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<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">IJMM</journal-id>
<journal-title-group>
<journal-title>International Journal of Molecular Medicine</journal-title></journal-title-group>
<issn pub-type="ppub">1107-3756</issn>
<issn pub-type="epub">1791-244X</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ijmm.2014.1983</article-id>
<article-id pub-id-type="publisher-id">ijmm-35-01-0247</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Withaferin A induces apoptosis through the generation of thiol oxidation in human head and neck cancer cells</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>PARK</surname><given-names>JONG WON</given-names></name><xref rid="af1-ijmm-35-01-0247" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>MIN</surname><given-names>KYOUNG-JIN</given-names></name><xref rid="af2-ijmm-35-01-0247" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>KIM</surname><given-names>DONG EUN</given-names></name><xref rid="af1-ijmm-35-01-0247" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-ijmm-35-01-0247"/></contrib>
<contrib contrib-type="author">
<name><surname>KWON</surname><given-names>TAEG KYU</given-names></name><xref rid="af2-ijmm-35-01-0247" ref-type="aff">2</xref><xref ref-type="corresp" rid="c1-ijmm-35-01-0247"/></contrib></contrib-group>
<aff id="af1-ijmm-35-01-0247">
<label>1</label>Department of Otolaryngology, School of Medicine, Keimyung University, Dalseo-Gu, Daegu 704-701, Republic of Korea</aff>
<aff id="af2-ijmm-35-01-0247">
<label>2</label>Department of Immunology, School of Medicine, Keimyung University, Dalseo-Gu, Daegu 704-701, Republic of Korea</aff>
<author-notes>
<corresp id="c1-ijmm-35-01-0247">Correspondence to: Dr Dong Eun Kim, Department of Otolaryngology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, Republic of Korea, E-mail: <email>entkde@dsmc.or.kr</email>. Professor Taeg Kyu Kwon, Department of Immunology, School of Medicine, Keimyung University, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu 704-701, Republic of Korea, E-mail: <email>kwontk@dsmc.or.kr</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>1</month>
<year>2015</year></pub-date>
<pub-date pub-type="epub">
<day>27</day>
<month>10</month>
<year>2014</year></pub-date>
<volume>35</volume>
<issue>1</issue>
<fpage>247</fpage>
<lpage>252</lpage>
<history>
<date date-type="received">
<day>12</day>
<month>06</month>
<year>2014</year></date>
<date date-type="accepted">
<day>22</day>
<month>10</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2015, Spandidos Publications</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p></license></permissions>
<abstract>
<p>Withaferin A is a steroidal lactone purified from the Indian medicinal plant, <italic>Withania somnifera</italic>. Withaferin A has been shown to inhibit the proliferation, metastasis, invasion and angiogenesis of cancer cells. In the present study, we investigated whether withaferin A induces apoptosis in the human head and neck cancer cells, AMC-HN4. Withaferin A markedly increased the sub-G1 cell population and the cleavage of poly(ADP-ribose) polymerase (PARP), which are markers of apoptosis. Pan-caspase inhibitor, z-VAD-fmk (z-VAD), markedly inhibited the withaferin A-induced apoptosis. However, the withaferin A-induced increase in the expression of COX-2 was not affected by treatment with z-VAD. Furthermore, withaferin A upregulated cyclooxygenase-2 (COX-2) expression. The COX-2 inhibitor, NS-398, reduced the withaferin A-induced production of prostaglandin E<sub>2</sub>. However, treatment with NS-398 did not affect the sub-G1 population and the cleavage of PARP. In addition, the withaferin A-induced apoptosis was independent of reactive oxygen species production. Thiol donors &#x0005B;N-acetylcysteine (NAC) and dithiothreitol (DTT)&#x0005D; reversed withaferin A-induced apoptosis. Therefore, our data suggest that withaferin A induces apoptosis through the mechanism of thiol oxidation in head and neck carcinoma cells.</p></abstract>
<kwd-group>
<kwd>withaferin A</kwd>
<kwd>cyclooxygenase-2</kwd>
<kwd>reactive oxygen species</kwd>
<kwd>apoptosis</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Withaferin A is a steroidal lactone purified from the Indian medicinal plant, <italic>Withania somnifera</italic> and has been shown to exert anticancer effects in different types of cancer cells, such as prostate cancer (<xref ref-type="bibr" rid="b1-ijmm-35-01-0247">1</xref>), myeloid leukemia (<xref ref-type="bibr" rid="b2-ijmm-35-01-0247">2</xref>), breast cancer (<xref ref-type="bibr" rid="b3-ijmm-35-01-0247">3</xref>) and renal cancer (<xref ref-type="bibr" rid="b4-ijmm-35-01-0247">4</xref>) cells. The mechanisms responsible for the withaferin A-mediated anticancer effects are multiple. For example, withaferin A has been shown to induce apoptosis through the upregulation of intracellular reactive oxygen species (ROS) generation (<xref ref-type="bibr" rid="b5-ijmm-35-01-0247">5</xref>,<xref ref-type="bibr" rid="b6-ijmm-35-01-0247">6</xref>), prostate apoptosis response-4 (Par-4) induction (<xref ref-type="bibr" rid="b1-ijmm-35-01-0247">1</xref>), p38 MAP kinase activation (<xref ref-type="bibr" rid="b7-ijmm-35-01-0247">7</xref>), Akt inactivation (<xref ref-type="bibr" rid="b8-ijmm-35-01-0247">8</xref>) and the upregulation of endoplasmic reticulum (ER) stress (<xref ref-type="bibr" rid="b4-ijmm-35-01-0247">4</xref>). It has been reported that withaferin A induces apoptosis in head and neck carcinoma cells and inhibits Akt activation (<xref ref-type="bibr" rid="b9-ijmm-35-01-0247">9</xref>). However, the cellular and molecular mechanisms underlying withaferin A-induced apoptosis in head and neck carcinoma cells are not yet fully understood.</p>
<p>Cyclooxygenase (COX) converts arachidonic acid into prostaglandin (PG)G<sub>2</sub>, which is then reduced to PGH<sub>2</sub>, a is precursor of other prostanoids. COX is divided into 2 isoforms. COX-1 is constitutively expressed in the majority of tissues and has physiological functions, whereas COX-2 is induced by inflammatory cytokines (<xref ref-type="bibr" rid="b10-ijmm-35-01-0247">10</xref>), the mutation of oncogenes (<xref ref-type="bibr" rid="b11-ijmm-35-01-0247">11</xref>) and tumor promoters (<xref ref-type="bibr" rid="b12-ijmm-35-01-0247">12</xref>). COX-2 is overexpressed in multiple types of cancer, such as pancreatic (<xref ref-type="bibr" rid="b13-ijmm-35-01-0247">13</xref>), colon (<xref ref-type="bibr" rid="b14-ijmm-35-01-0247">14</xref>), cervical (<xref ref-type="bibr" rid="b15-ijmm-35-01-0247">15</xref>), renal (<xref ref-type="bibr" rid="b16-ijmm-35-01-0247">16</xref>) and head and neck (<xref ref-type="bibr" rid="b17-ijmm-35-01-0247">17</xref>) cancer. The overexpression of COX-2 has been shown to be associated with the promotion of angiogenesis, invasion and proliferation, and the inhibition of apoptosis. Therefore, the downregulation of COX-2 expression and activity enhances apoptosis (<xref ref-type="bibr" rid="b18-ijmm-35-01-0247">18</xref>,<xref ref-type="bibr" rid="b19-ijmm-35-01-0247">19</xref>). Furthermore, Limami <italic>et al</italic> (<xref ref-type="bibr" rid="b20-ijmm-35-01-0247">20</xref>) reported that the attenuation of COX-2 expression and COX-2 downregulation by siRNA enhanced apoptosis in ursolic acid-treated colorectal cancer cells. Therefore, the upregulation of COX-2 expression by anticancer drugs may promote resistance to apoptosis; thus, the downregulation of COX-2 expression and activity may enhance susceptibility to apoptosis.</p>
<p>In the present study, we investigated whether the withaferin A-induced COX-2 upregulation is involved in resistance to apoptosis in the human head and neck carcinoma cells, AMC-HN4.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title>Cells and materials</title>
<p>The human head and neck cancer cells, AMC-HN4, were obtained from the Asan Medical Center (Seoul, Korea). The cells were cultured in Dulbecco&#x02019;s modified Eagle&#x02019;s medium that contained 10&#x00025; fetal bovine serum, 20 mM HEPES buffer and 100 mg/ml gentamicin. Withaferin A was purchased from Biomol Research Laboratories, Inc. (Plymouth Meeting, PA, USA). z-VAD-fmk (a pan-caspase inhibitor) and NS-398 (a COX-2 specific inhibitor) were purchased from Calbiochem (San Diego, CA, USA). Anti-poly(ADP-ribose) polymerase (PARP) antibodies (sc-25780) were purchased from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA, USA). Anti-actin antibody (A5441) was obtained from Sigma (St. Louis, MO, USA). Anti-COX-2 (Cat#160106) antibody was purchased from Cayman Chemical Co. (Ann Arbor, MI, USA). N-acetylcysteine (NAC), dithiothreitol (DTT) and all the other chemicals were obtained from Sigma.</p></sec>
<sec>
<title>Flow cytometric analysis and cell morphology</title>
<p>Approximately 1&#x000D7;10<sup>6</sup> cells were suspended in 100 &#x003BC;l PBS, and 200 &#x003BC;l 95&#x00025; ethanol were added while vortexing. The cells were incubated at 4&#x000B0;C for 1 h, washed with PBS and resuspended in 250 &#x003BC;l 1,12&#x00025; sodium citrate buffer (pH 8.4) together with 12,5 &#x003BC;g RNase. Incubation was carried out at 37&#x000B0;C for 30 min. Cellular DNA was then stained by applying 250 &#x003BC;l propidium iodide (50 &#x003BC;g/ml) for 30 min at room temperature. The stained cells were analyzed by fluorescence-activated cell sorting (FACS) on a FACScan flow cytometer (E5464; Becton-Dickinson, Franklin Lakes, NJ, USA) for relative DNA content based on red fluorescence. Cell morphology was analyzed using a light microscope (Zeiss Axiovert 200M; Carl Zeiss, G&#x000F6;ttingen, Germany).</p></sec>
<sec>
<title>Western blot analysis</title>
<p>The cells were washed with cold PBS and lysed on ice in modified RIPA buffer (50 mM Tris-HCl, pH 7,4, 1&#x00025; NP-40, 0,25&#x00025; Na-deoxycholate, 150 mM NaCl, 1 mM Na<sub>3</sub>VO<sub>4</sub>, and 1 mM NaF) containing protease inhibitors (100 &#x003BC;M phenylmethylsulfonyl fluoride, 10 &#x003BC;g/ml leupeptin, 10 &#x003BC;g/ml pepstatin and 2 mM EDTA). The lysates were centrifuged at 13,000 &#x000D7; g for 15 min at 4&#x000B0;C and the supernatant fractions were collected. Proteins were separated by SDS-PAGE and transferred onto an immobilon-P membrane (Amersham, Uppsala, Sweden). Specific proteins were detected using enhanced chemiluminescence.</p></sec>
<sec>
<title>Prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) assay</title>
<p>PGE<sub>2</sub> levels in the culture medium were assayed using an enzyme immunoassay kit following the manufacturer&#x02019;s instructions (Cayman Chemical Co.). The assay is based on the competition between peroxidase (or alkaline phosphate)-conjugated tracer PGE<sub>2</sub> and PGE<sub>2</sub> in the medium for a limited number of PGE<sub>2</sub>-specific Abs. The amount of remaining tracer PGE<sub>2</sub> was determined by the addition of substrates for peroxidase (or alkaline phosphatase). OD values were determined at 405 (or 450) nm, as previously described (<xref ref-type="bibr" rid="b21-ijmm-35-01-0247">21</xref>).</p></sec>
<sec>
<title>Measurement of ROS production</title>
<p>The intracellular accumulation of ROS was determined using the fluorescent probe, 2&#x02032;,7&#x02032;-dichlorodihydrofluorescein diacetate (H<sub>2</sub>DCFDA). H<sub>2</sub>DCFDA is commonly used to measure ROS generation (<xref ref-type="bibr" rid="b22-ijmm-35-01-0247">22</xref>). The AMC-HN4 cells were pre-treated with 200 &#x003BC;M trolox and 500 &#x003BC;M MnTBAP for 30 min, and the cells were then incubated with 3 &#x003BC;M withaferin A for 30 min. The cells were stained with the fluorescent dye, H<sub>2</sub>DCFDA, for an additional 10 min. Subsequently, the cells were trypsinized and resuspended in PBS, and fluorescence was measured at specific time intervals with a flow cytometer (Becton-Dickinson) or was detected using a fluorescence microscope (Zeiss, Goettingen, Germany).</p></sec>
<sec>
<title>Statistical analysis</title>
<p>The data were analyzed using one-way ANOVA and post-hoc comparisons (Student-Newman-Keuls test) using the Statistical Package for Social Sciences 22.0 software (SPSS Inc., Chicago, IL, USA).</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Withaferin A induces apoptosis and COX-2 expression in the human head and neck carcinoma cells, AMC-HN4</title>
<p>We have previously reported that withaferin A induces apoptosis in human renal carcinoma Caki cells (<xref ref-type="bibr" rid="b23-ijmm-35-01-0247">23</xref>) and human leukemia U937 cells (<xref ref-type="bibr" rid="b8-ijmm-35-01-0247">8</xref>). In this study, to determine whether withaferin A induces apoptosis, AMC-HN4 cells were treated with the indicated concentrations of withaferin A for 24 h. FACS analysis for the measurement of DNA content and western blot analysis for the detection of the cleavage of PARP, a substrate of caspase-3, were performed. Withaferin A markedly increased the sub-G1 population and the cleavage of PARP in a dose- and time-dependent manner (<xref rid="f1-ijmm-35-01-0247" ref-type="fig">Fig. 1</xref>). COX-2-overexpressing cancer cells are resistant to anticancer drug-mediated apoptosis (<xref ref-type="bibr" rid="b24-ijmm-35-01-0247">24</xref>). Therefore, we examined whether withaferin A increases COX-2 expression in the AMC-HN4 cells. As shown in <xref rid="f1-ijmm-35-01-0247" ref-type="fig">Fig. 1</xref>, withaferin A increased COX-2 expression in a dose- and time-dependent manner.</p>
<p>Subsequently, we investigated whether the withaferin A-induced expression of COX-2 is a consequence of apoptosis. Treatment with the pan-caspase inhibitor, z-VAD-fmk (z-VAD), markedly inhibited the withaferin A-induced increase in the sub-G1 population and the cleavage of PARP (<xref rid="f2-ijmm-35-01-0247" ref-type="fig">Fig. 2</xref>). However, the withaferin A-induced increase in the expression COX-2 was not affected by treatment with z-VAD. Therefore, these data indicate that the withaferin A-mediated COX-2 expression is not a consequence of apoptosis.</p></sec>
<sec>
<title>Withaferin A-induced COX-2 expression has no effect on apoptosis</title>
<p>Previous studies have reported that the downregulation of COX-2 expression and the inhibition of PGE<sub>2</sub> production enhances anticancer drug-mediated apoptosis (<xref ref-type="bibr" rid="b19-ijmm-35-01-0247">19</xref>,<xref ref-type="bibr" rid="b20-ijmm-35-01-0247">20</xref>,<xref ref-type="bibr" rid="b22-ijmm-35-01-0247">22</xref>,<xref ref-type="bibr" rid="b23-ijmm-35-01-0247">23</xref>,<xref ref-type="bibr" rid="b25-ijmm-35-01-0247">25</xref>). Therefore, we examined whether the inhibition of PGE<sub>2</sub> production increases withaferin A-mediated apoptosis. NS-398, a COX-2 inhibitor, markedly blocked the withaferin A-mediated production of PGE<sub>2</sub> (<xref rid="f3-ijmm-35-01-0247" ref-type="fig">Fig. 3A</xref>). However, the withaferin A-induced increase in the sub-G1 population and the cleavage of PARP were not affected by NS-398 treatment (<xref rid="f3-ijmm-35-01-0247" ref-type="fig">Fig. 3B</xref>). These data indicate that the withaferin A-induced expression of COX-2 is not associated with apoptosis in the head and neck carcinoma cells, AMC-HN4.</p></sec>
<sec>
<title>Withaferin A-mediated apoptosis is independent of ROS signaling</title>
<p>Withaferin A has been shown to increase ROS production, and ROS is involved in apoptosis (<xref ref-type="bibr" rid="b5-ijmm-35-01-0247">5</xref>). Therefore, we investigated whether withaferin A increases intracellular ROS levels in AMC-HN4 cells. Withaferin A markedly increased intracellular ROS production (<xref rid="f4-ijmm-35-01-0247" ref-type="fig">Fig. 4A</xref>). Subsequently, we wished to dertermine whether ROS are involved in withaferin A-induced apoptosis. The ROS scavengers, trolox and MnTBAP, inhibited withaferin A-mediated ROS production (<xref rid="f4-ijmm-35-01-0247" ref-type="fig">Fig. 4A</xref>); however, the sub-G1 population and the cleavage of PARP were not affected (<xref rid="f4-ijmm-35-01-0247" ref-type="fig">Fig. 4B</xref>). Furthermore, the induction of COX-2 expression by withaferin A was independent of ROS production (<xref rid="f4-ijmm-35-01-0247" ref-type="fig">Fig. 4B</xref>). These data indicate that ROS is not associated with withaferin A-mediated apoptosis.</p></sec>
<sec>
<title>Withaferin A-mediated apoptosis is reversed by thiol donors</title>
<p>Previous studies have reported that excess amounts of thiol donors block the effects of withaferin A (<xref ref-type="bibr" rid="b26-ijmm-35-01-0247">26</xref>,<xref ref-type="bibr" rid="b27-ijmm-35-01-0247">27</xref>). To determine whether thiol donors inhibit withaferin A-induced apoptosis, AMC-HN4 cells were treated with NAC and DTT. Both thiol donors markedly inhibited morphological changes in the withaferin A-treated cells (<xref rid="f5-ijmm-35-01-0247" ref-type="fig">Fig. 5A</xref>). Furthermore, NAC and DTT blocked the increase in the sub-G1 population and the cleavage of PARP (<xref rid="f5-ijmm-35-01-0247" ref-type="fig">Fig. 5B</xref>). These data suggest that the mechanism of thiol oxidation is important for withaferin A-mediated apoptosis.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>In the present study, we demonstrated that withaferin A induced apoptosis in the human head and neck carcinoma cells, AMC-HN4. Withaferin A increased COX-2 expression and PGE<sub>2</sub> production, but PGE<sub>2</sub> was not associated with apoptosis. Furthermore, the upregulation of intracellular ROS had no effect on apoptosis. Thiol donors only markedly inhibited withaferin A-mediated apoptosis. Therefore, our results suggest that thiol oxidation plays an important role in withaferin A-mediated apoptosis.</p>
<p>COX-2 was overexpressed and the levels of PG, such as PGE<sub>2</sub>, were increased in the cancer cells. Previous studies have reported that COX-2 induces proliferation, angiogenesis, migration and invasion, and inhibits apoptosis. A selective COX-2 inhibitor (celecoxib) has been shown to induce apoptosis in prostate carcinoma (<xref ref-type="bibr" rid="b25-ijmm-35-01-0247">25</xref>), colon carcinoma (<xref ref-type="bibr" rid="b28-ijmm-35-01-0247">28</xref>), cholangiocarcinoma (<xref ref-type="bibr" rid="b29-ijmm-35-01-0247">29</xref>), pancreatic carcinoma and melanoma (<xref ref-type="bibr" rid="b30-ijmm-35-01-0247">30</xref>) cells. Furthermore, the overexpression of COX-2 reduces apoptosis. Sun <italic>et al</italic> (<xref ref-type="bibr" rid="b31-ijmm-35-01-0247">31</xref>) reported that COX-2 overexpression inhibits the release of cytochrome <italic>c</italic> and caspase activation in colon carcinoma cells treated with COX-2 inhibitor and 5-fluorouracil. By contrast, the overexpression of COX-2 in osteosarcoma cells has been shown to decrease cell viability (<xref ref-type="bibr" rid="b32-ijmm-35-01-0247">32</xref>). Xu <italic>et al</italic> (<xref ref-type="bibr" rid="b32-ijmm-35-01-0247">32</xref>) reported that apoptosis by COX-2-overexpression is independent of PGE<sub>2</sub>, whereas the inhibition of ROS production reduces apoptosis in osteosarcoma cells. In head and neck carcinoma, celecoxib and sulindac have been shown to reduce proliferation and induce apoptosis (<xref ref-type="bibr" rid="b33-ijmm-35-01-0247">33</xref>). Furthermore, the inhibition of COX-2 enhances sensitivity to anticancer drugs, such as doxorubicin, vincristine, cisplatin, bleomycin and 5-fluorouracil (<xref ref-type="bibr" rid="b33-ijmm-35-01-0247">33</xref>). Therefore, we hypothesized that the withaferin A-induced expression of COX-2 and PGE<sub>2</sub> production enhances resistance to apoptosis. However, although NS-398 (a COX-2 inhibitor) markedly blocked withaferin A-mediated PGE<sub>2</sub> production, apoptosis was not affected (<xref rid="f3-ijmm-35-01-0247" ref-type="fig">Fig. 3B</xref>). Therefore, the role of COX-2 in anticancer effects is dependent on cell type and cell conditions.</p>
<p>Withaferin A exerts pro-apoptotic (<xref ref-type="bibr" rid="b4-ijmm-35-01-0247">4</xref>&#x02013;<xref ref-type="bibr" rid="b8-ijmm-35-01-0247">8</xref>), anti-proliferative (<xref ref-type="bibr" rid="b34-ijmm-35-01-0247">34</xref>), anti-angiogenic (<xref ref-type="bibr" rid="b35-ijmm-35-01-0247">35</xref>), and anti-invasive (<xref ref-type="bibr" rid="b36-ijmm-35-01-0247">36</xref>) effects through multiple mechanisms. Among these, the upregulation of intracellular ROS is important for withaferin A-mediated apoptosis (<xref ref-type="bibr" rid="b37-ijmm-35-01-0247">37</xref>). We also detected withaferin A-mediated ROS production in AMC-HN4 cells (<xref rid="f4-ijmm-35-01-0247" ref-type="fig">Fig. 4A</xref>). ROS scavengers (trolox and MnTBAP) reduced ROS production in the withaferin A-treated cells, whereas the sub-G1 population and the cleavage of PARP were not affected (<xref rid="f4-ijmm-35-01-0247" ref-type="fig">Fig. 4B</xref>). Thiol oxidation is important for the function of withaferin A. Withaferin A inhibits I&#x003BA;B kinase-&#x003B2; activity, and DTT reverses the inhibitory effects (<xref ref-type="bibr" rid="b27-ijmm-35-01-0247">27</xref>). Furthermore, withaferin A-mediated apoptosis is reversed by DTT in erythromyelogenous leukemia cells (<xref ref-type="bibr" rid="b26-ijmm-35-01-0247">26</xref>). In this study, the thiol donors, DTT and NAC, markedly blocked withaferin A-mediated apoptosis (<xref rid="f5-ijmm-35-01-0247" ref-type="fig">Fig. 5B</xref>). Withaferin A has &#x003B1;,&#x003B2;-unsaturated ketone moiety in the A ring, which reacts with protein thiol nucleophiles (<xref ref-type="bibr" rid="b38-ijmm-35-01-0247">38</xref>). Therefore, withaferin A may target cysteine residues of proteins, such as kinases, phosphatases and chaperons. Therefore, further studies are required to identify the target proteins of withaferin A in head and neck carcinoma cells.</p>
<p>Taken together, our results suggest that the withaferin A-mediated apoptosis is independent of COX-2 expression and ROS production. Thiol oxidation is an important mechanisms of withaferin A-induced apoptosis in head and neck carcinoma cells.</p></sec></body>
<back>
<ref-list>
<title>References</title>
<ref id="b1-ijmm-35-01-0247"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Srinivasan</surname><given-names>S</given-names></name><name><surname>Ranga</surname><given-names>RS</given-names></name><name><surname>Burikhanov</surname><given-names>R</given-names></name><name><surname>Han</surname><given-names>SS</given-names></name><name><surname>Chendil</surname><given-names>D</given-names></name></person-group><article-title>Par-4-dependent apoptosis by the dietary compound withaferin A in prostate cancer cells</article-title><source>Cancer Res</source><volume>67</volume><fpage>246</fpage><lpage>253</lpage><year>2007</year><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-06-2430</pub-id></element-citation></ref>
<ref id="b2-ijmm-35-01-0247"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Malik</surname><given-names>F</given-names></name><name><surname>Kumar</surname><given-names>A</given-names></name><name><surname>Bhushan</surname><given-names>S</given-names></name><etal/></person-group><article-title>Reactive oxygen species generation and mitochondrial dysfunction in the apoptotic cell death of human myeloid leukemia HL-60 cells by a dietary compound withaferin A with concomitant protection by N-acetyl cysteine</article-title><source>Apoptosis</source><volume>12</volume><fpage>2115</fpage><lpage>2133</lpage><year>2007</year><pub-id pub-id-type="doi">10.1007/s10495-007-0129-x</pub-id><pub-id pub-id-type="pmid">17874299</pub-id></element-citation></ref>
<ref id="b3-ijmm-35-01-0247"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stan</surname><given-names>SD</given-names></name><name><surname>Hahm</surname><given-names>ER</given-names></name><name><surname>Warin</surname><given-names>R</given-names></name><name><surname>Singh</surname><given-names>SV</given-names></name></person-group><article-title>Withaferin A causes FOXO3a- and Bim-dependent apoptosis and inhibits growth of human breast cancer cells in vivo</article-title><source>Cancer Res</source><volume>68</volume><fpage>7661</fpage><lpage>7669</lpage><year>2008</year><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-08-1510</pub-id><pub-id pub-id-type="pmid">18794155</pub-id><pub-id pub-id-type="pmcid">2562581</pub-id></element-citation></ref>
<ref id="b4-ijmm-35-01-0247"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Choi</surname><given-names>MJ</given-names></name><name><surname>Park</surname><given-names>EJ</given-names></name><name><surname>Min</surname><given-names>KJ</given-names></name><name><surname>Park</surname><given-names>JW</given-names></name><name><surname>Kwon</surname><given-names>TK</given-names></name></person-group><article-title>Endoplasmic reticulum stress mediates withaferin A-induced apoptosis in human renal carcinoma cells</article-title><source>Toxicol In Vitro</source><volume>25</volume><fpage>692</fpage><lpage>698</lpage><year>2011</year><pub-id pub-id-type="doi">10.1016/j.tiv.2011.01.010</pub-id><pub-id pub-id-type="pmid">21266191</pub-id></element-citation></ref>
<ref id="b5-ijmm-35-01-0247"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mayola</surname><given-names>E</given-names></name><name><surname>Gallerne</surname><given-names>C</given-names></name><name><surname>Esposti</surname><given-names>DD</given-names></name><etal/></person-group><article-title>Withaferin A induces apoptosis in human melanoma cells through generation of reactive oxygen species and down-regulation of Bcl-2</article-title><source>Apoptosis</source><volume>16</volume><fpage>1014</fpage><lpage>1027</lpage><year>2011</year><pub-id pub-id-type="doi">10.1007/s10495-011-0625-x</pub-id><pub-id pub-id-type="pmid">21710254</pub-id></element-citation></ref>
<ref id="b6-ijmm-35-01-0247"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hahm</surname><given-names>ER</given-names></name><name><surname>Moura</surname><given-names>MB</given-names></name><name><surname>Kelley</surname><given-names>EE</given-names></name><name><surname>Van Houten</surname><given-names>B</given-names></name><name><surname>Shiva</surname><given-names>S</given-names></name><name><surname>Singh</surname><given-names>SV</given-names></name></person-group><article-title>Withaferin A-induced apoptosis in human breast cancer cells is mediated by reactive oxygen species</article-title><source>PLoS One</source><volume>6</volume><fpage>e23354</fpage><year>2011</year><pub-id pub-id-type="doi">10.1371/journal.pone.0023354</pub-id><pub-id pub-id-type="pmid">21853114</pub-id><pub-id pub-id-type="pmcid">3154436</pub-id></element-citation></ref>
<ref id="b7-ijmm-35-01-0247"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mandal</surname><given-names>C</given-names></name><name><surname>Dutta</surname><given-names>A</given-names></name><name><surname>Mallick</surname><given-names>A</given-names></name><name><surname>Chandra</surname><given-names>S</given-names></name><name><surname>Misra</surname><given-names>L</given-names></name><name><surname>Sangwan</surname><given-names>RS</given-names></name></person-group><article-title>Withaferin A induces apoptosis by activating p38 Mitogen-activated protein kinase signaling cascade in leukemic cells of lymphoid and myeloid origin through mitochondrial death cascade</article-title><source>Apoptosis</source><volume>13</volume><fpage>1450</fpage><lpage>1464</lpage><year>2008</year><pub-id pub-id-type="doi">10.1007/s10495-008-0271-0</pub-id><pub-id pub-id-type="pmid">18987975</pub-id></element-citation></ref>
<ref id="b8-ijmm-35-01-0247"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Oh</surname><given-names>JH</given-names></name><name><surname>Lee</surname><given-names>TJ</given-names></name><name><surname>Kim</surname><given-names>SH</given-names></name><etal/></person-group><article-title>Induction of apoptosis by withaferin A in human leukemia U937 cells through down-regulation of Akt phosphorylation</article-title><source>Apoptosis</source><volume>13</volume><fpage>1494</fpage><lpage>1504</lpage><year>2008</year><pub-id pub-id-type="doi">10.1007/s10495-008-0273-y</pub-id><pub-id pub-id-type="pmid">19002588</pub-id></element-citation></ref>
<ref id="b9-ijmm-35-01-0247"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Samadi</surname><given-names>AK</given-names></name><name><surname>Tong</surname><given-names>X</given-names></name><name><surname>Mukerji</surname><given-names>R</given-names></name><name><surname>Zhang</surname><given-names>H</given-names></name><name><surname>Timmermann</surname><given-names>BN</given-names></name><name><surname>Cohen</surname><given-names>MS</given-names></name></person-group><article-title>Withaferin A, a cytotoxic steroid from Vassobia breviflora, induces apoptosis in human head and neck squamous cell carcinoma</article-title><source>J Nat Prod</source><volume>73</volume><fpage>1476</fpage><lpage>1481</lpage><year>2010</year><pub-id pub-id-type="doi">10.1021/np100112p</pub-id><pub-id pub-id-type="pmid">20726569</pub-id><pub-id pub-id-type="pmcid">2945430</pub-id></element-citation></ref>
<ref id="b10-ijmm-35-01-0247"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tanabe</surname><given-names>T</given-names></name><name><surname>Tohnai</surname><given-names>N</given-names></name></person-group><article-title>Cyclooxygenase isozymes and their gene structures and expression</article-title><source>Prostaglandins Other Lipid Mediat</source><volume>68&#x02013;69</volume><fpage>95</fpage><lpage>114</lpage><year>2002</year><pub-id pub-id-type="doi">10.1016/S0090-6980(02)00024-2</pub-id></element-citation></ref>
<ref id="b11-ijmm-35-01-0247"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsuji</surname><given-names>S</given-names></name><name><surname>Tsujii</surname><given-names>M</given-names></name><name><surname>Kawano</surname><given-names>S</given-names></name><name><surname>Hori</surname><given-names>M</given-names></name></person-group><article-title>Cyclooxygenase-2 upregulation as a perigenetic change in carcinogenesis</article-title><source>J Exp Clin Cancer Res</source><volume>20</volume><fpage>117</fpage><lpage>129</lpage><year>2001</year><pub-id pub-id-type="pmid">11370818</pub-id></element-citation></ref>
<ref id="b12-ijmm-35-01-0247"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ledwith</surname><given-names>BJ</given-names></name><name><surname>Pauley</surname><given-names>CJ</given-names></name><name><surname>Wagner</surname><given-names>LK</given-names></name><name><surname>Rokos</surname><given-names>CL</given-names></name><name><surname>Alberts</surname><given-names>DW</given-names></name><name><surname>Manam</surname><given-names>S</given-names></name></person-group><article-title>Induction of cyclooxygenase-2 expression by peroxisome proliferators and non-tetradecanoylphorbol 12,13-myristate-type tumor promoters in immortalized mouse liver cells</article-title><source>J Biol Chem</source><volume>272</volume><fpage>3707</fpage><lpage>3714</lpage><year>1997</year><pub-id pub-id-type="doi">10.1074/jbc.272.6.3707</pub-id><pub-id pub-id-type="pmid">9013627</pub-id></element-citation></ref>
<ref id="b13-ijmm-35-01-0247"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Okami</surname><given-names>J</given-names></name><name><surname>Yamamoto</surname><given-names>H</given-names></name><name><surname>Fujiwara</surname><given-names>Y</given-names></name><etal/></person-group><article-title>Overexpression of cyclooxygenase-2 in carcinoma of the pancreas</article-title><source>Clin Cancer Res</source><volume>5</volume><fpage>2018</fpage><lpage>2024</lpage><year>1999</year><pub-id pub-id-type="pmid">10473081</pub-id></element-citation></ref>
<ref id="b14-ijmm-35-01-0247"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Eberhart</surname><given-names>CE</given-names></name><name><surname>Coffey</surname><given-names>RJ</given-names></name><name><surname>Radhika</surname><given-names>A</given-names></name><name><surname>Giardiello</surname><given-names>FM</given-names></name><name><surname>Ferrenbach</surname><given-names>S</given-names></name><name><surname>DuBois</surname><given-names>RN</given-names></name></person-group><article-title>Up-regulation of cyclooxygenase 2 gene expression in human colorectal adenomas and adenocarcinomas</article-title><source>Gastroenterology</source><volume>107</volume><fpage>1183</fpage><lpage>1188</lpage><year>1994</year><pub-id pub-id-type="pmid">7926468</pub-id></element-citation></ref>
<ref id="b15-ijmm-35-01-0247"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ryu</surname><given-names>HS</given-names></name><name><surname>Chang</surname><given-names>KH</given-names></name><name><surname>Yang</surname><given-names>HW</given-names></name><name><surname>Kim</surname><given-names>MS</given-names></name><name><surname>Kwon</surname><given-names>HC</given-names></name><name><surname>Oh</surname><given-names>KS</given-names></name></person-group><article-title>High cyclooxygenase-2 expression in stage IB cervical cancer with lymph node metastasis or parametrial invasion</article-title><source>Gynecol Oncol</source><volume>76</volume><fpage>320</fpage><lpage>325</lpage><year>2000</year><pub-id pub-id-type="doi">10.1006/gyno.1999.5690</pub-id><pub-id pub-id-type="pmid">10684704</pub-id></element-citation></ref>
<ref id="b16-ijmm-35-01-0247"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hara</surname><given-names>S</given-names></name><name><surname>Kondo</surname><given-names>Y</given-names></name><name><surname>Matsuzawa</surname><given-names>I</given-names></name><etal/></person-group><article-title>Expression of cycloxygenase-2 in human bladder and renal cell carcinoma</article-title><source>Adv Exp Med Biol</source><volume>507</volume><fpage>123</fpage><lpage>126</lpage><year>2002</year><pub-id pub-id-type="doi">10.1007/978-1-4615-0193-0_20</pub-id></element-citation></ref>
<ref id="b17-ijmm-35-01-0247"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Celenk</surname><given-names>F</given-names></name><name><surname>Bayramoglu</surname><given-names>I</given-names></name><name><surname>Yilmaz</surname><given-names>A</given-names></name><name><surname>Menevse</surname><given-names>A</given-names></name><name><surname>Bayazit</surname><given-names>Y</given-names></name></person-group><article-title>Expression of cyclooxygenase-2, 12-lipoxygenase, and inducible nitric oxide synthase in head and neck squamous cell carcinoma</article-title><source>J Craniofac Surg</source><volume>24</volume><fpage>1114</fpage><lpage>1117</lpage><year>2013</year><pub-id pub-id-type="doi">10.1097/SCS.0b013e31828f2491</pub-id><pub-id pub-id-type="pmid">23851751</pub-id></element-citation></ref>
<ref id="b18-ijmm-35-01-0247"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hara</surname><given-names>A</given-names></name><name><surname>Yoshimi</surname><given-names>N</given-names></name><name><surname>Niwa</surname><given-names>M</given-names></name><name><surname>Ino</surname><given-names>N</given-names></name><name><surname>Mori</surname><given-names>H</given-names></name></person-group><article-title>Apoptosis induced by NS-398, a selective cyclooxygenase-2 inhibitor, in human colorectal cancer cell lines</article-title><source>Jpn J Cancer Res</source><volume>88</volume><fpage>600</fpage><lpage>604</lpage><year>1997</year><pub-id pub-id-type="doi">10.1111/j.1349-7006.1997.tb00424.x</pub-id><pub-id pub-id-type="pmid">9263538</pub-id></element-citation></ref>
<ref id="b19-ijmm-35-01-0247"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sawaoka</surname><given-names>H</given-names></name><name><surname>Kawano</surname><given-names>S</given-names></name><name><surname>Tsuji</surname><given-names>S</given-names></name><etal/></person-group><article-title>Cyclooxygenase-2 inhibitors suppress the growth of gastric cancer xenografts via induction of apoptosis in nude mice</article-title><source>Am J Physiol</source><volume>274</volume><fpage>G1061</fpage><lpage>1067</lpage><year>1998</year><pub-id pub-id-type="pmid">9696706</pub-id></element-citation></ref>
<ref id="b20-ijmm-35-01-0247"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Limami</surname><given-names>Y</given-names></name><name><surname>Pinon</surname><given-names>A</given-names></name><name><surname>Leger</surname><given-names>DY</given-names></name><etal/></person-group><article-title>HT-29 colorectal cancer cells undergoing apoptosis overexpress COX-2 to delay ursolic acid-induced cell death</article-title><source>Biochimie</source><volume>93</volume><fpage>749</fpage><lpage>757</lpage><year>2011</year><pub-id pub-id-type="doi">10.1016/j.biochi.2011.01.003</pub-id><pub-id pub-id-type="pmid">21251952</pub-id></element-citation></ref>
<ref id="b21-ijmm-35-01-0247"><label>21</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yang</surname><given-names>MS</given-names></name><name><surname>Ji</surname><given-names>KA</given-names></name><name><surname>Jeon</surname><given-names>SB</given-names></name><etal/></person-group><article-title>Interleukin-13 enhances cyclooxygenase-2 expression in activated rat brain microglia: implications for death of activated microglia</article-title><source>J Immunol</source><volume>177</volume><fpage>1323</fpage><lpage>1329</lpage><year>2006</year><pub-id pub-id-type="doi">10.4049/jimmunol.177.2.1323</pub-id><pub-id pub-id-type="pmid">16818793</pub-id></element-citation></ref>
<ref id="b22-ijmm-35-01-0247"><label>22</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>LeBel</surname><given-names>CP</given-names></name><name><surname>Ischiropoulos</surname><given-names>H</given-names></name><name><surname>Bondy</surname><given-names>SC</given-names></name></person-group><article-title>Evaluation of the probe 2&#x02032;,7&#x02032;-dichlorofluorescin as an indicator of reactive oxygen species formation and oxidative stress</article-title><source>Chem Res Toxicol</source><volume>5</volume><fpage>227</fpage><lpage>231</lpage><year>1992</year><pub-id pub-id-type="doi">10.1021/tx00026a012</pub-id><pub-id pub-id-type="pmid">1322737</pub-id></element-citation></ref>
<ref id="b23-ijmm-35-01-0247"><label>23</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Um</surname><given-names>HJ</given-names></name><name><surname>Min</surname><given-names>KJ</given-names></name><name><surname>Kim</surname><given-names>DE</given-names></name><name><surname>Kwon</surname><given-names>TK</given-names></name></person-group><article-title>Withaferin A inhibits JAK/STAT3 signaling and induces apoptosis of human renal carcinoma Caki cells</article-title><source>Biochem Biophys Res Commun</source><volume>427</volume><fpage>24</fpage><lpage>29</lpage><year>2012</year><pub-id pub-id-type="doi">10.1016/j.bbrc.2012.08.133</pub-id><pub-id pub-id-type="pmid">22982675</pub-id></element-citation></ref>
<ref id="b24-ijmm-35-01-0247"><label>24</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname><given-names>B</given-names></name><name><surname>Qu</surname><given-names>L</given-names></name><name><surname>Tao</surname><given-names>H</given-names></name></person-group><article-title>Cyclo-oxygenase 2 up-regulates the effect of multidrug resistance</article-title><source>Cell Biol Int</source><volume>34</volume><fpage>21</fpage><lpage>25</lpage><year>2009</year><pub-id pub-id-type="pmid">20001974</pub-id></element-citation></ref>
<ref id="b25-ijmm-35-01-0247"><label>25</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hsu</surname><given-names>AL</given-names></name><name><surname>Ching</surname><given-names>TT</given-names></name><name><surname>Wang</surname><given-names>DS</given-names></name><name><surname>Song</surname><given-names>X</given-names></name><name><surname>Rangnekar</surname><given-names>VM</given-names></name><name><surname>Chen</surname><given-names>CS</given-names></name></person-group><article-title>The cyclooxygenase-2 inhibitor celecoxib induces apoptosis by blocking Akt activation in human prostate cancer cells independently of Bcl-2</article-title><source>J Biol Chem</source><volume>275</volume><fpage>11397</fpage><lpage>11403</lpage><year>2000</year><pub-id pub-id-type="doi">10.1074/jbc.275.15.11397</pub-id></element-citation></ref>
<ref id="b26-ijmm-35-01-0247"><label>26</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Suttana</surname><given-names>W</given-names></name><name><surname>Mankhetkorn</surname><given-names>S</given-names></name><name><surname>Poompimon</surname><given-names>W</given-names></name><etal/></person-group><article-title>Differential chemosensitization of P-glycoprotein overexpressing K562/Adr cells by withaferin A and Siamois polyphenols</article-title><source>Mol Cancer</source><volume>9</volume><fpage>99</fpage><year>2010</year><pub-id pub-id-type="doi">10.1186/1476-4598-9-99</pub-id><pub-id pub-id-type="pmid">20438634</pub-id><pub-id pub-id-type="pmcid">2873443</pub-id></element-citation></ref>
<ref id="b27-ijmm-35-01-0247"><label>27</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kaileh</surname><given-names>M</given-names></name><name><surname>Vanden Berghe</surname><given-names>W</given-names></name><name><surname>Heyerick</surname><given-names>A</given-names></name><etal/></person-group><article-title>Withaferin A strongly elicits IkappaB kinase beta hyperphosphorylation concomitant with potent inhibition of its kinase activity</article-title><source>J Biol Chem</source><volume>282</volume><fpage>4253</fpage><lpage>4264</lpage><year>2007</year><pub-id pub-id-type="doi">10.1074/jbc.M606728200</pub-id></element-citation></ref>
<ref id="b28-ijmm-35-01-0247"><label>28</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Arico</surname><given-names>S</given-names></name><name><surname>Pattingre</surname><given-names>S</given-names></name><name><surname>Bauvy</surname><given-names>C</given-names></name><etal/></person-group><article-title>Celecoxib induces apoptosis by inhibiting 3-phosphoinositide-dependent protein kinase-1 activity in the human colon cancer HT-29 cell line</article-title><source>J Biol Chem</source><volume>277</volume><fpage>27613</fpage><lpage>27621</lpage><year>2002</year><pub-id pub-id-type="doi">10.1074/jbc.M201119200</pub-id><pub-id pub-id-type="pmid">12000750</pub-id></element-citation></ref>
<ref id="b29-ijmm-35-01-0247"><label>29</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wu</surname><given-names>GS</given-names></name><name><surname>Zou</surname><given-names>SQ</given-names></name><name><surname>Liu</surname><given-names>ZR</given-names></name><name><surname>Tang</surname><given-names>ZH</given-names></name><name><surname>Wang</surname><given-names>JH</given-names></name></person-group><article-title>Celecoxib inhibits proliferation and induces apoptosis via prostaglandin E2 pathway in human cholangiocarcinoma cell lines</article-title><source>World J Gastroenterol</source><volume>9</volume><fpage>1302</fpage><lpage>1306</lpage><year>2003</year><pub-id pub-id-type="pmid">12800245</pub-id></element-citation></ref>
<ref id="b30-ijmm-35-01-0247"><label>30</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wu</surname><given-names>G</given-names></name><name><surname>Yi</surname><given-names>J</given-names></name><name><surname>Di</surname><given-names>F</given-names></name><name><surname>Zou</surname><given-names>S</given-names></name><name><surname>Li</surname><given-names>X</given-names></name></person-group><article-title>Celecoxib inhibits proliferation and induces apoptosis via cyclooxygenase-2 pathway in human pancreatic carcinoma cells</article-title><source>J Huazhong Univ Sci Technolog Med Sci</source><volume>25</volume><fpage>42</fpage><lpage>44</lpage><year>2005</year><pub-id pub-id-type="doi">10.1007/BF02831383</pub-id><pub-id pub-id-type="pmid">15934305</pub-id></element-citation></ref>
<ref id="b31-ijmm-35-01-0247"><label>31</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sun</surname><given-names>Y</given-names></name><name><surname>Tang</surname><given-names>XM</given-names></name><name><surname>Half</surname><given-names>E</given-names></name><name><surname>Kuo</surname><given-names>MT</given-names></name><name><surname>Sinicrope</surname><given-names>FA</given-names></name></person-group><article-title>Cyclooxygenase-2 overexpression reduces apoptotic susceptibility by inhibiting the cytochrome c-dependent apoptotic pathway in human colon cancer cells</article-title><source>Cancer Res</source><volume>62</volume><fpage>6323</fpage><lpage>6328</lpage><year>2002</year><pub-id pub-id-type="pmid">12414664</pub-id></element-citation></ref>
<ref id="b32-ijmm-35-01-0247"><label>32</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Xu</surname><given-names>Z</given-names></name><name><surname>Choudhary</surname><given-names>S</given-names></name><name><surname>Voznesensky</surname><given-names>O</given-names></name><etal/></person-group><article-title>Overexpression of COX-2 in human osteosarcoma cells decreases proliferation and increases apoptosis</article-title><source>Cancer Res</source><volume>66</volume><fpage>6657</fpage><lpage>6664</lpage><year>2006</year><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-05-3624</pub-id><pub-id pub-id-type="pmid">16818639</pub-id></element-citation></ref>
<ref id="b33-ijmm-35-01-0247"><label>33</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hashitani</surname><given-names>S</given-names></name><name><surname>Urade</surname><given-names>M</given-names></name><name><surname>Nishimura</surname><given-names>N</given-names></name><etal/></person-group><article-title>Apoptosis induction and enhancement of cytotoxicity of anticancer drugs by celecoxib, a selective cyclooxygenase-2 inhibitor, in human head and neck carcinoma cell lines</article-title><source>Int J Oncol</source><volume>23</volume><fpage>665</fpage><lpage>672</lpage><year>2003</year><pub-id pub-id-type="pmid">12888902</pub-id></element-citation></ref>
<ref id="b34-ijmm-35-01-0247"><label>34</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cai</surname><given-names>Y</given-names></name><name><surname>Sheng</surname><given-names>ZY</given-names></name><name><surname>Chen</surname><given-names>Y</given-names></name><name><surname>Bai</surname><given-names>C</given-names></name></person-group><article-title>Effect of Withaferin A on A549 cellular proliferation and apoptosis in non-small cell lung cancer</article-title><source>Asian Pac J Cancer Prev</source><volume>15</volume><fpage>1711</fpage><lpage>1714</lpage><year>2014</year><pub-id pub-id-type="doi">10.7314/APJCP.2014.15.4.1711</pub-id><pub-id pub-id-type="pmid">24641396</pub-id></element-citation></ref>
<ref id="b35-ijmm-35-01-0247"><label>35</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mohan</surname><given-names>R</given-names></name><name><surname>Hammers</surname><given-names>HJ</given-names></name><name><surname>Bargagna-Mohan</surname><given-names>P</given-names></name><etal/></person-group><article-title>Withaferin A is a potent inhibitor of angiogenesis</article-title><source>Angiogenesis</source><volume>7</volume><fpage>115</fpage><lpage>122</lpage><year>2004</year><pub-id pub-id-type="doi">10.1007/s10456-004-1026-3</pub-id><pub-id pub-id-type="pmid">15516832</pub-id></element-citation></ref>
<ref id="b36-ijmm-35-01-0247"><label>36</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thaiparambil</surname><given-names>JT</given-names></name><name><surname>Bender</surname><given-names>L</given-names></name><name><surname>Ganesh</surname><given-names>T</given-names></name><etal/></person-group><article-title>Withaferin A inhibits breast cancer invasion and metastasis at sub-cytotoxic doses by inducing vimentin disassembly and serine 56 phosphorylation</article-title><source>Int J Cancer</source><volume>129</volume><fpage>2744</fpage><lpage>2755</lpage><year>2011</year><pub-id pub-id-type="doi">10.1002/ijc.25938</pub-id><pub-id pub-id-type="pmid">21538350</pub-id></element-citation></ref>
<ref id="b37-ijmm-35-01-0247"><label>37</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sen</surname><given-names>N</given-names></name><name><surname>Banerjee</surname><given-names>B</given-names></name><name><surname>Das</surname><given-names>BB</given-names></name><etal/></person-group><article-title>Apoptosis is induced in leishmanial cells by a novel protein kinase inhibitor withaferin A and is facilitated by apoptotic topoisomerase I-DNA complex</article-title><source>Cell Death Differ</source><volume>14</volume><fpage>358</fpage><lpage>367</lpage><year>2007</year><pub-id pub-id-type="doi">10.1038/sj.cdd.4402002</pub-id></element-citation></ref>
<ref id="b38-ijmm-35-01-0247"><label>38</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fuska</surname><given-names>J</given-names></name><name><surname>Fuskova</surname><given-names>A</given-names></name><name><surname>Rosazza</surname><given-names>JP</given-names></name><name><surname>Nicholas</surname><given-names>AW</given-names></name></person-group><article-title>Novel cytotoxic and antitumor agents. IV Withaferin A: relation of its structure to the in vitro cytotoxic effects on P388 cells</article-title><source>Neoplasma</source><volume>31</volume><fpage>31</fpage><lpage>36</lpage><year>1984</year></element-citation></ref></ref-list></back>
<floats-group>
<fig id="f1-ijmm-35-01-0247" position="float">
<label>Figure 1</label>
<caption>
<p>Withaferin A induces apoptosis and upregulates cyclooxygenase-2 (COX-2) expression in AMC-HN4 cells. (A) AMC-HN4 cells were treated with the indicated concentrations of withaferin A for 24 h. (B) AMC-HN4 cells were treated with withaferin A (3 &#x003BC;M) for the indicated perios of time. The sub-G1 population was analyzed by fluorescence activated cell sorting (FACS) (upper panels). Equal amounts of cell lysates (60 &#x003BC;g) were separated by gel electrophoresis and analyzed by western blotting for PARP and COX-2 protein. Actin served as a control for protein loading (lower panels). The values in (A and B) represent the means &#x000B1; SD from 3 independent samples. <sup>*</sup>p&lt;0.05 compared to the control (untreated cells).</p></caption>
<graphic xlink:href="IJMM-35-01-0247-g00.gif"/></fig>
<fig id="f2-ijmm-35-01-0247" position="float">
<label>Figure 2</label>
<caption>
<p>Upregulation of cyclooxygenase-2 (COX-2) expression is not a consequence of apoptosis in withaferin A-treated AMC-HN4 cells. AMC-HN4 cells were treated with 20 &#x003BC;M z-VAD-fmk (z-VAD; a pan-caspase inhibitor) for 30 min prior to treatment with withaferin A (3 &#x003BC;M) for 24 h. The sub-G1 population was analyzed by fluorescence activated cell sorting (FACS) (left panel). Equal amounts of cell lysates (60 &#x003BC;g) were separated by gel electrophoresis and analyzed by western blotting for PARP and COX-2 protein. Actin served as a control for protein loading (right panel). <sup>*</sup>p&lt;0.05 compared to treatment with withaferin A alone.</p></caption>
<graphic xlink:href="IJMM-35-01-0247-g01.gif"/></fig>
<fig id="f3-ijmm-35-01-0247" position="float">
<label>Figure 3</label>
<caption>
<p>Upregulation of cyclooxygenase-2 (COX-2) expression is not associated with withaferin A-induced apoptosis in AMC-HN4 cells. (A and B) AMC-HN4 cells were treated with the indicated concentrations of NS-398 for 30 min prior to treatment with withaferin A (3 &#x003BC;M) for 24 h. (A) PGE<sub>2</sub> production was determined using an enzyme immunoassay kit. (B) The sub-G1 population was analyzed by fluorescence activated cell sorting (FACS) (left panel). Equal amounts of cell lysates (60 &#x003BC;g) were separated by gel electrophoresis and analyzed by western blotting for PARP and COX-2 protein. (B) Actin served as a control for protein loading (right panel). <sup>*</sup>p&lt;0.05 compared to treatment with withaferin A alone.</p></caption>
<graphic xlink:href="IJMM-35-01-0247-g02.gif"/></fig>
<fig id="f4-ijmm-35-01-0247" position="float">
<label>Figure 4</label>
<caption>
<p>Reactive oxygen species (ROS) production is not involved in withaferin A-mediated apoptosis and the upregulation of cyclooxynase-2 (COX-2) expression in AMC-HN4 cells. (A) AMC-HN4 cells were treated with trolox (200 M) and MnTBAP (500 &#x003BC;M) for 30 min prior to treatment with withaferin A (3 &#x003BC;M) for 30 min and then stained with the fluorescent dye, H<sub>2</sub>DCFDA, for an additional 10 min. Fluorescence was immediately assayed by flow cytometry. (B) AMC-HN4 cells were treated with trolox (200 &#x003BC;M) and MnTBAP (500 &#x003BC;M) for 30 min prior to treatment with withaferin A (3 &#x003BC;M) for 24 h. The sub-G1 population was analyzed by fluorescence activated cell sorting (FACS) (left panel). Equal amounts of cell lysates (60 &#x003BC;g) were separated by gel electrophoresis and analyzed by western blot analysis for PARP and COX-2 protein. Actin served as a control for protein loading (right panel).</p></caption>
<graphic xlink:href="IJMM-35-01-0247-g03.gif"/></fig>
<fig id="f5-ijmm-35-01-0247" position="float">
<label>Figure 5</label>
<caption>
<p>Effects of thiol oxidation on withaferin A-induced apoptosis of AMC-HN4 cells. (A and B) AMC-HN4 cells were treated with dithiothreitol (DTT, 2 mM) and N-acetylcysteine (NAC, 5 mM) for 30 min prior to treatment with withaferin A (3 &#x003BC;M) for 24 h. (A) Cell morphology was examined using interference light microscopy. (B) The sub-G1 population was analyzed by fluorescence activated cell sorting (FACS) (left panel). Equal amounts of cell lysates (60 &#x003BC;g) were separated by gel electrophoresis and analyzed by western blotting for PARP and cyclooxygenase-2 (COX-2) protein. (B) Actin served as a control for protein loading (right panel). <sup>*</sup>p&lt;0.05 compared to treatment with withaferin A alone. The data represent 3 independent experiments.</p></caption>
<graphic xlink:href="IJMM-35-01-0247-g04.gif"/></fig></floats-group></article>
