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<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Molecular Medicine Reports</journal-id>
<journal-title-group>
<journal-title>Molecular Medicine Reports</journal-title></journal-title-group>
<issn pub-type="ppub">1791-2997</issn>
<issn pub-type="epub">1791-3004</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/mmr.2014.2979</article-id>
<article-id pub-id-type="publisher-id">mmr-11-03-2262</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title><italic>para</italic>-Phenylenediamine-induces apoptosis via a pathway dependent on PTK-Ras-Raf-JNK activation but independent of the PI3K/Akt pathway in NRK-52E cells</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>KASI</surname><given-names>REENA A.P.</given-names></name><xref rid="af1-mmr-11-03-2262" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>MOI</surname><given-names>CHYE SOI</given-names></name><xref rid="af1-mmr-11-03-2262" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-mmr-11-03-2262"/></contrib>
<contrib contrib-type="author">
<name><surname>KIEN</surname><given-names>YIP WAI</given-names></name><xref rid="af2-mmr-11-03-2262" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>YIAN</surname><given-names>KOH RHUN</given-names></name><xref rid="af1-mmr-11-03-2262" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>CHIN</surname><given-names>NG WEI</given-names></name><xref rid="af1-mmr-11-03-2262" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>YEN</surname><given-names>NG KHUEN</given-names></name><xref rid="af3-mmr-11-03-2262" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>PONNUDURAI</surname><given-names>GNANAJOTHY</given-names></name><xref rid="af1-mmr-11-03-2262" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>FONG</surname><given-names>SEOW HENG</given-names></name><xref rid="af2-mmr-11-03-2262" ref-type="aff">2</xref></contrib></contrib-group>
<aff id="af1-mmr-11-03-2262">
<label>1</label>Department of Human Biology, Cells and Molecules, International Medical University, Kuala Lumpur 57000, Malaysia</aff>
<aff id="af2-mmr-11-03-2262">
<label>2</label>Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia</aff>
<aff id="af3-mmr-11-03-2262">
<label>3</label>Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Bandar Sunway, Selangor 47500, Malaysia</aff>
<author-notes>
<corresp id="c1-mmr-11-03-2262">Correspondence to: Dr Chye Soi Moi, Department of Human Biology, Cells and Molecules, International Medical University, 126 Jalan 19/155B, Bukit Jalil, Kuala Lumpur 57000, Malaysia, E-mail: <email>chye_soimoi@imu.edu.my</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>3</month>
<year>2015</year></pub-date>
<pub-date pub-type="epub">
<day>19</day>
<month>11</month>
<year>2014</year></pub-date>
<volume>11</volume>
<issue>3</issue>
<fpage>2262</fpage>
<lpage>2268</lpage>
<history>
<date date-type="received">
<day>29</day>
<month>11</month>
<year>2013</year></date>
<date date-type="accepted">
<day>08</day>
<month>08</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><italic>para</italic>-Phenylenediamine (<italic>p</italic>-PD) is a potential carcinogen, and widely used in marketed hair dye formulations. In the present study, the role of the protein tyrosine kinase (PTK)/Ras/Raf/<italic>c</italic>-Jun N-terminal kinase (JNK) and phosphoinositide 3-kinase (PI3k)/protein kinase B (Akt) pathways on the growth of NRK-52E cells was investigated. The results demonstrated that <italic>p</italic>-PD reduced cell viability in a dose-dependent manner. The cell death due to apoptosis was confirmed by cell cycle analysis and an Annexin-V-fluorescein isothiocyanate binding assay. Subsequent to staining with 2&#x02032;,7&#x02032;-dichlorofluorescin diacetate, the treated cells demonstrated a significant increase in reactive oxygen species (ROS) generation compared with the controls. The effects of <italic>p</italic>-PD on the signalling pathways were analysed by western blotting. <italic>p</italic>-PD-treated cells exhibited an upregulated phospho-stress-activated protein kinase/JNK protein expression level and downregulated Ras and Raf protein expression levels; however, Akt, Bcl-2, Bcl-XL and Bad protein expression levels were not significantly altered compared with the control. In conclusion, <italic>p</italic>-PD induced apoptosis by a PTK/Ras/Raf/JNK-dependent pathway and was independent of the PI3K/Akt pathway in NRK-52E cells.</p></abstract>
<kwd-group>
<kwd><italic>para</italic>-phenylenediamine</kwd>
<kwd>apoptosis</kwd>
<kwd>NRK52E cells</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p><italic>para</italic>-Phenylenediamine (<italic>p</italic>-PD) is used in hair dye formulations and it is estimated that two-thirds of the hair dye formulations that are marketed contain <italic>p</italic>-PD (<xref rid="b1-mmr-11-03-2262" ref-type="bibr">1</xref>). Various azo dyes used by the industry also contain <italic>p</italic>-PD. Upon azo reduction of these compounds by environmental or intestinal microorganisms, <italic>p</italic>-PD is released. When <italic>p</italic>-PD is ingested, it is absorbed and redistributed to target sites to exert its effects (<xref rid="b2-mmr-11-03-2262" ref-type="bibr">2</xref>,<xref rid="b3-mmr-11-03-2262" ref-type="bibr">3</xref>). Epidemiological studies have indicated that increased usage of permanent hair dye may increase the risk of bladder cancer, non-Hodgkin&#x02019;s lymphoma, multiple myeloma, and haematopoietic cancer (<xref rid="b4-mmr-11-03-2262" ref-type="bibr">4</xref>,<xref rid="b5-mmr-11-03-2262" ref-type="bibr">5</xref>). Besides personal usage, professional hairdressers and dye industry workers are frequently exposed to dyes containing <italic>p</italic>-PD, and epidemiological studies have demonstrated that those who are frequently exposed to this chemical compound have incurred a higher risk of various cancers (<xref rid="b1-mmr-11-03-2262" ref-type="bibr">1</xref>,<xref rid="b4-mmr-11-03-2262" ref-type="bibr">4</xref>). In addition, Sontag (<xref rid="b6-mmr-11-03-2262" ref-type="bibr">6</xref>) demonstrated that the incidence of kidney tumours increased with exposure to <italic>p</italic>-PD in rats. Thus, in the current study, the mechanism by which <italic>p</italic>-PD induces apoptosis in normal rat kidney proximal tubular epithelial (NRK52E) cells was investigated. This cell line is a commonly used cell line for <italic>in vitro</italic> evaluation of apoptotic pathways. For example, it was demonstrated in NRK52E cells that Numb protects against puromycin aminonucleoside-induced apoptosis by inhibiting the Notch signalling pathway (<xref rid="b7-mmr-11-03-2262" ref-type="bibr">7</xref>). In addition, urografin was demonstrated to induce apoptosis in NRK52E cells via upregulated glucose-regulated protein 78 (GRP78) and GRP94 expression, procaspase-12 cleavage and phosphorylation of protein kinase-like endoplasmic reticulum kinase and eukaryotic initiation factor 2&#x003B1; (<xref rid="b8-mmr-11-03-2262" ref-type="bibr">8</xref>).</p>
<p>Focal adhesion kinase (FAK) phosphorylation is the pivotal integrin-mediated signalling event, since this cytoplasmic tyrosine kinase acts as the scaffold for several effector molecules, such as phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) and the Ras/Raf/<italic>c</italic>-Jun N-terminal kinase (JNK) cascades (<xref rid="b9-mmr-11-03-2262" ref-type="bibr">9</xref>,<xref rid="b10-mmr-11-03-2262" ref-type="bibr">10</xref>). FAK activation has been associated with survival signals through the activation of the PI3K/Akt and Ras/Raf/JNK pathways (<xref rid="b11-mmr-11-03-2262" ref-type="bibr">11</xref>,<xref rid="b12-mmr-11-03-2262" ref-type="bibr">12</xref>,<xref rid="b13-mmr-11-03-2262" ref-type="bibr">13</xref>). PI3K/Akt is intimately involved in cell survival, as it regulates the activity of several Bcl-2 family members (<xref rid="b14-mmr-11-03-2262" ref-type="bibr">14</xref>,<xref rid="b15-mmr-11-03-2262" ref-type="bibr">15</xref>,<xref rid="b16-mmr-11-03-2262" ref-type="bibr">16</xref>). Protein tyrosine kinases (PTKs) are activated by and form complexes with growth factor receptor-bound protein 2 and Son of sevenless, resulting in activation of Ras, and subsequent activation of the Raf and JNK cascade survival pathways (<xref rid="b17-mmr-11-03-2262" ref-type="bibr">17</xref>,<xref rid="b18-mmr-11-03-2262" ref-type="bibr">18</xref>). For example, evodiamine-induced oxidative stress and cell cycle arrest was demonstrated to act through the PTK/Ras/Raf/JNK pathway in HeLa human cervical carcinoma cells (<xref rid="b19-mmr-11-03-2262" ref-type="bibr">19</xref>), and oridonin has been indicated to induce G<sub>2</sub>/M phase cell cycle arrest and apoptosis via inhibition of the PTK/Ras/Raf/JNK survival pathway in L929 murine fibrosarcoma cells (<xref rid="b20-mmr-11-03-2262" ref-type="bibr">20</xref>).</p>
<p>Previous studies have demonstrated that <italic>p</italic>-PD induces apoptosis via p53 in addition to intrinsic and extrinsic pathways in MDCK cells (<xref rid="b21-mmr-11-03-2262" ref-type="bibr">21</xref>,<xref rid="b22-mmr-11-03-2262" ref-type="bibr">22</xref>). Huang <italic>et al</italic> (<xref rid="b23-mmr-11-03-2262" ref-type="bibr">23</xref>) also demonstrated that <italic>p</italic>-PD induces DNA damage and the expression of mutant p53 and COX-2 proteins in SV-40 immortalized human uroepithelial cells. In the present study, the roles of the PTK/Ras/Raf/JNK and PI3K/Akt signalling pathways on <italic>p</italic>-PD-treated NRK-52E cells was investigated in relation to cell death.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec sec-type="materials">
<title>Materials</title>
<p>Dulbecco&#x02019;s modified Eagle&#x02019;s medium (DMEM), foetal bovine serum (FBS) and trypsin-EDTA were purchased from Gibco Life Technologies (Grand Island, NY, USA). <italic>p</italic>-PD, dimethyl sulfoxide (DMSO), Triton X-100, Tergitol NP-40, EDTA, Tris-HCl, trypan blue, phosphate-buffered saline (PBS), goat anti-rabbit Immunoglobulin G horseradish peroxidase (HRP)-conjugated polyclonal secondary antibodies, dithiothreitol (DTT), sodium dodecyl sulphate (SDS), ammonium acetate, Tris-borate-EDTA buffer, Bradford reagent and phenylmethyl sulfonyl fluoride were purchased from Sigma-Aldrich (St. Louis, MO, USA). The Annexin-V-FLUOS Staining kit was purchased from Roche Diagnostics GmbH (Mannheim, Germany). Proteinase K, ribonuclease A (RNase A) were obtained from BD Pharmingen (San Diego, CA, USA). Rabbit anti-rat monoclonal antibodies for Ras, SAPK-JNK, Akt, Bcl-2, Bcl-xL, Bad, tubulin and phospho SAPK-JNK and mouse anti-rat c-Raf were perchased from Cell Signaling Technology, Inc. (Danvers, MA, USA). Amersham ECL-Plus Western Blotting Reagents and polyvinylidine fluoride (PVDF) membranes were obtained from GE Healthcare Bio-Sciences (Pittsburgh, PA, USA). All of the chemicals were of the highest grade commercially available.</p></sec>
<sec>
<title>Cell culture and treatment</title>
<p>The NRK-52E normal rat renal tubular epithelial cell line was obtained from the American Type Culture Collection (Manassas, VA, USA). The cells were maintained as a monolayer in DMEM with 2.0 mM L-glutamine adjusted to contain 3.7 g/l sodium bicarbonate and 4.5 g/l glucose. The medium was supplemented with 1&#x00025; penicillin (100 U/ml; Sigma-Aldrich), streptomycin (10,000 &#x003BC;g/ml; Sigma-Aldrich) and 10&#x00025; FBS. Cells were cultured in 25-cm<sup>2</sup> tissue culture-treated flasks at 37&#x000B0;C and 5&#x00025; CO<sub>2</sub> in humidified chambers.</p>
<p>The stock solution of <italic>p</italic>-PD (100 mg/ml) was dissolved in DMSO and different concentrations were prepared in the culture medium with a final DMSO concentration of 0.1&#x00025;.</p></sec>
<sec>
<title>Cell viability assay</title>
<p>The NRK-52E cells were treated with various concentrations of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml), or 0.1&#x00025; DMSO for the control, for 24 h at 37&#x000B0;C. A trypan blue exclusion protocol was used to determine the cell viability. Briefly, ~10 &#x003BC;l cell suspension in PBS was mixed with 40 &#x003BC;l trypan blue, and the numbers of stained (dead cells) and unstained cells (live cells) were examined under a Nikon Eclipse TS-100F inverted microscope (Nikon Corp., Tokyo, Japan) (<xref rid="b24-mmr-11-03-2262" ref-type="bibr">24</xref>).</p></sec>
<sec>
<title>Cell cycle analysis</title>
<p>The NRK-52E cells were cultured in 25-cm<sup>2</sup> culture flasks and treated with different concentrations of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) for 24 h. Subsequent to exposure, the cells were collected, washed with PBS and fixed with ice-cold 70&#x00025; ethanol overnight at 4&#x000B0;C. The cells were washed with PBS, stained with 1 ml fluorochrome solution from the Annexin-V-FLUOS Staining kit &#x0005B;containing 20 &#x003BC;g/ml propidium iodide (PI) and 10 &#x003BC;g/ml RNase A&#x0005D; for 15 min in dark conditions and analysed using a BD FACSCalibur flow cytometer (E97500679; BD Biosciences, Franklin Lakes, NJ, USA).</p></sec>
<sec>
<title>Annexin-V staining</title>
<p>The NRK52E cells were cultured in 60-mm tissue-culture dishes. The culture medium was replaced with fresh medium as cells reached 70&#x00025; confluence, then different concentrations of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) were added prior to 24-h culture. Levels of apoptosis were determined by staining with the Annexin-V kit (<xref rid="b25-mmr-11-03-2262" ref-type="bibr">25</xref>). Following incubation, floating or adherent cells that were later trypsinised were pooled and centrifuged for 5 min at 1,000 &#x000D7; g. Pelleted cells were washed with PBS. Next, cells were centrifuged for 5 min at 1,000 &#x000D7; g and resuspended in 100 &#x003BC;l Annexin-V-Fluos and PI labelling solution (from the Annexin-V kit) for 10 min. The stained cells were analysed by flow cytometry, where the fluorescence emission was measured at 530 nm. The percentage cell apoptosis was calculated using BD Multiset&#x02122; 2.2, BD FACStation&#x02122; 5.2.1, ModFit LT 3.0 and CellQuest software (BD Biosciences).</p></sec>
<sec>
<title>Detection of intracellular reactive oxygen species (ROS)</title>
<p>The NRK52E cells were treated with 100 &#x003BC;g/ml <italic>p</italic>-PD for 1, 2 or 3 h, and controls were treated with 0.1&#x00025; DMSO. All cells were stained with 10 &#x003BC;M 2&#x02032;,7&#x02032;-dichlorofluorescin diacetate (DCFH-DA; Sigma-Aldrich) for 30 min. Subsequent to washing with PBS, the fluorescence intensity was detected by a Tecan Infinite 200 PRO fluorescence plate reader (Tecan Group Ltd., Maennedorf, Switzerland) with excitation and emission wavelengths of 488 and 525 nm, respectively.</p></sec>
<sec>
<title>Western blot analysis</title>
<p>Western blot analysis was performed according to the methods of a previous study (<xref rid="b26-mmr-11-03-2262" ref-type="bibr">26</xref>). The culture medium was replaced with fresh medium as cells reached 70&#x00025; confluence, then different concentrations of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) were added and cells were cultured for 24 h. Next, adherent and floating cells were collected and homogenised in a lysis buffer (10 mM Tris-HCl, pH 8.0; 0.32 mM sucrose; 5 mM EDTA; 2 mM DTT; 1 mM phenylmethyl sulfonyl fluoride; and 1&#x00025; Triton X-100) and centrifuged at 10,621 &#x000D7; g (5427R; Eppendorf, Hamburg, Germany) for 10 min. The supernatants were collected and assayed for protein concentration using the Bradford protein assay method (<xref rid="b27-mmr-11-03-2262" ref-type="bibr">27</xref>). An equal quantity of protein per sample was subjected to 10&#x00025; SDS-polyacrylamide gel electrophoresis. Following electrophoresis, the proteins were transferred to the PVDF membranes by electroblotting and incubated with diluted primary antibodies for 1 h at 25&#x000B0;C. The membranes were washed, incubated for 30 min at 25&#x000B0;C with the HRP-conjugated secondary antibodies and subsequently washed extensively prior to detection by chemiluminescence with the ECL-Plus kit. The proteins were visualised by exposing the blots to film (Kodak, Rochester, NY, USA). The western blot data were quantified using Image J software (<ext-link xlink:href="http://imagej.nih.gov/ij/" ext-link-type="uri">http://imagej.nih.gov/ij/</ext-link>).</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Results are expressed as the mean &#x000B1; standard deviation from at least three independent experiments. Statistical analysis was performed using Student&#x02019;s t-test. <sup>*</sup>P&lt;0.05 was considered to indicate a statistically significant difference. The error bars denote standard deviation.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>p-PD alters cell morphology</title>
<p>The NRK-52E cells were treated with four different concentrations of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) for 24 h, then observed under an inverted microscope. The control cells retained their normal, clear plasma membrane. There was a uniform cell distribution with neighbouring cells closely connected to each other and clear cell nuclei (<xref rid="f1-mmr-11-03-2262" ref-type="fig">Fig. 1A</xref>). Following <italic>p</italic>-PD treatment, the cells were enlarged, forming a variety of shapes and sizes. The cells lost contact with neighbouring cells and cytoplasmic vacuolisation occurred (<xref rid="f1-mmr-11-03-2262" ref-type="fig">Fig. 1B and C</xref>). In addition, cell shrinkage and blebbing of the plasma membrane were also observed at higher <italic>p</italic>-PD concentrations (<xref rid="f1-mmr-11-03-2262" ref-type="fig">Fig. 1D and E</xref>).</p></sec>
<sec>
<title>p-PD reduces cell viability</title>
<p>The cell viability of <italic>p</italic>-PD-treated NRK-52E cells was examined with a trypan blue exclusion assay subsequent to a 24 h incubation period. The results demonstrated reduced cell viability in NRK-52E cells that were treated with <italic>p</italic>-PD; and as the concentration increased, cell viability reduced. Treatments of 50, 100, 200 and 300 &#x003BC;g/ml led to cell viabilities of 62.2, 52.5, 36.8 and 25.4&#x00025; of the control (<xref rid="f2-mmr-11-03-2262" ref-type="fig">Fig. 2</xref>), respectively.</p></sec>
<sec>
<title>p-PD alters cell cycle progression and inhibits mitosis</title>
<p><italic>p</italic>-PD was previously demonstrated to induce cell death. To determine the nature of the cell death (necrotic or apoptotic) changes in the DNA content of the <italic>p</italic>-PD-treated cells were detected using the PI staining method. The cell cycle results indicated that the cell cycle distribution of control cells was as follows: 0.64&#x000B1;0.01&#x00025; in the sub-G<sub>1</sub> phase; 53.04&#x000B1;1.52&#x00025; in the G<sub>1</sub> phase; 13.29&#x000B1;0.65&#x00025; in the S phase; and 33.41&#x000B1;2.45&#x00025; in the G<sub>2</sub>+M phase.</p>
<p>In cells exposed to 50 &#x003BC;g/ml <italic>p</italic>-PD, the percentage of cells in the sub-G<sub>1</sub> phase increased to 20.99&#x000B1;0.89&#x00025;, compared with 34.02&#x000B1;0.45&#x00025; following exposure to 100 &#x003BC;g/ml <italic>p</italic>-PD. When the <italic>p</italic>-PD concentrations increased to 200 and 300 &#x003BC;g/ml, the percentages of cells in the sub-G<sub>1</sub> phase further increased to 47.23&#x000B1;3.11 and 76.74&#x000B1;2.45&#x00025;, respectively (<xref rid="f3-mmr-11-03-2262" ref-type="fig">Fig. 3</xref>).</p>
<p><italic>p</italic>-PD also induced a reduction in the numbers of cells in the G<sub>2</sub>+M phase compared with the control cells. Compared with 33.41&#x000B1;2.45&#x00025; in the control cells, the cells treated with <italic>p</italic>-PD at concentrations of 50, 100, 200 and 300 &#x003BC;g/ml presented 14.92&#x000B1;0.98, 20.76&#x000B1;1.02, 20.84&#x000B1;0.87 and 9.46&#x000B1;0.06&#x00025; of cells in the G<sub>2</sub>+M phase, respectively. This result demonstrates a reduction in mitosis in the treated cells compared with the control cells (<xref rid="f3-mmr-11-03-2262" ref-type="fig">Fig. 3</xref>).</p></sec>
<sec>
<title>Annexin-V staining and flow cytometry</title>
<p>The induction of apoptosis by <italic>p</italic>-PD was further confirmed by Annexin-V staining. Following incubation with <italic>p</italic>-PD at a concentration of 50, 100, 200 or 300 &#x003BC;g/ml for 24 h, the percentages of Annexin V<sup>+</sup>/PI<sup>+</sup> cells increased to 8.47&#x000B1;0.04, 15.05&#x000B1;0.08, 25.01&#x000B1;0.14 and 29.52&#x000B1;0.31&#x00025;, respectively, compared with the control group (2.13&#x000B1;0.03&#x00025;). Additionally, Annexin V<sup>+</sup>/PI&#x02212; cells were also increased to 12.95&#x000B1;0.02, 16.10&#x000B1;0.05, 15.87&#x000B1;0.05 and 36.01&#x000B1;0.29&#x00025;, respectively, compared with the control group (6.98&#x000B1;0.01&#x00025;) (<xref rid="f4-mmr-11-03-2262" ref-type="fig">Fig. 4</xref>).</p></sec>
<sec>
<title>p-PD induces intracellular ROS generation</title>
<p>The effects of <italic>p</italic>-PD on the production of intracellular ROS were examined following DCFH-DA staining. The control cells exhibited low-level ROS generation (<xref rid="f5-mmr-11-03-2262" ref-type="fig">Fig. 5</xref>), and the cells treated with 100 &#x003BC;g/ml <italic>p</italic>-PD for 1 h presented a ROS level twice as high as controls. Following 2-h treatment, the ROS level had increased four-fold compared with the control cells. The intracellular ROS level increased markedly in the cells that were treated with 100 &#x003BC;g/ml <italic>p</italic>-PD for 3 h (<xref rid="f5-mmr-11-03-2262" ref-type="fig">Fig. 5</xref>).</p></sec>
<sec>
<title>Effects of <italic>p</italic>-PD on the protein expression levels of Ras, Raf, SAPK-JNK, Akt, Bcl-2, Bcl-xL and Bad</title>
<p>To assess the molecular mechanism underlying <italic>p</italic>-PD-induced apoptosis, the expression levels of the survival proteins Ras, Raf, Bcl-2 and Bcl-XL were assessed at 24 h following <italic>p</italic>-PD treatments of 50, 100, 200 and 300 &#x003BC;g/ml. The results demonstrated that the expression levels of the Ras and Raf survival proteins were reduced by <italic>p</italic>-PD in a dose-dependent manner (<xref rid="f6-mmr-11-03-2262" ref-type="fig">Fig. 6</xref>). However, Akt, Bcl-2 and Bcl-xL protein expression levels were not markedly altered compared with controls.</p>
<p>With regards to the apoptotic proteins, SAPK-JNK expression level was not markedly altered, and the phosphorylated SAPK-JNK expression levels markedly increased as <italic>p</italic>-PD concentrations increased (<xref rid="f6-mmr-11-03-2262" ref-type="fig">Fig. 6</xref>). In addition, <italic>p</italic>-PD had no effect on the Bad expression level with <italic>p</italic>-PD treatment, compared with the control cells. Tubulin was used as a loading control.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Carcinogenesis is a process resulting from genetic alterations leading to mutations of oncogenes or tumour suppressor genes that drive the progressive transformation of normal cells into malignant cells (<xref rid="b28-mmr-11-03-2262" ref-type="bibr">28</xref>,<xref rid="b29-mmr-11-03-2262" ref-type="bibr">29</xref>). At the molecular level, genetic mutations are able to alter translated proteins and thereby disrupt downstream signalling pathways that are essential for apoptosis, cell cycle and other cellular processes (<xref rid="b30-mmr-11-03-2262" ref-type="bibr">30</xref>,<xref rid="b31-mmr-11-03-2262" ref-type="bibr">31</xref>). Cadmium, a causative agent in various types of cancer, elevates intracellular free calcium ion (&#x0005B;Ca<sup>2+</sup>&#x0005D;i) levels, leading to neuronal apoptosis partly by activating mitogen-activated protein kinases (MAPK) and mammalian target of rapamycin pathways (<xref rid="b32-mmr-11-03-2262" ref-type="bibr">32</xref>). Additionally, cadmium exposure leads to the induction of the ERK signalling pathway, which alters gene expression in osteoblasts, and apoptotic death in Saos-2 cells (<xref rid="b33-mmr-11-03-2262" ref-type="bibr">33</xref>). Chronic exposure to arsenic can lead to the development of various types of cancer; it downregulates Akt and c-Fos protein expression, and induces apoptosis in glutathione-deficient cells (<xref rid="b34-mmr-11-03-2262" ref-type="bibr">34</xref>).</p>
<p><italic>p</italic>-PD is a potential carcinogen that is widely used in permanent hair dye (<xref rid="b35-mmr-11-03-2262" ref-type="bibr">35</xref>,<xref rid="b36-mmr-11-03-2262" ref-type="bibr">36</xref>), and it has been reported that incidences of kidney tumours increase in rats following exposure to <italic>p</italic>-PD (<xref rid="b6-mmr-11-03-2262" ref-type="bibr">6</xref>). Therefore, in the present study, the molecular mechanism underlying <italic>p</italic>-PD-induced apoptosis was investigated in NRK-52E cells, and to the best of our knowledge, it was demonstrated for the first time that <italic>p</italic>-PD-induces cell death in a dose-dependent manner in NRK-52E cells (<xref rid="f2-mmr-11-03-2262" ref-type="fig">Fig. 2</xref>). It was confirmed that this cell death was due to apoptosis, as indicated in <xref rid="f3-mmr-11-03-2262" ref-type="fig">Fig. 3</xref>. Cell cycle analysis demonstrated a reduction in the number of cells in the G<sub>2</sub>+M phase in addition to an increase in the number of cells in the sub-G<sub>1</sub> phase in the treated cells, when compared with the respective percentages in the control group. This finding indicates that <italic>p</italic>-PD induced cell cycle arrest. In addition, Annexin-V staining demonstrated that the number of apoptotic cells increased following <italic>p</italic>-PD exposure in a dose-dependent manner (<xref rid="f4-mmr-11-03-2262" ref-type="fig">Fig. 4</xref>). In previous studies, it has been established that oxidised <italic>p</italic>-PD induces the production of ROS, leading to an imbalance between production and the removal of ROS and overwhelming oxidative stress that eventually induces apoptosis (<xref rid="b37-mmr-11-03-2262" ref-type="bibr">37</xref>,<xref rid="b38-mmr-11-03-2262" ref-type="bibr">38</xref>).</p>
<p>ROS generated primarily by the mitochondria are highly reactive metabolites that are produced during normal cell metabolism (<xref rid="b39-mmr-11-03-2262" ref-type="bibr">39</xref>). Curtin <italic>et al</italic> (<xref rid="b40-mmr-11-03-2262" ref-type="bibr">40</xref>) reported that the increases in intracellular ROS levels may lead to apoptosis. The underlying mechanism may involve the direct interaction and destruction of cellular proteins, lipids and DNA, and/or indirect interference with normal cellular signalling pathways and gene regulation (<xref rid="b41-mmr-11-03-2262" ref-type="bibr">41</xref>). Consistent with these findings, the present results demonstrated that intracellular ROS levels increased significantly in the <italic>p</italic>-PD-treated NRK-52E cells in a dose-dependent manner (<xref rid="f5-mmr-11-03-2262" ref-type="fig">Fig. 5</xref>). High levels of intracellular ROS cause disruption of the mitochondrial membrane potential, release of cytochrome <italic>c</italic> with subsequent activation of the caspase cascade and ultimately, programmed cell death (<xref rid="b42-mmr-11-03-2262" ref-type="bibr">42</xref>,<xref rid="b43-mmr-11-03-2262" ref-type="bibr">43</xref>). Additionally, intracellular ROS can catalytically inactivate protein tyrosine phosphatases through the oxidation of active-site cysteine residues, which negatively regulate receptor tyrosine kinase (RTK) activity and downstream signalling, and hence allow sustained PTK phosphorylation and activation (<xref rid="b44-mmr-11-03-2262" ref-type="bibr">44</xref>).</p>
<p>PTKs serve a key role in the transmission of various signals from cell-surface receptors to the nucleus. PTKs can be divided into the transmembrane (T)RTKs and non-RTKs (<xref rid="b45-mmr-11-03-2262" ref-type="bibr">45</xref>). Ras links RTKs and non-RTKs to downstream serine/threonine kinases, including the MAPKs (<xref rid="b46-mmr-11-03-2262" ref-type="bibr">46</xref>). The activation of the Ras/Raf/MAPK pathway has been demonstrated to induce growth arrest in several cell types. Oridonin induces apoptosis in L929 cells through inhibition of the PTK/Ras/Raf/JNK pathway (<xref rid="b20-mmr-11-03-2262" ref-type="bibr">20</xref>). In addition, PKT/Ras/Raf/JNK inhibition-derived ROS/NO production contributed to G2/M phase cell cycle arrest in evodiamine-treated human cervix carcinoma HeLa cells (<xref rid="b19-mmr-11-03-2262" ref-type="bibr">19</xref>). Consistent with these findings, in the current study it was demonstrated that the Ras/Raf/JNK pathway is able to promote apoptosis by inducing <italic>p</italic>-PD in NRK52E cells. Additionally, anti-carcinogenic compounds, UV- and gamma-irradiation have previously been indicated to induce apoptosis via a JNK-dependent pathway (<xref rid="b47-mmr-11-03-2262" ref-type="bibr">47</xref>&#x02013;<xref rid="b50-mmr-11-03-2262" ref-type="bibr">50</xref>).</p>
<p>Oxidative stress stimulates multiple intracellular signal transduction pathways such as Akt-Bad. Akt, which is downstream of PI3K, regulates mechanically driven and receptor-ligand signalling (<xref rid="b51-mmr-11-03-2262" ref-type="bibr">51</xref>). Activation of the PI3K/Akt can lead to Bad phosphorylation at specific serine residues. Phosphorylated Bad binds 14-3-3&#x003B6; proteins in the cytosol that sequester and tag Bad for subsequent degradation (<xref rid="b52-mmr-11-03-2262" ref-type="bibr">52</xref>). Alternatively, pro-apoptotic proteins can be retained in the cytosol by binding to anti-apoptotic proteins, such as Bcl-2 and Bcl-xL (<xref rid="b53-mmr-11-03-2262" ref-type="bibr">53</xref>). An increase in Bcl-2 and Bcl-xL expression prevents cytochrome <italic>c</italic> release from the mitochondria, thereby inhibiting activation of caspases, such as caspase-9 and caspase-3, and preventing apoptosis (<xref rid="b54-mmr-11-03-2262" ref-type="bibr">54</xref>,<xref rid="b55-mmr-11-03-2262" ref-type="bibr">55</xref>). In the present study, it was demonstrated that there were no changes in the levels of Bcl-2, Bcl-xL and Bad proteins compared with controls (Fig. 7). These findings suggest that the molecular mechanism triggered by <italic>p</italic>-PD-induced cell death is independent of the PI3K/Akt/Bad pathway.</p>
<p>In conclusion, the results of the present study demonstrated that <italic>p</italic>-PD induced apoptosis in NRK52E cells; in addition, DCFH-DA staining confirmed that apoptosis was induced due to oxidative stress. Furthermore, the results indicated that <italic>p</italic>-PD induced apoptosis via the PTK-Ras-Raf-JNK pathway, which upregulated SAPK/JNK protein expression levels and downregulated Ras and Raf protein expression levels. However, <italic>p</italic>-PD was found to induce apoptosis independent of PI3K/Akt pathway, as Akt, Bcl-2, Bcl-XL and Bad protein expression levels were not significantly altered compared with the control. Future studies are required in order to further elucidate the role of <italic>p</italic>-PD in tumorigenesis.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>The present study was supported by grants FRGS/2/2010/ST/IMU/03/1(SKK) from Jabatan Pengajian Tinggi Malaysia and BMS 102-2010 (<xref rid="b10-mmr-11-03-2262" ref-type="bibr">10</xref>) from the International Medical University, Kuala Lumpur, Malaysia.</p></ack>
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<floats-group>
<fig id="f1-mmr-11-03-2262" position="float">
<label>Figure 1</label>
<caption>
<p>Effects of <italic>p</italic>-PD on cell morphology in NRK52E cells. NRK52E cells were treated with (A) DMSO or <italic>p</italic>-PD at a concentration of (B) 50, (C) 100, (D) 200 and (E) 300 &#x003BC;g/ml for 24 h. The results were observed under an inverted microscope; magnification, &#x000D7;200. <italic>p</italic>-PD, <italic>para</italic>-phenylenediamine; DMSO, dimethyl sulfoxide.</p></caption>
<graphic xlink:href="MMR-11-03-2262-g00.gif"/></fig>
<fig id="f2-mmr-11-03-2262" position="float">
<label>Figure 2</label>
<caption>
<p>Effect of <italic>p</italic>-PD on cell viability in NRK52E cells, evaluated by a trypan blue exclusion assay. NRK52E cells were treated with different doses of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) for 24 h. Data are presented as the mean &#x000B1; standard deviation and are representative of three independent experiments. <sup>*</sup>P&lt;0.05 vs. the control group. <italic>p</italic>-PD, <italic>para</italic>-phenylenediamine.</p></caption>
<graphic xlink:href="MMR-11-03-2262-g01.gif"/></fig>
<fig id="f3-mmr-11-03-2262" position="float">
<label>Figure 3</label>
<caption>
<p>Effect of <italic>p</italic>-PD on cell cycle distributions in NRK52E cells. Cells were treated with different doses of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) for 24 h. Following staining with PI, the cell cycle was analysed by flow cytometry. The percentages of cells in the sub G<sub>1</sub>, G<sub>1</sub>, S and G<sub>2</sub>+M phases following treatment with various doses of <italic>p</italic>-PD are presented as cumulative data from three independent experiments. <italic>p</italic>-PD, <italic>para</italic>-phenylenediamine; PI, propidium iodide.</p></caption>
<graphic xlink:href="MMR-11-03-2262-g02.gif"/></fig>
<fig id="f4-mmr-11-03-2262" position="float">
<label>Figure 4</label>
<caption>
<p>Effect of <italic>p</italic>-PD on apoptosis in NRK52E cells. Cells were treated with different doses of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) for 24 h. Following staining with Annexin-V and PI, levels of apoptosis were analysed by flow cytometry. The cumulative data are from three independent experiments. <italic>p</italic>-PD, <italic>para</italic>-phenylenediamine; PI, propidium iodide; ; FITC, fluorescien isothiocyanate.</p></caption>
<graphic xlink:href="MMR-11-03-2262-g03.gif"/></fig>
<fig id="f5-mmr-11-03-2262" position="float">
<label>Figure 5</label>
<caption>
<p>Effect of <italic>p</italic>-PD on ROS generation in NRK52E cells. NRK52E cells were treated with 100 &#x003BC;g/ml <italic>p</italic>-PD for 1, 2 and 3 h. ROS generation was indicated by DCFH-DA fluorescence. The fluorescence intensity levels were detected using a fluorescence plate reader at excitation and emission wavelengths of 488 nm and 525 nm, respectively. The fluorescence intensity in cells treated with various doses of <italic>p</italic>-PD is presented as cumulative data from three independent experiments (P&lt;0.05 vs. control). <italic>p</italic>-PD, <italic>para</italic>-phenylenediamine.</p></caption>
<graphic xlink:href="MMR-11-03-2262-g04.gif"/></fig>
<fig id="f6-mmr-11-03-2262" position="float">
<label>Figure 6</label>
<caption>
<p>Effects of <italic>p</italic>-PD on signalling pathways in NRK52E cells. NRK52E cells were treated with different doses of <italic>p</italic>-PD (50, 100, 200 and 300 &#x003BC;g/ml) for 24 h. The protein expression levels of Ras, Raf, SAPK-JNK, Akt, Bcl-2, Bcl-xL and Bad were evaluated by western blot analysis. <italic>p</italic>-PD, <italic>para</italic>-phenylenediamine; SAPK, stress-activated protein kinase; JNK, c-Jun N-terminal kinase Akt, protein kinase B.</p></caption>
<graphic xlink:href="MMR-11-03-2262-g05.gif"/></fig></floats-group></article>
