of A 549/DDP lung cancer cells by activating intracellular redox system, decreasing mitochondrial membrane potential and P-glycoprotein expression, and inducing apoptosis. Thorac Cancer 2014; 5(4): 304-12.
[http://dx.doi.org/10.1111/1759-7714.12093] [PMID: 26767017]
[19]
Ru J, Li P, Wang J, et al. TCMSP: A database of systems pharmacology for drug discovery from herbal medicines. J Cheminform 2014; 6(1): 13.
[http://dx.doi.org/10.1186/1758-2946-6-13] [PMID: 24735618]
[20]
Davis AP, Wiegers TC, Johnson RJ, Sciaky D, Wiegers J, Mattingly CJ. Comparative Toxicogenomics Database (CTD): Update 2023. Nucleic Acids Res 2023; 51(D1): D1257-62.
[http://dx.doi.org/10.1093/nar/gkac833] [PMID: 36169237]
[21]
Daina A, Michielin O, Zoete V. SwissTargetPrediction: Updated data and new features for efficient prediction of protein targets of small molecules. Nucleic Acids Res 2019; 47(W1): W357-64.
[http://dx.doi.org/10.1093/nar/gkz382] [PMID: 31106366]
[22]
Bindea G, Mlecnik B, Hackl H, et al. ClueGO: A cytoscape plug-in to decipher functionally grouped gene ontology and pathway annotation networks. Bioinformatics 2009; 25(8): 1091-3.
[http://dx.doi.org/10.1093/bioinformatics/btp101] [PMID: 19237447]
[23]
Yuan H, Yan M, Zhang G, et al. CancerSEA: A cancer single-cell state atlas. Nucleic Acids Res 2019; 47(D1): D900-8.
[http://dx.doi.org/10.1093/nar/gky939] [PMID: 30329142]
[24]
Gupta P, Srivastava SK. Antitumor activity of phenethyl isothiocyanate in HER2-positive breast cancer models. BMC Med 2012; 10(1): 80.
[http://dx.doi.org/10.1186/1741-7015-10-80] [PMID: 22824293]
[25]
Li F, Lu J, Liu J, et al. A water-soluble nucleolin aptamer-paclitaxel conjugate for tumor-specific targeting in ovarian cancer. Nat Commun 2017; 8(1): 1390.
[http://dx.doi.org/10.1038/s41467-017-01565-6] [PMID: 29123088]
[26]
Li R, Moudgil T, Ross HJ, Hu HM. Apoptosis of non-small-cell lung cancer cell lines after paclitaxel treatment involves the BH3-only proapoptotic protein Bim. Cell Death Differ 2005; 12(3): 292-303.
[http://dx.doi.org/10.1038/sj.cdd.4401554] [PMID: 15711598]
[27]
Subramanian IV, Devineni S, Ghebre R, et al. AAV-P125A-endostatin and paclitaxel treatment increases endoreduplication in endothelial cells and inhibits metastasis of breast cancer. Gene Ther 2011; 18(2): 145-54.
[http://dx.doi.org/10.1038/gt.2010.118] [PMID: 20844568]
[28]
Wu CH, Hong BH, Ho CT, Yen GC. Targeting cancer stem cells in breast cancer: Potential anticancer properties of 6-shogaol and pterostilbene. J Agric Food Chem 2015; 63(9): 2432-41.
[http://dx.doi.org/10.1021/acs.jafc.5b00002] [PMID: 25686711]
[29]
Li QQ, Wang G, Reed E, Huang L, Cuff CF. Evaluation of cisplatin in combination with β-elemene as a regimen for prostate cancer chemotherapy. Basic Clin Pharmacol Toxicol 2010; 107(5): 868-76.
[http://dx.doi.org/10.1111/j.1742-7843.2010.00592.x] [PMID: 22545969]
[30]
Rui D, Xiaoyan C, Taixiang W, Guanjian L. Elemene for the treatment of lung cancer. Cochrane Syst Rev 2007; 4: CD6054.
[31]
Zhou J, He LL, Ding XF, et al. Combinatorial antitumor effect of rapamycin and β-elemene in follicular thyroid cancer cells. BioMed Res Int 2016; 2016: 1-8.
[http://dx.doi.org/10.1155/2016/6723807] [PMID: 27274989]
[32]
Zhang Y, Sun X, Nan N, et al. Elemene inhibits the migration and invasion of 4T1 murine breast cancer cells via heparanase. Mol Med Rep 2017; 16(1): 794-800.
[http://dx.doi.org/10.3892/mmr.2017.6638] [PMID: 28560389]
[33]
Liu S, Li Q, Li G, et al. The mechanism of m6A methyltransferase METTL3-mediated autophagy in reversing gefitinib resistance in NSCLC cells by β-elemene. Cell Death Dis 2020; 11(11): 969.
[http://dx.doi.org/10.1038/s41419-020-03148-8] [PMID: 33177491]
[34]
Zhang R, Pan T, Xiang Y, et al. β-elemene reverses the resistance of p53-deficient colorectal cancer cells to 5-fluorouracil by inducing pro-death autophagy and cyclin D3-dependent cycle arrest. Front Bioeng Biotechnol 2020; 8: 378.
[http://dx.doi.org/10.3389/fbioe.2020.00378] [PMID: 32457882]
[35]
Zhang J, Zhang H, Yao YF, Zhong SL, Zhao JH, Tang JH. β-elemene reverses chemoresistance of breast cancer cells by reducing resistance transmission via exosomes. Cell Physiol Biochem 2015; 36(6): 2274-86.
[http://dx.doi.org/10.1159/000430191] [PMID: 26279432]
[36]
Zhang J, Zhang H, Chen L, et al. β-elemene reverses chemoresistance of breast cancer via regulating MDR-related microRNA expression. Cell Physiol Biochem 2014; 34(6): 2027-37.
[http://dx.doi.org/10.1159/000366398] [PMID: 25562151]
[37]
Hopkins AL. Network pharmacology: The next paradigm in drug discovery. Nat Chem Biol 2008; 4(11): 682-90.
[http://dx.doi.org/10.1038/nchembio.118] [PMID: 18936753]
[38]
Wang N, Zheng Y, Gu J, et al. Network-pharmacology-based validation of TAMS/CXCL-1 as key mediator of XIAOPI formula preventing breast cancer development and metastasis. Sci Rep 2017; 7(1): 14513.
[http://dx.doi.org/10.1038/s41598-017-15030-3] [PMID: 29109519]
[39]
Wang S, Wang H, Lu Y. Tianfoshen oral liquid: A CFDA approved clinical traditional Chinese medicine, normalizes major cellular pathways disordered during colorectal carcinogenesis. Oncotarget 2017; 8(9): 14549-69.
[http://dx.doi.org/10.18632/oncotarget.14675] [PMID: 28099904]
[40]
Wang N, Yang B, Zhang X, et al. Network pharmacology-based validation of caveolin-1 as a key mediator of Ai Du Qing inhibition of drug resistance in breast cancer. Front Pharmacol 2018; 9: 1106.
[http://dx.doi.org/10.3389/fphar.2018.01106] [PMID: 30333750]
[41]
Hassin O, Oren M. Drugging p53 in cancer: One protein, many targets. Nat Rev Drug Discov 2023; 22(2): 127-44.
[http://dx.doi.org/10.1038/s41573-022-00571-8] [PMID: 36216888]
[42]
Jones SA, Jenkins BJ. Recent insights into targeting the IL-6 cytokine family in inflammatory diseases and cancer. Nat Rev Immunol 2018; 18(12): 773-89.
[http://dx.doi.org/10.1038/s41577-018-0066-7] [PMID: 30254251]
[43]
Hu F, Song D, Yan Y, et al. IL-6 regulates autophagy and chemotherapy resistance by promoting BECN1 phosphorylation. Nat Commun 2021; 12(1): 3651.
[http://dx.doi.org/10.1038/s41467-021-23923-1] [PMID: 34131122]
[44]
Kitajima S, Yoshida A, Kohno S, et al. The RB–IL-6 axis controls self-renewal and endocrine therapy resistance by fine-tuning mitochondrial activity. Oncogene 2017; 36(36): 5145-57.
[http://dx.doi.org/10.1038/onc.2017.124] [PMID: 28481867]
[45]
Di L. The impact of carboxylesterases in drug metabolism and pharmacokinetics. Curr Drug Metab 2019; 20(2): 91-102.
[http://dx.doi.org/10.2174/1389200219666180821094502] [PMID: 30129408]
[46]
Nagaoka M, Sakai Y, Nakajima M, Fukami T. Role of carboxylesterase and arylacetamide deacetylase in drug metabolism, physiology, and pathology. Biochem Pharmacol 2024; 223: 116128.
[http://dx.doi.org/10.1016/j.bcp.2024.116128] [PMID: 38492781]
[47]
Ding F, Qiu C, Li W, et al. CNR1 may reverse progesterone-resistance of endometrial cancer through the ERK pathway. Biochem Biophys Res Commun 2021; 548: 148-54.
[http://dx.doi.org/10.1016/j.bbrc.2021.02.038] [PMID: 33640608]
[48]
Huang R, Zhang J, Li M, et al. The role of Peroxisome Proliferator-activated Receptors (PPARs) in pan-cancer. PPAR Res 2020; 2020: 1-19.
[http://dx.doi.org/10.1155/2020/6527564] [PMID: 33029111]
[49]
Massacci G, Perfetto L, Sacco F. The Cyclin-dependent kinase 1: More than a cell cycle regulator. Br J Cancer 2023; 129(11): 1707-16.
[http://dx.doi.org/10.1038/s41416-023-02468-8] [PMID: 37898722]
[50]
Qin X, Guo H, Wang X, et al. Exosomal miR-196a derived from cancer-associated fibroblasts confers cisplatin resistance in head and neck cancer through targeting CDKN1B and ING5. Genome Biol 2019; 20(1): 12.
[http://dx.doi.org/10.1186/s13059-018-1604-0] [PMID: 30642385]
[51]
Wang Q, Bode AM, Zhang T. Targeting CDK1 in cancer: Mechanisms and implications. NPJ Precis Oncol 2023; 7(1): 58.
[http://dx.doi.org/10.1038/s41698-023-00407-7] [PMID: 37311884]
[52]
Chu IM, Hengst L, Slingerland JM. The Cdk inhibitor p27 in human cancer: Prognostic potential and relevance to anticancer therapy. Nat Rev Cancer 2008; 8(4): 253-67.
[http://dx.doi.org/10.1038/nrc2347] [PMID: 18354415]
[53]
Fernández NB, Sosa SM, Roberts JT, et al. RUNX1 is regulated by androgen receptor to promote cancer stem markers and chemotherapy resistance in triple negative breast cancer. CELLS-BASEL 2023; 12(3): 444.
[http://dx.doi.org/10.3390/cells12030444]
[54]
Liu N, Meng QX, Wang GS. The relationship between the expression of amplified in breast cancer 1, androgen receptor and tamoxifen resistance in breast cancer. Zhonghua Yi Xue Za Zhi 2023; 103(20): 1553-9.
[PMID: 37246005]
[55]
Ali A, Creevey L, Hao Y, et al. Prosaposin activates the androgen receptor and potentiates resistance to endocrine treatment in breast cancer. Breast Cancer Res 2015; 17(1): 123.
[http://dx.doi.org/10.1186/s13058-015-0636-6] [PMID: 26341737]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy