Abstract
Introduction
Hepatocellular carcinoma (HCC) is found within the first five most common tumors worldwide. Sorafenib is an approved agent in HCC treatment. Sertraline is a selective serotonin reuptake inhibitor. The aim of the study is to investigate the combination of sertraline and sorafenib at hepatocellular cancer cell proliferation and death.
Methods
HepG2 cells were treated with drugs and viability test XTT was performed. Cells were stained with hematoxylin and eosin for histological examination or with anti-Bcl-2 antibody and Hoechst 33258 for immunofluorescence.
Results
Viability results supported dose-dependent antiproliferative effect for both sertraline and sorafenib. Microscopic evaluation of stained cells exerts morphological changes.
Discussion
This is the first study to show that sorafenib and sertraline have synergistic effect in hepatocellular cancer.
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References
Ashburn, T. T., Thor, K. B. (2004) Drag repositioning: identifying and developing new uses for existing drugs. Nat. Rev. Drug Discov. 3, 673–683.
Bellmunt, J., Eisen, T., Fishman, M., Quinn, D. (2011) Experience with sorafenib and adverse event management. Crit. Rev. Oncol. Hematol. 78, 24–32.
Bliss, C. I. (1939) The toxicity of poisons applied jointly. Ann. Appl. Biol. 26, 585–615.
Cervello, M., Bachvarov, D., Lampiasi, N., Cusimano, A., Azzolina, A., McCubrey, J.A., Montalto, G. (2012) Molecular mechanisms of sorafenib action in liver cancer cells. Cell Cycle 11, 2843–2855.
Chan, H. L., Chi, W. C., Chen, V. C., Huang, K. Y., Wang, T. N., Lee, Y., Mclntyre, R. S., Hsu, T. C., Lee, C. T., Tzang, B. S. (2018) SSRIs associated with decreased risk of hepatocellular carcinoma: a population-based case-control study. Psychooncology 27, 187–192.
Chang, C. H., Chen, S. J., Liu, C. Y. (2015) Risk of developing depressive disorders following hepatocellular carcinoma: a nationwide population-based study. PLoS One 10, e0135417.
Chen, S., Xuan, J., Couch, L., Iyer, A., Wu, Y., Li, Q. Z., Guo, L. (2014a) Sertraline induces endoplasmic reticulum stress in hepatic cells. Toxicology 322, 78–88.
Chen, S., Xuan, J., Wan, L., Lin, H., Couch, L., Mei, N., Dobrovolsky, V. N., Guo, L. (2014b) Sertraline, an antidepressant, induces apoptosis in hepatic cells through the mitogen-activated protein kinase pathway. Toxicol. Sci. 137, 404–415.
Daher, S., Massarwa, M., Benson, A. A., Khoury, T. (2017) Current and future treatment of hepatocellular carcinoma: an updated comprehensive review. J Clin. Transl. Hepatol. 6, 69–78.
DeVane, C. L., Liston, H. L., Markowitz, J. S. (2002) Clinical pharmacokinetics of sertraline. Clin. Pharmacokinet. 41, 1247–1266.
Fishback, J. A., Robson, M. J., Xu, Y. T., Matsumoto, R. R. (2010) Sigma receptors: potential targets for a new class of antidepressant drug. Pharmacol. Ther. 127, 271–282.
Ghouri, Y. A., Mian, I., Rowe, J. H. (2017) Review of hepatocellular carcinoma: epidemiology, etiology, and carcinogenesis. J. Carcinog. 16, 1.
Gil-Ad, I., Zolokov, A., Lomnitski, L., Taler, M., Bar, M., Luria, D., Ram, E., Weizman, A. (2008) Evaluation of the potential anti-cancer activity of the antidepressant sertraline in human colon cancer cell lines and in colorectal cancer-xenografted mice. Int. J Oncol. 33, 277–286.
Hoetelmans, R., Van Slooten, H. J., Keijzer, R., Erkeland, S., van de Velde, C. J., Dierendonck, J. H. (2000) Bcl-2 and Bax proteins are present in interphase nuclei of mammalian cells. Cell Death Differ. 7, 384–392.
Ianevski, A., He, L., Aittokallio, T., Tang, J. (2017) SynergyFinder: a web application for analyzing drug combination dose–response matrix data. Bioinformatics 33, 2413–2415.
Huang, J., Zhao, D., Liu, Z., Liu, F. (2018) Repurposing psychiatric drugs as anti-cancer agents. Cancer Lett. 419, 257–265.
Joong, S. S., Liu, J. O. (2014) Recent advances in drug repositioning for the discovery of new anticancer drugs. Int. J. Biol. Sci. 10, 654–663.
Keating, G. M., Santoro, A. (2009) Sorafenib: a review of its use in advanced hepatocellular carcinoma. Drugs 69, 223–240.
Kuwahara, J., Takaaki, Y., Nobuaki, E., Mitsuyo, U., Nina, Z., Soichiro, U., Satohiro, M. (2015) Comparison of the antitumor effects of selective serotonin reuptake inhibitors as well as serotonin and norepinephrine reuptake inhibitors in human hepatocellular carcinoma cells. Biol. Pharm. Bull. 38, 1410–1414.
Liang, C., Chen, W., Zhi, X., Ma, T., Xia, X., Liu, H., Zhang, Q., Hu, Q., Hang, Y., Bai, X., Liang, T. (2013) Serotonin promotes the proliferation of serum-deprived hepatocellular carcinoma cells via upregulation of FOXO3a. Mol. Cancer 12, 14.
Ozunal, Z. G. (2014) Drug development, drug repositioning in oncology. In: 19th World Congress on Advances in Oncology and 17th International Symposium on Molecular Medicine, Athens, Greece, October 9–11, 2014.
Part, Y., Rojas-Hernandez, C., Fekrazad, H. M., Bansal, P., Lee, F. C. (2017) Phase II trial of sorafenib in combination with capecitabine in patients with hepatocellular carcinoma: INST 08–20. Oncologist 22, 1158–1160.
Peng, L., Gu, L., Li, B., Hertz, L. (2014) Fluoxetine and all other SSRIs are 5-HT2B Agonists – importance for their therapeutic effects. Cur. Neuropharmacol. 12, 365–379.
Raza, A., Sood, G. K. (2014) Hepatocellular carcinoma review: current treatment, and evidence-based medicine. World J. Gastroenterol. 20, 4115–4127.
Reddy, K. K., Lefkove, B., Chen, L. B., Govindarajan, B., Carracedo, A., Velasco, G., Carrillo, C. O., Bhandarkar, S. S., Owens, M. J., Mechta-Grigoriou, F., Arbiser, J. L. (2008) The antidepressant sertraline downregulates Akt and has activity against melanoma cells. Pigment Cell Melanoma Res. 21, 451–456.
Sarrouilhe, D., Clarhaut, J., Defamie, N., Mesnil, M. (2015) Serotonin and cancer: what is the link? Curr. Mol. Med. 15, 62–77.
Schrödter, S., Braun, M., Syring, I., Klümper, N., Deng, M., Schmidt, D., Perner, S., Mülle, R. S. C., Ellinger, J. (2016) Identification of the dopamine transporter SLC6A3 as a biomarker for patients with renal cell carcinoma. Mol. Cancer 15, 10.
Soll, C., Riener, M. O., Oberkofler, C. E., Hellerbrand, C., Wild, P. J., DeOliveira, M. L., Clavien, P. A. (2012) Expression of serotonin receptors in human hepatocellular cancer. Clin. Cancer Res. 18, 5902–5910.
Tesei, A., Cortesi, M., Zamagni, A., Arienti, C., Pignatta, S., Zanoni, M., Paolillo, M., Curti, D., Rui, M., Rossi, D., Collina, S. (2018) Sigma receptors as endoplasmic reticulum stress “Gatekeepers” and their modulators as emerging new weapons in the fight against cancer. Front. Pharmacol. 9, 711.
Wei, J. C., Meng, F. D., Qu, K., Wang, Z. X., Wu, Q. F., Zhang, L. Q., Pang, Q., Liu, C. (2015) Sorafenib inhibits proliferation and invasion of human hepatocellular carcinoma cells via upregulation of p53 and suppressing FoxM1. Acta Pharmacol. Sin. 36, 241–251.
Xia, D., Zhang, Y. T., Xu, G. P., Yan, W. W., Pan, X. R., Tong, J. H. (2017) Sertraline exerts its antitumor functions through both apoptosis and autophagy pathways in acute myeloid leukemia cells. Leukemia & Lymphoma 58, 2208–2217.
Xu, J. J., Wang, S. Y., Chen, Y., Chen, G. P., Li, Z. Q., Shao, X. Y., Li, L., Lu, W., Zhou, T. Y. (2014) Dopamine D1 receptor activation induces dehydroepiandrosterone sulfotransferase (SULT2A1) in HepG2 cells. Acta Pharmacol. Sin. 35, 889–898.
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Ozunal, Z.G., Cakil, Y.D., Isan, H. et al. Sertraline in combination with sorafenib: A promising pharmacotherapy to target both depressive disorders and hepatocellular cancer. BIOLOGIA FUTURA 70, 341–348 (2019). https://doi.org/10.1556/019.70.2019.39
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DOI: https://doi.org/10.1556/019.70.2019.39