<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "journalpublishing3.dtd">
<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<?release-delay 0|0?>
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">IJO</journal-id>
<journal-title-group>
<journal-title>International Journal of Oncology</journal-title></journal-title-group>
<issn pub-type="ppub">1019-6439</issn>
<issn pub-type="epub">1791-2423</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ijo.2014.2426</article-id>
<article-id pub-id-type="publisher-id">ijo-45-01-0047</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>The effects of fucodian on senescence are controlled by the p16<sup>INK4a</sup>-pRb and p14<sup>Arf</sup>-p53 pathways in hepatocellular carcinoma and hepatic cell lines</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>MIN</surname><given-names>EUN-YOUNG</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>KIM</surname><given-names>IN-HYE</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>LEE</surname><given-names>JUNGIM</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>KIM</surname><given-names>EUN-YOUNG</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>CHOI</surname><given-names>YOUN-HEE</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>NAM</surname><given-names>TAEK-JEONG</given-names></name><xref ref-type="corresp" rid="c1-ijo-45-01-0047"/></contrib>
<aff id="af1-ijo-45-01-0047">Institute of Fisheries Sciences, Pukyong National University, Ilgwang-ro, Ilgwang-myeon, Gijang-gun, Busan 619-911, 
<country>Republic of Korea</country></aff></contrib-group>
<author-notes>
<corresp id="c1-ijo-45-01-0047">Correspondence to: Professor Taek-Jeong Nam, Institute of Fisheries Sciences, Pukyong National University, Ilgwang-ro, Ilgwang-myeon, Gijang-gun, Busan 619-911, Republic of Korea, E-mail: <email>namtj@pknu.ac.kr</email></corresp></author-notes>
<pub-date pub-type="collection">
<month>7</month>
<year>2014</year></pub-date>
<pub-date pub-type="epub">
<day>08</day>
<month>05</month>
<year>2014</year></pub-date>
<volume>45</volume>
<issue>1</issue>
<fpage>47</fpage>
<lpage>56</lpage>
<history>
<date date-type="received">
<day>07</day>
<month>02</month>
<year>2014</year></date>
<date date-type="accepted">
<day>11</day>
<month>04</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2014, Spandidos Publications</copyright-statement>
<copyright-year>2014</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>Fucoidan is known to have various pharmacological effects, including antitumor activity. Although it has potential as a therapeutic agent for cancer cells, the anti-senescence effects and detailed mechanism of action remain poorly understood in normal hepatic cells. We investigated the anticancer functions of fucoidan using HepG2 cells as well as the mechanisms mediating the anti-senescent actions in Chang liver cells. Fucoidan effectively inhibited HepG2 cell viability and induced apoptosis. Also, fucoidan-induced G<sub>1</sub> phase arrest was caused by the activity of the p16<sup>INK4a</sup>-Rb and p14<sup>Arf</sup>-p53 pathways. Furthermore, upregulation of p16<sup>INK4a</sup> was critical to the antitumor activity of HepG2 cells treated with fucoidan and was correlated with inhibition of Cdk4 and pRb and upregulation of p21 expression. Our results suggest that fucoidan upregulates <italic>INK4a</italic> locus genes to induce apoptosis through p38 MAPK in HepG2 cells. Moreover, it prevents cellular senescence of Chang-L cells, by decreasing p14<sup>Arf</sup> expression as cells enter quiescence, with the reduction of p16<sup>INK4a</sup>. Fucoidan treatment also downregulated the expression of &#x003B1;<sub>2</sub>M. In conclusion, fucoidan can be considered a potential therapeutic agent against liver cancer that does not cause senescence in normal hepatic cells. Thus, it may be possible to use fucoidan therapeutically in both tumor suppression and aging.</p></abstract>
<kwd-group>
<kwd>fucoidan</kwd>
<kwd>anti-tumor</kwd>
<kwd>anti-senescence</kwd>
<kwd>p16<sup>INK4a</sup>-Rb</kwd>
<kwd>p14<sup>Arf</sup>-p53</kwd>
<kwd>&#x003B1;<sub>2</sub>M</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Fucoidan is a polysaccharide from the cell wall of brown seaweed containing a substantial percentage of L-fucose and sulfate ester groups (<xref rid="b1-ijo-45-01-0047" ref-type="bibr">1</xref>). It has numerous pharmacological properties as an anti-coagulant, anti-tumor, anti-inflammatory and anti-oxidant agent (<xref rid="b2-ijo-45-01-0047" ref-type="bibr">2</xref>&#x02013;<xref rid="b5-ijo-45-01-0047" ref-type="bibr">5</xref>). In particular, its anti-tumor activity has recently attracted considerable attention (<xref rid="b6-ijo-45-01-0047" ref-type="bibr">6</xref>,<xref rid="b7-ijo-45-01-0047" ref-type="bibr">7</xref>) as a potential therapeutic agent for cancer. However, the anti-senescence effects and detailed mechanism of action remains poorly understood in normal hepatic cells.</p>
<p>Treatment options for liver cancer focus primarily on chemotherapy (<xref rid="b8-ijo-45-01-0047" ref-type="bibr">8</xref>). While these chemotherapeutic regimens are well established, the major drawback remains their limited specificity for the tumor site. Chemotherapeutic drugs, such as cisplatin, induce senescence by enhancing the activity of the tumor suppressor p16<sup>INK4a</sup> in cancer and normal cells, which results in increased toxicity to normal cells, which require balanced expression of p16<sup>INK4a</sup> for growth and differentiation to maintain cell homeostasis. Thus, cancer cell-specific expression of p16<sup>INK4a</sup> would be a valuable therapeutic strategy for cancer treatment (<xref rid="b9-ijo-45-01-0047" ref-type="bibr">9</xref>).</p>
<p>Cellular senescence, leading to cell death through the prevention of regular cell renewal, is associated with the upregulation of p16<sup>INK4a</sup> in most mammalian tissues (<xref rid="b10-ijo-45-01-0047" ref-type="bibr">10</xref>). This process requires activation of several signaling pathways, including phosphorylated retinoblastoma (pRb) and p14<sup>Arf</sup>-p53 (<xref rid="b11-ijo-45-01-0047" ref-type="bibr">11</xref>). Phosphorylation of the Rb protein results in increased p16<sup>INK4a</sup> expression to inhibit cyclin-dependent kinase (Cdk) 4/6. This leads to increased levels of hypophosphorylated Rb that decrease p16<sup>INK4a</sup> expression (<xref rid="b12-ijo-45-01-0047" ref-type="bibr">12</xref>). Although there is a feedback loop between p16<sup>INK4a</sup> and Rb, p16<sup>INK4a</sup> expression does not change appreciably during the cell cycle to correlate with the activation status of Rb (<xref rid="b13-ijo-45-01-0047" ref-type="bibr">13</xref>). However, increased expression of p16<sup>INK4a</sup> leads to senescence and cancer cells inactivate p16<sup>INK4a</sup> by homozygous deletion or hypermethylation to overcome its effects. The tumor suppressor p14<sup>Arf</sup> (p19<sup>Arf</sup> in mouse cells) has emerged as an interesting candidate linking transformation and senescence responses. Arf is the second protein, in addition to p16, expressed from the <italic>INK4a</italic>/<italic>Arf</italic> locus, but bears no homology to p16 or any other cyclin-dependent kinase inhibitors (CKIs) (<xref rid="b14-ijo-45-01-0047" ref-type="bibr">14</xref>). Arf neutralizes the ability of MDM2 to promote p53 degradation, leading to the stabilization and accumulation of p53 (<xref rid="b15-ijo-45-01-0047" ref-type="bibr">15</xref>). Increased expression of Arf also causes growth arrest, one of the hallmarks of premature senescence (<xref rid="b16-ijo-45-01-0047" ref-type="bibr">16</xref>). Thus, the tumor suppressor proteins of the <italic>INK4a</italic>/<italic>Arf</italic> locus function in distinct anticancer pathways as p16<sup>INK4a</sup> directly regulates pRb, while p14<sup>Arf</sup> directly regulates p53 and indirectly regulates pRb (<xref rid="f1-ijo-45-01-0047" ref-type="fig">Fig. 1</xref>). Inactivation of the p53 and pRb pathways through a variety of mechanisms occurs in the majority of, if not all, human cancers. Although these pathways play important roles in differentiation, development and DNA repair, the <italic>INK4a</italic>/<italic>Arf</italic> locus responds largely to aberrant growth or oncogenic stress. Therefore, the <italic>INK4a</italic>/<italic>Arf</italic> locus appears to function as a dual-pronged brake to malignant growth, which engages two potent anti-proliferative pathways represented by p16<sup>INK4a</sup>-pRb and p14<sup>Arf</sup>-p53 signaling (<xref rid="b17-ijo-45-01-0047" ref-type="bibr">17</xref>).</p>
<p>The p38 mitogen-activated protein kinase (MAPK) pathway regulates cellular processes that directly contribute to tumor suppression, including oncogene-induced senescence and replicative senescence (<xref rid="b18-ijo-45-01-0047" ref-type="bibr">18</xref>), as well as proliferation and tumorigenesis (<xref rid="b19-ijo-45-01-0047" ref-type="bibr">19</xref>). Senescence is also accompanied by markers associated with replicative exhaustion of normal cells, such as senescence-associated &#x003B2;-galactosidase (SA-&#x003B2;-gal) activity and the induction of p21, p16<sup>INK4a</sup> and/or p14<sup>Arf</sup> (<xref rid="b16-ijo-45-01-0047" ref-type="bibr">16</xref>,<xref rid="b20-ijo-45-01-0047" ref-type="bibr">20</xref>). A previous study suggested that expression of &#x003B1;-2-macroglobulin (&#x003B1;<sub>2</sub>M) can be used as a biomarker of aging in cultured human fibroblasts, can be measured easily by reverse-transcriptase polymerase chain reaction (RT-PCR) with a limited sample, and is a more suitable biomarker candidate of aging then the well-known senescence-associated genes such as p16<sup>INK4a</sup> (<xref rid="b21-ijo-45-01-0047" ref-type="bibr">21</xref>). In this study, we determined the expression of &#x003B1;<sub>2</sub>M as a biomarker of cellular senescence to assess the anti-senescence effects of fucoidan in normal human liver cells.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Fucoidan</title>
<p>Commercially available fucoidan purified form <italic>F. vesiculosus</italic> (F5631) was purchased from Sigma-Aldrich, Inc. (St. Louis, MO, USA).</p></sec>
<sec>
<title>Cell culture</title>
<p>The human hepatocellular carcinoma cell line (HepG2; HB-8065) and the human normal liver cell line (Chang-L; CCL-13) were obtained from the American Type Culture Collection (ATCC, GA, USA). Cells were cultured in MEM medium supplemented with 10&#x00025; fetal bovine serum, penicillin (100 U/ml) and streptomycin (100 <italic>&#x003BC;</italic>g/ml) at 37&#x000B0;C in a humidified 5&#x00025; CO<sub>2</sub> incubator.</p></sec>
<sec>
<title>Cell viability assay</title>
<p>Cell viability was determined by the Cyto<sup>&#x02122;</sup> cell viability assay kit (LPS solution, Daejeon, Korea). Cells were seeded at a density of 1&#x000D7;10<sup>4</sup> cells/well in a 96-well plate. After 24 h, the cells were treated with the phosphate-buffered saline (PBS) vehicle or 100, 250 and 500 <italic>&#x003BC;</italic>g/ml fucoidan. The Cyto solution was added to each well and incubated for 4 h. The formazan product was estimated by measuring absorbance at 450 nm in a microplate reader (BioTek Instruments, Inc., Winooski, VT, USA). The viability of fucoidan-treated cells was expressed as a percentage of vehicle-treated control cells considered 100&#x00025; viable.</p></sec>
<sec>
<title>Cell cycle analysis</title>
<p>Cells were seeded at a density of 1&#x000D7;10<sup>4</sup> cells/well and treated with various concentrations of fucoidan for 24 h. Control and treated cells were harvested, washed in cold PBS, fixed in 70&#x00025; ethanol and stored at 4&#x000B0;C. The resulting cells were stained with 200 <italic>&#x003BC;</italic>l of Muse<sup>&#x02122;</sup> cell cycle reagent at room temperature for 30 min in the dark before analysis. DNA content was assessed by Muse<sup>&#x02122;</sup> cell analyzer (EMD Millipore Co., CA, USA).</p></sec>
<sec>
<title>Apoptosis analysis</title>
<p>The Muse Annexin V and Dead cell kit (EMD Millipore Co., MA, USA) was used for the apoptosis assay. HepG2 cells and Chang-L cells plated at a density of 1&#x000D7;10<sup>6</sup> cells/well were treated with varying concentrations of fucoidan for 24 h. Cells were harvested by trypsinization, washed twice with PBS, and re-suspended in Annexin V and 7-aminoactinomycin D (7-AAD) for 20 min at room temperature in the dark. The cells were evaluated immediately by Muse cell analyzer. The percentage of apoptotic cells was assessed using the Muse<sup>&#x02122;</sup> software.</p></sec>
<sec>
<title>Western blotting</title>
<p>Samples were analyzed by western blotting, as described previously (<xref rid="b20-ijo-45-01-0047" ref-type="bibr">20</xref>). Whole-cell lysates were prepared by lysing cell pellets in a NETN lysis buffer &#x0005B;0.5&#x00025; Nonidet P-40, 1 mM EDTA, 50 mM Tris (pH 7.4), 12 mM NaCl, 1 mM DTT, 10 mM NaF, 2 mM Na<sub>3</sub>VO<sub>4</sub>, 1 mM PMSF&#x0005D;. Samples (50 <italic>&#x003BC;</italic>g) were resolved by SDS-PAGE and transferred to Immobilion-P transfer membranes (Millipore Co., MA USA). The primary antibodies used included monoclonal anti-p16<sup>INK4a</sup>, polyclonal anti-Cdk4 and -Cdk6, polyclonal anti-p21, polyclonal anti-p38, monoclonal anti-p-p38, polyclonal anti-p53 and polyclonal anti-pRb (1:1,000, Santa Cruz Biotechnology, Inc., TX, USA). Membranes were washed and incubated with the corresponding HRP-conjugated secondary antibody at 1:10,000. Bound secondary antibody was detected using a chemiluminescence substrate (Advansta, Menlo Park, CA, USA) and visualized on GeneSys imaging system (SynGene Synoptics, Ltd., London, UK).</p></sec>
<sec>
<title>Real-time PCR</title>
<p>Cells were harvested 24 h after treatment with PBS, 100, 250 or 500 <italic>&#x003BC;</italic>g/ml fucoidan. Total-RNA was extracted from HepG2 and Chang-L cells using the QIAzol lysis reagent (Qiagen Sciences, Inc., Germantown, MD, USA). RNA quality was evaluated by measuring absorbance at 260 and 280 nm to calculate the concentration and to assess the purity of RNA, respectively. Agarose electrophoresis was used to detect RNA purity and integrity.</p>
<p>The GoScript<sup>&#x02122;</sup> Reverse Transcription System (Promega Corp., Madison, WI, USA) was used to prepare cDNA according to the manufacturer&#x02019;s instructions; the samples were stored at &#x02212;20&#x000B0;C. The quality of cDNA was assessed by amplifying an internal reference gene, glyceraldehyde 3-phosphate dehydrogenase (GAPDH), by PCR and the results were confirmed by 2&#x00025; agarose gel electrophoresis. The products were examined by computerized gel imaging system (Bio-Rad, Hercules, CA, USA).</p>
<p>Quantitative PCR was conducted in 20 <italic>&#x003BC;</italic>l reactions containing QuantiMix SYBR kit (PhilKorea Technology, Inc., Daejeon, Korea) using the Illumina Eco<sup>&#x02122;</sup> real-time PCR system (Illumina, Inc., Hayward, CA, USA). The oligonucleotide primers for p16<sup>INK4a</sup>, p14<sup>Arf</sup>, p21, p53, p38, &#x003B1;<sub>2</sub>M and GAPDH are shown in <xref rid="t1-ijo-45-01-0047" ref-type="table">Table I</xref>. Reaction mixtures were incubated for an initial denaturation at 95&#x000B0;C for 10 min followed by 40 cycles of 95&#x000B0;C for 15 sec, 55&#x000B0;C for 15 sec and 72&#x000B0;C for 15 sec. For each sample, the expression level of each mRNA was quantified as the cycle threshold difference (&#x00394;C<sub>t</sub>) to GAPDH mRNA. All reactions were performed in triplicate and repeated with two independent experiments.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>SPSS software (Chicago, IL, USA) was used to perform the statistical analysis. For comparisons for more than two groups, data were analyzed by one-way analysis of variance (ANOVA), followed by Duncan&#x02019;s test for multiple comparisons. For all tests, P&#x0003C;0.05 was considered to indicate significance.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Effects of fucoidan on cell viability</title>
<p>To verify the effects of fucoidan on cell viability, cells were treated with fucoidan at the concentrations indicated for 24 h (<xref rid="f2-ijo-45-01-0047" ref-type="fig">Fig. 2</xref>). Compared to the untreated controls, Chang-L cells exhibited no cytotoxicity at concentrations between 0 and 500 <italic>&#x003BC;</italic>g/ml. In contrast, proliferation of HepG2 cells was dose-dependently inhibited by fucoidan treatment (250 <italic>&#x003BC;</italic>g/ml, 79.75&#x000B1;9.94&#x00025; inhibition; 500 <italic>&#x003BC;</italic>g/ml, 62.43&#x000B1;1.0&#x00025; inhibition). Thus, the ability of fucoidan to inhibit proliferation was significantly different between HepG2 and Chang-L cells.</p></sec>
<sec>
<title>Effects of fucoidan on apoptosis</title>
<p>To determine whether the cytotoxicity of fucoidan was caused by apoptosis, Annexin V/7-AAD double-staining was performed. In fucoidan-treated HepG2 cells, the percentage of the early apoptotic cells, as well as the total percentage of Annexin V-positive cells indicating late apoptotic cells, was significantly increased in a dose-dependent manner (<xref rid="f3-ijo-45-01-0047" ref-type="fig">Fig. 3</xref>). In Chang-L cells, the percentage of apoptotic cells did not differ between fucoidan-treated groups and controls (data not shown). These results indicate that fucoidan had a strong antitumor effect on hepatocellular carcinoma cells and is a potent apoptosis-inducing agent.</p></sec>
<sec>
<title>Effects of fucoidan on the cell cycle</title>
<p>To determine whether fucoidan affected the cell cycles of HepG2 and Chang-L cells, we performed cell analysis 24 h after fucoidan treatment. Treatment with 500 <italic>&#x003BC;</italic>g/ml fucoidan led to a significant decrease in the production of S and G<sub>2</sub>/M phases and G<sub>0</sub>/G<sub>1</sub> phase arrest in HepG2 cells (43.12&#x00025; in W/O, 77.78&#x00025; in fucoidan-treated samples; P&#x0003C;0.05). Treatment at concentrations between 0 and 500 <italic>&#x003BC;</italic>g/ml did not significantly change the cell cycles of Chang-L cells (<xref rid="t2-ijo-45-01-0047" ref-type="table">Table II</xref>). These results suggest that the anti-proliferative effect of fucoidan on HepG2 cells can be attributed to a blocking of the G<sub>0</sub>/G<sub>1</sub> phase of the cell cycle.</p></sec>
<sec>
<title>Expression of p16<sup>INK4a</sup>-pRb pathway-related proteins in fucoidan-treated cells</title>
<p>To evaluate the mechanism underlying the tumor-suppressing activity of fucoidan, we examined the expressions of p16<sup>INK4a</sup>, Cdk4/6 and pRb by western blotting in HepG2 cells after treatment with fucoidan for 24 h. We further explored the mechanism of this antitumor action by evaluating mRNA expression by real-time PCR.</p>
<p>The p16<sup>INK4a</sup> is a key component of the Rb pathway that can inhibit the activity of Cdks, thereby preventing proliferating cells from entering the S phase (<xref rid="b22-ijo-45-01-0047" ref-type="bibr">22</xref>). As shown in <xref rid="f4-ijo-45-01-0047" ref-type="fig">Figs. 4A</xref> and <xref rid="f5-ijo-45-01-0047" ref-type="fig">5</xref>, 250 and 500 <italic>&#x003BC;</italic>g/ml fucoidan significantly increased p16<sup>INK4a</sup> expression levels in HepG2 cells (P&#x0003C;0.05). We determined that fucoidan likely activates the Cdk4 and pRb pathway by triggering p16<sup>INK4a</sup> overexpression and maintaining the hypophosphorylated state of Rb (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Figs. 4A</xref> and <xref rid="f5-ijo-45-01-0047" ref-type="fig">5</xref>). Therefore, we determined that p16<sup>INK4a</sup> arrests cells in the G1 phase by inhibiting the activities of Cdk4 and pRb (<xref rid="t2-ijo-45-01-0047" ref-type="table">Table II</xref>).</p>
<p>To identify the effects of fucoidan that regulate cell growth arrest and thus promote cellular senescence in Chang-L cells, we analyzed p16<sup>INK4a</sup>/Cdk4 and Cdk6/pRb, which are primarily responsible for inhibiting cell growth and inducing cellular senescence (<xref rid="b23-ijo-45-01-0047" ref-type="bibr">23</xref>). The activation of p16<sup>INK4a</sup> is a common step in the induction of senescence arrest. However, in Chang-L cells treated with fucoidan, overexpression of p16<sup>INK4a</sup> protein was not detected (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Figs. 4B</xref> and <xref rid="f6-ijo-45-01-0047" ref-type="fig">6</xref>). In addition, Cdk4-dependent activation of pRb, which is important for cell cycle arrest, did not significantly change (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4</xref>). The p16<sup>INK4a</sup> also links several senescence-initiating signals to p53 activation. However, fucoidan resulted in a significant downregulation of p16<sup>INK4a</sup> compared to non-treated Chang-L cells when analyzed by real-time PCR (<xref rid="f6-ijo-45-01-0047" ref-type="fig">Fig. 6</xref>).</p></sec>
<sec>
<title>Expression of p14<sup>Arf</sup>-p53 pathway-related proteins in fucoidan-treated cells</title>
<p>The p14<sup>Arf</sup> and p16<sup>INK4a</sup> are key tumor suppressor genes that inactivate p53. To explore the effects of the p14<sup>Arf</sup>-p53 pathway on maintaining senescence arrest by fucoidan, we analyzed the expression of the pathway in Chang-L cells by western blotting and real-time PCR. We further investigated the tumor suppressor activity of fucoidan in HepG2 cells through the p14<sup>Arf</sup>-p53 pathway.</p>
<p>Although p14<sup>Arf</sup> protein expression was not detected by western blotting, the expression of p14<sup>Arf</sup> mRNA was detected in both HepG2 and Chang-L cells. Real-time PCR determined that fucoidan significantly increased p14<sup>Arf</sup> mRNA expression in HepG2 cells at concentrations of 250 and 500 <italic>&#x003BC;</italic>g/ml (<xref rid="f5-ijo-45-01-0047" ref-type="fig">Fig. 5</xref>) but significantly decreased expression in Chang-L cells (<xref rid="f6-ijo-45-01-0047" ref-type="fig">Fig. 6</xref>). Hence, fucoidan suppresses p14<sup>Arf</sup> expression as well as p16<sup>INK4a</sup> expression in Chang-L cells.</p>
<p>In parallel experiments, treatment of HepG2 cells with 250 and 500 <italic>&#x003BC;</italic>g/ml fucoidan increased the protein expression of p53 and p21, which are involved in the activation of tumor suppressors (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4A</xref>), and upregulated p53 mRNA. Furthermore, fucoidan-induced p53 mRNA resulted in upregulation of p21 mRNA (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Figs. 4A</xref> and <xref rid="f5-ijo-45-01-0047" ref-type="fig">5</xref>).</p>
<p>In Chang-L cells, the mRNA levels of p14<sup>Arf</sup> and p21, which are involved in cellular senescence, were significantly lower at concentrations &#x0003E;100 <italic>&#x003BC;</italic>g/ml (<xref rid="f6-ijo-45-01-0047" ref-type="fig">Fig. 6</xref>). However, fucoidan treatment did not significantly affect p53 mRNA compared to controls (<xref rid="f6-ijo-45-01-0047" ref-type="fig">Fig. 6</xref>). Thus, decreased expression of p14<sup>Arf</sup> and p21 induced senescence arrest due to inactivation of the p53 pathway, and significant changes in the cell cycle were observed after treatment with fucoidan (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4B</xref>, <xref rid="t2-ijo-45-01-0047" ref-type="table">Table II</xref>).</p></sec>
<sec>
<title>Expression of p38 MAPK in fucoidan-treated cells</title>
<p>p38 MAPK can trigger premature senescence in primary cells and permanent oncogene-induced proliferative arrest, which has been proposed as an anti-tumorigenic defense mechanism that induces p53 phosphorylation and upregulation of p16<sup>INK4a</sup> (<xref rid="b18-ijo-45-01-0047" ref-type="bibr">18</xref>). We defined whether activation of p38 MAPK mediated tumor suppression and replicative senescence, and examined the relationship between fucoidan-stimulated activation of p16<sup>INK4a</sup>/p53 and p38 MAPK in HepG2 and Chang-L cells (<xref rid="f1-ijo-45-01-0047" ref-type="fig">Fig. 1</xref>). We further determined whether the expression of phosphorylated p38 MAPK increased in both cell types. Fucoidan dose-dependently elevated phospho-p38 MAPK (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4A</xref>) and p38 MAPK gene expression in HepG2 cells (<xref rid="f7-ijo-45-01-0047" ref-type="fig">Fig. 7</xref>). In contrast, it did not significantly affect p38 and phospho-p38 protein levels in Chang-L cells (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4B</xref>).</p>
<p>Correlation analysis was used to examine the relevance of p38 MAPK, p16<sup>INK4a</sup> and p53 expression after fucoidan treatment of HepG2 and Chang-L cells. Positive correlations between p38 MAPK and p16<sup>INK4a</sup>/p53 were found in HepG2 cells (<xref rid="f9-ijo-45-01-0047" ref-type="fig">Fig. 9</xref>), whereas p38 MAPK was closely related with p16<sup>INK4a</sup> in Chang-L cells (data not shown). However, the levels of p53 mRNA were not associated with p38 MAPK (data not shown).</p></sec>
<sec>
<title>Gene expression of &#x003B1;<sub>2</sub>M as an aging biomarker</title>
<p>The expression of &#x003B1;<sub>2</sub>M can easily be measured by real-time PCR and it is a more suitable biomarker candidate of aging then well-known senescence-associated genes such as p16<sup>INK4a</sup>.</p>
<p>Compared to controls, the mRNA level of &#x003B1;<sub>2</sub>M significantly increased in HepG2 cells treated with fucoidan in a manner similar to p16<sup>INK4a</sup> expression (<xref rid="f8-ijo-45-01-0047" ref-type="fig">Fig. 8</xref>). In Chang-L cells, fucoidan treatment dose-dependently decreased &#x003B1;<sub>2</sub>M expression, but not p16<sup>INK4a</sup>. When we compared HepG2 and Chang-L cells, a significant difference in &#x003B1;<sub>2</sub>M mRNA levels was noted after incubation with 250 and 500 <italic>&#x003BC;</italic>g/ml fucoidan (<xref rid="f8-ijo-45-01-0047" ref-type="fig">Fig. 8</xref>).</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Natural products have played a pivotal role in the quest to develop novel chemotherapeutic agents with enhanced specificity and potency in liver cancer. Many marine compounds have chemopreventive and chemotherapeutic effects through various cell-signaling pathways involved in the transduction of mitogenic signals and subsequent regulation of cell growth and proliferation (<xref rid="b24-ijo-45-01-0047" ref-type="bibr">24</xref>).</p>
<p>The diverse biological activities of fucoidan have been studied intensively and include anti-oxidant, immunomodulatory, anti-virus and anti-coagulant effects (<xref rid="b3-ijo-45-01-0047" ref-type="bibr">3</xref>,<xref rid="b4-ijo-45-01-0047" ref-type="bibr">4</xref>,<xref rid="b25-ijo-45-01-0047" ref-type="bibr">25</xref>,<xref rid="b26-ijo-45-01-0047" ref-type="bibr">26</xref>). In particular, the anti-tumor activity has recently attracted considerable attention and several studies have addressed its anti-carcinogenic effects (<xref rid="b7-ijo-45-01-0047" ref-type="bibr">7</xref>). Fucoidan inhibits the growth of a wide variety of tumor cells (<xref rid="b3-ijo-45-01-0047" ref-type="bibr">3</xref>,<xref rid="b26-ijo-45-01-0047" ref-type="bibr">26</xref>), which has become a focus of great interest because it is expected to be a new candidate for low-toxicity cancer therapy (<xref rid="b7-ijo-45-01-0047" ref-type="bibr">7</xref>).</p>
<p>Cancer cells need to evade anti-proliferative signals that negatively regulate growth and proliferation. Cancer cells can avoid this control step by losing the physiological function of the pRb, which controls all anti-proliferative signals (<xref rid="b24-ijo-45-01-0047" ref-type="bibr">24</xref>). Consequently, natural product compounds that inhibit constitutive hyper-phosphorylation of pRb contribute efficiently to the reestablishment of regulated growth in cancer (<xref rid="b24-ijo-45-01-0047" ref-type="bibr">24</xref>). In cancer cells, the hyper-proliferation stress response tends to be suppressed, allowing the continued proliferation of cells carrying overactive mitogenic signals. Hyper-proliferation signals lead to increased levels of p16<sup>INK4a</sup> and p14<sup>Arf</sup> resulting in cell cycle arrest or cell death through the pRb and p53 pathways. In many cell types, particularly in humans, the Cdk inhibitor p16<sup>INK4a</sup> contributes to the cell cycle arrest that occurs after hyper-proliferation stress. Thus, the loss of p16<sup>INK4a</sup>, which occurs in many cancers, helps abolish this response in some cell types. Some cancer-associated chromosomal deletions disrupt both p16<sup>INK4a</sup> and p14<sup>Arf</sup> genes, thereby knocking out regulators of both the pRb and p53 pathways. Loss of p53 function is a remarkably common event in tumor cells because it allows cell proliferation to continue following different forms of stress and DNA damage (<xref rid="b27-ijo-45-01-0047" ref-type="bibr">27</xref>). In addition, the <italic>INK4</italic>/<italic>Arf</italic> locus gene, p16<sup>INK4a</sup> and p14<sup>Arf</sup> (or p19<sup>Arf</sup> in mouse), which is upregulated during aging (<xref rid="b28-ijo-45-01-0047" ref-type="bibr">28</xref>) has been genetically linked to numerous aging-associated diseases in humans (<xref rid="b29-ijo-45-01-0047" ref-type="bibr">29</xref>). Accordingly, we anticipated that marine compounds such as fucoidan could have chemopreventive and chemotherapeutic effects by regulating the expression of p16<sup>INK4a</sup>, p14<sup>Arf</sup> and p53 in cancer cells.</p>
<p>Fedorov <italic>et al</italic> showed that the natural marine chamigrane-type sesquiterpenoid dactylone inhibited cyclin D, Cdk4 expression and pRb phosphorylation (<xref rid="b30-ijo-45-01-0047" ref-type="bibr">30</xref>). The inhibition of these cell cycle components was followed by cell cycle arrest at the G<sub>1</sub>-S transition, with subsequent p53-independent apoptosis in human cancer cells. Park <italic>et al</italic> described the suppression of U937 human monocytic leukemia cell growth by dideoxypetrosynol A, a polyacetylene from the sponge <italic>Petrosia</italic> sp., via induction of the Cdk inhibitor p16<sup>INK4a</sup> and downregulation of pRb phosphorylation (<xref rid="b31-ijo-45-01-0047" ref-type="bibr">31</xref>).</p>
<p>Interestingly, the wild-type p53 gene is often inactivated in HepG2 cells (<xref rid="b32-ijo-45-01-0047" ref-type="bibr">32</xref>). However, we determined that fucoidan significantly upregulated the expression of p53 in HepG2 cells, while simultaneously inducing apoptosis with inhibition of cellular proliferation (<xref rid="f2-ijo-45-01-0047" ref-type="fig">Figs. 2</xref> and <xref rid="f3-ijo-45-01-0047" ref-type="fig">3</xref>). Real-time PCR and western blotting studies correlated increased mRNA and protein expression for p16<sup>INK4a</sup> and p21 (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Figs. 4A</xref> and <xref rid="f5-ijo-45-01-0047" ref-type="fig">5</xref>). These results suggest that the growth arrest in hepatocellular carcinoma cells results from an increase in p53-mediated p21 expression as cells enter senescence, followed by a sustained elevation of p16<sup>INK4a</sup> (<xref rid="f5-ijo-45-01-0047" ref-type="fig">Fig. 5</xref>).</p>
<p>The p21 gene is a cell cycle inhibitor and tumor suppressor downstream of p53. When cells are damaged, p53 and p21 act together to inactivate the cyclin-Cdk complex, which could mediate G<sub>1</sub> and G<sub>2</sub>/M arrest (<xref rid="b33-ijo-45-01-0047" ref-type="bibr">33</xref>). In this study, induction of G<sub>1</sub> arrest by fucoidan was accompanied by a large accumulation of p53 and p21. In particular, p21 sustains hypophosphorylated Rb and arrests cells in the G<sub>1</sub> phase. Therefore, we can deduce that the anti-proliferative effect of fucoidan regulates pRb- or p53-mediated cell cycle arrest in HepG2 cells (<xref rid="t2-ijo-45-01-0047" ref-type="table">Table II</xref>). This supports the idea that p16<sup>INK4a</sup>-pRb-mediated G<sub>1</sub> arrest by fucoidan is elicited by p53 and p21 upregulation.</p>
<p>Fujii <italic>et al</italic> suggested that the expression of <italic>INK4a</italic>/<italic>Arf</italic> locus genes p16<sup>INK4a</sup> and p14<sup>Arf</sup> could be related to cellular senescence and apoptosis and reported that expression of this locus was increased by valproic acid treatment and induced apoptosis in sphere cells from rat sarcomas (<xref rid="b34-ijo-45-01-0047" ref-type="bibr">34</xref>). We also demonstrated that fucoidan caused induction of apoptosis and tumor suppression by p16<sup>INK4a</sup> and p14<sup>Arf</sup> overexpression in HepG2 cells but did not affect normal Chang-L cells. Resistance to apoptosis by cancer cells can be acquired through a variety of strategies, including p53 tumor suppressor gene inactivation. The p53 can lead to induction of the apoptotic cascade (<xref rid="b24-ijo-45-01-0047" ref-type="bibr">24</xref>). However, numerous studies have determined that p38 MAPK may be correlated with apoptosis in various cancer cells (<xref rid="b35-ijo-45-01-0047" ref-type="bibr">35</xref>). The p38 MAPK can regulate cell proliferation and apoptosis through phosphorylation of p53, increased c-myc expression and regulation of Fas/FasL-mediated apoptosis (<xref rid="b36-ijo-45-01-0047" ref-type="bibr">36</xref>). The impact of p38 MAPK on cell cycle regulators plays a crucial role in oncogene-induced senescence involved in the suppression of tumorigenesis and replicative senescence (<xref rid="b18-ijo-45-01-0047" ref-type="bibr">18</xref>). Indeed, we found that fucoidan induced the activation of p38 protein and mRNA in HepG2 cells. Our results show that activation of p38 leads to increased expression of p16<sup>INK4a</sup>, similarly to previous reports on oncogene-induced senescence (<xref rid="b19-ijo-45-01-0047" ref-type="bibr">19</xref>). These studies indicate that p53 is a downstream effector of p38 MAPK, which has been proposed to function as an anti-tumorigenic defense mechanism by inducing p53 and upregulating p16<sup>INK4a</sup>.</p>
<p>We found that fucoidan treatment induced phosphorylation of p38 MAPK and concurrently increased p38 MAPK in HepG2 cells. Consistent with these results, a previous study determined that the anti-tumor activity of fucoidan was mediated by the induction of apoptosis through the activation of p38 MAPK in human colon carcinoma cells (<xref rid="b37-ijo-45-01-0047" ref-type="bibr">37</xref>). Interestingly, in a previous study, honokiol, a novel antitumor agent isolated from a plant, increased the phosphorylated p38 MAPK without affecting p38 expression in HepG2 cells (<xref rid="b35-ijo-45-01-0047" ref-type="bibr">35</xref>). Numerous studies have demonstrated that increased levels of phosphorylated p38 are correlated with malignancy in various cancers (<xref rid="b38-ijo-45-01-0047" ref-type="bibr">38</xref>,<xref rid="b39-ijo-45-01-0047" ref-type="bibr">39</xref>). These data support the hypothesis that fucoidan may have therapeutic potential for cancer treatment.</p>
<p>In summary, in HepG2 cells, it is apparent that p16<sup>INK4a</sup> upregulation is a key event in anti-tumor activity, and that fucoidan-induced overexpression of p38 MPAK is associated with the p14<sup>Arf</sup>-p53 pathway during apoptosis. This suggests that fucoidan treatment can induce growth-suppressive signals from both p16<sup>INK4a</sup>-Rb and p14<sup>Arf</sup>-p53 pathways, a valuable therapeutic strategy for cancer treatment (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4A</xref>). However, in Chang-L cells, no increase in these pathway-related proteins was noted and no evidence for apoptosis was observed after fucoidan treatment (<xref rid="f4-ijo-45-01-0047" ref-type="fig">Fig. 4B</xref>). Among the marine compounds, lactone spongistatin induces the degradation of XIAP (<xref rid="b40-ijo-45-01-0047" ref-type="bibr">40</xref>), an anti-apoptotic protein that is overexpressed in chemoresistant cancer cells (<xref rid="b41-ijo-45-01-0047" ref-type="bibr">41</xref>). This compound, similar to our results, does not induce apoptosis in healthy peripheral blood cells (<xref rid="b40-ijo-45-01-0047" ref-type="bibr">40</xref>). Therefore, we suggest that fucoidan could have selective chemotherapeutic effects.</p>
<p>Cellular senescence is an aging mechanism that prevents cell renewal, leading to apoptosis and increased expression of the tumor suppressor gene p16<sup>INK4a</sup> (<xref rid="b42-ijo-45-01-0047" ref-type="bibr">42</xref>). As proof of the stochastic model, early fibroblasts have low levels of p16<sup>INK4a</sup> but aging fibroblasts show significantly increased p16<sup>INK4a</sup> expression (<xref rid="b43-ijo-45-01-0047" ref-type="bibr">43</xref>). The loss or inactivation of p16<sup>INK4a</sup> is correlated with cell immortality (<xref rid="b44-ijo-45-01-0047" ref-type="bibr">44</xref>). Given the postulated importance of p16<sup>INK4a</sup> in cell senescence, it is expected that inhibition of p16<sup>INK4a</sup> would extend the proliferative life span of cultured cells (<xref rid="b45-ijo-45-01-0047" ref-type="bibr">45</xref>). In the present study, we investigated in detail the pathways induced by fucoidan in a normal liver cell line. The expression of p16<sup>INK4a</sup> and p14<sup>Arf</sup> mRNA significantly decreased with increasing fucoidan concentration (<xref rid="f6-ijo-45-01-0047" ref-type="fig">Fig. 6</xref>). Carnero <italic>et al</italic> used a strategy to express antisense p16<sup>INK4a</sup> and p19<sup>Arf</sup> (p14<sup>Arf</sup> in human) RNA in primary mouse embryonic fibroblasts (MEFs) (<xref rid="b46-ijo-45-01-0047" ref-type="bibr">46</xref>). Consequently, the lifespan of MEFs was extended, and a percentage of these cells eventually became immortal. Their study suggested that cellular immortality derived from p16<sup>INK4a</sup> acts through the Rb pathway, whereas p19<sup>Arf</sup> acts through both the p53 and Rb pathways. Furthermore, Jung <italic>et al</italic> determined that the p14<sup>Arf</sup>-p53-p21 pathway, in addition to the p16<sup>INK4a</sup>-Rb pathway, controls senescence (<xref rid="b47-ijo-45-01-0047" ref-type="bibr">47</xref>). Phosphorylation of Rb results in increased p16<sup>INK4a</sup> expression, which inhibits Cdk4/6 resulting in increased levels of hypophosphorylated Rb and decreased p16<sup>INK4a</sup> expression (<xref rid="b12-ijo-45-01-0047" ref-type="bibr">12</xref>,<xref rid="b13-ijo-45-01-0047" ref-type="bibr">13</xref>). The p14<sup>Arf</sup>-p53 pathway is important as part of the normal life cycle of many cells; it regulates a cell&#x02019;s entrance into senescence (<xref rid="b48-ijo-45-01-0047" ref-type="bibr">48</xref>). In the present study, the expression of p14<sup>Arf</sup> and p21 mRNA was significantly downregulated, regardless of protein expression in Chang-L cells. However, the expression of p53 did not appear to change significantly under the same conditions. In agreement, several experimental studies have observed p14<sup>Arf</sup> in senescent human fibroblasts, independent of p53 (<xref rid="b16-ijo-45-01-0047" ref-type="bibr">16</xref>,<xref rid="b48-ijo-45-01-0047" ref-type="bibr">48</xref>). Moreover, the upregulation of p21 in aging and senescent human fibroblasts is well documented (<xref rid="b11-ijo-45-01-0047" ref-type="bibr">11</xref>,<xref rid="b49-ijo-45-01-0047" ref-type="bibr">49</xref>).</p>
<p>It should be noted that <italic>INK4a/Arf</italic> expression is both a biomarker and effector of aging. Our results suggest that fucoidan prevented senescence in hepatoma cells by mediating a process that included a decrease in p14<sup>Arf</sup> expression as cells entered quiescence followed by a decline in the level of p16<sup>INK4a</sup>. We must be clear that these results do not negate an anti-aging effect of fucoidan in normal hepatic cells, but only indicate that reduced levels of these proteins are not enough to cause cellular longevity. Therefore, we examined other clinical biomarkers of aging. Like oncogene-induced senescence, replicative senescence is identified by senescence biomarkers such as SA-&#x003B2;-gal and &#x003B1;<sub>2</sub>M. The &#x003B1;<sub>2</sub>M and SA-&#x003B2;-gal expression is accompanied by increased expression of negative growth regulators including p53, p21, p16<sup>INK4a</sup> and p14<sup>Arf</sup> (<xref rid="b20-ijo-45-01-0047" ref-type="bibr">20</xref>). &#x003B1;<sub>2</sub>M is a major plasma protein that functions as a panprotease inhibitor. Ma <italic>et al</italic> showed that expression of p16<sup>INK4a</sup> at each passage was exponentially correlated with cumulative population doubling level (PDL) (<xref rid="b21-ijo-45-01-0047" ref-type="bibr">21</xref>), in agreement with previous reports on p16<sup>INK4a</sup> (<xref rid="b45-ijo-45-01-0047" ref-type="bibr">45</xref>), and provided further evidence that mRNA expression of &#x003B1;<sub>2</sub>M had a positive linear correlation with cumulative PDL, similar to p16<sup>INK4a</sup>. These results, including the positive relationship between &#x003B1;<sub>2</sub>M and p16<sup>INK4a</sup>, suggest that &#x003B1;<sub>2</sub>M mRNA expression can be used as a biomarker of cellular senescence (<xref rid="b21-ijo-45-01-0047" ref-type="bibr">21</xref>). Another study found that the amount of &#x003B1;<sub>2</sub>M fragment derived from culture medium increased as the cells aged (<xref rid="b50-ijo-45-01-0047" ref-type="bibr">50</xref>). We attempted to identify changes that are essential for a cellular anti-aging response by comparing the effects of fucoidan on &#x003B1;<sub>2</sub>M mRNA expression in HepG2 and Chang-L cells. We found that expression of &#x003B1;<sub>2</sub>M was upregulated in HepG2 cells, but significantly downregulated in Chang-L cells after incubation with fucoidan. These results suggest that fucoidan has the anti-senescence effect in normal hepatic cell line. As we have seen, there are several independent pathways that control replicative senescence in human cells.</p>
<p>In conclusion, fucoidan arrests cells in the G<sub>1</sub> phase through p16<sup>INK4a</sup> and p14<sup>Arf</sup> in HepG2 cells. It also increases the activity of tumor suppressor proteins p53 and p38 MAPK, which play a critical role in the regulation of apoptosis. Accordingly, in addition to directly inhibiting the proliferation of tumor cells, fucoidan may also restrain the development of tumor cells by inducing apoptosis. Fucoidan also affected the senescence of Chang-L cells by decreasing mRNA expression of p16<sup>INK4a</sup>, p14<sup>Arf</sup>, p21 and the senescence biomarker &#x003B1;<sub>2</sub>M. These findings suggest that fucoidan may offer substantial therapeutic potential for cancer treatment without inducing senescence in normal cells, and that it may be possible to use fucoidan therapeutically.</p></sec></body>
<back>
<ack>
<p>This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012R1A6A1028677).</p></ack>
<ref-list>
<title>References</title>
<ref id="b1-ijo-45-01-0047"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Li</surname><given-names>Y</given-names></name><name><surname>Nichols</surname><given-names>MA</given-names></name><name><surname>Shay</surname><given-names>JW</given-names></name><name><surname>Xiong</surname><given-names>Y</given-names></name></person-group><article-title>Transcriptional repression of the D-type cyclin-dependent kinase inhibitor p16 by the retinoblastoma susceptibility gene product pRb</article-title><source>Cancer Res</source><volume>54</volume><fpage>6078</fpage><lpage>6082</lpage><year>1994</year></element-citation></ref>
<ref id="b2-ijo-45-01-0047"><label>2.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>D&#x000FC;rig</surname><given-names>J</given-names></name><name><surname>Vruhn</surname><given-names>T</given-names></name><name><surname>Zurborn</surname><given-names>KH</given-names></name><name><surname>Gutensohn</surname><given-names>K</given-names></name><name><surname>Bruhn</surname><given-names>HD</given-names></name><name><surname>B&#x000E8;ress</surname><given-names>L</given-names></name></person-group><article-title>Anticoagulant fucoidan fractions from <italic>Fucus vesiculosus</italic> induce platelet activation <italic>in vitro</italic></article-title><source>Thromb Res</source><volume>85</volume><fpage>479</fpage><lpage>491</lpage><year>1997</year></element-citation></ref>
<ref id="b3-ijo-45-01-0047"><label>3.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Maruyama</surname><given-names>H</given-names></name><name><surname>Tamauchi</surname><given-names>H</given-names></name><name><surname>Hasimoto</surname><given-names>M</given-names></name><name><surname>Nakano</surname><given-names>T</given-names></name></person-group><article-title>Antitumor activity and immune response of Mekabu fucoidan extracted from Sporophyll of <italic>Undaria pinnatifida</italic></article-title><source>In vivo</source><volume>17</volume><fpage>245</fpage><lpage>249</lpage><year>2003</year></element-citation></ref>
<ref id="b4-ijo-45-01-0047"><label>4.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>J</given-names></name><name><surname>Zhang</surname><given-names>Q</given-names></name><name><surname>Zang</surname><given-names>Z</given-names></name><name><surname>Li</surname><given-names>Z</given-names></name></person-group><article-title>Antioxidant activity of sulfated polysaccharide fractions extracted from <italic>Laminaria japonica</italic></article-title><source>Int J Biol Macromol</source><volume>42</volume><fpage>127</fpage><lpage>132</lpage><year>2008</year></element-citation></ref>
<ref id="b5-ijo-45-01-0047"><label>5.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hu</surname><given-names>T</given-names></name><name><surname>Liu</surname><given-names>D</given-names></name><name><surname>Chen</surname><given-names>Y</given-names></name><name><surname>Wu</surname><given-names>J</given-names></name><name><surname>Wang</surname><given-names>S</given-names></name></person-group><article-title>Antioxidant activity of sulfated polysaccharide fractions extracted from <italic>Undaria pinnitafida in vitro</italic></article-title><source>Int J Biol Macromol</source><volume>46</volume><fpage>193</fpage><lpage>198</lpage><year>2010</year></element-citation></ref>
<ref id="b6-ijo-45-01-0047"><label>6.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>H</given-names></name><name><surname>Kim</surname><given-names>JS</given-names></name><name><surname>Kim</surname><given-names>E</given-names></name></person-group><article-title>Fucoidan form seaweed <italic>Fucus vesiculosus</italic> inhibits migration and invasion of human lung cancer cells via PI3K-Akt-mTOR pathways</article-title><source>PLoS One</source><volume>7</volume><fpage>e50624</fpage><year>2012</year></element-citation></ref>
<ref id="b7-ijo-45-01-0047"><label>7.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Xue</surname><given-names>M</given-names></name><name><surname>Ge</surname><given-names>Y</given-names></name><name><surname>Zhang</surname><given-names>J</given-names></name><etal/></person-group><article-title>Anticancer properties and mechanisms of fucoidan on mouse breast cancer in vitro and in vivo</article-title><source>PLoS One</source><volume>7</volume><fpage>e43483</fpage><year>2012</year></element-citation></ref>
<ref id="b8-ijo-45-01-0047"><label>8.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kim</surname><given-names>NY</given-names></name><name><surname>Sun</surname><given-names>JM</given-names></name><name><surname>Kim</surname><given-names>YJ</given-names></name><etal/></person-group><article-title>Cisplatin-based combination chemotherapy for advanced hepatocellular carcinoma: a single centre experience before the sorafenib era</article-title><source>Cancer Res Treat</source><volume>42</volume><fpage>203</fpage><lpage>209</lpage><year>2010</year></element-citation></ref>
<ref id="b9-ijo-45-01-0047"><label>9.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rayess</surname><given-names>H</given-names></name><name><surname>Wang</surname><given-names>MB</given-names></name><name><surname>Srivatsan</surname><given-names>ES</given-names></name></person-group><article-title>Cellular senescence and tumor suppressor gene p16</article-title><source>Int J Cancer</source><volume>130</volume><fpage>1715</fpage><lpage>1725</lpage><year>2012</year></element-citation></ref>
<ref id="b10-ijo-45-01-0047"><label>10.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Krishnamurthy</surname><given-names>J</given-names></name><name><surname>Torrice</surname><given-names>C</given-names></name><name><surname>Ramsey</surname><given-names>MR</given-names></name><etal/></person-group><article-title>Ink4a/Arf expression is a biomarker of aging</article-title><source>J Clin Invest</source><volume>114</volume><fpage>1299</fpage><lpage>1307</lpage><year>2004</year></element-citation></ref>
<ref id="b11-ijo-45-01-0047"><label>11.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stein</surname><given-names>GH</given-names></name><name><surname>Drullinger</surname><given-names>LF</given-names></name><name><surname>Soulard</surname><given-names>A</given-names></name><name><surname>Duli&#x00107;</surname><given-names>V</given-names></name></person-group><article-title>Differential roles for cyclin-dependent kinase inhibitors p21 and p16 in the mechanisms of senescence and differentiation in human fibro-blasts</article-title><source>Mol Cell Biol</source><volume>19</volume><fpage>2109</fpage><lpage>2117</lpage><year>1999</year></element-citation></ref>
<ref id="b12-ijo-45-01-0047"><label>12.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Li</surname><given-names>B</given-names></name><name><surname>Lu</surname><given-names>F</given-names></name><name><surname>Wei</surname><given-names>X</given-names></name><name><surname>Zhao</surname><given-names>R</given-names></name></person-group><article-title>Fucoidan: structure and bioactivity</article-title><source>Molecules</source><volume>13</volume><fpage>1671</fpage><lpage>1695</lpage><year>2008</year></element-citation></ref>
<ref id="b13-ijo-45-01-0047"><label>13.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hara</surname><given-names>E</given-names></name><name><surname>Smith</surname><given-names>R</given-names></name><name><surname>Parry</surname><given-names>D</given-names></name><name><surname>Tahara</surname><given-names>H</given-names></name><name><surname>Stone</surname><given-names>S</given-names></name><name><surname>Peters</surname><given-names>G</given-names></name></person-group><article-title>Regulation of p16CDKN2 expression and its implications for cell immortalization and senescence</article-title><source>Mol Cell Biol</source><volume>16</volume><fpage>859</fpage><lpage>867</lpage><year>2008</year></element-citation></ref>
<ref id="b14-ijo-45-01-0047"><label>14.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Haber</surname><given-names>DA</given-names></name></person-group><article-title>Splicing into senescence: the curious case of p16 and p19<sup>Arf</sup></article-title><source>Cell</source><volume>91</volume><fpage>555</fpage><lpage>558</lpage><year>1997</year></element-citation></ref>
<ref id="b15-ijo-45-01-0047"><label>15.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pomerantz</surname><given-names>J</given-names></name><name><surname>Schreiber-Agus</surname><given-names>N</given-names></name><name><surname>Li&#x000E9;geois</surname><given-names>NJ</given-names></name><etal/></person-group><article-title>Ink4a tumor suppressor gene product, p19<sup>Arf</sup>, interacts with MDM2 and neutralizes MDM2&#x02019;s inhibition of p53</article-title><source>Cell</source><volume>92</volume><fpage>713</fpage><lpage>723</lpage><year>1998</year></element-citation></ref>
<ref id="b16-ijo-45-01-0047"><label>16.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dimri</surname><given-names>GP</given-names></name><name><surname>Itahana</surname><given-names>K</given-names></name><name><surname>Acosta</surname><given-names>M</given-names></name><name><surname>Campisi</surname><given-names>J</given-names></name></person-group><article-title>Regulation of a senescence checkpoint response by the E2F1 transcription factor and p14<sup>Arf</sup>tumor suppressor</article-title><source>Mol Cell Biol</source><volume>20</volume><fpage>273</fpage><lpage>285</lpage><year>2000</year></element-citation></ref>
<ref id="b17-ijo-45-01-0047"><label>17.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sharpless</surname><given-names>NE</given-names></name></person-group><article-title>INK4a/ARF: A multifunctional tumor suppressor locus</article-title><source>Mutat Res</source><volume>576</volume><fpage>22</fpage><lpage>38</lpage><year>2005</year></element-citation></ref>
<ref id="b18-ijo-45-01-0047"><label>18.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Han</surname><given-names>J</given-names></name><name><surname>Sun</surname><given-names>P</given-names></name></person-group><article-title>2007. The pathways to tumor suppression via route p38</article-title><source>Trends Biochem Sci</source><volume>32</volume><fpage>364</fpage><lpage>371</lpage><year>2007</year></element-citation></ref>
<ref id="b19-ijo-45-01-0047"><label>19.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bulavin</surname><given-names>DV</given-names></name><name><surname>Fornace</surname><given-names>AJ</given-names><suffix>Jr</suffix></name></person-group><article-title>p38 MAPK kinase&#x02019;s emerging role as a tumor suppressor</article-title><source>Adv Cancer Res</source><volume>92</volume><fpage>95</fpage><lpage>118</lpage><year>2004</year></element-citation></ref>
<ref id="b20-ijo-45-01-0047"><label>20.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Serrano</surname><given-names>M</given-names></name><name><surname>Lin</surname><given-names>AW</given-names></name><name><surname>McCurrach</surname><given-names>ME</given-names></name><name><surname>Beach</surname><given-names>D</given-names></name><name><surname>Lowe</surname><given-names>SW</given-names></name></person-group><article-title>Oncogenic ras provokes premature cell senescence associated with accumulation of p53 and p16<sup>INK4a</sup></article-title><source>Cell</source><volume>88</volume><fpage>593</fpage><lpage>602</lpage><year>1997</year></element-citation></ref>
<ref id="b21-ijo-45-01-0047"><label>21.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ma</surname><given-names>H</given-names></name><name><surname>Li</surname><given-names>R</given-names></name><name><surname>Zhang</surname><given-names>Z</given-names></name><name><surname>Tong</surname><given-names>T</given-names></name></person-group><article-title>mRNA level of alpha-2-macro-globulin as an aging biomarker of human fibroblasts in culture</article-title><source>Exp Gerontol</source><volume>39</volume><fpage>415</fpage><lpage>421</lpage><year>2004</year></element-citation></ref>
<ref id="b22-ijo-45-01-0047"><label>22.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Serrano</surname><given-names>M</given-names></name></person-group><article-title>The INK4a/ARF locus in murine tumorigenesis</article-title><source>Carcinogenesis</source><volume>21</volume><fpage>865</fpage><lpage>869</lpage><year>2000</year></element-citation></ref>
<ref id="b23-ijo-45-01-0047"><label>23.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schmitt</surname><given-names>CA</given-names></name><name><surname>Fridman</surname><given-names>JS</given-names></name><name><surname>Yang</surname><given-names>M</given-names></name><etal/></person-group><article-title>A senescence program controlled by p53 and p16<sup>INK4a</sup>contributes to the outcome of cancer therapy</article-title><source>Cell</source><volume>109</volume><fpage>335</fpage><lpage>346</lpage><year>2002</year></element-citation></ref>
<ref id="b24-ijo-45-01-0047"><label>24.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schumacher</surname><given-names>M</given-names></name><name><surname>Kelkel</surname><given-names>M</given-names></name><name><surname>Dicato</surname><given-names>M</given-names></name><name><surname>Diederich</surname><given-names>M</given-names></name></person-group><article-title>Gold from the sea: marine compounds as inhibitors of the hallmarks of cancer</article-title><source>Biotechnol Adv</source><volume>29</volume><fpage>531</fpage><lpage>547</lpage><year>2011</year></element-citation></ref>
<ref id="b25-ijo-45-01-0047"><label>25.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ishii</surname><given-names>H</given-names></name><name><surname>Iwatsuki</surname><given-names>M</given-names></name><name><surname>Ieta</surname><given-names>K</given-names></name><etal/></person-group><article-title>Cancer stem cells and chemoradiation resistance</article-title><source>Cancer Sci</source><volume>99</volume><fpage>1871</fpage><lpage>1877</lpage><year>2008</year></element-citation></ref>
<ref id="b26-ijo-45-01-0047"><label>26.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Alekseyenko</surname><given-names>TV</given-names></name><name><surname>Zhanayeva</surname><given-names>SY</given-names></name><name><surname>Venediktova</surname><given-names>AA</given-names></name><etal/></person-group><article-title>Antitumor and antimetastatic activity of fucoidan, a sulfated polysaccharide isolated from the Okhotsk Sea <italic>Fucus evanescens</italic> brown alga</article-title><source>Bull Exp Biol Med</source><volume>143</volume><fpage>730</fpage><lpage>732</lpage><year>2007</year></element-citation></ref>
<ref id="b27-ijo-45-01-0047"><label>27.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Meek</surname><given-names>DW</given-names></name></person-group><article-title>2009. Tumour suppression by p53: a role for the DNA damage response? </article-title><source>Nat Rev Cancer</source><volume>9</volume><fpage>714</fpage><lpage>723</lpage><year>2009</year></element-citation></ref>
<ref id="b28-ijo-45-01-0047"><label>28.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ressler</surname><given-names>S</given-names></name><name><surname>Bartkova</surname><given-names>J</given-names></name><name><surname>Niederegger</surname><given-names>H</given-names></name><etal/></person-group><article-title>p16<sup>INK4a</sup>is a robust in vivo biomarker of cellular aging in human skin</article-title><source>Aging Cell</source><volume>5</volume><fpage>379</fpage><lpage>389</lpage><year>2006</year></element-citation></ref>
<ref id="b29-ijo-45-01-0047"><label>29.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Melzer</surname><given-names>D</given-names></name></person-group><article-title>Genetic polymorphisms and human aging: association studies deliver</article-title><source>Rejuvenation Res</source><volume>11</volume><fpage>523</fpage><lpage>526</lpage><year>2008</year></element-citation></ref>
<ref id="b30-ijo-45-01-0047"><label>30.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fedorov</surname><given-names>SN</given-names></name><name><surname>Shubina</surname><given-names>LK</given-names></name><name><surname>Bode</surname><given-names>AM</given-names></name><name><surname>Stonik</surname><given-names>VA</given-names></name><name><surname>Dong</surname><given-names>Z</given-names></name></person-group><article-title>Dactylone inhibits epidermal growth factor-induced transformation and phenotype expression of human cancer cells and induces G1-S arrest and apoptosis</article-title><source>Cancer Res</source><volume>67</volume><fpage>5914</fpage><lpage>5920</lpage><year>2007</year></element-citation></ref>
<ref id="b31-ijo-45-01-0047"><label>31.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Park</surname><given-names>C</given-names></name><name><surname>Kim</surname><given-names>GY</given-names></name><name><surname>Kim</surname><given-names>GD</given-names></name><etal/></person-group><article-title>Suppression of U937 human monocytic leukemia cell growth by dideoxypetrosynol A, a polyacetylene from the sponge Petrosia sp., via induction of Cdk inhibitor p16 and down-regulation of pRB phosphorylation</article-title><source>Oncol Rep</source><volume>16</volume><fpage>171</fpage><lpage>176</lpage><year>2006</year></element-citation></ref>
<ref id="b32-ijo-45-01-0047"><label>32.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>M&#x000FC;ller</surname><given-names>M</given-names></name><name><surname>Strand</surname><given-names>S</given-names></name><name><surname>Hug</surname><given-names>H</given-names></name><etal/></person-group><article-title>Drug-induced apoptosis in hepatoma cells is mediated by the CD95 (APO-1/Fas) receptor/ligand system and involves activation of wild-type p53</article-title><source>J Clin Invest</source><volume>99</volume><fpage>403</fpage><lpage>413</lpage><year>1997</year></element-citation></ref>
<ref id="b33-ijo-45-01-0047"><label>33.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vogelstein</surname><given-names>B</given-names></name><name><surname>Lane</surname><given-names>D</given-names></name><name><surname>Levine</surname><given-names>AJ</given-names></name></person-group><article-title>Surfing the p53 network</article-title><source>Nature</source><volume>408</volume><fpage>307</fpage><lpage>310</lpage><year>2000</year></element-citation></ref>
<ref id="b34-ijo-45-01-0047"><label>34.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fujii</surname><given-names>H</given-names></name><name><surname>Honoki</surname><given-names>K</given-names></name><name><surname>Tsujiuchi</surname><given-names>T</given-names></name><etal/></person-group><article-title>Reduced expression of INK4a/ARF genes in stem-like sphere cells from rat sarcomas</article-title><source>Biochem Biophysic Res Commun</source><volume>362</volume><fpage>773</fpage><lpage>778</lpage><year>2007</year></element-citation></ref>
<ref id="b35-ijo-45-01-0047"><label>35.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Deng</surname><given-names>J</given-names></name><name><surname>Qian</surname><given-names>Y</given-names></name><name><surname>Geng</surname><given-names>L</given-names></name><etal/></person-group><article-title>Involvement of p38 mitogen-activated protein kinase pathway in honokiol-induced apoptosis in a human hepatoma cell line (HepG2)</article-title><source>Liver Int</source><volume>28</volume><fpage>1458</fpage><lpage>1464</lpage><year>2008</year></element-citation></ref>
<ref id="b36-ijo-45-01-0047"><label>36.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>YX</given-names></name><name><surname>Xu</surname><given-names>XY</given-names></name><name><surname>Su</surname><given-names>WL</given-names></name><etal/></person-group><article-title>Activation and clinical significance of p38 MAPK signaling pathway in patients with severe trauma</article-title><source>J Surg Res</source><volume>161</volume><fpage>119</fpage><lpage>125</lpage><year>2009</year></element-citation></ref>
<ref id="b37-ijo-45-01-0047"><label>37.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hyun</surname><given-names>JH</given-names></name><name><surname>Kim</surname><given-names>SC</given-names></name><name><surname>Kang</surname><given-names>JI</given-names></name><etal/></person-group><article-title>Apoptosis inducing activity of fucoidan in HCT-15 colon carcinoma cells</article-title><source>Biol Pharm Bull</source><volume>32</volume><fpage>1760</fpage><lpage>1764</lpage><year>2009</year></element-citation></ref>
<ref id="b38-ijo-45-01-0047"><label>38.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Iyoda</surname><given-names>K</given-names></name><name><surname>Sasaki</surname><given-names>Y</given-names></name><name><surname>Horimoto</surname><given-names>M</given-names></name><etal/></person-group><article-title>Involvement of the p38 mitogen-activated protein kinase cascade in hepatocellular carcinoma</article-title><source>Cancer</source><volume>97</volume><fpage>3017</fpage><lpage>3026</lpage><year>2003</year></element-citation></ref>
<ref id="b39-ijo-45-01-0047"><label>39.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wagner</surname><given-names>EF</given-names></name><name><surname>Nebreda</surname><given-names>AR</given-names></name></person-group><article-title>Signal integration by JNK and p38 MAPK pathways in cancer development</article-title><source>Nat Rev Cancer</source><volume>9</volume><fpage>537</fpage><lpage>549</lpage><year>2009</year></element-citation></ref>
<ref id="b40-ijo-45-01-0047"><label>40.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schyschka</surname><given-names>L</given-names></name><name><surname>Rudy</surname><given-names>A</given-names></name><name><surname>Jeremias</surname><given-names>I</given-names></name><name><surname>Barth</surname><given-names>N</given-names></name><name><surname>Pettit</surname><given-names>GR</given-names></name><name><surname>Vollmar</surname><given-names>AM</given-names></name></person-group><article-title>Spongistatin 1: a new chemosensitizing marine compound that degrades XIAP</article-title><source>Leukemia</source><volume>22</volume><fpage>1737</fpage><lpage>1745</lpage><year>2008</year></element-citation></ref>
<ref id="b41-ijo-45-01-0047"><label>41.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Igney</surname><given-names>FH</given-names></name><name><surname>Krammer</surname><given-names>PH</given-names></name></person-group><article-title>Death and anti-death: tumor resistance to apoptosis</article-title><source>Nat Rev Cancer</source><volume>2</volume><fpage>277</fpage><lpage>288</lpage><year>2002</year></element-citation></ref>
<ref id="b42-ijo-45-01-0047"><label>42.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Verzola</surname><given-names>D</given-names></name><name><surname>Gandolfo</surname><given-names>MT</given-names></name><name><surname>Gaetani</surname><given-names>G</given-names></name><etal/></person-group><article-title>Accelerated senescence in the kidneys of patients with type 2 diabetic nephropathy</article-title><source>Am J Physiol Renal Physiol</source><volume>295</volume><fpage>F1563</fpage><lpage>F1573</lpage><year>2008</year></element-citation></ref>
<ref id="b43-ijo-45-01-0047"><label>43.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsygankow</surname><given-names>D</given-names></name><name><surname>Liu</surname><given-names>Y</given-names></name><name><surname>Sanoff</surname><given-names>HK</given-names></name><name><surname>Sharpless</surname><given-names>NE</given-names></name><name><surname>Elston</surname><given-names>TC</given-names></name></person-group><article-title>A quantitative model for age-dependent expression of the p16<sup>INK4a</sup>tumor suppressor</article-title><source>Proc Natl Acad Sci USA</source><volume>106</volume><fpage>16562</fpage><lpage>16567</lpage><year>2009</year></element-citation></ref>
<ref id="b44-ijo-45-01-0047"><label>44.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Huschtscha</surname><given-names>LI</given-names></name><name><surname>Reddel</surname><given-names>RR</given-names></name></person-group><article-title>p16<sup>INK4a</sup>and the control of cellular proliferative life span</article-title><source>Carcinogenesis</source><volume>20</volume><fpage>921</fpage><lpage>926</lpage><year>1999</year></element-citation></ref>
<ref id="b45-ijo-45-01-0047"><label>45.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Duan</surname><given-names>J</given-names></name><name><surname>Zhang</surname><given-names>Z</given-names></name><name><surname>Tong</surname><given-names>T</given-names></name></person-group><article-title>Senescence delay of human diploid fibroblast induced by anti-sense p16<sup>INK4a</sup>expression</article-title><source>J Biol Chem</source><volume>276</volume><fpage>48325</fpage><lpage>48331</lpage><year>2001</year></element-citation></ref>
<ref id="b46-ijo-45-01-0047"><label>46.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Carnero</surname><given-names>A</given-names></name><name><surname>Hudson</surname><given-names>JD</given-names></name><name><surname>Price</surname><given-names>CM</given-names></name><name><surname>Beach</surname><given-names>DH</given-names></name></person-group><article-title>p16<sup>INK4A</sup>and p19ARF act in overlapping pathways in cellular immortalization</article-title><source>Nat Cell Biol</source><volume>2</volume><fpage>148</fpage><lpage>155</lpage><year>2000</year></element-citation></ref>
<ref id="b47-ijo-45-01-0047"><label>47.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jung</surname><given-names>YS</given-names></name><name><surname>Qian</surname><given-names>Y</given-names></name><name><surname>Chen</surname><given-names>X</given-names></name></person-group><article-title>Examination of the expanding pathway for the regulation of p21 expression and activity</article-title><source>Cell Signal</source><volume>22</volume><fpage>1003</fpage><lpage>1012</lpage><year>2010</year></element-citation></ref>
<ref id="b48-ijo-45-01-0047"><label>48.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Collado</surname><given-names>M</given-names></name><name><surname>Blasco</surname><given-names>MA</given-names></name><name><surname>Serrano</surname><given-names>M</given-names></name></person-group><article-title>Cellular senescence in cancer and aging</article-title><source>Cell</source><volume>130</volume><fpage>223</fpage><lpage>233</lpage><year>2007</year></element-citation></ref>
<ref id="b49-ijo-45-01-0047"><label>49.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tahara</surname><given-names>H</given-names></name><name><surname>Sato</surname><given-names>E</given-names></name><name><surname>Noda</surname><given-names>A</given-names></name><name><surname>Ide</surname><given-names>T</given-names></name></person-group><article-title>Increase in the expression level of p21<italic>sdi1</italic>/<italic>cip1</italic>/<italic>waf1</italic> with increasing division age in both normal and SV40-transformed human fibroblasts</article-title><source>Oncogene</source><volume>10</volume><fpage>835</fpage><lpage>840</lpage><year>1995</year></element-citation></ref>
<ref id="b50-ijo-45-01-0047"><label>50.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kondo</surname><given-names>T</given-names></name><name><surname>Sakaguchi</surname><given-names>M</given-names></name><name><surname>Namba</surname><given-names>M</given-names></name></person-group><article-title>Two-dimensional gel electrophoresis studies on the cellular aging: accumulation of alpha-2-macroglobulin in human fibroblasts with aging</article-title><source>Exp Gerontol</source><volume>36</volume><fpage>487</fpage><lpage>495</lpage><year>2001</year></element-citation></ref></ref-list>
<sec sec-type="display-objects">
<title>Figures and Tables</title>
<fig id="f1-ijo-45-01-0047" position="float">
<label>Figure 1.</label>
<caption>
<p>The p16<sup>INK4a</sup>-pRb and p14<sup>Arf</sup>-p53 pathways mediate the hyperproliferative stress response in cancer. Hyperproliferative signals including cellular stress, DNA damage and oncogenes lead to increased levels of p16<sup>INK4a</sup> and p14<sup>Arf</sup>. p16<sup>INK4a</sup> inhibits Cdk4/6 activity, inducing Rb phosphorylation, which leads to cell cycle arrest. p14<sup>Arf</sup> inhibits MDM2-mediated degradation of p53, which activates p21, a Cdk inhibitor. Through an unknown mechanism, active p38 MAPK also induces the expression of p16<sup>INK4a</sup> and p14<sup>Arf</sup>, which together with the p53-p21 cascade, causes premature senescence that serves as a tumor-suppressing defense mechanism <italic>in vitro</italic> and <italic>in vivo</italic>.</p></caption>
<graphic xlink:href="IJO-45-01-0047-g00.tif"/></fig>
<fig id="f2-ijo-45-01-0047" position="float">
<label>Figure 2.</label>
<caption>
<p>The effects of fucoidan on cell viability. HepG2 and Chang-L cells were incubated with increasing concentrations of fucoidan for 24 h. Concentration-dependent changes in cell viability were determined by the Cyto cell viability assay kit. Data represent means &#x000B1; standard deviation in trip-licate. Different superscripts represent significantly different results (P&#x0003C;0.05).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g01.tif"/></fig>
<fig id="f3-ijo-45-01-0047" position="float">
<label>Figure 3.</label>
<caption>
<p>Fucoidan treatment induces dose-dependent apoptosis in HepG2 cells. After treatment with increasing concentrations of fucoidan for 24 h, apoptosis was assessed using a cell analyzer. &#x02018;Early Apop&#x02019; indicates the percentage of early apoptotic cells (Annexin V-stained cells) and &#x02018;Late Apop/Dead&#x02019; indicates the percentage of late apoptotic cells (Annexin V &#x0002B; 7-AAD-stained cells).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g02.tif"/></fig>
<fig id="f4-ijo-45-01-0047" position="float">
<label>Figure 4.</label>
<caption>
<p>Effects of fucoidan treatment on the p16<sup>INK4a</sup>-pRb pathway and p53, p21, p38 and p-p38 protein expression. GAPDH was used as an internal loading control. HepG2 (A) and Chang-L (B) cells treated with 100, 250 and 500 <italic>&#x003BC;</italic>g/ml fucoidan for 24 h. Western blotting was performed as described in Materials and methods.</p></caption>
<graphic xlink:href="IJO-45-01-0047-g03.tif"/></fig>
<fig id="f5-ijo-45-01-0047" position="float">
<label>Figure 5.</label>
<caption>
<p>Expression of p16<sup>INK4a</sup>, p14<sup>Arf</sup>, p53 and p21 in HepG2 cells after treatment with fucoidan for 24 h detected by qualitative and real-time PCR. Expression of the GAPDH gene was used as the internal control. Data represent means &#x000B1; SD of one representative experiment performed in triplicate. Different superscripts represent significantly different results (P&#x0003C;0.05).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g04.tif"/></fig>
<fig id="f6-ijo-45-01-0047" position="float">
<label>Figure 6.</label>
<caption>
<p>Expression of p16<sup>INK4a</sup>, p14<sup>Arf</sup>, p53 and p21 in Chang-L cells after 24 h treatment with fucoidan as detected by qualitative and real-time PCR. Expression of the GAPDH gene was used as the internal control. Data represent the mean &#x000B1; SD of one representative experiment performed in triplicate. Different superscripts indicate significantly different values (P&#x0003C;0.05).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g05.tif"/></fig>
<fig id="f7-ijo-45-01-0047" position="float">
<label>Figure 7.</label>
<caption>
<p>Expression of p38 MAPK mRNA in HepG2 and Chang-L cells after 24 h treatment with fucoidan. Expression of the GAPDH gene was used as the internal control. Data represent the mean &#x000B1; SD of one representative experiment performed in triplicate. Different superscripts indicate significantly different values (P&#x0003C;0.05).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g06.tif"/></fig>
<fig id="f8-ijo-45-01-0047" position="float">
<label>Figure 8.</label>
<caption>
<p>Expression of &#x003B1;<sub>2</sub>M mRNA in HepG2 and Chang-L cells after 24 h treatment with fucoidan. Expression of the GAPDH gene was used as the internal control. Data represent the mean &#x000B1; SD of one representative experiment performed in triplicate. Different superscripts indicate significantly different values (P&#x0003C;0.05).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g07.tif"/></fig>
<fig id="f9-ijo-45-01-0047" position="float">
<label>Figure 9.</label>
<caption>
<p>Correlation between p38 MAPK and p16<sup>INK4a</sup> in HepG2 cells after fucoidan incubation. There was a positive correlation between p38 expression and p16<sup>INK4a</sup> (r&#x0003D;0.8747, P&#x0003D;0.0987).</p></caption>
<graphic xlink:href="IJO-45-01-0047-g08.tif"/></fig>
<table-wrap id="t1-ijo-45-01-0047" position="float">
<label>Table I.</label>
<caption>
<p>Primers for real-time PCR.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="center" valign="middle"/>
<th align="center" valign="middle">Forward</th>
<th align="center" valign="middle">Reverse</th></tr></thead>
<tbody>
<tr>
<td align="left" valign="top">GAPDH</td>
<td align="left" valign="top">TGC ACC ACC AAC TGC TTA GC</td>
<td align="left" valign="top">GGC ATG GAC TGT GGT CAT GAG</td></tr>
<tr>
<td align="left" valign="top">p16<sup>INK4a</sup></td>
<td align="left" valign="top">GCC CAA CGC CCC GAA CTC TTT C</td>
<td align="left" valign="top">TGA AGC TAT GCC CGT CGG TCT G</td></tr>
<tr>
<td align="left" valign="top">p14<sup>Arf</sup></td>
<td align="left" valign="top">GGA GGC GGC GAG AAC AT</td>
<td align="left" valign="top">TGA ACC ACG AAA ACC CTC ACT</td></tr>
<tr>
<td align="left" valign="top">p53</td>
<td align="left" valign="top">GAG GGA TGT TTG GGA GAT GTA A</td>
<td align="left" valign="top">CCC TGG TTA GTA CGG TGA AGT G</td></tr>
<tr>
<td align="left" valign="top">p38</td>
<td align="left" valign="top">GAG GAT GCC AAG CCA TG</td>
<td align="left" valign="top">TCT TAT CTG AGT CCA ATA CAA GCA TC</td></tr>
<tr>
<td align="left" valign="top">p21</td>
<td align="left" valign="top">CCG CGA CTG TGA TGC GCT AAT G</td>
<td align="left" valign="top">CTC GGT GAC AAA GTC GAA GTT C</td></tr>
<tr>
<td align="left" valign="top">&#x003B1;<sub>2</sub>M</td>
<td align="left" valign="top">TTG TCA GTG ACG TTT GCC TC</td>
<td align="left" valign="top">CAA ACT CAT CCG TCT CGT AG</td></tr></tbody></table></table-wrap>
<table-wrap id="t2-ijo-45-01-0047" position="float">
<label>Table II.</label>
<caption>
<p>Fractions of each cell cycle phase in HepG2 and Chang-L cells cultured in the presence of fucoidan for 24 h.</p></caption>
<table frame="hsides" rules="groups">
<tbody>
<tr>
<td align="left" valign="bottom">Fucoidan in HepG2(<italic>&#x003BC;</italic>g/ml)</td>
<td align="center" valign="bottom">G<sub>0</sub>/G<sub>1</sub> (&#x00025;)</td>
<td align="center" valign="bottom">S (&#x00025;)</td>
<td align="center" valign="bottom">G<sub>2</sub>/M (&#x00025;)</td></tr>
<tr>
<td colspan="4" align="center" valign="bottom">
<hr/></td></tr>
<tr>
<td align="left" valign="top">0</td>
<td align="center" valign="top">43.12&#x000B1;6.50<sup>a</sup></td>
<td align="center" valign="top">28.86&#x000B1;4.20<sup>a</sup></td>
<td align="center" valign="top">23.86&#x000B1;5.91<sup>a</sup></td></tr>
<tr>
<td align="left" valign="top">100</td>
<td align="center" valign="top">68.52&#x000B1;4.67<sup>b</sup></td>
<td align="center" valign="top">21.74&#x000B1;5.98<sup>a,b</sup></td>
<td align="center" valign="top">8.26&#x000B1;5.33<sup>b</sup></td></tr>
<tr>
<td align="left" valign="top">250</td>
<td align="center" valign="top">71.76&#x000B1;2.37<sup>b,c</sup></td>
<td align="center" valign="top">17.60&#x000B1;3.03<sup>b</sup></td>
<td align="center" valign="top">13.90&#x000B1;1.25<sup>b</sup></td></tr>
<tr>
<td align="left" valign="top">500</td>
<td align="center" valign="top">77.78&#x000B1;2.00<sup>c</sup></td>
<td align="center" valign="top">8.94&#x000B1;1.38<sup>c</sup></td>
<td align="center" valign="top">12.20&#x000B1;2.23<sup>b</sup></td></tr>
<tr>
<td colspan="4" align="center" valign="top">
<hr/></td></tr>
<tr>
<td align="left" valign="bottom">Fucoidan in Chang-L(<italic>&#x003BC;</italic>g/ml)</td>
<td align="center" valign="bottom">G<sub>0</sub>/G<sub>1</sub> (&#x00025;)</td>
<td align="center" valign="bottom">S (&#x00025;)</td>
<td align="center" valign="bottom">G<sub>2</sub>/M (&#x00025;)</td></tr>
<tr>
<td colspan="4" align="center" valign="bottom">
<hr/></td></tr>
<tr>
<td align="left" valign="top">0</td>
<td align="center" valign="top">44.18&#x000B1;2.12<sup>a</sup></td>
<td align="center" valign="top">23.68&#x000B1;2.06<sup>a</sup></td>
<td align="center" valign="top">30.78&#x000B1;2.65<sup>a</sup></td></tr>
<tr>
<td align="left" valign="top">100</td>
<td align="center" valign="top">45.67&#x000B1;1.05<sup>a</sup></td>
<td align="center" valign="top">18.67&#x000B1;1.47<sup>b</sup></td>
<td align="center" valign="top">35.67&#x000B1;1.07<sup>b</sup></td></tr>
<tr>
<td align="left" valign="top">250</td>
<td align="center" valign="top">43.83&#x000B1;1.60<sup>a</sup></td>
<td align="center" valign="top">25.63&#x000B1;1.51<sup>a</sup></td>
<td align="center" valign="top">29.30&#x000B1;2.82<sup>a</sup></td></tr>
<tr>
<td align="left" valign="top">500</td>
<td align="center" valign="top">45.50&#x000B1;5.24<sup>a</sup></td>
<td align="center" valign="top">25.63&#x000B1;1.51<sup>a</sup></td>
<td align="center" valign="top">28.00&#x000B1;5.91<sup>a</sup></td></tr></tbody></table>
<table-wrap-foot><fn id="tfn1-ijo-45-01-0047">
<p>Data represent means &#x000B1; SD, n&#x0003D;5. Different superscripts represent significantly different results (P&#x0003C;0.05).</p></fn></table-wrap-foot></table-wrap></sec></back></article>
