Kavindra Nath1, Jeffrey Roman1, David S Nelson1, Mary E Putt1, Kevin Muriuki1, Stepan Orlovskiy1, Dennis B Leeper2, and Jerry D Glickson1
1University of Pennsylvania, Philadelphia, PA, United States, 2Thomas Jefferson University, Philadelphia, PA, United States
Synopsis
Using 31P magnetic
resonance spectroscopy, we have shown that LND selectively lowers the
intracellular pH and decreases ATP levels in human melanoma xenografts. Tumor
acidification results from inhibition of lactate export via the monocarboxylic
acid transporters and inhibition of pyruvate transport and oxidation via the
mitochondrial pyruvate carrier. Energetics is further attenuated by inhibition
of electron transport at complex II. Under these conditions, temozolomide accumulates
in the tumor as a result of decreases in intracellular pH, which inhibits DNA repair by O6-alkyltransferase
via conversion to dacarbazine and formation of diazomethane, and also inhibits
glutathione-S-transferase that deactivates the reactive alkylating intermediate.
TARGET AUDIENCE
Investigators
interested in animal models of cancer, 1H and 31P MRS,
Seahorse analysis, tumor microenvironment, and potentiation of chemotherapy.INTRODUCTION
This
study investigates changes in metabolism in DB-1 and WM983B melanomas in
response to treatment with lonidamine (LND, an antineoplastic drug that
inhibits transmembrane monocarboxylate transporters (MCTs), the mitochondrial
pyruvate carrier (MPC) and complex II of electron transport chain.1-6 DB-1 and
WM983B are established human melanoma cell lines that express the V600D, E, K,
BRAF mutation.7 Using 31P and 1H magnetic
resonance spectroscopy (MRS), we detected changes in intracellular pH (pHi),
bioenergetics (βNTP/Pi), and lactate concentration of melanoma xenografts in
response to treatment with LND indicate that LND potentiates the activity
of temozolomide (TMZ) by increasing drug uptake, inhibiting glutathione
scavenger activity and DNA repair; these results are supported by initial
investigations of DB-1 melanoma xenografts. In the future, treatment with LND
plus TMZ could be combined with treatment with targeted mutated BRAF inhibitors
and immune checkpoint inhibitors. METHODS
DB-1 and WM983B melanoma
cells were grown as described previously.6
In vitro oxygen consumption and extracellular
acidification rates for DB-1 and WM983B cells were determined using the
Seahorse XF-96 Extracellular Flux Analyzer with and without LND treatment. Glucose
and lactate concentrations were measured in both cell lines under the same
conditions using a YSI 2300 STAT Plus Glucose & Lactate Analyzer. One
million DB-1 and WM983B cells were inoculated subcutaneously (s.c.) into each
mouse in 0.1 mL suspensions. MR experiments were performed on a 9.4 T/31 cm
horizontal bore Varian spectrometer. When the tumor reached 7-10 mm in diameter
along the longest axis, 31P and 1H MRS experiments were
performed after positioning the s.c. tumor in a dual-frequency slotted-tube
resonator; the pHi, extracellular pH (pHe), βNTP/Pi, and lactate concentration
were measured after LND (100 mg/kg; i.p.) administration. Physiological
monitoring was maintained during the experiment. Procedures for data
acquisition, post processing and parameter estimation were performed as
previously described.4-6
Treatment response of DB-1 xenografts to TMZ and LND was measured by tumor
growth delay analysis; four cohorts of five age- and weight-matched animals
were randomized to the following treatment groups: cohort 1 (sham treated control)
was infused intravenously (i.v.) with PBS and given appropriate sham
intraperitoneal (i.p.) injections of tris/glycine buffer; cohort 2 was infused
i.v. with PBS 40 min after LND administration (100 mg/kg, i.p.); cohort 3 was
injected i.p. with tris/glycine buffer and infused i.v. with TMZ (18 mg/kg) in
PBS; cohort 4 was injected i.p. with LND and after 40 min (time required for maximum
tumor acidification) TMZ (18 mg/kg) was infused i.v. Growth delay data analysis
and cell kill estimation were performed as previously described.7
Analysis of variance was performed with Tukey adjustment for multiple
comparisons and post-hoc t-tests.RESULTS
Representative
localized 31P MR spectra of DB-1 and WM983B human melanoma
xenografts before and after LND treatment are shown in figure 1. Figure 2 shows changes in pHi, pHe, bioenergetics and
lactate in response to LND. Figure 3 and table 1 summarize Seahorse data on the
metabolic characteristics of DB-1 and WM983B melanoma cells with and without
LND treatment. These data show that DB-1 is more glycolytic, LND inhibits mitochondrial
capacity of both cell lines but to a smaller extent for the more glycolytic DB-1
line. The effect of treatment with LND + TMZ was evaluated by in vivo tumor growth delay experiments in DB-1 melanoma
xenografts (Figure 4). For LND + TMZ, the median time to regrowth (4 doublings)
was 113 days compared to 82 days for TMZ alone (Figure 4). 100% of the
melanomas (5 animals) responded to treatment with TMZ or LND + TMZ, 20% were
cured in both treatment regimens, and 20% in the TMZ regimen exhibited
long-term response with recurrence.DISCUSSION AND CONCLUSION
The 31P MR spectra demonstrate
that LND leads to intracellular acidification and bioenergetics depression of
both lines with more pronounced effects on in vivo DB-1 melanoma
xenografts; these parameters are critical indices for tumor response to TMZ. The
mechanism of LND potentiation of TMZ via conversion into dacarbazine and
formation of diazomethane results from decreases in pHi, which inhibits DNA
repair by O6-alkyltransferase and also inhibits
glutathione-S-transferase that deactivates the reactive alkylating
intermediate. However, TMZ also induces energy-dependent multi-drug resistance
that is inhibited by tumor de-energization. Hence, the response to LND + TMZ depends
on both the glycolytic and oxidative capacities of the tumors. LND may also
increase tumor oxygenation and enhance the effects of reactive oxygen species.Acknowledgements
Support for this project was provided by NIH grants R01-CA129544 and R01-CA172820.References
1. Guo
L, Shestov AA, Worth AJ, et al. Inhibition of mitochondrial complex II by the
anti-cancer agent lonidamine. J Biol Chem. 2016;291(1):42-57.
2. Nancolas B, Guo L, Zhou R, et al. The
anti-tumour agent lonidamine is a potent inhibitor of the mitochondrial
pyruvate carrier and plasma membrane monocarboxylate transporters. Biochem J. 2016 Apr 1;473(7):929-36.
3. Nath K, Guo L, Nancolas B, et al. Mechanism
of antineoplastic activity of lonidamine. Biochim Biophys Acta.
2016;1866(2):151-62.
4. Nath K, Nelson DS, Heitjan DF, et al.
Lonidamine induces intracellular tumor acidification and ATP depletion in
breast, prostate and ovarian cancer xenografts and potentiates response to
doxorubicin. NMR Biomed. 2015;28(3):281-90.
5. Nath K, Nelson DS, Heitjan DF, et al. Effects
of hyperglycemia on lonidamine-induced acidification and de-energization of
human melanoma xenografts and sensitization to melphalan. NMR Biomed.
2015;28(3):395-403.
6. Nath K, Nelson DS, Ho AM, et al. 31P
and 1H MRS of DB-1 melanoma xenografts: lonidamine selectively
decreases tumor intracellular pH and energy status and sensitizes tumors to
melphalan. NMR Biomed. 2013;26(1):98-105. PMCID: 3465621.
7. Nath K, Nelson DS, Putt ME, et al. Comparison
of the Lonidamine Potentiated Effect of Nitrogen Mustard Alkylating Agents on
the Systemic Treatment of DB-1 Human Melanoma Xenografts in Mice. PLoS One.
2016;11(6):e0157125.