Paola Porcari1, Ellen Ackerstaff1, Dov P Winkleman1, Suresh Veeraperumal1, Natalia Kruchevsky1, H. Carl Lekaye1, and Jason A. Koutcher1,2,3,4
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 2Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 3Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 4Weill Cornell Medical College, Cornell University, New York, NY, United States
Synopsis
Intracellular iron, essential for cancer cell proliferation and
metabolism, is modified in cancer cells. Triple-negative breast cancers are
metastatic cancers associated with a high recurrence rate, poor prognosis and
lack of effective targeted therapies. We are investigating the potential of Deferiprone,
a clinically approved intracellular iron chelator for non-cancer related
diseases, to improve chemotherapeutic treatment response in triple-negative
breast cancer by altering iron-dependent proliferation and metabolism. The effectiveness of Deferiprone to impair triple-negative
breast cancer cell growth and affect cellular metabolism was evaluated by
monitoring live cells, exposed to Deferiprone, in an MR-compatible cell
bioreactor using multi-nuclear MRS.
Introduction
Triple-negative breast
cancers (TNBC) lack estrogen (ER-), progesterone (PR-)
and HER2- receptors and are metastatic cancers associated with a
high recurrence rate, poor prognosis and lack of effective targeted therapies.
Infiltration of iron-rich tumour-associated macrophages promotes tumour
progression.1,2 Cellular iron is essential for cell proliferation3
and metabolism and increases cancer cell susceptibility to modest iron
deficiency.5-7
Deferiprone (DFP), a
clinically approved iron chelator for non-cancer related diseases,8 enters
cancer cells and alters iron-dependent enzyme activities by decreasing
intracellular iron.9-11
Based
on preliminary data showing a DFP-induced cytostatic effect in multiple breast
cancer cell lines (Table 1), we
investigate the mechanism of DFP to induce cell cytostasis in TNBC and its potential
to improve chemotherapeutic treatment response in combination therapy. Specifically,
the effectiveness of DFP to impair TNBC cell growth and affect cellular
metabolism was evaluated in live cells in an MR-compatible cell bioreactor12
by measuring the metabolization of 13C-1-Glucose using13C-MRS
and cell energy state by 31P-MRS.Methods
Murine
metastatic TNBC 4T1 cells were grown in Dulbecco’s Modified Essential (DME)
medium, containing 25 mM glucose, 6 mM glutamine, 10% fetal bovine serum, and
1% penicillin/streptomycin at 37 ⁰C in humidified 5% CO2 / 95% air.
For the MR-cell bioreactor studies, 4T1 cells were cultured on microcarriers
(125-212 μm diameter; PP3772, Corning, New York, NY; 3×106 cells/0.5
ml beads×6) to ~70% confluence. Cell number and viability were estimated from a
representative sample at the start (#cellsinitial) and end (#cellsend)
of each MR experiment by Trypan Blue exclusion. Continually perfused, live
cells were studied in an MR-compatible cell bioreactor12 on a 500
MHz MR system (Bruker BioSpin, Billerica, MA) equipped with a 10-mm broad-band
probe for 1H and 31P/13C scans. To monitor
metabolism changes, cells were continuously perfused for 31 hours with DME
media. After 1 h setup and the first 31P MR spectrum, the un-labeled
perfusion medium was replaced with medium containing 25 mM 1-13C-labeled
glucose for the remaining 30 h of experiment. Three independent experiments
were performed in regular medium conditions (CTRL) and three in medium
containing 100 µM DFP (DFP-treated). During each experiment, 1H-decoupled,
Nuclear Overhauser Effect-enhanced 13C MR spectra (TR = 1200 s, 45
degree flip angle, 30 kHz sweep width, 8k points, 1000 averages, 20 min
acquisition time) were acquired repeatedly interspaced with two consecutive 31P
spectra (TR = 1200 s, 45 degree flip angle, 20 kHz sweep width, 2k points, 1800
averages, 30 min acquisition time) every six hours. Quantification of MR spectral
peaks was performed in time domain using AMARES (jMRUI v5.2). Metabolites were
normalized to the β-NTP signal of the first 31P
MR spectrum (βNTPinit). A two-tail unpaired
Student t test was used to compare DFP-treated and untreated (CTRL) 4T1
cell data. The effect of DFP on the migration of confluent 4T1 cells was
assessed by wound healing assay.3Results
Figure
2A shows the
comparison between the cell count ratios rC=[#cellsend/#cellsinitial]
of each experiment and the corresponding cellular energy ratios (rE=[β-NTPend/β-NTPinit])
determined for both DFP-treated and untreated cells. In DFP-treated 4T1 cells
the cell mass was significantly lower than in untreated 4T1 cells, whereas rE
decreases significantly slower than the cell loss determined by cell counting. This
agrees with our IC50 studies showing decreased proliferation caused
by DFP. Wound healing is significantly reduced in DFP-treated 4T1 cells at 24
and 36 h exposure, delaying wound closure to about 48 h compared to the 36 h in
untreated and 50 µM DFP-treated 4T1 cells (Fig.
2B).
Figure 3A shows representative 31P spectra
of DFP-treated and untreated 4T1 cells acquired at 31 h. The time course of β-NTP levels is similar
between DFP-treated and control 4T1 cells (Fig.
3B). The phospholipid precursors PCho (Fig.
3C) and GPCho (data not shown) exhibit significant differences between DFP-treated and control
4T1 cells at the latest time points. The intracellular pH was stable throughout and unaffected by DFP (data
not shown). Representative 13C spectra acquired over time in control
and DFP-treated cells are shown in Figure
4. The quantitative evaluation of 13C spectra metabolites of
DFP-treated and control 4T1 cells (Fig.
5), show various average metabolite levels that differ significantly
between DFP-treated and untreated 4T1 cells. Specifically, less glucose-C1
signal loss, lower lactate-C3, glutamine-C4, fatty acid chains (CH2)n,
and Alanine-C3 13C-labelling were found in DFP-treated than in
control 4T1 cells.Discussion
Our
findings that DFP exposure of TNBC 4T1 cells can impair their migration and cell
growth (Fig. 2) agrees with our
previous findings in prostate cancer.3 Changes in PCho (Fig. 3C), GPCho and GPCho/PCho
indicated subtle phospholipid membrane turnover differences
between DFP-treated and control cells. The time course effects of DFP on 4T1
cell metabolism, assayed by 13C MRS (Fig. 5), suggest that DFP exposure affects the Krebs cycle, cell
energy and fatty acid metabolism in accordance with our previous study using
live TRAMP-C2 cells.3Conclusion
In
conclusion, this study shows the cytostatic effect of DFP on the TNBC 4T1 cells
and can be considered as a first step for a potential clinical translation in
combination therapy into humans. Clinical translation is straightforward
considering that Deferiprone is already approved clinically for non-cancer
related diseases.Acknowledgements
This
work was support by grants W81ZWH-17-1-0525 (JAK) and P30CA008748 (Cancer
Center Support Grant). We thank Dr. RV Simões for helpful discussions and the
Molecular Cytology Core Facility for their assistance with the wound healing
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