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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">OL</journal-id>
<journal-title-group>
<journal-title>Oncology Letters</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-1074</issn>
<issn pub-type="epub">1792-1082</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ol.2018.7769</article-id>
<article-id pub-id-type="publisher-id">OL-0-0-7769</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Fucosterol exhibits selective antitumor anticancer activity against HeLa human cervical cell line by inducing mitochondrial mediated apoptosis, cell cycle migration inhibition and downregulation of m-TOR/PI3K/Akt signalling pathway</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Jiang</surname><given-names>Hongye</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/>
<xref rid="fn1-ol-0-0-7769" ref-type="author-notes">&#x002A;</xref></contrib>
<contrib contrib-type="author"><name><surname>Li</surname><given-names>Jie</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/>
<xref rid="fn1-ol-0-0-7769" ref-type="author-notes">&#x002A;</xref></contrib>
<contrib contrib-type="author"><name><surname>Chen</surname><given-names>Aiyue</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/></contrib>
<contrib contrib-type="author"><name><surname>Li</surname><given-names>Yinguang</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/></contrib>
<contrib contrib-type="author"><name><surname>Xia</surname><given-names>Meng</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/></contrib>
<contrib contrib-type="author"><name><surname>Guo</surname><given-names>Peng</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/></contrib>
<contrib contrib-type="author"><name><surname>Yao</surname><given-names>Shuzhong</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/></contrib>
<contrib contrib-type="author"><name><surname>Chen</surname><given-names>Shuqin</given-names></name>
<xref rid="af1-ol-0-0-7769" ref-type="aff"/>
<xref rid="c1-ol-0-0-7769" ref-type="corresp"/></contrib>
</contrib-group>
<aff id="af1-ol-0-0-7769">Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510086, P.R. China</aff>
<author-notes>
<corresp id="c1-ol-0-0-7769"><italic>Correspondence to</italic>: Dr Shuqin Chen, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Er Road, Guangzhou, Guangdong 510086, P.R. China, E-mail: <email>shuqinchen134@hotmail.com</email></corresp>
<fn id="fn1-ol-0-0-7769"><label>&#x002A;</label><p>Contributed equally</p></fn>
</author-notes>
<pub-date pub-type="ppub">
<month>03</month>
<year>2018</year></pub-date>
<pub-date pub-type="epub">
<day>10</day>
<month>01</month>
<year>2018</year></pub-date>
<volume>15</volume>
<issue>3</issue>
<fpage>3458</fpage>
<lpage>3463</lpage>
<history>
<date date-type="received"><day>21</day><month>02</month><year>2017</year></date>
<date date-type="accepted"><day>05</day><month>09</month><year>2017</year></date>
</history>
<permissions>
<copyright-statement>Copyright: &#x00A9; Jiang et al.</copyright-statement>
<copyright-year>2018</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license>
</permissions>
<abstract>
<p>Cervical cancer greatly contributes to cancer-associated mortalities worldwide. The growing incidence of cervical cancer is of primary concern, and has signaled the need for multiple treatment options. Despite preliminary responses to chemotherapy and/or surgical interventions, the tumors consistently relapse. Previously, natural products gained attention for their diverse bioactivities, which include however are not limited to, neuroprotective, antimicrobial and anticancer effects. The present study evaluated the anticancer activity of fucosterol against a panel of human cancer cell lines. Results indicated that fucosterol exhibited selective inhibitory activity against human HeLa cervical cancer cell line with an IC<sub>50</sub> of 40 &#x00B5;M. Fucosterol also induced apoptosis in HeLa cells and prompted reactive oxygen species mediated alterations in mitochondrial membrane potential. It triggered cell cycle arrest of HeLa cells at G2/M check point and exerted inhibitory effects on cell migration. The activation of the phosphoinositide-3-kinase (PI3K)/AKT Serine/Threonine Kinase 1 (AKT)/mechanistic target of Rapamycin (mTOR) pathway is important in cancer tumorigenesis, progression and chemotherapy resistance. The results demonstrated that fucosterol significantly inhibited the expression levels of key proteins of the PI3K/Akt/mTOR signaling pathway. Overall, the results of the present study suggest that fucosterol may prove beneficial in the management of cervical cancer.</p>
</abstract>
<kwd-group>
<kwd>cervical carcinoma</kwd>
<kwd>chemotherapy</kwd>
<kwd>ROS</kwd>
<kwd>fucosterol</kwd>
<kwd>apoptosis</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Cervical cancer ranks third among the most frequently detected cancer in women around the globe. Every year more than 500,000 women are diagnosed for this disease which approximately accounts for about 9&#x0025; of the total newly diagnosed cancer cases (<xref rid="b1-ol-0-0-7769" ref-type="bibr">1</xref>). Nevertheless, existing treatment options including radical hysterectomy and radiotherapy have decent clinical outcomes, still around 300,000 deaths are accredited to cervical cancer annually. Moreover, surgery is lone and appropriate option for early stage cervical cancer and radiotherapy exhibits severe side effects which badly influence the quality of life (<xref rid="b2-ol-0-0-7769" ref-type="bibr">2</xref>). Natural products have gained tremendous importance as anticancer agents due to their lower side effects. Among these, anticancer marine plants form one of the important sources for isolation of anti-cancerous molecules (<xref rid="b3-ol-0-0-7769" ref-type="bibr">3</xref>). Recently, a compound fucosterol (<xref rid="f1-ol-0-0-7769" ref-type="fig">Fig. 1A</xref>) has been shown toexhibit tremendous pharmacological potential activities have been attributed to this molecule which include, but are not limited to anticancer, antidepressant, anticonvulsant, anti-inflammatory, and antimicrobial (<xref rid="b3-ol-0-0-7769" ref-type="bibr">3</xref>,<xref rid="b4-ol-0-0-7769" ref-type="bibr">4</xref>). Here in the present study a natural product, fucosterol was evaluated against human cervical cells. Moreover, the probable underlying mechanism was assessed with particular emphasis on the effect of this natural product on PI3K/Akt/mTOR cascade. Except for p53 signaling pathway, the PI3K/Akt/mTOR cascade is probably the most recurrently changed signaling pathway in cancer (<xref rid="b5-ol-0-0-7769" ref-type="bibr">5</xref>). Consistent with this, first generation mTOR inhibitors exhibit significant anti-cancer properties and several have even been approved for the management of several types of cancers which include, but are not limited to pancreatic, cervical, renal and breast cancers. Additionally, PI3K, Akt together with second generation inhibitors of mTOR are undergoing clinical trials (<xref rid="b5-ol-0-0-7769" ref-type="bibr">5</xref>,<xref rid="b6-ol-0-0-7769" ref-type="bibr">6</xref>). Of note, the results of the present study indicated that fucosterol exhibits a significant anticancer activity by inducing apoptosis in human cervical HeLa cancer cell line by reactive oxygen species (ROS) mediated alterations in mitochondrial membrane potential (&#x0394;&#x03A8;<sub>m</sub>) and cell cycle arrest. It was also found to downregulate the expression key proteins of PI3K/Akt/mTOR signalling pathway. Additionally, fucosterol also caused significant inhibition on cell migration. Taken together, we propose that fucosterol may prove a potential candidate towards the management of cervical cancer.</p>
</sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Chemicals and reagents</title>
<p>Fucosterol, propidium iodide (PI), RNase A triton X-100 dimethyl and sulfoxide (DMSO), were obtained from Sigma-Aldrich Co. (St. Louis, MO, USA). All primary and secondary antibodies were purchased from Santa Cruz Biotechnology Inc. (Santa Cruz, CA, USA). The fluorescent probes DCFH-DA, DiOC<sub>6</sub>, 4&#x2032;-6-diamidino-2-phenylindole (DAPI), Fetal bovine serum (FBS), RPMI-1640 medium, L-glutamine, antibiotics were obtained from Invitrogen Life Technologies (Carlsbad, CA, USA).</p>
</sec>
<sec>
<title>Cell line and culture conditions</title>
<p>Human cancer cell lines, human lung cancer cell line (A-549), pancreas (MiaPaca-2), prostate (PC-3, CVCL_0035), breast (MCF-7), gastric cancer cell line (SNU-5), cervical cancer cell line (HeLa) and human normal cell line (fR2) were procured from Cancer Research Institute of Beijing, China, and it was maintained in DMEM and was supplemented with 10&#x0025; FBS and antibiotics (100 &#x00B5;g/ml streptomycin and 100 U/ml penicillin G) in a incubator at 37&#x00B0;C (5&#x0025; CO<sub>2</sub> and 95&#x0025; air).</p>
</sec>
<sec>
<title>MTT assay</title>
<p>The anti-proliferation effect of fucosterol was evaluated against a panel of human cancer cell linesby MTT assay. Cells were grown at 1&#x00D7;10<sup>6</sup> cells per well in 96-well plates for a time period of 12 h and then exposed to different concentration of fucosterol (0&#x2013;160 &#x00B5;M) for 48&#x2013;72 h. To each well, MTT solution (20 &#x00B5;l) was added. Prior to the addition of 500 &#x00B5;l of DMSO, the medium was completely removed. To solubilize MTT formazan crystals, 500 &#x00B5;l DMSO was added. ELISA plate reader was used for the determination of optical density. Since an lowest IC50 was observed for HeLa cervical cancer cell line, they were subjected to further evaluation at the doses of 0, 20, 40 and 80 &#x00B5;M of fucosterol dose for 24, 48 and 72 h. We selected one dose lower and one dose higher than the IC50 of fucosterol.</p>
</sec>
<sec>
<title>Colony formation assay</title>
<p>For clonogenic assay, cervical cancer HeLa cells at the exponential growth phase were harvested and counted with a hemocytometer. Seeding of the cells was done at 200 cells per well, incubated for a time period of 48 h to allow the cells to attach and then to the cell culture different doses (0, 20 40 and 80 &#x00B5;M) of fucosterol was added. After treatment, the cells were again incubated for 6 days, washing was done with PBS and methanol was used to fix colonies and then stained with crystal violet for about 30 min before being counted under light microscope.</p>
</sec>
<sec>
<title>DAPI staining</title>
<p>HeLa cells at a density of 2&#x00D7;10<sup>5</sup> cells/well were seeded in 6-well plates were administrated with 0, 20, 40 and 80 &#x00B5;M fucosterol for 48 h. The cells were then subjected to DAPI staining. Afterwards, the cell sample was studied and photographs taken under fluorescence microscopy as previously described (<xref rid="b7-ol-0-0-7769" ref-type="bibr">7</xref>).</p>
</sec>
<sec>
<title>Determination of ROS, and &#x0394;&#x03A8;<sub>m</sub></title>
<p>HeLa cells were seeded at a density of 2&#x00D7;10<sup>5</sup> cells/wel in a 6-well plate and kept for 24 h and treated with (0&#x2013;100 &#x00B5;M) fucosterol for 48 h at 37&#x00B0;C in 5&#x0025; CO<sub>2</sub> and 95&#x0025; air. Thereafter cells from all samples were collected, washed 2 times by PBS and re-suspended in 500 &#x00B5;l of DCFH-DA (10 &#x00B5;M) for ROS estimation and DiOC<sub>6</sub> (1 &#x00B5;mol/l) for &#x0394;&#x03A8;<sub>m</sub> at 37&#x00B0;C indark room for 30 min. The samples were then examined instantly using flow cytometer as described previously in literature (<xref rid="b8-ol-0-0-7769" ref-type="bibr">8</xref>).</p>
</sec>
<sec>
<title>Determination of cell cycle distribution of HeLa cells</title>
<p>The cells seeded in 6 well plates (2&#x00D7;10<sup>5</sup> cells/well) and fucosterol was administrated to the cells at the doses of 0, 20,40 and 80 &#x00B5;M followed by 24 h of incubation. DMSO was used as a control. For estimation of DNA content, PBS was used to wash the cells and fixed in ethanol at &#x2212;20&#x00B0;C. This was followed by re-suspension in PBS holding 40 &#x00B5;g/ml PI and, RNase A (0.1 mg/ml) and Triton X-100 (0.1&#x0025;) for 30 min in a dark room at 37&#x00B0;C. Afterwards, analysis was carried out by flow cytometry as reported previously (<xref rid="b9-ol-0-0-7769" ref-type="bibr">9</xref>).</p>
</sec>
<sec>
<title>Cell migration assay</title>
<p>Cell migration assay was carried out by Boyden chamber assay with some modifications. Cells at the density of 5&#x00D7;10<sup>4</sup> cells/well were suspended in 2&#x0025; FBS medium and placed in the upper chamber of 8 &#x00B5;m pore size transwells. After wards, medium supplemented with 10&#x0025; FBS was added to lower chamber. This was followed by an incubation of 48 h. On the upper surface of the membrane, unmigrated cells were removed while as on the lower surface of the membrane the migrated cells were fixed in methanol (100&#x0025;) and Giemsa stained. The cell migration was estimated by counting the number of the migrated cells under a microscope.</p>
</sec>
<sec>
<title>Western blotting analysis</title>
<p>The fucosterol administrated cells were harvested and lysed. The protein concentrations of the lysates were quantified by BCA assay using specific antibodies. &#x03B2;-actin was used as a control. From each sample equal amounts of protein were loaded and separated by electrophoresis on a 12&#x0025; denaturing SDS gel. Afterwards, the proteins were then electroblotted on polyvinylidene difluoride membranes (0.45 m pore size).</p>
</sec>
<sec>
<title>Statistical analysis</title>
<p>All experiments were carried out in triplicates and expressed as mean &#x00B1; standard deviation (SD). Statistical analysis was carried by Students t-test and one way ANOVA (in case of comparisons between more than two groups) using Tukey&#x0027;s HSD test. GraphPad prism 7 software (GraphPad Software, Inc, USA). The values were considered significant at &#x002A;P&#x003C;0.01, &#x002A;&#x002A; P&#x003C;0.001, &#x002A;&#x002A;&#x002A;P&#x003C;0.0001.</p>
</sec>
</sec>
</sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title/>
<sec>
<title>Anti-proliferative potential of fucosterol on Cervical HeLa cancer cell line</title>
<p>To identify the anti-proliferative role of fucosterol was evaluated against a panel of human cancer cell lines (<xref rid="tI-ol-0-0-7769" ref-type="table">Table I</xref>). However, fucosterol exhibited selective anticancer activity against cervical cancer HeLa cells in a dose dependent manner and exhibited an IC<sub>50</sub> 40 &#x00B5;M (<xref rid="tI-ol-0-0-7769" ref-type="table">Table I</xref> and <xref rid="f1-ol-0-0-7769" ref-type="fig">Fig. 1B</xref>). In the colony formation assay, we observed that fucosterol administration reduced the number of colonies in a dose-dependent manner (<xref rid="f1-ol-0-0-7769" ref-type="fig">Fig. 1C</xref>).</p>
</sec>
<sec>
<title>Fucosterol induced apoptosis in human HeLa cervical cancer cells</title>
<p>In order to confirm apoptotic cell death induced by fucosterol Annexin V/PI staining was performed. Flow cytometric results showed that the percentage of apoptotic cell population increased to 12.2, 37 and 62 &#x0025; in HeLa cancer cells after 48 h at the concentrations of 20, 40 and 80 &#x00B5;M, respectively as compared to untreated control (<xref rid="f2-ol-0-0-7769" ref-type="fig">Fig. 2</xref>). Thus the results indicate that the extract caused apoptotic cell death in a concentration dependent manner.</p>
</sec>
<sec>
<title>Fucosterol triggered the ROS activation in human HeLa cervical cancer cells</title>
<p>The pro-apoptotic potential of fucosterol observed through DAPI staining study suggested that fucosterol might induce generation of intracellular ROS. Therefore, we calculated the ROS level at varied concentrations of fucosterol for 48 h. The results showed that the intracellular ROS levels of treated cells increased 110 to 305&#x0025; as compared to untreated cells (<xref rid="f3-ol-0-0-7769" ref-type="fig">Fig. 3A</xref>). Our result suggested that fucosterol is a potent molecule for activating ROS in HeLa cells to trigger the apoptosis.</p>
</sec>
<sec>
<title>Fucosterol reduces the mitochondrial membrane potential (&#x0394;&#x03A8;m)</title>
<p>ROS generationis related to mitochondrial dysfunction. It disrupts the outer mitochondrial potential to release the death-promoting proteins (<xref rid="b10-ol-0-0-7769" ref-type="bibr">10</xref>). Therefore, we examined whether fucosterol reduces the &#x0394;&#x03A8;<sub>m</sub> in HeLa cells treated with fucosterol at varied concentrations. Fucosterol treated HeLa cells showed a significant reduction in &#x0394;&#x03A8;<sub>m</sub> in a dose-dependent manner (<xref rid="f3-ol-0-0-7769" ref-type="fig">Fig. 3B</xref>).</p>
</sec>
<sec>
<title>Fucosterol caused alterations in cell cycle distribution of HeLa cancer cells</title>
<p>It was observed that the percentage of cells was considerably increased in G2 at the concentrations of 0 to 80 &#x00B5;M concentrations of fucosterol causing G2 arrest (<xref rid="f4-ol-0-0-7769" ref-type="fig">Fig. 4</xref>). Additionally the populations of HeLa cells G2 phase were marginally increased at a dose of 20 &#x00B5;M, reasonably increased at 20 &#x00B5;M, and dramatically increased at 40 &#x00B5;M. This fucosterol-induced G2 increase of HeLa cancer cells was observed to exhibit a dose-dependent pattern.</p>
</sec>
<sec>
<title>Fucosterol inhibits cell migration</title>
<p>Further, we investigated fucosterol can inhibit the migration of cervical cancer cells at the IC<sub>50</sub> concentration (40 &#x00B5;M). The results of transwell assays showed that fucosterol reduced the migratory capability of cervical cancer HeLa cells (<xref rid="f5-ol-0-0-7769" ref-type="fig">Fig. 5</xref>).</p>
</sec>
<sec>
<title>Fucosterol targets m-TOR/PI3K/Akt signalling pathway</title>
<p>The fact that fucosterol could modulate the protein expressions of m-TOR/PI3K/Akt signalling pathway, we carried out the western blot analysis. The findings are shown in (<xref rid="f6-ol-0-0-7769" ref-type="fig">Fig. 6</xref>) and indicate an interesting outcome. Compared to the untreated control cells, fucosterol treated cells showed a concentration-dependent downregulation of m-TOR and pm-TOR proteins. It also caused marked downregulation of PI3K/Akt protein expressions. Thus it may be concluded that fucosterol induced anticancer and apoptotic effects partly via m-TOR/PI3K/Akt signalling pathway.</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Cervical cancer is one of the major cancers detected in women around the globe. Around 500,000 women are diagnosed for this disease annually (<xref rid="b1-ol-0-0-7769" ref-type="bibr">1</xref>). Nevertheless, the treatment options for cervical cancer are limited. Moreover, surgery is the only appropriate choiceif the cancer is detected at an early stage. Other options such as radiotherapy have severe side effects which badly influence the quality of life (<xref rid="b2-ol-0-0-7769" ref-type="bibr">2</xref>). Against this backdrop, molecules from natural sources with limited side effects may prove handy. In the current study, fucosterol showed potential and selective growth inhibiting activity against HeLa cervical cancer cells as evident from the proliferation assay. The selective anticancer activity of fucosterol on HeLa cells is interesting. It may be explained by the fact that several anticancer agents tend exhibit selective anticancer effects against particular cell line due to the involvement specific signalling pathways in different cancer types (<xref rid="b10-ol-0-0-7769" ref-type="bibr">10</xref>). However, it would be too early to delimit any particular reason for the selective anticancer effects of fucosterol and thus will require further investigation in future. As reported previously, many drugs exhibit antiproliferative effects via induction of apoptosis. For instance, several chemotherapeutic drugs, such as cisplatin, taxol and 5-fluorouracil (<xref rid="b11-ol-0-0-7769" ref-type="bibr">11</xref>&#x2013;<xref rid="b17-ol-0-0-7769" ref-type="bibr">17</xref>) have been reported to alter explicit apoptotic pathways. Additionally, resistance to drug is partially explained by the ability of cancer cells to flee apoptosis (<xref rid="b18-ol-0-0-7769" ref-type="bibr">18</xref>). To asses weather fucosterol induces apoptosis in HeLa cells, we carried out the DAPI staining of the fucosterol treated cells. It was observed that fucosterol induces apoptosis in a concentration dependent manner. Further it was observed that fucosterol treated cells displayed ROS mediated MMP reduction. Our results are in agreement with studies carried out previously (<xref rid="b17-ol-0-0-7769" ref-type="bibr">17</xref>). Therefore the results suggest that fucosterol may induce apoptosis through increasing intracellular ROS and reduction in MMP. Several anti-cancer drugs target cancer cells partly by accretion of high levels of ROS (<xref rid="b18-ol-0-0-7769" ref-type="bibr">18</xref>). Moreover, mitochondria play a key role in ROS (<xref rid="b19-ol-0-0-7769" ref-type="bibr">19</xref>). For example, capsaicin disrupts MMP and mediates oxidative stress resulting in apoptosis in pancreatic cancer cells (<xref rid="b11-ol-0-0-7769" ref-type="bibr">11</xref>&#x2013;<xref rid="b17-ol-0-0-7769" ref-type="bibr">17</xref>). Flow cytometry using propidium iodide as a probe was used to study effects of fucosterolon cell cycle progression. Fucosterol induced G2/M cell cycle arrest and led to a significant increase of G2 cells in a dose dependently. Further, it was shown that fucosterol could inhibit HeLa cancer cell in a concentration dependent manner. These findings are promising since it is well established that cervical cancer is one of the most lethal cancers and fucosterol could inhibit this behavior. Additionally, fucosterol also inhibited the cell migration of HeLa cells as evident from the transwell assays. This migration inhibiting potential indicates that fucosterol may prove beneficial in inhibiting the metastasis of cancer cells <italic>in vivo</italic> and therefore deserves further investigation.</p>
<p>Akt and mTOR are well-known major regulatory signaling cascade that control cell proliferation, metabolism and survival of cancer cells. Therefore, several inhibitors, such as everolimus, have been developed and used for treatment to induce apoptosis in cancer cells. To inhibit the mTOR signaling pathway, rapamycin has been used in several studies. However, rapamycin only inhibits mTOR complex (TORC) 1, and it consequently induces Akt phosphorylation via feedback activation (<xref rid="b20-ol-0-0-7769" ref-type="bibr">20</xref>,<xref rid="b21-ol-0-0-7769" ref-type="bibr">21</xref>) Thefore we investigated the effects of fucosterol on PI3/Akt/mTOR pathway. Our results indicated that the expression levels of various proteins including m-TOR, pm-TOR, PI3K, p-PI3K and Akt were downregulated as evident from the western blot assay. These results indicate the potential of fucosterol to inhibit cancer cell growth via inhibition of PI3K/Akt/mTOR pathway. Though our results showed promising activity of fucosterol, the feasibility of uses of fucosterol in human and its bioavailability will require further <italic>in vivo</italic> studies However, the low toxicity of fucosterol towards normal cancer cells indicated that it could be used at even at the concentrations that 4 times higher than its IC<sub>50</sub>.</p>
<p>Taken together, we conclude that fucosterol may prove a potential candidate for the treatment of cervical cancer by regulating m-TOR/PI3K/Akt signalling pathway. With limited drug options available and limited toxicity associated with this naturally occurring fucosterol, this molecule seems a strongoption and deserves further research endeavors.</p>
</sec>
</body>
<back>
<ref-list>
<title>References</title>
<ref id="b1-ol-0-0-7769"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jemal</surname><given-names>A</given-names></name><name><surname>Bray</surname><given-names>F</given-names></name><name><surname>Center</surname><given-names>MM</given-names></name><name><surname>Ferlay</surname><given-names>J</given-names></name><name><surname>Ward</surname><given-names>E</given-names></name><name><surname>Forman</surname><given-names>D</given-names></name></person-group><article-title>Global cancer statistics</article-title><source>CA Cancer J Clin</source><volume>61</volume><fpage>69</fpage><lpage>90</lpage><year>2011</year><pub-id pub-id-type="doi">10.3322/caac.20107</pub-id><pub-id pub-id-type="pmid">21296855</pub-id></element-citation></ref>
<ref id="b2-ol-0-0-7769"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cadron</surname><given-names>I</given-names></name><name><surname>Van Gorp</surname><given-names>T</given-names></name><name><surname>Amant</surname><given-names>F</given-names></name><name><surname>Leunen</surname><given-names>K</given-names></name><name><surname>Neven</surname><given-names>P</given-names></name><name><surname>Vergote</surname><given-names>I</given-names></name></person-group><article-title>Chemotherapy for recurrent cervical cancer</article-title><source>Gynecol Oncol</source><volume>107</volume><issue>1 Suppl 1</issue><fpage>S113</fpage><lpage>S118</lpage><year>2007</year><pub-id pub-id-type="doi">10.1016/j.ygyno.2007.07.004</pub-id><pub-id pub-id-type="pmid">17804044</pub-id></element-citation></ref>
<ref id="b3-ol-0-0-7769"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Blunden</surname><given-names>G</given-names></name></person-group><article-title>Biologically active compounds from marine organisms</article-title><source>Phytother Res</source><volume>15</volume><fpage>89</fpage><lpage>94</lpage><year>2001</year><pub-id pub-id-type="doi">10.1002/ptr.982</pub-id><pub-id pub-id-type="pmid">11268103</pub-id></element-citation></ref>
<ref id="b4-ol-0-0-7769"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhen</surname><given-names>XH</given-names></name><name><surname>Quan</surname><given-names>YC</given-names></name><name><surname>Jiang</surname><given-names>HY</given-names></name><name><surname>Wen</surname><given-names>ZS</given-names></name><name><surname>Qu</surname><given-names>YL</given-names></name><name><surname>Guan</surname><given-names>LP</given-names></name></person-group><article-title>Fucosterol, a sterol extracted from sargassum fusiforme, shows antidepressant and anticonvulsant effects</article-title><source>Eur J Pharmacol</source><volume>768</volume><fpage>131</fpage><lpage>138</lpage><year>2015</year><pub-id pub-id-type="doi">10.1016/j.ejphar.2015.10.041</pub-id><pub-id pub-id-type="pmid">26515446</pub-id></element-citation></ref>
<ref id="b5-ol-0-0-7769"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Engelman</surname><given-names>JA</given-names></name></person-group><article-title>Targeting PI3K signalling in cancer: Opportunities, challenges and limitations</article-title><source>Nat Rev Cancer</source><volume>9</volume><fpage>550</fpage><lpage>562</lpage><year>2009</year><pub-id pub-id-type="doi">10.1038/nrc2664</pub-id><pub-id pub-id-type="pmid">19629070</pub-id></element-citation></ref>
<ref id="b6-ol-0-0-7769"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Romashkova</surname><given-names>JA</given-names></name><name><surname>Makarov</surname><given-names>SS</given-names></name></person-group><article-title>NF-kappaB is a target of AKT in anti-apoptotic PDGF signalling</article-title><source>Nature</source><volume>401</volume><fpage>86</fpage><lpage>90</lpage><year>1999</year><pub-id pub-id-type="doi">10.1038/43474</pub-id><pub-id pub-id-type="pmid">10485711</pub-id></element-citation></ref>
<ref id="b7-ol-0-0-7769"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chiang</surname><given-names>LC</given-names></name><name><surname>Ng</surname><given-names>LT</given-names></name><name><surname>Lin</surname><given-names>IC</given-names></name><name><surname>Kuo</surname><given-names>PL</given-names></name><name><surname>Lin</surname><given-names>CC</given-names></name></person-group><article-title>Anti-proliferative effect of apigenin and its apoptotic induction in human Hep G2 cells</article-title><source>Cancer Lett</source><volume>237</volume><fpage>207</fpage><lpage>214</lpage><year>2006</year><pub-id pub-id-type="doi">10.1016/j.canlet.2005.06.002</pub-id><pub-id pub-id-type="pmid">16023288</pub-id></element-citation></ref>
<ref id="b8-ol-0-0-7769"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chiang</surname><given-names>JH</given-names></name><name><surname>Yang</surname><given-names>JS</given-names></name><name><surname>Ma</surname><given-names>CY</given-names></name><name><surname>Yang</surname><given-names>MD</given-names></name><name><surname>Huang</surname><given-names>HY</given-names></name><name><surname>Hsia</surname><given-names>TC</given-names></name><name><surname>Kuo</surname><given-names>HM</given-names></name><name><surname>Wu</surname><given-names>PP</given-names></name><name><surname>Lee</surname><given-names>TH</given-names></name><name><surname>Chung</surname><given-names>JG</given-names></name></person-group><article-title>Danthron, an anthraquinone derivative, induces DNA damage and caspase cascades-mediated apoptosis in SNU-1 human gastric cancer cells through mitochondrial permeability transition pores and bax-triggered pathways</article-title><source>Chem Res Toxicol</source><volume>24</volume><fpage>20</fpage><lpage>29</lpage><year>2011</year><pub-id pub-id-type="doi">10.1021/tx100248s</pub-id><pub-id pub-id-type="pmid">21126053</pub-id></element-citation></ref>
<ref id="b9-ol-0-0-7769"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sun</surname><given-names>SY</given-names></name><name><surname>Hail</surname><given-names>N</given-names><suffix>Jr</suffix></name><name><surname>Lotan</surname><given-names>R</given-names></name></person-group><article-title>Apoptosis as a novel target for cancer chemoprevention</article-title><source>J Natl Cancer Inst</source><volume>96</volume><fpage>662</fpage><lpage>672</lpage><year>2004</year><pub-id pub-id-type="doi">10.1093/jnci/djh123</pub-id><pub-id pub-id-type="pmid">15126603</pub-id></element-citation></ref>
<ref id="b10-ol-0-0-7769"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stierle</surname><given-names>AA</given-names></name><name><surname>Stierle</surname><given-names>DB</given-names></name><name><surname>Kelly</surname><given-names>K</given-names></name></person-group><article-title>Berkelic acid, a novel spiroketal with selective anticancer activity from an acid mine waste fungal extremophile</article-title><source>J Org Chem</source><volume>71</volume><fpage>5357</fpage><lpage>5360</lpage><year>2006</year><pub-id pub-id-type="doi">10.1021/jo060018d</pub-id><pub-id pub-id-type="pmid">16808526</pub-id></element-citation></ref>
<ref id="b11-ol-0-0-7769"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Maitra</surname><given-names>R</given-names></name><name><surname>Porter</surname><given-names>MA</given-names></name><name><surname>Huang</surname><given-names>S</given-names></name><name><surname>Gilmour</surname><given-names>BP</given-names></name></person-group><article-title>Inhibition of NFkappaB by the natural product Withaferin A in cellular models of Cystic Fibrosis inflammation</article-title><source>J Inflamm (Lond)</source><volume>6</volume><fpage>15</fpage><year>2009</year><pub-id pub-id-type="doi">10.1186/1476-9255-6-15</pub-id><pub-id pub-id-type="pmid">19439083</pub-id></element-citation></ref>
<ref id="b12-ol-0-0-7769"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hissin</surname><given-names>PJ</given-names></name><name><surname>Hilf</surname><given-names>R</given-names></name></person-group><article-title>A fluorometric method for determination of oxidized and reduced glutathione in tissues</article-title><source>Anal Biochem</source><volume>74</volume><fpage>214</fpage><lpage>226</lpage><year>1976</year><pub-id pub-id-type="doi">10.1016/0003-2697(76)90326-2</pub-id><pub-id pub-id-type="pmid">962076</pub-id></element-citation></ref>
<ref id="b13-ol-0-0-7769"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chipuk</surname><given-names>JE</given-names></name><name><surname>Bouchier-Hayes</surname><given-names>L</given-names></name><name><surname>Green</surname><given-names>DR</given-names></name></person-group><article-title>Mitochondrial outer membrane permeabilization during apoptosis: The innocent bystander scenario</article-title><source>Cell Death Diff</source><volume>13</volume><fpage>1396</fpage><lpage>1402</lpage><year>2006</year><pub-id pub-id-type="doi">10.1038/sj.cdd.4401963</pub-id></element-citation></ref>
<ref id="b14-ol-0-0-7769"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Azuma</surname><given-names>M</given-names></name><name><surname>Tamatani</surname><given-names>T</given-names></name><name><surname>Ashida</surname><given-names>Y</given-names></name><name><surname>Takashima</surname><given-names>R</given-names></name><name><surname>Harada</surname><given-names>K</given-names></name><name><surname>Sato</surname><given-names>M</given-names></name></person-group><article-title>Cisplatin induces apoptosis in oral squamous carcinoma cells by the mitochondria-mediated but not the NF-kappaB-suppressed pathway</article-title><source>Oral Oncol</source><volume>39</volume><fpage>282</fpage><lpage>289</lpage><year>2003</year><pub-id pub-id-type="doi">10.1016/S1368-8375(02)00116-1</pub-id><pub-id pub-id-type="pmid">12618201</pub-id></element-citation></ref>
<ref id="b15-ol-0-0-7769"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yoneda</surname><given-names>K</given-names></name><name><surname>Yamamoto</surname><given-names>T</given-names></name><name><surname>Osaki</surname><given-names>T</given-names></name></person-group><article-title>p53- and p21-independent apoptosis of squamous cell carcinoma cells induced by 5-fluorouracil and radiation</article-title><source>Oral Oncol</source><volume>34</volume><fpage>529</fpage><lpage>537</lpage><year>1998</year><pub-id pub-id-type="doi">10.1016/S1368-8375(98)00036-0</pub-id><pub-id pub-id-type="pmid">9930367</pub-id></element-citation></ref>
<ref id="b16-ol-0-0-7769"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Abal</surname><given-names>M</given-names></name><name><surname>Andreu</surname><given-names>JM</given-names></name><name><surname>Barasoain</surname><given-names>I</given-names></name></person-group><article-title>Taxanes: Microtubule and centrosome targets, and cell cycle dependent mechanisms of action</article-title><source>Curr Cancer Drug Targets</source><volume>3</volume><fpage>193</fpage><lpage>203</lpage><year>2003</year><pub-id pub-id-type="doi">10.2174/1568009033481967</pub-id><pub-id pub-id-type="pmid">12769688</pub-id></element-citation></ref>
<ref id="b17-ol-0-0-7769"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ferreira</surname><given-names>CG</given-names></name><name><surname>Epping</surname><given-names>M</given-names></name><name><surname>Kruyt</surname><given-names>FA</given-names></name><name><surname>Giaccone</surname><given-names>G</given-names></name></person-group><article-title>Apoptosis: Target of cancer therapy</article-title><source>Clin Cancer Res</source><volume>8</volume><fpage>2024</fpage><lpage>2034</lpage><year>2002</year><pub-id pub-id-type="pmid">12114400</pub-id></element-citation></ref>
<ref id="b18-ol-0-0-7769"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Malaguarnera</surname><given-names>L</given-names></name></person-group><article-title>Implications of apoptosis regulators in tumorigenesis</article-title><source>Cancer Metastasis Rev</source><volume>23</volume><fpage>367</fpage><lpage>387</lpage><year>2004</year><pub-id pub-id-type="doi">10.1023/B:CANC.0000031774.32572.df</pub-id><pub-id pub-id-type="pmid">15197336</pub-id></element-citation></ref>
<ref id="b19-ol-0-0-7769"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ding</surname><given-names>H</given-names></name><name><surname>Han</surname><given-names>C</given-names></name><name><surname>Guo</surname><given-names>D</given-names></name><name><surname>Chin</surname><given-names>YW</given-names></name><name><surname>Ding</surname><given-names>Y</given-names></name><name><surname>Kinghorn</surname><given-names>AD</given-names></name><name><surname>D&#x0027;Ambrosio</surname><given-names>SM</given-names></name></person-group><article-title>Selective induction of apoptosis of human oral cancer cell lines by avocado extracts via a ROS-mediated mechanism</article-title><source>Nutr Cancer</source><volume>61</volume><fpage>348</fpage><lpage>356</lpage><year>2009</year><pub-id pub-id-type="doi">10.1080/01635580802567158</pub-id><pub-id pub-id-type="pmid">19373608</pub-id></element-citation></ref>
<ref id="b20-ol-0-0-7769"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Radhakrishnan</surname><given-names>P</given-names></name><name><surname>Baraneedharan</surname><given-names>U</given-names></name><name><surname>Veluchamy</surname><given-names>S</given-names></name><name><surname>Dhandapani</surname><given-names>M</given-names></name><name><surname>Pinto</surname><given-names>DD</given-names></name><name><surname>Thiyagarajan</surname><given-names>S</given-names></name><name><surname>Thayakumar</surname><given-names>A</given-names></name><name><surname>Prasath</surname><given-names>A</given-names></name><name><surname>K</surname><given-names>A</given-names></name><name><surname>Velu</surname><given-names>A</given-names></name><etal/></person-group><article-title>Inhibition of rapamycin-induced AKT activation elicits differential antitumor response in head and neck cancers</article-title><source>Cancer Res</source><volume>73</volume><fpage>1118</fpage><lpage>1127</lpage><year>2013</year><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-12-2545</pub-id><pub-id pub-id-type="pmid">23361299</pub-id></element-citation></ref>
<ref id="b21-ol-0-0-7769"><label>21</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Khursheed</surname><given-names>A</given-names></name><name><surname>Rather</surname><given-names>MA</given-names></name><name><surname>Rashid</surname><given-names>R</given-names></name></person-group><article-title>Plant-based natural compounds and herbal extracts as promising apoptotic agents: Their implications for cancer prevention and treatment</article-title><source>Bio Med Pharma</source><volume>3</volume><fpage>245</fpage><lpage>269</lpage><year>2016</year></element-citation></ref>
</ref-list>
</back>
<floats-group>
<fig id="f1-ol-0-0-7769" position="float">
<label>Figure 1.</label>
<caption><p>(A) structure of fucosterol (B) Effect of indicated doses fucosterol on HeLa cervical cancer cell line (C) Colony forming potential of HeLa cells at indicated doses (Magnification 100X). The experiments were carried out in triplicates and expressed as mean &#x00B1; SD and the values were considered significant at &#x002A;P&#x003C;0.01 vs. control, &#x002A;&#x002A;P&#x003C;0.001 vs. control, &#x002A;&#x002A;&#x002A;P&#x003C;0.0001 vs. control.</p></caption>
<graphic xlink:href="ol-15-03-3458-g00.tif"/>
</fig>
<fig id="f2-ol-0-0-7769" position="float">
<label>Figure 2.</label>
<caption><p>Induction of apoptosis by fucosterol at indicated doses as depicted by (A) DAPI staining (B) quantification of apoptotic cell populations (Magnification 200X). Experiments were carried out in triplicates and expressed as mean &#x00B1; SD and the values were considered significant at &#x002A;&#x002A;P&#x003C;0.001 vs. control and &#x002A;&#x002A;&#x002A;P&#x003C;0.0001 vs. control.</p></caption>
<graphic xlink:href="ol-15-03-3458-g01.tif"/>
</fig>
<fig id="f3-ol-0-0-7769" position="float">
<label>Figure 3.</label>
<caption><p>Effect of indicated doses fucosterol on (A) ROS generation and (B) Mitochondrial membrane potential. Experiments were carried out in triplicates and expressed as mean &#x00B1; SD and the values were considered significant at &#x002A;P&#x003C;0.01 vs. control, &#x002A;&#x002A;P&#x003C;0.001 vs. control, &#x002A;&#x002A;&#x002A;P&#x003C;0.0001 vs. control.</p></caption>
<graphic xlink:href="ol-15-03-3458-g02.tif"/>
</fig>
<fig id="f4-ol-0-0-7769" position="float">
<label>Figure 4.</label>
<caption><p>Effect of indicated doses of fucosterol on cell cycle arrest. The cells were treated with several doses of the drug and then analyzed by flow cytometry. Experiments were carried out in triplicates and expressed as mean &#x00B1; SD.</p></caption>
<graphic xlink:href="ol-15-03-3458-g03.tif"/>
</fig>
<fig id="f5-ol-0-0-7769" position="float">
<label>Figure 5.</label>
<caption><p>Cell migration inhibitory potential of fucosterol at IC<sub>50</sub> concentration (40 &#x00B5;M) in human cervical cancer cell (Magnification 100X). Experiments were carried out in triplicates and expressed as mean &#x00B1; SD and the values were considered significant at &#x002A;&#x002A;P&#x003C;0.001 vs. control.</p></caption>
<graphic xlink:href="ol-15-03-3458-g04.tif"/>
</fig>
<fig id="f6-ol-0-0-7769" position="float">
<label>Figure 6.</label>
<caption><p>Effect of indicated doses of fucosterol on protien expression of m-TOR/PI3K/Akt signalling pathway proteins. The experiments were carried out in triplicates by western blotting. The experiments were carried out in three biological replicates.</p></caption>
<graphic xlink:href="ol-15-03-3458-g05.tif"/>
</fig>
<table-wrap id="tI-ol-0-0-7769" position="float">
<label>Table I.</label>
<caption><p>IC<sub>50</sub> of fucosterol against different cancer cell lines as determined by MTT assay.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Cell line</th>
<th align="center" valign="bottom">IC<sub>50</sub> (&#x00B5;M)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Gastric cancer SNU-5</td>
<td align="center" valign="top">125</td>
</tr>
<tr>
<td align="left" valign="top">Lung cancer A-549</td>
<td align="center" valign="top">125</td>
</tr>
<tr>
<td align="left" valign="top">Cervical cancer HeLa</td>
<td align="center" valign="top">&#x00A0;&#x00A0;40</td>
</tr>
<tr>
<td align="left" valign="top">Prostate PC-3</td>
<td align="center" valign="top">125</td>
</tr>
<tr>
<td align="left" valign="top">Breast MCF-7</td>
<td align="center" valign="top">125</td>
</tr>
<tr>
<td align="left" valign="top">Pancreas MiaPaca-2</td>
<td align="center" valign="top">250</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</article>
