Combinatorial effect of non-steroidal anti-inflammatory drugs and NF-κB inhibitors in ovarian cancer therapy

PLoS One. 2011;6(9):e24285. doi: 10.1371/journal.pone.0024285. Epub 2011 Sep 12.

Abstract

Several epidemiological studies have correlated the use of non-steroidal anti-inflammatory drugs (NSAID) with reduced risk of ovarian cancer, the most lethal gynecological cancer, diagnosed usually in late stages of the disease. We have previously established that the pro-apoptotic cytokine melanoma differentiation associated gene-7/Interleukin-24 (mda-7/IL-24) is a crucial mediator of NSAID-induced apoptosis in prostate, breast, renal and stomach cancer cells. In this report we evaluated various structurally different NSAIDs for their efficacies to induce apoptosis and mda-7/IL-24 expression in ovarian cancer cells. While several NSAIDs induced apoptosis, Sulindac Sulfide and Diclofenac most potently induced apoptosis and reduced tumor growth. A combination of these agents results in a synergistic effect. Furthermore, mda-7/IL-24 induction by NSAIDs is essential for programmed cell death, since inhibition of mda-7/IL-24 by small interfering RNA abrogates apoptosis. mda-7/IL-24 activation leads to upregulation of growth arrest and DNA damage inducible (GADD) 45 α and γ and JNK activation. The NF-κB family of transcription factors has been implicated in ovarian cancer development. We previously established NF-κB/IκB signaling as an essential step for cell survival in cancer cells and hypothesized that targeting NF-κB could potentiate NSAID-mediated apoptosis induction in ovarian cancer cells. Indeed, combining NSAID treatment with NF-κB inhibitors led to enhanced apoptosis induction. Our results indicate that inhibition of NF-κB in combination with activation of mda-7/IL-24 expression may lead to a new combinatorial therapy for ovarian cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Apoptosis / drug effects
  • Blotting, Western
  • Cell Cycle Proteins / genetics
  • Cell Line, Tumor
  • Diclofenac / administration & dosage
  • Drug Synergism
  • Enzyme Activation / drug effects
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Interleukins / genetics
  • Intracellular Signaling Peptides and Proteins / genetics
  • JNK Mitogen-Activated Protein Kinases / metabolism
  • Mice
  • Mice, SCID
  • NF-kappa B / antagonists & inhibitors*
  • Nuclear Proteins / genetics
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • RNA Interference
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sesquiterpenes / administration & dosage
  • Sulindac / administration & dosage
  • Sulindac / analogs & derivatives
  • Tumor Burden / drug effects
  • Xenograft Model Antitumor Assays*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cell Cycle Proteins
  • GADD45A protein, human
  • GADD45G protein, human
  • Interleukins
  • Intracellular Signaling Peptides and Proteins
  • NF-kappa B
  • Nuclear Proteins
  • Sesquiterpenes
  • interleukin-24
  • isohelenin
  • Diclofenac
  • Sulindac
  • sulindac sulfide
  • JNK Mitogen-Activated Protein Kinases