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<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">OR</journal-id>
<journal-title-group>
<journal-title>Oncology Reports</journal-title></journal-title-group>
<issn pub-type="ppub">1021-335X</issn>
<issn pub-type="epub">1791-2431</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/or.2012.2034</article-id>
<article-id pub-id-type="publisher-id">or-28-06-2049</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Anthocyanins in the black soybean (<italic>Glycine max</italic> L.) protect U2OS cells from apoptosis by inducing autophagy via the activation of adenosyl monophosphate-dependent protein kinase</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>CHOE</surname><given-names>YUN-JEONG</given-names></name><xref rid="af1-or-28-06-2049" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>HA</surname><given-names>TAE JOUNG</given-names></name><xref rid="af3-or-28-06-2049" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>KO</surname><given-names>KYOUNG-WON</given-names></name><xref rid="af1-or-28-06-2049" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>LEE</surname><given-names>SUN-YOUNG</given-names></name><xref rid="af1-or-28-06-2049" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>SHIN</surname><given-names>SEOK JOON</given-names></name><xref rid="af2-or-28-06-2049" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>KIM</surname><given-names>HO-SHIK</given-names></name><xref rid="af1-or-28-06-2049" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-or-28-06-2049"/></contrib></contrib-group>
<aff id="af1-or-28-06-2049">
<label>1</label>Department of Biochemistry, The Catholic University of Korea, Seoul 137-701</aff>
<aff id="af2-or-28-06-2049">
<label>2</label>Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701</aff>
<aff id="af3-or-28-06-2049">
<label>3</label>Department of Functional Crop, National Institute of Crop Science (NCIS), Rural Development Administration (RDA), Miryang 627-803, Republic of Korea</aff>
<author-notes>
<corresp id="c1-or-28-06-2049"><italic>Correspondence to:</italic> Professor Ho-Shik Kim, Department of Bio- chemistry, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Socho-gu, Seoul 137-701, Republic of Korea, E-mail: <email>hoshik@catholic.ac.kr</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>12</month>
<year>2012</year></pub-date>
<pub-date pub-type="epub">
<day>17</day>
<month>09</month>
<year>2012</year></pub-date>
<volume>28</volume>
<issue>6</issue>
<fpage>2049</fpage>
<lpage>2056</lpage>
<history>
<date date-type="received">
<day>21</day>
<month>06</month>
<year>2012</year></date>
<date date-type="accepted">
<day>23</day>
<month>07</month>
<year>2012</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2012, Spandidos Publications</copyright-statement>
<copyright-year>2012</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>Anthocyanins (ATCs) have been reported to induce apoptosis in various types of cancer cells, stimulating the development of ATCs as a cancer chemotherapeutic or chemopreventive agent. It was recently reported that ATCs can induce autophagy, however, the mechanism for this remains unclear. In the present report, we carried out mechanistic studies of the mechanism involved in ATC-induced autophagy using ATCs extracted from black soybeans (cv. Cheongja 3, <italic>Glycine max</italic> L.). ATCs clearly induced hallmarks of autophagy, including LC3 puncta formation and the conversion of LC3-I to LC3-II in U2OS human osteosarcoma cells. The induction of autophagy was accompanied by the phosphorylation of multiple protein kinases including extracellular signal-regulated kinase (ERK)1/2, p38 mitogen-activated protein kinase (MAPK), c-Jun N-terminal kinase (JNK), protein kinase B (AKT) and adenosyl monophosphate-dependent protein kinase (AMPK). While chemical inhibitors against ERK1/2, p38 MAPK, JNK and AKT failed to inhibit ATC-induced autophagy, the suppression of AMPK by compound C (CC) as well as siRNA against <italic>AMPK</italic> reduced ATC-induced autophagy. The treatment of ATCs resulted in a decrease in intracellular ATP contents and the activation of AMPK by AICAR treatment also induced autophagy. It is noteworthy that the reduction of autophagy via the inhibition of AMPK resulted in enhanced apoptosis in ATC-treated cells. In addition, siRNA against forkhead box O3A (<italic>FOXO3a</italic>), a downstream target of AMPK, suppressed ATC-induced autophagy and <italic>p27</italic><italic><sup>KIP1</sup></italic> siRNA increased apoptosis in ATC-treated cells. Collectively, it can be concluded that ATCs induce autophagy in U2OS cells via activation of the AMPK-FOXO3a pathway and protect cells from ATC-induced apoptosis via the AMPK-p27<sup>KIP1</sup> pathway. These results also suggest that autophagy-modulating agents could contribute to the efficient development of ATCs as anticancer therapy.</p></abstract>
<kwd-group>
<kwd>anthocyanins</kwd>
<kwd>adenosyl monophosphate-dependent protein kinase</kwd>
<kwd>autophagy</kwd>
<kwd>apoptosis</kwd>
<kwd>forkhead box O3A</kwd>
<kwd>p27<sup>KIP1</sup></kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Anthocyanins (ATCs) are natural phytochemicals which are produced by fruits and vegetables. ATCs have noteworthy biological functions, including anti-inflammatory and apoptosis-inducing effects. It has been reported that ATCs induce apoptosis in various cancer cell lines including hepatoma, colorectal carcinoma, gastric adenocarcinoma, leukemia and prostate cancer (<xref rid="b1-or-28-06-2049" ref-type="bibr">1</xref>&#x02013;<xref rid="b5-or-28-06-2049" ref-type="bibr">5</xref>). The ATC-induced apoptosis occurs via both caspase-dependent and -independent mechanisms. It has been demonstrated that ATCs initially induced an alteration of protein kinase B (AKT) and mitogen-activated protein kinases (MAPKs) such as p38 MAPK, extracellular signal-regulated kinase (ERK)1/2 and c-Jun N-terminal kinase (JNK), which led to the upregulation of the BAX/BCL2 ratio and hence the activation of intrinsic apoptosis in cancer cells (<xref rid="b1-or-28-06-2049" ref-type="bibr">1</xref>&#x02013;<xref rid="b4-or-28-06-2049" ref-type="bibr">4</xref>). However, in prostate cancer PC3 cells, ATCs induced caspase-independent apoptosis via the nuclear translocation of endonuclease G and AIF (<xref rid="b5-or-28-06-2049" ref-type="bibr">5</xref>). Regarding their anti-inflammatory activity, ATCs prevent the LPS- and UVB-induced expression of inflammatory mediators such as cyclooxygenase (COX)-2 and prostaglandin E2 (PGE<sub>2</sub>) by suppressing the nuclear factor of &#x003BA; light polypeptide gene enhancer in activated B cells (NF-&#x003BA;B) and phosphoinositide 3-kinase (PI3K)/AKT pathways in human keratinocytes and macrophage cell lines (<xref rid="b6-or-28-06-2049" ref-type="bibr">6</xref>,<xref rid="b7-or-28-06-2049" ref-type="bibr">7</xref>). This anti-inflammatory activity of ATCs was shown to be effective <italic>in vivo</italic> to subside circulatory and multiple organ failures due to endotoxemia (<xref rid="b8-or-28-06-2049" ref-type="bibr">8</xref>). Based on these apoptosis-inducing and anti-inflammatory as well as anti-invasive and anti-angiogenic effects (<xref rid="b9-or-28-06-2049" ref-type="bibr">9</xref>,<xref rid="b10-or-28-06-2049" ref-type="bibr">10</xref>), attempts have been made to develop ATCs as a chemopreventive agent, and promising results of pilot studies in rodent models of esophageal and colorectal cancers and human colorectal cancer patients have provided support for this hypothesis (<xref rid="b11-or-28-06-2049" ref-type="bibr">11</xref>,<xref rid="b12-or-28-06-2049" ref-type="bibr">12</xref>).</p>
<p>In addition to inducing apoptosis, it has been suggested that ATCs induce autophagy in cancer and glial cells (<xref rid="b13-or-28-06-2049" ref-type="bibr">13</xref>,<xref rid="b14-or-28-06-2049" ref-type="bibr">14</xref>), although the mechanism for this remains to be clarified. Autophagy is considered to be a cellular defense system that can protect cancer cells from anticancer therapeutics. Accordingly, autophagy inhibition augments ATC-induced apoptosis (<xref rid="b13-or-28-06-2049" ref-type="bibr">13</xref>). A more detailed understanding of the mechanism underlying ATC-induced autophagy could contribute to the development of effective strategies for the use of ATCs as a chemopreventive or chemotherapeutic agent against cancer in the future.</p>
<p>AMPK, which plays a central role in energy balance and metabolism, is one of the critical regulators of autophagy induction. AMPK becomes activated once it is phosphorylated by several kinases (<xref rid="b15-or-28-06-2049" ref-type="bibr">15</xref>,<xref rid="b16-or-28-06-2049" ref-type="bibr">16</xref>). Under metabolic stresses that restrain ATP synthesis, elevated AMP binds to the &#x003B3; subunit of AMPK for both allosteric activation of AMPK and prevention of the dephosphorylation of AMPK, leading to a sustained activity of AMPK. Allosterically activated AMPK is phosphorylated by liver kinase B1 (LKB1) at Thr172 of the &#x003B1; subunit to become fully activated. In response to elevated intracellular calcium levels and cytokine signaling, calmodulin-dependent protein kinase kinase (CaMKK) &#x003B2; and transforming growth factor-&#x003B2;-activated kinase 1 (TAK1), respectively, phosphorylate AMPK. Activated AMPK phosphorylates mTORC1, an inhibitor of autophagy, and a serine/threonine kinase with homology to yeast atg1 (ULK1), an initiator of autophagy, thereby leading to autophagy induction (<xref rid="b17-or-28-06-2049" ref-type="bibr">17</xref>,<xref rid="b18-or-28-06-2049" ref-type="bibr">18</xref>). P27<sup>KIP1</sup>, a CDK inhibitor, is directly phosphorylated at Thr198 and stabilized by AMPK for the induction of autophagy and, notably, the knockdown of p27<sup>KIP1</sup> in the presence of activated AMPK induced apoptosis instead of autophagy, an observation that explains the inhibitory effect of apoptosis by autophagy and the possibility that p27<sup>KIP1</sup> may mediate the decision between apoptosis and autophagy (<xref rid="b19-or-28-06-2049" ref-type="bibr">19</xref>). Forkhead box O3a (FOXO3a), an important regulator of glucose metabolism and tumor suppression, was reported to be phosphorylated by AMPK (<xref rid="b20-or-28-06-2049" ref-type="bibr">20</xref>). Recently, FOXO3a was shown to upregulate p27<sup>KIP1</sup> to induce cell cycle arrest in glioma cells (<xref rid="b21-or-28-06-2049" ref-type="bibr">21</xref>,<xref rid="b22-or-28-06-2049" ref-type="bibr">22</xref>). Therefore, it can be argued that under metabolic stress, autophagy formation can be induced through interactions among AMPK, FOXO3a, and p27<sup>KIP1</sup>.</p>
<p>ATC was recently reported to suppress IGF-I-induced mammalian target of rapamycin (mTOR) phosphorylation by AMPK activation in colon cancer cells, providing further support for its anticancer activity (<xref rid="b23-or-28-06-2049" ref-type="bibr">23</xref>). However, the relationship between autophagy and AMPK in ATC-treated cells is not yet fully understood. To address this issue, we used ATCs extracted from black soybeans (cv Cheongja 3). These ATC extracts were shown to promote apoptosis in a model of prostate hyperplasia <italic>in vivo</italic> and to induce autophagy in glial cells, which proved to contain biologically active components of autophagy induction as well as apoptosis (<xref rid="b14-or-28-06-2049" ref-type="bibr">14</xref>,<xref rid="b24-or-28-06-2049" ref-type="bibr">24</xref>). In the present study, we observed the induction of autophagy and AMPK activation by ATCs and analyzed the role of AMPK in this autophagy.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Chemicals</title>
<p>AICAR, compound C (CC), SP600125, SB203580, U0126, and triciribine were obtained from Sigma-Aldrich Corp. (St. Louis, MO, USA) or Merck (Darmstadt, Germany). All chemicals used are of molecular biology or cell culture grade.</p></sec>
<sec>
<title>Extraction of ATCs</title>
<p>ATCs were extracted from black seed coated soybean, Cheongja 3, developed by the National Institute of Crop Science, Rural Development Administration at Miryang, Korea, as previously described, with minor modifications (<xref rid="b25-or-28-06-2049" ref-type="bibr">25</xref>). Briefly, hand-peeled seed coats were extracted twice with 80&#x00025; ethanol containing 0.1&#x00025; acetic acid for 2 days at 4&#x000B0;C. These ethanol extracts were filtered through a 0.45-&#x003BC;m filter and concentrated in a rotary evaporator to obtain crude ATC extracts. The crude extracts were freeze-dried and kept below &#x02212;70&#x000B0;C.</p></sec>
<sec>
<title>Establishment of U2OS-GFP-LC3 cells</title>
<p>U2OS cells were cultured in high glucose DMEM (Invitrogen, Carlsbad, CA, USA) supplemented with 10&#x00025; heat-inactivated fetal bovine serum (FBS; Hyclone Laboratories Inc., Logan, UT, USA), 100 U/ml penicillin/streptomycin (Hyclone). Plasmid EGFP-LC3 was generously donated by Professor S.H. Lee at the Department of Pathology, the Catholic University of Korea. To establish stable cell lines expressing GFP-LC3, pEGFP-empty vector or pEGFP-LC3 was transfected into U2OS cells. Following the selection of transfected cells using G418 for 14 days, viable cells were pooled, and GFP expression was observed under a fluorescence microscope. Total cellular extracts were prepared and subjected to immunoblot analysis against GFP or LC3.</p></sec>
<sec>
<title>Immunoblot analysis</title>
<p>U2OS cells treated with ATCs with or without other chemicals as indicated were lysed with RIPA buffer (50 mM Tris-HCl, pH 7.4, 150 mM NaCl, 0.25&#x00025; Na-deoxycholate, 1&#x00025; NP-40, 1 mM EDTA) containing protease inhibitors (Roche Applied Sciences, Indianapolis, IN, USA). Total cellular proteins were separated by SDS-polyacrylamide gels and transferred to nitrocellulose membranes (Millipore, Billerica, MA, USA), which were hybridized with primary and then secondary antibodies. Finally, protein bands were detected by enhanced chemiluminescence (ECL; GE Healthcare, UK). Antibodies against phospho-AMPK-Thr172, phospho-p38 MAPK (T180/Y182), p38 MAPK, JNK, Erk1/2, phospho-Erk1/2 (T202/Y204), mTOR, and phospho-mTOR (S2448) were obtained from Cell Signaling Technology, Inc. (Danvers, MA, USA) and antibodies against phospho-JNK (Y185/Y223), AKT, phospho-AKT (S473), ACC, phospho-ACC (S79), and cleaved PARP were from Epitomics, Inc. (Burlingame, CA, USA). Antibodies against actin, &#x003B1;-tubulin, and GAPDH from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA, USA) and LC3 from Sigma-Aldrich Corp. were used.</p></sec>
<sec>
<title>Transfection of small interfering RNA</title>
<p>Small interfering RNA against <italic>AMPK&#x003B1;1</italic> (si<italic>AMPK</italic>) was purchased from Sigma-Aldrich Corp., and small interfering RNAs against <italic>p27</italic><italic><sup>KIP1</sup></italic> and <italic>FOXO3a</italic> were from Bioneer (Daejeon, Korea). Each siRNA was transfected into U2OS cells or U2OS-GFP-LC3 cells by the reverse transfection method using RNAiMAX reagent (Invitrogen) according to the manufacturer&apos;s protocol. The sequences of duplex siRNAs are as follows: si<italic>AMPK</italic>, 5&#x02032;-CCCAUAUUAUUUGCGUGUA(dTdT)::5&#x02032;-UACACGCAAAUAAUAUGGG(dTdT); si<italic>p27</italic><italic><sup>KIP1</sup></italic>, 5&#x02032;-CGA CGAUUCUUCUACUCAA(dTdT)::5&#x02032;-UUGAGUAGAAGA AUCGUCG(dTdT); si<italic>FOXO3a</italic>, 5&#x02032;-GACGAUGAUGCGCCU CUCU(dTdT)::5&#x02032;-AGAGAGGCGCAUCAUCGUC(dTdT).</p></sec>
<sec>
<title>Assessment of cell death</title>
<p>Cell death was examined by measuring sub-G1 cells and phosphatidylserine translocation. For measurement of sub-G1 cells, cells were fixed in ice-cold 70&#x00025; ethanol for 2 h at 4&#x000B0;C and stained with propidium iodide (PI; 0.2 mg/ml), followed by flow cytometric analysis (FACSCalibur, BD Bioscience, San Jose, CA, USA). To determine phosphatidylserine translocation, the cells stained with PI and annexin V using ApoScan Kit (BioBud, Gyunggi-do, Korea) were analyzed using a previously described method (<xref rid="b26-or-28-06-2049" ref-type="bibr">26</xref>).</p></sec>
<sec>
<title>Measurement of intracellular ATP levels</title>
<p>Intracellular ATP levels were measured using a CellTiter Glo Kit (Promega, Madison, WI, USA) following the manufacturer&apos;s instructions.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Statistical significances were evaluated using the one-way ANOVA test. The data represent three independent experiments performed in triplicate as the mean &#x000B1; SD.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>ATCs induce autophagy in U2OS cells</title>
<p>When human osteosarcoma U2OS cells were treated with ATCs, their growth was not inhibited in the first 24 h. However, after 24 h, ATCs suppressed the growth of U2OS cells associated with apoptosis (<xref rid="f1-or-28-06-2049" ref-type="fig">Fig. 1A and B</xref>), suggesting that ATCs activate the cell death program after 24 h in this cell line and autophagy may be induced before 24 h. To investigate this further, we examined the autophagy by ATCs before 24 h. For this end, we generated U2OS cells stably expressing GFP-LC3 (U2OS-GFP-LC3) and first observed LC3 puncta formation in these cells. When U2OS-GFP-LC3 cells were treated with ATCs for 6 h, it appeared that GFP-LC3 puncta were formed (<xref rid="f1-or-28-06-2049" ref-type="fig">Fig. 1C</xref>). Consistent with LC3 foci formation, the conversion of LC3-I to LC3-II occurred in both U2OS (<xref rid="f1-or-28-06-2049" ref-type="fig">Fig. 1D</xref>) and U2OS-GFP-LC3 cells (data not shown) in a dose-dependent manner, reaching a plateau level at concentrations of ATCs above 200 &#x003BC;g/ml of ATCs. These findings demonstrated that ATCs induced autophagy in U2OS cells prior to the activation of apoptosis.</p></sec>
<sec>
<title>ATC-induced autophagy is not prevented by inhibitors of MAPKs or AKT</title>
<p>To identify the signal transduction pathway leading to autophagy in ATC-treated cells, we investigated the phosphorylation of signal transduction proteins which have been reported to be involved in ATC-induced apoptosis. As shown in <xref rid="f2-or-28-06-2049" ref-type="fig">Fig. 2A</xref>, the phosphorylation of ERK1/2, p38 MAPK, JNK, and AKT was increased by ATC treatment, suggesting that they are involved in this autophagy. However, neither the formation of GFP-LC3 puncta nor LC3-I conversion to LC3-II was prevented by any of the chemical inhibitors of AKT (Triciribine, Tri), MEK (U0126, U), p38 MAPK (SB203580, SB), and JNK (SP600125, SP) (<xref rid="f2-or-28-06-2049" ref-type="fig">Fig. 2B</xref>). These findings led us to speculate that pathways other than AKT and MAPKs including p38 MAPK, ERK, and JNK may contribute to the induction of autophagy by ATCs.</p></sec>
<sec>
<title>ATC-induced autophagy is prevented by AMPK inhibition</title>
<p>We then explored the activation of AMPK in ATC-treated cells. While the phosphorylation of mTOR was decreased, the phosphorylation of both AMPK&#x003B1;1 and its substrate, acetyl CoA carboxylase (ACC) increased according to concentrations of ATCs, indicating that AMPK is activated in this autophagy (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3A</xref>). Pretreatment with CC, an inhibitor of AMPK, reduced both the GFP-LC3 puncta formation (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3B</xref>) and the conversion of LC3-I to LC3-II (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3C</xref>). Consistent with the effect of CC, the knockdown of AMPK&#x003B1;1 using siRNA against <italic>AMPK&#x003B1;1</italic> also suppressed the conversion of LC3-I to LC3-II (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3D</xref>). Furthermore, ATCs diminished intracellular ATP levels (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3E</xref>) and AICAR, an analog of AMP, also induced autophagy in U2OS cells (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3F</xref>). Collectively, these findings suggest that ATC-induced autophagy is dependent on AMPK activation which may be due to the depletion of ATP.</p></sec>
<sec>
<title>AMPK inhibition enhances ATC-induced apoptosis</title>
<p>Based on the report that autophagy inhibition augmented the ATC-induced apoptosis in hepatocellular carcinoma cells (<xref rid="b13-or-28-06-2049" ref-type="bibr">13</xref>), we analyzed the effect of AMPK on apoptosis in ATC-treated U2OS cells. As shown in <xref rid="f4-or-28-06-2049" ref-type="fig">Fig. 4</xref>, while ATCs induced a subtle apoptosis at 6 h in U2OS cells that had been transfected with control siRNA, ATCs dramatically induced apoptotic features such as accumulation of hypo-diploidic cells (<xref rid="f4-or-28-06-2049" ref-type="fig">Fig. 4A</xref>) and poly(ADP-ribose) polymerase-1 (PARP) cleavage (<xref rid="f4-or-28-06-2049" ref-type="fig">Fig. 4B</xref>) in <italic>AMPK&#x003B1;1</italic> siRNA-transfected U2OS cells. Thus, these data suggest that ATC-activated AMPK protects U2OS cells from apoptosis.</p></sec>
<sec>
<title>Differential effects of p27<sup>KIP1</sup> and FOXO3a on ATC-induced autophagy</title>
<p>To investigate the downstream targets of AMPK that play a role in the induction of autophagy, we attempted the transfection of siRNAs against <italic>ULK1</italic>, p27<sup>KIP1</sup>, and <italic>FOXO3a</italic> which have been demonstrated to be autophagy modulators under AMPK. The knockdown of ULK1 by <italic>ULK1</italic> siRNA did not exert an inhibitory effect on either ATC-induced autophagy or apoptosis, ruling out the involvement of ULK1 in this autophagy (data not shown). As shown in <xref rid="f5-or-28-06-2049" ref-type="fig">Fig. 5</xref>, both ATC-induced LC3 puncta formation (<xref rid="f5-or-28-06-2049" ref-type="fig">Fig. 5A</xref>) and the conversion of LC3-I to LC3-II (<xref rid="f5-or-28-06-2049" ref-type="fig">Fig. 5B</xref>) were reduced, but ATC-induced PARP cleavage was not altered by FOXO3a knockdown, suggesting that FOXO3a may be responsible for the induction of autophagy induction under active AMPK. In contrast to the effect of <italic>FOXO3a</italic> siRNA, <italic>p27</italic><italic><sup>KIP1</sup></italic> siRNA potentiated ATC-induced PARP cleavage but had no effect on LC3-II levels (<xref rid="f5-or-28-06-2049" ref-type="fig">Fig. 5C</xref>), suggesting that p27<sup>KIP1</sup> may inhibit ATC-induced apoptosis, but has no effect on autophagy. Thus, it can be suggested that AMPK activated by ATCs may induce autophagy via FOXO3a and inhibit apoptosis via p27<sup>KIP1</sup>.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>The findings reported herein indicate that ATCs induce autophagy in human osteosarcoma U2OS cells, accompanied by the activation of MAPKs and AMPK. By analyzing the effects of chemical inhibitors and siRNAs against MAPKs and AMPK on ATC-induced autophagy, the findings suggest that AMPK plays a critical role in this autophagy. However, how ATCs specifically activate AMPK, remains unknown. It has been reported that phytochemicals such as galegine, berberine, as well as resveratrol activate AMPK in an AMP-dependent manner (<xref rid="b27-or-28-06-2049" ref-type="bibr">27</xref>). ATCs also reduced ATP levels in this cell line and AICAR, an analog of AMP, induced autophagy (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3E and F</xref>), indicating that AMP/LKB1-dependent AMPK activation results from ATC treatment. However, LKB1 was not phosphorylated by ATCs and AMPK was still phosphorylated in U2OS cells that had been transfected with LKB1 siRNA (data not shown). In addition, ATC-induced AMPK phosphorylation was not altered by BAPTA-AM, a calcium chelator, <italic>CaMKK</italic> siRNA, <italic>TAK1</italic> siRNA or ROS scavengers (data not shown). Collectively, it can be assumed that ATCs may enrich intracellular AMP levels which induce the allosteric activation of AMPK without the action of LKB1 or inhibit the dephosphorylation of AMPK that was phosphorylated by unidentified enzymes other than LKB1. However, as it is known that the allosteric activation of AMPK by AMP is induced in AMPK phosphorylated by basal LKB1 activity, this assumption leaves many questions to be resolved. Considering the numerous studies reporting that AMPK-activating compounds including phytochemicals inhibit mitochondrial respiratory complexes to reduce synthesis of ATP, we speculate that ATCs might contain two major features for activating AMPK: one is to reduce ATP synthesis possibly via the inhibition of mitochondrial respiratory complexes and the other is to induce the basal phosphorylation of AMPK or the allosteric activation of AMPK in conjunction with AMP even in the absence of LKB1 activity.</p>
<p>A recent study showed that AMPK phosphorylates ULK1 to initiate autophagy (<xref rid="b18-or-28-06-2049" ref-type="bibr">18</xref>). In the present model, ATC-induced AMPK phosphorylation was accompanied by the dephosphorylation of mTOR (<xref rid="f3-or-28-06-2049" ref-type="fig">Fig. 3</xref>) and rapamycin, an inhibitor of mTOR, induced autophagy (data not shown). Moreover, ATCs induced autophagy in ULK1-knocked down cells to a comparable extent as in control siRNA-transfected U2OS cells (data not shown), suggesting that AMPK-induced mTORC1 inhibition may play a more important role in ATC-induced autophagy than does ULK1 activation. In addition to the mTOR and ULK1 pathways, AMPK modulates downstream target proteins such as p27<sup>KIP1</sup> and FOXO3a to induce autophagy. P27<sup>KIP1</sup>, an inhibitor of CDK1, which can be phosphorylated by AMPK and can be induced transcriptionally by FOXO3a as well, was reported to induce autophagy but inhibit apoptosis (<xref rid="b19-or-28-06-2049" ref-type="bibr">19</xref>), suggesting that it is a strong molecular target of ATC-activated AMPK. Different from these reports, in our model, it appeared that p27<sup>KIP1</sup> inhibited apoptosis but was not involved in autophagy, whereas FOXO3a contributed to the induction of autophagy but not apoptosis. Therefore, it can be concluded that AMPK activated by ATC-inhibited ATP synthesis induces autophagy by activating FOXO3a while suppressing mTORC1, and inhibits ATC-induced apoptosis via the upregulation of p27<sup>KIP1</sup>, as summarized in <xref rid="f6-or-28-06-2049" ref-type="fig">Fig. 6</xref>. To verify this, however, the mechanism by which p27<sup>KIP1</sup> and FOXO3a are regulated by ATCs remains to be clarified. As shown in <xref rid="f5-or-28-06-2049" ref-type="fig">Fig. 5C-E</xref>, p27<sup>KIP1</sup> protein levels were upregulated by ATC treatment, which returned to basal levels in U2OS cells that had been pretreated with compound C (CC) or transfected with <italic>AMPK&#x003B1;1</italic> siRNA before ATC treatment, suggesting that p27<sup>KIP1</sup> may be stabilized by active AMPK. In contrast to p27<sup>KIP1</sup>, FOXO3a protein levels were not consistently altered by ATCs and the phosphorylation of FOXO3a-Ser413, a site known to be phosphorylated by AMPK, was not detected either (data not shown), suggesting that the phosphorylation of Ser or Thr residues other than Ser413 by AMPK or an indirect effect of AMPK on FOXO3a induces autophagy.</p>
<p>The role of AMPK in cancer cells is known to be varied. AMPK can activate p53 by phosphorylating p53-Ser15 to induce cell cycle arrest and apoptosis (<xref rid="b28-or-28-06-2049" ref-type="bibr">28</xref>,<xref rid="b29-or-28-06-2049" ref-type="bibr">29</xref>). For example, a combined treatment with metformin and 2-deoxyguanosine, as well as vincristine, an anticancer agent, induced apoptosis in prostate and melanoma cells, respectively, by activating AMPK (<xref rid="b30-or-28-06-2049" ref-type="bibr">30</xref>,<xref rid="b31-or-28-06-2049" ref-type="bibr">31</xref>). Contrary to these reports, AMPK inhibition resulted in the sensitization of cancer cells to apoptosis by anticancer drugs such as cisplatin as well as metabolic stress such as hypoxia (<xref rid="b32-or-28-06-2049" ref-type="bibr">32</xref>,<xref rid="b33-or-28-06-2049" ref-type="bibr">33</xref>). This variable effect of AMPK on cell death may be due to both types of stresses and cellular context. It was recently reported that autophagy inhibition can enhance the cytotoxicity of ATCs in hepatoma cells (<xref rid="b13-or-28-06-2049" ref-type="bibr">13</xref>), which may be consistent with the data in our study showing that AMPK and p27<sup>KIP1</sup> siRNAs enhanced ATC-induced apoptosis (<xref rid="f4-or-28-06-2049" ref-type="fig">Figs. 4</xref> and <xref rid="f5-or-28-06-2049" ref-type="fig">5C</xref>). Therefore, AMPK activation by ATCs may contribute to the cancer cell survival via the induction of autophagy.</p>
<p>In non-transformed cells, autophagy serves to preserve genomic integrity, thereby preventing malignant transformations (<xref rid="b34-or-28-06-2049" ref-type="bibr">34</xref>). This autophagy-inducing activity of ATCs could explain the chemopreventive effect of ATCs reported in the esophagus and the colon (<xref rid="b11-or-28-06-2049" ref-type="bibr">11</xref>,<xref rid="b12-or-28-06-2049" ref-type="bibr">12</xref>), although the autophagy-inducing activity of ATCs in non-transformed cells remains to be determined. A metabolic shift to aerobic glycolysis has generally been regarded as a driving force for carcinogenesis (<xref rid="b35-or-28-06-2049" ref-type="bibr">35</xref>,<xref rid="b36-or-28-06-2049" ref-type="bibr">36</xref>), and dysregulated metabolic homeostasis and obesity have been reported to increase the risk of certain types of cancer, such as breast cancer (<xref rid="b37-or-28-06-2049" ref-type="bibr">37</xref>). Since AMPK is a central regulator of metabolism and preserves metabolic homeostasis, AMPK could prevent cancer formation under conditions of metabolic distress. Consistent with this assumption, metformin was reported to inhibit the formation of pre-neoplastic lesions in the colon and showed chemopreventive activity against breast cancer associated with obesity (<xref rid="b38-or-28-06-2049" ref-type="bibr">38</xref>). Therefore, even if ATCs do not induce autophagy in non-transformed cells, only the AMPK-activating effect of ATCs could contribute to chemopreventive effects against cancer.</p>
<p>Autophagy can prevent the induction of apoptosis and, instead, initiate necrotic cell death in cancer cells <italic>in vivo</italic>, accompanied by an inflammatory response, which can contribute to the invasion and metastasis of cancer cells (<xref rid="b39-or-28-06-2049" ref-type="bibr">39</xref>,<xref rid="b40-or-28-06-2049" ref-type="bibr">40</xref>). This autophagy-inducing activity of ATCs could dampen the anticancer effect of ATCs, thereby constituting a negative feedback loop of ATC-induced apoptosis.</p>
<p>Collectively, it could be concluded that while ATCs may activate AMPK and, thus, prevent carcinogenesis in non-transformed cells by activating autophagy and preserving metabolic homeostasis, autophagy in cancer cells may diminish the apoptosis-inducing activity of ATCs. Therefore, to develop ATCs for use as efficient anticancer therapy or as a chemopreventive agent against cancer, the mechanism underlying the autophagy-inducing activity of ATCs as well as ATC-induced apoptosis needs to be thoroughly examined to determine whether it is possible to modulate genes to enhance the anticancer effects of ATCs.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>This study was supported by the Biogreen 21 Program (code no. PJ007186), Rural Development Administration Korea. Part of this study was also supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011&#x02013;0027115).</p></ack>
<glossary>
<title>Abbreviations</title>
<def-list>
<def-item>
<term id="G1">AKT</term>
<def>
<p>protein kinase B</p></def></def-item>
<def-item>
<term id="G2">AMPK</term>
<def>
<p>adenosyl monophosphate-dependent protein kinase</p></def></def-item>
<def-item>
<term id="G3">ATCs</term>
<def>
<p>anthocyanins</p></def></def-item>
<def-item>
<term id="G4">CaMKK</term>
<def>
<p>calmodulin-dependent protein kinase kinase</p></def></def-item>
<def-item>
<term id="G5">CC</term>
<def>
<p>compound C</p></def></def-item>
<def-item>
<term id="G6">COX</term>
<def>
<p>cyclooxygenase</p></def></def-item>
<def-item>
<term id="G7">ERK</term>
<def>
<p>extracellular signal-regulated kinase</p></def></def-item>
<def-item>
<term id="G8">FOXO3a</term>
<def>
<p>forkhead box O3A</p></def></def-item>
<def-item>
<term id="G9">JNK</term>
<def>
<p>c-Jun N-terminal kinase</p></def></def-item>
<def-item>
<term id="G10">LC3</term>
<def>
<p>light chain 3</p></def></def-item>
<def-item>
<term id="G11">LKB1</term>
<def>
<p>liver kinase B1</p></def></def-item>
<def-item>
<term id="G12">MAPK</term>
<def>
<p>mitogen-activated protein kinase</p></def></def-item>
<def-item>
<term id="G13">mTOR</term>
<def>
<p>mammalian target of rapamycin</p></def></def-item>
<def-item>
<term id="G14">NF-&#x003BA;B</term>
<def>
<p>nuclear factor of &#x003BA; light polypeptide gene enhancer in activated B cells</p></def></def-item>
<def-item>
<term id="G15">PGE<sub>2</sub></term>
<def>
<p>prostaglandin E2</p></def></def-item>
<def-item>
<term id="G16">PI3K</term>
<def>
<p>phosphoinositide 3-kinase</p></def></def-item>
<def-item>
<term id="G17">TAK1</term>
<def>
<p>transforming growth factor-&#x003B2;-activated kinase 1</p></def></def-item>
<def-item>
<term id="G18">ULK1</term>
<def>
<p>a serine/threonine kinase with homology to yeast atg1</p></def></def-item></def-list></glossary>
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<floats-group>
<fig id="f1-or-28-06-2049" position="float">
<label>Figure 1</label>
<caption>
<p>Induction of autophagy by ATCs. (A) U2OS cells were treated with the indicated concentrations of ATCs. After 24 and 48 h, MTT assays were performed and the data are presented as the relative cell survival (&#x00025;). (B) U2OS cells treated by ATCs at the indicated concentrations for 48 h were subjected to Annexin V/PI staining followed by flow cytometric analysis. (C) After U2OS-GFP-LC3 cells were treated with the indicated concentrations of ATCs for 6 h, the cells were observed under a fluorescence microscope at a magnification &#x000D7;40. (D) U2OS cells treated the same as described in (C) were subjected to immunoblot analysis against LC3. Actin was used for the equal loading of proteins.</p></caption>
<graphic xlink:href="OR-28-06-2049-g00.gif"/></fig>
<fig id="f2-or-28-06-2049" position="float">
<label>Figure 2</label>
<caption>
<p>Activation of multiple protein kinases by ATCs. (A) Total cell lysates of U2OS cells treated with the indicated concentrations of ATCs were subjected to immunoblot analysis against the indicated proteins. (B) U2OS-GFP-LC3 (upper panel) or U2OS (lower panel) cells were pretreated with 20 &#x003BC;M of each inhibitor against protein kinases for 1 h and incubated in the absence or presence of ATCs (200 &#x003BC;g/ml) for 6 h. Cells were observed under a fluorescence microscope at a magnification &#x000D7;100 (upper panel) and total cell lysates were subjected to immunoblot analysis against LC3 (lower panel). Actin was used for the equal loading of proteins. Tri, triciribine; U, U0126; SB, SB203580; SP, SP600125.</p></caption>
<graphic xlink:href="OR-28-06-2049-g01.gif"/></fig>
<fig id="f3-or-28-06-2049" position="float">
<label>Figure 3</label>
<caption>
<p>Prevention of ATC-induced autophagy by AMPK inhibition. (A) Lysates of U2OS cells incubated with the indicated concentrations of ATCs for 6 h were subjected to immunoblot analysis against the indicated proteins. (B) U2OS-GFP-LC3 or (C) U2OS cells pretreated with vehicle or CC (5 &#x003BC;M) were incubated in the absence or presence of ATCs (200 &#x003BC;g/ml). After 6 h, (B) cells were observed under a fluorescence microscope at a magnification &#x000D7;40 and (C) U2OS cell lysates were subjected to immunoblot analysis against LC3. (D) U2OS cells transfected with scrambled (control) siRNA or AMPK siRNA for 48 h, were incubated in the presence or absence of ATCs (200 &#x003BC;g/ml) for a further 6 h. Immunoblot analyses against the indicated proteins were performed. (E) Intracellular ATP levels were measured in U2OS cells treated in triplicate with vehicle or ATCs (200 &#x003BC;g/ml) for 6 h. The values represents the mean &#x000B1; SD of three independent experiments. (F) U2OS cells treated with the indicated concentrations of AICAR for 24 h were subjected to immunoblot analysis against LC3. Actin was used for the equal loading of proteins.</p></caption>
<graphic xlink:href="OR-28-06-2049-g02.gif"/></fig>
<fig id="f4-or-28-06-2049" position="float">
<label>Figure 4</label>
<caption>
<p>Increase of ATC-induced apoptosis by AMPK-knockdown. U2OS cells transfected by siRNA against <italic>AMPK&#x003B1;1</italic> or scrambled siRNA as a negative control for 48 h were incubated in the absence or presence of ATCs (200 &#x003BC;g/ml) for a further 6 h. Cells were then processed for (A) cell cycle analysis using FACSCalibur, and for (B) immunoblot analysis against cleaved poly(ADP-ribose) polymerase-1 (p25, C-PARP). GAPDH was used as a control.</p></caption>
<graphic xlink:href="OR-28-06-2049-g03.gif"/></fig>
<fig id="f5-or-28-06-2049" position="float">
<label>Figure 5</label>
<caption>
<p>The effect of siRNA against <italic>FOXO3a</italic> or <italic>p27</italic><italic><sup>KIP1</sup></italic> on the ATC-induced autophagy. U2OS-GFP-LC3 or U2OS cells transfected by siRNA against scrambled (control) siRNA or <italic>FOXO3a</italic> for 48 h were incubated with ATCs (200 &#x003BC;g/ml) for a further 6 h. (A) U2OS-GFP-LC3 cells were then observed under a fluorescence microscope at a magnification &#x000D7;100. (B) U2OS cells were then subjected to immunoblot analysis. (C) U2OS cells transfected by scrambled (control) siRNA or <italic>p27</italic><italic><sup>KIP</sup></italic> siRNA for 48 h were incubated with ATCs for a further 6 h. Cells were then subjected to immunoblot analyses. (D) U2OS cells pretreated with CC (5 &#x003BC;M) for 1 h were incubated in the presence of vehicle or ATCs (200 &#x003BC;g/ml) for a further 6 h, followed by immunoblot analyses. (E) U2OS cells transfected with scrambled (control) siRNA or <italic>AMPK&#x003B1;1</italic> siRNA for 48 h were treated with vehicle or ATCs (200 &#x003BC;g/ml) for a further 6 h, followed by immunoblot analyses. GAPDH was used for the equal loading of proteins. C-PARP, p25 cleaved-poly(ADP-ribose) polymerase-1.</p></caption>
<graphic xlink:href="OR-28-06-2049-g04.gif"/></fig>
<fig id="f6-or-28-06-2049" position="float">
<label>Figure 6</label>
<caption>
<p>Schematic diagram representing the proposed mechanism of ATC-induced autophagy in U2OS cells.</p></caption>
<graphic xlink:href="OR-28-06-2049-g05.gif"/></fig></floats-group></article>
