陳 軍,趙文暉,劉玲玲,謝克亮,宋張駿
(1.陜西省腫瘤醫(yī)院麻醉科,陜西西安 710061;2.天津醫(yī)科大學(xué)總醫(yī)院麻醉科,天津市麻醉學(xué)研究所,天津 300052;3.陜西省腫瘤醫(yī)院乳腺科,陜西西安 710061)
異丙酚通過激活PI3K/Akt信號(hào)通路抑制癌細(xì)胞轉(zhuǎn)移
陳 軍1,趙文暉1,劉玲玲2,謝克亮2,宋張駿3
(1.陜西省腫瘤醫(yī)院麻醉科,陜西西安 710061;2.天津醫(yī)科大學(xué)總醫(yī)院麻醉科,天津市麻醉學(xué)研究所,天津 300052;3.陜西省腫瘤醫(yī)院乳腺科,陜西西安 710061)
目的 研究異丙酚對(duì)腫瘤細(xì)胞轉(zhuǎn)移相關(guān)信號(hào)通路PI3K/Akt的影響。方法 將來源于人類乳腺癌細(xì)胞株移植到SPF級(jí)裸基因的免疫缺陷型小鼠制備乳腺癌模型。將接種成功小鼠隨機(jī)分為4組:對(duì)照組(C組,n=6)、異丙酚輸注組(P組,50mg/kg,輸注2h,n=6)、PI3K抑制劑(BYL719)組(B組,n=6)和異丙酚加PI3K抑制劑組(P+B組,n=6)。于給藥后4周分別采用蛋白質(zhì)免疫印跡試驗(yàn)(Western blot)檢測(cè)4組小鼠癌組織中PI3K、磷酸化Akt (p-Akt)、Akt的蛋白表達(dá)水平,逆轉(zhuǎn)錄-聚合酶鏈反應(yīng)(RT-PCR)檢測(cè)PI3KR1(PI3Kregulatory subunit 1)和Akt (Akt1和Akt2)的mRNA表達(dá)水平;取雙肺,觀察小鼠肺表面轉(zhuǎn)移結(jié)節(jié)數(shù)。結(jié)果 與C組相比,P組PI3K和p-Akt的蛋白表達(dá)明顯增高(P<0.05),PI3KR1的mRNA表達(dá)明顯升高(P<0.05),Akt1和Akt2的mRNA表達(dá)無明顯變化(P>0.05),肺表面轉(zhuǎn)移結(jié)節(jié)數(shù)明顯減少(P<0.05);B組PI3K和p-Akt的蛋白表達(dá)明顯下調(diào)(P<0.05),PI3KR1 mRNA、Akt1和Akt2的mRNA表達(dá)無明顯變化(P>0.05),肺表面結(jié)節(jié)數(shù)明顯增加(P<0.05)。與B組相比,P+B組明顯上調(diào)了PI3K和p-Akt的蛋白表達(dá)(P<0.05),PI3KR1的mRNA表達(dá)明顯升高(P<0.05),Akt1和Akt2的mRNA表達(dá)無明顯變化(P>0.05),肺表面結(jié)節(jié)數(shù)明顯減少(P<0.05)。結(jié)論 異丙酚可通過激活PI3K/Akt信號(hào)通路抑制腫瘤細(xì)胞的轉(zhuǎn)移。
異丙酚;PI3K/Akt;乳腺癌;轉(zhuǎn)移
與其他治療方法相比,手術(shù)切除早期乳癌原發(fā)灶仍是治療乳腺癌的有效方法,且預(yù)后良好。因此,手術(shù)仍是目前治療早期乳癌的最常用的方法[1]。但有研究發(fā)現(xiàn)手術(shù)是一把雙刃劍,它在切除癌癥灶的同時(shí),會(huì)誘發(fā)腫瘤細(xì)胞的轉(zhuǎn)移[2-3]。而乳腺癌遠(yuǎn)處轉(zhuǎn)移是導(dǎo)致患者死亡率增高的主要原因。手術(shù)誘發(fā)的腫瘤細(xì)胞轉(zhuǎn)移可能與多種因素有關(guān),如術(shù)后炎癥反應(yīng)[4]和免疫抑制[5]等。另一項(xiàng)研究發(fā)現(xiàn)磷酸肌醇3-激酶(PI3K)/Akt通路與腫瘤細(xì)胞的生長(zhǎng)和轉(zhuǎn)移有著高度的相關(guān)性。腫瘤細(xì)胞會(huì)引起該通路活性異常,造成PI3K的基因突變,促進(jìn)腫瘤細(xì)胞的轉(zhuǎn)移和侵潤(rùn)[6]。行乳癌根治術(shù)的患者大多在全身麻醉下施術(shù),異丙酚是目前臨床上應(yīng)用最為廣泛的全身麻醉藥物。該藥在發(fā)揮全身麻醉作用的同時(shí),具有抗炎、抗氧化等作用[7]。而且大量實(shí)驗(yàn)證實(shí)異丙酚具有抑制腫瘤細(xì)胞轉(zhuǎn)移的功能,其具體機(jī)制尚不完全清楚,其中包括減輕術(shù)后對(duì)自然殺傷細(xì)胞的抑制[5]以及抑制與腫瘤轉(zhuǎn)移有關(guān)的酶的活性,如基質(zhì)金屬蛋白酶-2(MMP-2)和MMP-9[8]。關(guān)于異丙酚是否通過作用于PI3K/Akt信號(hào)通路抑制癌癥患者腫瘤細(xì)胞轉(zhuǎn)移尚未見相關(guān)報(bào)道。
1.1 實(shí)驗(yàn)動(dòng)物與分組 SPF級(jí)裸基因的免疫缺陷型小鼠(西安交通大學(xué)醫(yī)學(xué)部實(shí)驗(yàn)動(dòng)物中心),8~10周,體質(zhì)量18~25g。將來源于人類乳腺癌細(xì)胞株(ATCC來源)移植到裸基因的免疫缺陷小鼠制備乳腺癌模型[9]。應(yīng)用雌激素受體陽(yáng)性的MCF-7人乳癌細(xì)胞株接種于裸鼠右側(cè)胸壁乳墊下,移植細(xì)胞總數(shù)為1×106/只。將裸鼠飼養(yǎng)于無特殊病原菌環(huán)境中:溫度22~25℃,相對(duì)濕度約40%,每日12h晝/夜交替,自由飲水、飲食。接種10d后在接種部位可見硬結(jié),表明接種成功。將接種成功小鼠隨機(jī)分為4組:對(duì)照組(C組)、異丙酚輸注組(P組,50mg/kg,經(jīng)股靜脈輸注2h)、異丙酚加PI3K抑制劑組(P+B組)和PI3K抑制劑組(B組,BYL719,1μmol/L,i.v.),每組6只。
1.2 Western blot檢測(cè)PI3K、磷酸化Akt(p-Akt)和Akt表達(dá) 于給藥后4周,用20g/L水合氯醛(15mg/kg)麻醉小鼠,分別取腫瘤組織通過Western blot檢測(cè)PI3K、p-Akt和Akt的表達(dá)水平。取癌組織,稱重,加入RIPA裂解液和蛋白酶抑制劑(批號(hào):P1905,上海生工生物工程技術(shù)服務(wù)有限公司),液氮?jiǎng)驖{,4℃離心5min,取上清,BCA法蛋白定量后于-80℃保存。取20g蛋白樣品,加入4×蛋白上樣緩沖液(北京索萊寶科技有限公司),95℃煮沸5min,SDS-PAGE電泳60min,濕轉(zhuǎn)90min,50g/L脫脂奶粉室溫封閉1h,分別滴加兔來源的多克隆PI3K一抗(1∶1 000,Abcam公司,英國(guó))、磷酸化絲氨酸-473-Akt蛋白一抗(1∶1 000,Abcam公司,英國(guó))和兔來源的多克隆Akt一抗(1∶5 000,Millipore公司,德國(guó))。4℃搖床過夜,1×TBST洗膜5min×3次,加HRP-羊抗兔IgG二抗(1∶5 000,Millipore公司,德國(guó)),室溫封閉1h。電化學(xué)發(fā)光溶液中顯影10~30s,暴露于X感光膠片。通過磷酸化法對(duì)條帶進(jìn)行分析,并進(jìn)行標(biāo)準(zhǔn)化。采用Ge1-pro軟件(Media Cybernetics公司,美國(guó))進(jìn)行分析。
1.3 熒光定量PCR檢測(cè)PI3KR1、Akt1和Akt2的mRNA表達(dá) 于給藥后4周,用20g/L水合氯醛(15 mg/kg)麻醉小鼠,分別取腫瘤組織提取總RNA。用RevertAidTM第一鏈cDNA合成試劑盒逆轉(zhuǎn)錄合成cDNA,42℃孵育60min,70℃加熱5min終止反應(yīng)。通過SYBR Green法進(jìn)行模板的熒光定量PCR檢測(cè)(天根Real Master Mix熒光定量PCR試劑盒)。PI3KR1、Akt1和Akt2的mRNA表達(dá)水平均以三磷酸甘油醛脫氫酶(GAPDH)為內(nèi)參照。引物序列為PI3KR1(F:5′-CAGCAACCTGGCAGAATTACGA-3′;R:5′-TGACAGGATTTGGTAAGTCCAGGAG-3′),Akt1(F:5′-CCCTTCTACAACCAGGACCA-3′;R:5′-ATACACAATAATGCCACACGA-3′),Akt2(F:5′-TTTGTGTTCCCTTCCCTGTC-3′;R:5′-TCACTCTCCATCCTCCCAAC-3′)和GAPDH(F:5′-A ACAGCAACTCCACTCTTC-3′;R:5′-CCTCTCTTGCTCAGTGTCCT-3′)。用iQTM5多重實(shí)時(shí)熒光定量PCR儀進(jìn)行擴(kuò)增并對(duì)各組腫瘤組織中的目的基因的相對(duì)表達(dá)量進(jìn)行分析。
1.4 肺表面轉(zhuǎn)移結(jié)節(jié)計(jì)數(shù) 于給藥后4周,用20g/L水合氯醛(15mg/kg)麻醉小鼠,取雙肺觀察肺表面轉(zhuǎn)移結(jié)節(jié)數(shù)。
1.5 統(tǒng)計(jì)學(xué)處理 采用SPSS 18.0統(tǒng)計(jì)學(xué)軟件進(jìn)行統(tǒng)計(jì)分析,正態(tài)分布的計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差(珔x±s)表示,組間比較采用單因素方差分析,組內(nèi)比較采用LSD法,P<0.05為差異有統(tǒng)計(jì)學(xué)意義。
與C組相比,P組PI3K和p-Akt的蛋白表達(dá)明顯增高(P<0.05),PI3KR1的mRNA表達(dá)明顯升高(P<0.05),Akt1和Akt2的mRNA表達(dá)無明顯變化(P> 0.05),肺表面轉(zhuǎn)移結(jié)節(jié)數(shù)明顯減少(P<0.05);B組PI3K和p-Akt的蛋白表達(dá)明顯下調(diào)(P<0.05),PI3KR1、Akt1和Akt2的mRNA表達(dá)無明顯變化(P>0.05),肺表面結(jié)節(jié)數(shù)明顯增加(P<0.05,圖1~圖3)。
與B組相比,P+B組明顯上調(diào)了PI3K和p-Akt的蛋白表達(dá)(P<0.05),PI3KR1的mRNA表達(dá)明顯升高(P<0.05),Akt1和Akt2的mRNA表達(dá)無明顯變化(P>0.05),肺表面結(jié)節(jié)數(shù)明顯減少(P<0.05,圖1~圖3)。
圖1 Western blot檢測(cè)不同組小鼠PI3K、p-Akt和Akt的蛋白表達(dá)水平(%對(duì)照組,珔x±s)Fig.1Expressions of PI3K,p-Akt and Akt protein detected by Western blot in different groups
圖2 RT-RCR檢測(cè)不同組小鼠PI3KR1、Akt1和Akt2 mRNA的表達(dá)水平(%對(duì)照組,珔x±s)Fig.2Expressions of PI3KR1,Akt1and Akt2mRNA detected by RT-PCR in different groups
圖3 不同組小鼠肺表面的轉(zhuǎn)移結(jié)節(jié)數(shù)(珔x±s)Fig.3The number of pulmonary metastasis tumor in rats in different groups
根據(jù)流行病學(xué)調(diào)查顯示,世界上導(dǎo)致患者死亡的癌癥中,乳腺癌排在第二位。據(jù)統(tǒng)計(jì),美國(guó)婦女中1/3的癌癥是乳腺癌[10-11]。乳腺癌的轉(zhuǎn)移情況是決定患者生存率的主要因素。與癌癥轉(zhuǎn)移相關(guān)的機(jī)制復(fù)雜,涉及多種蛋白和信號(hào)通路活性狀態(tài)。研究發(fā)現(xiàn),在癌細(xì)胞周圍包圍著許多細(xì)胞,如成纖維細(xì)胞、巨噬細(xì)胞、髓源抑制細(xì)胞和嗜中性粒細(xì)胞。這些炎癥細(xì)胞產(chǎn)生促炎癥因子,如TGF-β、TNF-α、IL-6和IL-1,激活NF-κB和STAT 3,通過調(diào)節(jié)轉(zhuǎn)錄因子和蛋白酶誘發(fā)內(nèi)皮-間皮轉(zhuǎn)移,進(jìn)而導(dǎo)致腫瘤細(xì)胞轉(zhuǎn)移[12]。本實(shí)驗(yàn)采用的人類乳腺癌細(xì)胞株移植法制備裸鼠乳癌模型,具有方法簡(jiǎn)單、成功率高、對(duì)全身影響小等優(yōu)點(diǎn)。
免疫抑制也是誘發(fā)腫瘤細(xì)胞轉(zhuǎn)移的主要原因。研究發(fā)現(xiàn),某些麻醉藥物通過抑制機(jī)體的免疫反應(yīng),如抑制自然殺傷(NK)細(xì)胞活性和損傷機(jī)體對(duì)腫瘤的免疫力,造成腫瘤細(xì)胞轉(zhuǎn)移[5]。但異丙酚作為目前應(yīng)用最為廣泛的全身麻醉藥物,具有抑制腫瘤轉(zhuǎn)移的作用,據(jù)報(bào)道50mg/kg異丙酚可抑制靜脈注射的腫瘤細(xì)胞肺轉(zhuǎn)移[13]。其作用機(jī)制可能是該藥具有抗炎[14]、抗氧化[15]和調(diào)節(jié)免疫力的功能[5]。手術(shù)本身是造成患者術(shù)后癌細(xì)胞轉(zhuǎn)移的又一主要原因,手術(shù)創(chuàng)傷導(dǎo)致患者處于心理和生理的高度應(yīng)激狀態(tài),從而降低機(jī)體的免疫力,加速癌細(xì)胞的轉(zhuǎn)移[16]。行乳腺癌根治術(shù)的患者一般在全身麻醉下施術(shù),全麻藥異丙酚具有鎮(zhèn)靜麻醉和減輕患者應(yīng)激反應(yīng)的作用。因此可以增加患者的免疫力,抑制癌細(xì)胞的轉(zhuǎn)移。
研究發(fā)現(xiàn),PI3K/Akt通路是腫瘤細(xì)胞凋亡的關(guān)鍵通路。Akt是一種絲氨酸/蘇氨酸蛋白激酶,可被與PI3K依賴的細(xì)胞外信號(hào)通路激活,使其處于磷酸化狀態(tài)。被激活的Akt進(jìn)入到胞質(zhì)、胞核和細(xì)胞內(nèi)的其他部位,造成細(xì)胞內(nèi)大量底物蛋白磷酸化,最終調(diào)節(jié)細(xì)胞的增殖、分化和遷移[17]。據(jù)報(bào)道,持續(xù)活化的Akt可降低活化的T細(xì)胞核因子和環(huán)氧合酶(COX)-2的表達(dá),進(jìn)而抑制乳腺癌細(xì)胞的侵襲性[18-19]。活化的Akt還可以通過促進(jìn)乳腺上皮細(xì)胞的分化抑制其轉(zhuǎn)移[20]。另?yè)?jù)報(bào)道,超過70%的乳腺癌患者出現(xiàn)PI3K/Akt信號(hào)通路遺傳學(xué)改變,主要是PIK3CA基因突變和HER2擴(kuò)增,進(jìn)而導(dǎo)致該通路活性降低和Akt磷酸化水平降低,從而不能抑制其下游的MEK/ERK通路,進(jìn)而造成腫瘤細(xì)胞增殖、轉(zhuǎn)移[21]。因此,PI3K/Akt通路活性與腫瘤細(xì)胞的增殖、轉(zhuǎn)移密切相關(guān)。但異丙酚能否通過激活PI3K/Akt信號(hào)通路抑制腫瘤細(xì)胞的轉(zhuǎn)移尚不清楚。本研究結(jié)果顯示,異丙酚可上調(diào)PI3K的蛋白和基因的表達(dá)水平,明顯增加p-Akt水平,減少肺轉(zhuǎn)移的癌結(jié)節(jié)數(shù),并且異丙酚還能減輕PI3K抑制劑導(dǎo)致的p-Akt水平降低,降低PI3K抑制劑導(dǎo)致的腫瘤細(xì)胞轉(zhuǎn)移增強(qiáng)。綜上所述,異丙酚可通過上調(diào)和激活PI3K/Akt信號(hào)通路抑制腫瘤細(xì)胞的轉(zhuǎn)移。
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(編輯 邱 芬)
Propofol inhibits the metastasis of tumor cells via activating PI3K/Akt signaling pathway
CHEN Jun1,ZHAO Wen-h(huán)ui1,LIU Ling-ling2,XIE Ke-liang2,SONG Zhang-jun3
(1.Department of Anesthesiology,Shaanxi Provincial Tumor Hospital,Xi’an 710061;2.Department of Anesthesiology,Tianjin Medical University General Hospital;Tianjin Institute of Anesthesiology,Tianjin 300052;3.Department of Galactophore,Shaanxi Provinical Tumor Hospital,Xi’an 710061,China)
Objective To study the effects of propofol on the metastasis of tumor cells related PI3K/Akt signaling pathway.Methods The breast cancer model was established by transplanting human derived breast cancer cell lines into immunodeficient mice with naked gene.The mice,inoculated successfully,were randomly divided into 4 groups:control group(C group,n=6),propofol group(P group,n=6),propofol+PI3K inhibitor (BYL719)group(P+B group,n=6),and PI3K inhibitor group(BYL719)(B group,n=6).The expressions of PI3K,p-Akt and Akt were examined by Western blot at week 4 after administration;the gene levels of PI3KR1,Akt1 and Akt2 were detected by RT-PCR at week 4 after administration;the number of metastatic lung nodules from both lungs was also observed at week 4 after administration.Results Compared with those in C group,the expressions of PI3K and p-Akt were significantly higher in P group(P<0.05),the level of PI3KR1 mRNA but not Akt1 and Akt2 mRNA was significantly increased(P<0.05),and metastatic lung nodules significantly decreased (P<0.05).In B group,the expressions of PI3K and p-Akt were significantly decreased(P<0.05),the levels of PI3KR1,Akt1 and Akt2 mRNA were not significantly increased(P>0.05),but metastatic lung nodules significantly increased(P<0.05).Compared with those in B group,in P+B group the expressions of PI3K and p-Akt were markedly higher(P<0.05),the level of PI3KR1 mRNA but not Akt1 and Akt2 mRNA was significantly increased (P<0.05),and metastatic lung nodules significantly decreased(P<0.05).Conclusion Propofol can inhibit the metastasis of tumor cells through the upregulated and activated PI3K/Akt signaling pathway.
propofol;PI3K/Akt;breast cancer;metastasis
R73-37
A
10.7652/jdyxb201602016
2015-06-15
2015-12-22
國(guó)家自然科學(xué)基金資助項(xiàng)目(No.81101409)Supported by the National Natural Science Foundation of China(No.81101409)
謝克亮.E-mail:xiekeliang2009@hotmail.com
優(yōu)先出版:http://www.cnki.net/kcms/detail/61.1399.R.20160202.1112.002.html(2016-02-02)
西安交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)2016年2期