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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.2014.3084</article-id>
<article-id pub-id-type="publisher-id">or-31-05-2413</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Anti-apoptotic effect of caspase inhibitors on H<sub>2</sub>O<sub>2</sub>-treated HeLa cells through early suppression of its oxidative stress</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>PARK</surname><given-names>WOO HYUN</given-names></name><xref ref-type="corresp" rid="c1-or-31-05-2413"/></contrib>
<aff id="af1-or-31-05-2413">Department of Physiology, Medical School, Research Institute for Endocrine Sciences, Chonbuk National University, Jeonju 561-180, Republic of Korea</aff></contrib-group>
<author-notes>
<corresp id="c1-or-31-05-2413">Correspondence to: Professor Woo Hyun Park, Department of Physiology, Medical School, Chonbuk National University, Jeonju 561-180, Republic of Korea, E-mail: <email>parkwh71@chonbuk.ac.kr</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>5</month>
<year>2014</year></pub-date>
<pub-date pub-type="epub">
<day>12</day>
<month>03</month>
<year>2014</year></pub-date>
<volume>31</volume>
<issue>5</issue>
<fpage>2413</fpage>
<lpage>2421</lpage>
<history>
<date date-type="received">
<day>08</day>
<month>01</month>
<year>2014</year></date>
<date date-type="accepted">
<day>20</day>
<month>02</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2014, Spandidos Publications</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p></license></permissions>
<abstract>
<p>Oxidative stress-induced cytotoxicity in cervical cancer cells may be of toxicological interest. In the present study, the effects of exogenous H<sub>2</sub>O<sub>2</sub> on cell growth and death in HeLa cervical cancer cells were investigated, and the anti-apoptotic effects of various caspase (pan-caspase, caspase-3, -8 or -9) inhibitors on H<sub>2</sub>O<sub>2</sub>-treated HeLa cells were also evaluated with regard to reactive oxygen species (ROS) and glutathione (GSH) levels. Based on MTT assays, H<sub>2</sub>O<sub>2</sub> inhibited the growth of HeLa cells with an IC<sub>50</sub> value of ~75 &#x003BC;M at 24 h. H<sub>2</sub>O<sub>2</sub> increased the number of dead cells and Annexin V-FITC-positive cells in the HeLa cells, which was accompanied by the activation of caspase-3 and the loss of mitochondrial membrane potential (MMP; &#x00394;&#x003A8;<sub>m</sub>). However, relatively higher doses of H<sub>2</sub>O<sub>2</sub> induced necrosis in HeLa cells. Caspase inhibitors significantly prevented H<sub>2</sub>O<sub>2</sub>-induced HeLa cell death. H<sub>2</sub>O<sub>2</sub> increased ROS including O<sub>2</sub><sup>&#x02022;&#x02212;</sup> at 24 h and increased the activity of catalase in HeLa cells. H<sub>2</sub>O<sub>2</sub> also increased the ROS level at 1 h, and several caspase inhibitors attenuated the increased level at 1 h but not at 6, 12 and 24 h. H<sub>2</sub>O<sub>2</sub> decreased the GSH level in HeLa cells at 1 h, and several caspase inhibitors attenuated the decreased level of GSH at this time. H<sub>2</sub>O<sub>2</sub> induced GSH depletion at 24 h. In conclusion, H<sub>2</sub>O<sub>2</sub> inhibited the growth of HeLa cells via apoptosis and/or necrosis, which was accompanied by intracellular increases in ROS levels and GSH depletion. Caspase inhibitors are suggested to suppress H<sub>2</sub>O<sub>2</sub>-induced oxidative stress to rescue HeLa cells at the early time point of 1 h.</p></abstract>
<kwd-group>
<kwd>HeLa cells</kwd>
<kwd>H<sub>2</sub>O<sub>2</sub></kwd>
<kwd>caspase inhibitors</kwd>
<kwd>cell death</kwd>
<kwd>reactive oxygen species</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Reactive oxygen species (ROS) are a group of oxygen moieties, which include hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>), the superoxide anion (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) and the hydroxyl radical (<sup>&#x02022;</sup>OH). Conventional theory has regarded ROS as deleterious or harmful to cells (<xref rid="b1-or-31-05-2413" ref-type="bibr">1</xref>). However, it has become clear that ROS delicately regulate many cellular functions such as gene expression, differentiation and cell proliferation (<xref rid="b2-or-31-05-2413" ref-type="bibr">2</xref>). They can also act as second messengers, influencing discrete signal transduction pathways in a variety of systems (<xref rid="b3-or-31-05-2413" ref-type="bibr">3</xref>,<xref rid="b4-or-31-05-2413" ref-type="bibr">4</xref>). ROS are continuously generated by the respiratory chain during oxidative phosphorylation in the form of the O<sub>2</sub><sup>&#x02022;&#x02212;</sup> and/or are specifically produced by oxidases such as nicotine adenine diphosphate oxidase and xanthine oxidase (<xref rid="b5-or-31-05-2413" ref-type="bibr">5</xref>). O<sub>2</sub><sup>&#x02022;&#x02212;</sup> is metabolized to H<sub>2</sub>O<sub>2</sub> by superoxide dismutases (SODs) (<xref rid="b6-or-31-05-2413" ref-type="bibr">6</xref>). Moreover, H<sub>2</sub>O<sub>2</sub> by catalase or glutathione (GSH) peroxidase yields O<sub>2</sub> and H<sub>2</sub>O (<xref rid="b7-or-31-05-2413" ref-type="bibr">7</xref>). Since a change in the redox state of a tissue implies an alteration in ROS generation or metabolism, cellular ROS are tightly regulated to prevent tissue damage. Oxidative stress may be the consequence of either overproduction of ROS and/or downregulation of antioxidants; this stress is believed to be responsible for a variety of pathological conditions such as inflammation, cardiovascular disease and cancer (<xref rid="b8-or-31-05-2413" ref-type="bibr">8</xref>&#x02013;<xref rid="b11-or-31-05-2413" ref-type="bibr">11</xref>).</p>
<p>Compared with other members of ROS, H<sub>2</sub>O<sub>2</sub> plays a pivotal role since it is able to freely travel through biological membranes to a distance of several cell diameters and interacts with ferrous iron (Fenton chemistry) causing the formation of the very aggressive and short-lived <sup>&#x02022;</sup>OH. Tissue concentrations of H<sub>2</sub>O<sub>2</sub> for the period of inflammation have been likely to reach close to millimolar levels whereas tiny amounts of H<sub>2</sub>O<sub>2</sub> generated by NADPH oxidase are assumed to take action only in microenvironments of the plasma membrane such as lipid rafts (<xref rid="b12-or-31-05-2413" ref-type="bibr">12</xref>,<xref rid="b13-or-31-05-2413" ref-type="bibr">13</xref>). Nevertheless, in both cases, H<sub>2</sub>O<sub>2</sub> may amend essential cellular functions of cell growth, proliferation and differentiation via altering signaling cascades and gene expression, or its higher level may lead to outcomes such as apoptosis or necrosis. Exogenous H<sub>2</sub>O<sub>2</sub> is often applied as the representative ROS in modeling oxidative stress in the cell and tissue.</p>
<p>The mechanism of apoptosis generally involves two signaling pathways, the mitochondrial pathway and the cell death receptor pathway (<xref rid="b14-or-31-05-2413" ref-type="bibr">14</xref>&#x02013;<xref rid="b16-or-31-05-2413" ref-type="bibr">16</xref>). The key constituent in the mitochondrial pathway is the efflux of cytochrome <italic>c</italic> from mitochondria to the cytosol, where it subsequently forms a complex (apoptosome) with Apaf-1 and caspase-9, activating other caspases including caspase-3 and -7 (<xref rid="b17-or-31-05-2413" ref-type="bibr">17</xref>). The cell death receptor pathway is characterized by binding cell death ligands such as TNF&#x003B1; and Fas and their cell death receptors, and subsequently activates caspase-8 and -3 (<xref rid="b18-or-31-05-2413" ref-type="bibr">18</xref>,<xref rid="b19-or-31-05-2413" ref-type="bibr">19</xref>). Particularly, cytosolic BID is cleaved by caspase-8 to generate a truncated product (tBID), which translocates to the mitochondria and decreases mitochondrial membrane potential (MMP; &#x00394;&#x003A8;<sub>m</sub>) resulting in release of cytochrome <italic>c</italic>. Therefore, crosstalk between both apoptotic pathways is manifested by the tBID. Caspase-3 is an executioner caspase, whose activation can systematically dismantle cells by cleaving key proteins such as poly(ADP-ribose) polymerase (PARP).</p>
<p>Cervical cancer is a major cause of cancer-related death in women worldwide, and the occurrence of this cancer is ascribed to changes in cancer-related genes as well as environmental events including viral infections. The carcinogenesis of cervical cancer has been known to be tightly linked to tissue inflammation mediated by ROS. Moreover, ROS influence genetic and epigenetic changes thereby modulating cellular proliferation and differentiation (<xref rid="b11-or-31-05-2413" ref-type="bibr">11</xref>). H<sub>2</sub>O<sub>2</sub>-induced cytotoxicity in cervical cancer cells may be of toxicological research interest. Thus, in the present study, the effects of exogenous H<sub>2</sub>O<sub>2</sub> on cell growth and death in human cervix adenocarcinoma HeLa cells were investigated and the anti-apoptotic effects of various caspase (pan-caspase, caspase-3, -8 or -9) inhibitors on H<sub>2</sub>O<sub>2</sub>-treated HeLa cells were evaluated in relation to changes in ROS and GSH levels.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Cell culture</title>
<p>Human cervical adenocarcinoma HeLa cells were obtained from the American Type Culture Collection (ATCC; Manassas, VA, USA) and maintained in a humidified incubator containing 5&#x00025; CO<sub>2</sub> at 37&#x000B0;C. HeLa cells were cultured in RPMI-1640 supplemented with 10&#x00025; fetal bovine serum (FBS) (both from Sigma-Aldrich Chemical Co., St. Louis, MO, USA) and 1&#x00025; penicillin-streptomycin (Gibco-BRL, Grand Island, NY, USA). Cells were routinely grown in 100-mm plastic tissue culture dishes (Nunc, Roskilde, Denmark) and harvested with a solution of trypsin-EDTA while in a logarithmic phase of growth.</p></sec>
<sec>
<title>Reagents</title>
<p>H<sub>2</sub>O<sub>2</sub> was purchased from Sigma-Aldrich Chemical Co. The pan-caspase inhibitor (Z-VAD-FMK; benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone), caspase-3 inhibitor (Z-DEVD-FMK; benzyloxycarbonyl-Asp-Glu-Val-Asp-fluoromethylketone), caspase-8 inhibitor (Z-IETD-FMK; benzyloxycarbonyl-Ile-Glu-Thr-Asp-fluoromethylketone) and caspase-9 inhibitor (Z-LEHD-FMK; benzyloxycarbonyl-Leu-Glu-His-Asp-fluoromethylketone) were obtained from R&amp;D Systems, Inc. (Minneapolis, MN, USA) and were dissolved in dimethyl sulfoxide (DMSO; Sigma-Aldrich Chemical Co.). Based on a previous study (<xref rid="b20-or-31-05-2413" ref-type="bibr">20</xref>), cells were pretreated with each caspase inhibitor for 1 h prior to treatment with H<sub>2</sub>O<sub>2</sub>. DMSO (0.2&#x00025;) was used as a control vehicle and it did not appear to affect cell growth or death.</p></sec>
<sec>
<title>Cell growth and cell number assays</title>
<p>Cell growth changes were determined by measuring the absorbance of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide dye (MTT; Sigma-Aldrich Chemical Co.) in living cells as described previously (<xref rid="b21-or-31-05-2413" ref-type="bibr">21</xref>). Changes in the numbers of viable and dead cells were determined by trypan blue cell counting. In brief, 5&#x000D7;10<sup>3</sup> cells/well were seeded in 96-well microtiter plates for the MTT assays and 3&#x000D7;10<sup>5</sup> cells/well were seeded in 24-well plates (both from Nunc) for cell counting. After exposure to the indicated amounts of H<sub>2</sub>O<sub>2</sub> for 24 h, the cells in the 96-well plates were used for MTT assays, and the cells in the 24-well plates were collected with trypsin digestion for trypan blue cell counting. Twenty microliters of MTT solution &#x0005B;2 mg/ml in phosphate-buffered saline (PBS)&#x0005D; was added to each well of the 96-well plates. The plates were incubated for an additional 4 h at 37&#x000B0;C. Media in plates were withdrawn by pipetting, and 200 &#x003BC;l DMSO was added to each well to solubilize the formazan crystals. The optical density was measured at 570 nm using a microplate reader (Synergy&#x02122; 2; BioTek Instruments Inc., Winooski, VT, USA).</p></sec>
<sec>
<title>Analysis of cell cycle distribution and sub-G1 phase cells</title>
<p>Cell cycle distribution and sub-G1 cell analysis were determined by propidium iodide (PI) (Sigma-Aldrich; Ex/Em &#x0003D; 488/617 nm) staining. In brief, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the indicated amounts of H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors for 1, 6, 12 or 24 h. Total cells including floating cells were then washed with PBS and fixed in 70&#x00025; (v/v) ethanol. Cells were washed again with PBS, and then incubated with PI (10 &#x003BC;g/ml) with simultaneous RNase treatment at 37&#x000B0;C for 30 min. Cellular DNA content was measured using a FACStar flow cytometer and analyzed using Lysis II and CellFit software (both from Becton-Dickinson, Franklin Lakes, NJ, USA).</p></sec>
<sec>
<title>Lactate dehydrogenase (LDH) activity for the detection of necrosis</title>
<p>Necrosis in cells treated with H<sub>2</sub>O<sub>2</sub> was evaluated using the LDH kit (Sigma-Aldrich Chemical Co.). In brief, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the indicated doses of H<sub>2</sub>O<sub>2</sub> for 24 h. After treatment, the culture media were collected and centrifuged for 5 min at 1,500 rpm. Fifty microliters of the media supernatant was added to a fresh 96-well plate along with the LDH assay reagent and then incubated at room temperature for 30 min. The absorbance values were measured at 490 nm using a microplate reader (Synergy&#x02122; 2). LDH release was expressed as the percentage of extracellular LDH activity compared with the control cells.</p></sec>
<sec>
<title>Annexin V-FITC/PI staining for cell death detection</title>
<p>Apoptotic cell death was determined by staining the cells with Annexin V-fluorescein isothiocyanate (FITC; Invitrogen Life Technologies, Camarillo, CA, USA; Ex/Em &#x0003D; 488/519 nm) as previously described (<xref rid="b22-or-31-05-2413" ref-type="bibr">22</xref>). In brief, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the designated doses of H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors for 1, 6, 12 or 24 h. Cells were washed twice with cold PBS and then resuspended in 500 &#x003BC;l of binding buffer &#x0005B;10 mM HEPES/NaOH (pH 7.4), 140 mM NaCl, 2.5 mM CaCl<sub>2</sub>&#x0005D; at a concentration of 1&#x000D7;10<sup>6</sup> cells/ml. Annexin V-FITC (5 &#x003BC;l) and PI (1 &#x003BC;g/ml) were then added, and the cells were analyzed with a FACStar flow cytometer. Viable cells were negative for both PI and Annexin V; apoptotic cells were positive for Annexin V and negative for PI whereas late apoptotic dead cells display both high Annexin V and PI labeling. Nonviable cells, which underwent necrosis, were positive for PI and negative for Annexin V.</p></sec>
<sec>
<title>Measurement of mitochondrial membrane potential (MMP; &#x00394;&#x003A8;<sub>m</sub>)</title>
<p>MMP (&#x00394;&#x003A8;<sub>m</sub>) levels were measured by Rhodamine 123 fluorescent dye (Sigma-Aldrich Chemical Co.; Ex/Em &#x0003D; 485/535 nm). In brief, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the indicated amounts of H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors for 24 h. Cells were washed twice with PBS and incubated with Rhodamine 123 (0.1 &#x003BC;g/ml) at 37&#x000B0;C for 30 min. Rhodamine 123 staining intensity was determined by a FACStar flow cytometer (Becton-Dickinson). Rhodamine 123-negative cells indicated the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) in the cells.</p></sec>
<sec>
<title>Western blot analysis</title>
<p>The change in caspase-3 and PARP in H<sub>2</sub>O<sub>2</sub>-treated cells was determined by western blotting. In brief, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the indicated amounts of H<sub>2</sub>O<sub>2</sub> for 24 h. The cells were then washed in PBS and suspended in five volumes of lysis buffer &#x0005B;20 mM HEPES. (pH 7.9), 20&#x00025; (v/v) glycerol, 200 mM KCl, 0.5 mM EDTA, 0.5&#x00025; (v/v) NP-40, 0.5 mM DTT and 1&#x00025; (v/v) protease inhibitor cocktail&#x0005D;. The protein concentrations in the supernatant were determined using the Bradford method. Samples containing 10 &#x003BC;g total protein were resolved by 8 or 12.5&#x00025; SDS-PAGE gels, transferred to Immobilon-P PVDF membranes (Millipore, Billerica, MA, USA) by electroblotting and then probed with anti-caspase-3, anti-PARP, anti-&#x003B2;-actin (Santa Cruz Biotechnology, Santa Cruz, CA, USA) and anti-LC3A/B (Cell Signaling Technology, Waltham, MA, USA) antibodies. Membranes were incubated with horseradish peroxidase-conjugated secondary antibodies. Blots were developed using an ECL kit (Amersham, Arlington Heights, IL, USA).</p></sec>
<sec>
<title>Quantification of caspase-3 and -8 activities</title>
<p>The activities of caspase-3 and -8 were assessed using the Caspase-3 and Caspase-8 Colorimetric Assay Kits (R&amp;D Systems, Inc.) as previously used (<xref rid="b23-or-31-05-2413" ref-type="bibr">23</xref>). In brief, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> for 24 h. The cells were then washed in PBS and suspended in 5 volumes of lysis buffer provided in the kits. Protein concentrations were determined using the Bradford method. Supernatant samples containing 50 &#x003BC;g total protein were used for determination of caspase-3 and -8 activities. These were added to each well in 96-well microtiter plates (Nunc) with DEVD-pNA or IETD-pNA as caspase-3 and -8 substrates respectively at 37&#x000B0;C for 1 h. The optical density of each well was measured at 405 nm using a microplate reader (SpectraMax 340; Molecular Devices Co. Sunnyvale, CA, USA). Caspase-3 and -8 activities were expressed in arbitrary absorbance units.</p></sec>
<sec>
<title>Detection of intracellular ROS levels</title>
<p>Intracellular ROS levels were detected by the fluorescent probe dye, 2&#x02032;,7&#x02032;-dichlorodihydrofluorescein diacetate (H<sub>2</sub>DCFDA) (Ex/Em &#x0003D; 495/529 nm; Invitrogen Molecular Probes, Eugene, OR, USA) at 1, 6, 12 or 24 h. H<sub>2</sub>DCFDA is poorly selective for the superoxide anion radical (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>). In contrast, dihydroethidium (DHE) (Invitrogen Molecular Probes; Ex/Em &#x0003D; 518/605 nm) is a fluorogenic probe that is highly selective for O<sub>2</sub><sup>&#x02022;&#x02212;</sup> among ROS. In brief, 1&#x000D7;10<sup>6</sup> cells/ml in FACS tube (Becton-Dickinson) were treated with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors in the presence of 20 &#x003BC;M H<sub>2</sub>DCFDA or DHE. The fluorescence levels of DCF and DHE were evaluated using a FACStar flow cytometer at 1 h. DCF (ROS) and DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) levels were expressed as mean fluorescence intensity (MFI), which was calculated by CellQuest software (Becton-Dickinson). In addition, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the indicated amounts of H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors for 6, 12 and 24 h. Cells were incubated with 20 &#x003BC;M H<sub>2</sub>DCFDA or DHE at 37&#x000B0;C for 30 min. H<sub>2</sub>DCFDA or DHE fluorescence was assessed using a FACStar flow cytometer.</p></sec>
<sec>
<title>Measurement of cellular SOD and catalase activities</title>
<p>SOD enzyme activity was measured using the SOD assay kit-WST (Fluka Co., Milwaukee, WI, USA), and catalase enzyme activity was measured using a catalase assay kit from Sigma-Aldrich Chemical Co. In brief, 1&#x000D7;10<sup>6</sup> cells were incubated with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> for 24 h. The cells were then washed in PBS and suspended in 5 volumes of lysis buffer &#x0005B;20 mM HEPES (pH 7.9), 20&#x00025; glycerol, 200 mM KCl, 0.5 mM EDTA, 0.5&#x00025; NP-40, 0.5 mM DTT and 1&#x00025; protease inhibitor cocktail (from Sigma)&#x0005D;. The protein concentration of the supernatant was determined by the Bradford method. Supernatant samples containing 100 &#x003BC;g total protein were used for determination of SOD and catalase enzyme activities. These were added to each well in 96-well microtiter plates (Nunc) with the appropriate working solutions (according to the manufacturer&#x02019;s instructions) at 25&#x000B0;C for 30 min. The color changes were measured at 450 or 520 nm using a microplate reader (SpectraMax 340). The value for the experimental group was expressed as a percentage of the control group.</p></sec>
<sec>
<title>Detection of the intracellular GSH</title>
<p>Cellular GSH levels were analyzed using a 5-chloromethylfluorescein diacetate dye (CMFDA) (Invitrogen Molecular Probes; Ex/Em &#x0003D; 522/595 nm) at 1, 6, 12, or 24 h. In brief, 1&#x000D7;10<sup>6</sup> cells/ml in a FACS tube (Becton-Dickinson) were treated with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors in the presence of 5 &#x003BC;M CMFDA. The level of CMF fluorescence was evaluated using a FACStar flow cytometer at 1 h. CMF (GSH) levels were expressed as MFI, which were calculated by CellQuest software. In addition, 1&#x000D7;10<sup>6</sup> cells in a 60-mm culture dish (Nunc) were incubated with the indicated amounts of H<sub>2</sub>O<sub>2</sub> with or without 15 &#x003BC;M caspase inhibitors for 6, 12 and 24 h. Cells were incubated with 5 &#x003BC;M CMFDA at 37&#x000B0;C for 30 min. CMF fluorescence was assessed using a FACStar flow cytometer. Negative CMF staining (GSH depleted) of cells was expressed as the percentage of (-) CMF cells.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>The results represent the means of at least two independent experiments (means &#x000B1; SD). The data were analyzed using InStat software (GraphPad Prism4; GraphPad Software, San Diego, CA, USA). The Student&#x02019;s t-test or one-way analysis of variance (ANOVA) with post hoc analysis using Tukey&#x02019;s multiple comparison test was used for parametric data. The statistical significance was defined as p&lt;0.05.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Effects of H<sub>2</sub>O<sub>2</sub> on cell growth in HeLa cells</title>
<p>The effect of H<sub>2</sub>O<sub>2</sub> on the growth of HeLa cells was examined at 24 h. Treatment with 50&#x02013;250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> significantly decreased the viable (trypan blue-negative) cell number in the HeLa cells in a dose-dependent manner whereas H<sub>2</sub>O<sub>2</sub> dose-dependently increased the number of dead (trypan blue-positive) cells (<xref rid="f1-or-31-05-2413" ref-type="fig">Fig. 1A</xref>). Based on the MTT assays, 50&#x02013;250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> significantly inhibited the growth of HeLa cells with an IC<sub>50</sub> (the half maximal inhibitory concentration) of ~75 &#x003BC;M (<xref rid="f1-or-31-05-2413" ref-type="fig">Fig. 1B</xref>). When the cell cycle distribution in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells was examined, none of the tested doses of H<sub>2</sub>O<sub>2</sub> significantly induced any specific cell cycle phase arrest when compared with these parameters in the control cells (<xref rid="f1-or-31-05-2413" ref-type="fig">Fig. 1C</xref>).</p></sec>
<sec>
<title>Effects of H<sub>2</sub>O<sub>2</sub> on cell death and MMP (&#x00394;&#x003A8;<sub>m</sub>) in HeLa cells</title>
<p>Next, we aimed to ascertain whether the H<sub>2</sub>O<sub>2</sub>-induced cell death was through apoptosis or necrosis in HeLa cells. While 50 or 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> significantly increased the percentages of sub-G1 cells in HeLa cells, 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> did not increase the percentages of sub-G1 cells in these cells (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2A</xref>). Since H<sub>2</sub>O<sub>2</sub> can induce necrosis in HeLa cells, the status of necrosis was assessed using the LDH release assay. Treatment with 100 or 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> significantly induced LDH release in HeLa cells at 24 h (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2B</xref>). Treatment with 50&#x02013;250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> increased the numbers of Annexin V-FITC-positive cells in the HeLa cells in a dose-dependent manner (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2C</xref>). Treatment with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> increased the portion of apoptotic cells (Annexin V-FITC-positive/PI-negative) whereas 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> relatively increased the portion of late apoptotic cells (Annexin V-FITC-positive/PI-positive) (data not shown). When the effect of H<sub>2</sub>O<sub>2</sub> on MMP (&#x00394;&#x003A8;<sub>m</sub>) in HeLa cells was assessed using Rhodamine 123, H<sub>2</sub>O<sub>2</sub> dose-dependently induced the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2D</xref>). Examination of apoptosis-related protein changes during H<sub>2</sub>O<sub>2</sub>-induced cell death revealed that the level of pro-caspase-3 was decreased by H<sub>2</sub>O<sub>2</sub> (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2E</xref>). The intact 116-kDa form of PARP was decreased by H<sub>2</sub>O<sub>2</sub> whereas the cleaved form was increased (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2E</xref>). Furthermore, autophagy marker light chain 3 (LC3) was converted to LC3-II in the 100 and 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub>-treated HeLa cells, indicating that H<sub>2</sub>O<sub>2</sub> induced autophagy in the HeLa cells (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2E</xref>). The activity of caspase-3 was increased in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells whereas that of caspase-8 was slightly increased (<xref rid="f2-or-31-05-2413" ref-type="fig">Fig. 2F</xref>).</p></sec>
<sec>
<title>Effects of caspase inhibitors on the apoptosis of H<sub>2</sub>O<sub>2</sub>-treated HeLa cells</title>
<p>We investigated whether caspases are required for H<sub>2</sub>O<sub>2</sub>-induced apoptosis. Based on a previous study (<xref rid="b20-or-31-05-2413" ref-type="bibr">20</xref>), HeLa cells were pretreated with 15 &#x003BC;M of caspase inhibitor for 1 h prior to treatment with H<sub>2</sub>O<sub>2</sub>. Treatment with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> did not significantly increase the percentages of sub-G1 cells in the HeLa cells at 1, 6 or 12 h, and the pan-caspase inhibitor (Z-VAD) did not affect the percentages at these times (<xref rid="f3-or-31-05-2413" ref-type="fig">Fig. 3A</xref>). H<sub>2</sub>O<sub>2</sub> increased the numbers of Annexin V-FITC-positive cells in the HeLa cells at 6 and 12 h, and Z-VAD markedly reduced the number at 12 h (<xref rid="f3-or-31-05-2413" ref-type="fig">Fig. 3B</xref>). Moreover, treatment with all of the tested caspase inhibitors (Z-VAD, Z-DEVD for caspase-3, Z-IETD for caspase-8 and Z-LEHD for caspase-9) showed the marked rescue of HeLa cells from H<sub>2</sub>O<sub>2</sub>-induced cell death at 24 h, as measured by the population of sub-G1 cells (<xref rid="f3-or-31-05-2413" ref-type="fig">Fig. 3C</xref>). In addition, these inhibitors decreased the numbers of Annexin V-FITC-positive cells in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells at 24 h, and Z-VAD particularly showed a strong effect (<xref rid="f3-or-31-05-2413" ref-type="fig">Fig. 3D</xref>). However, none of the caspase inhibitors significantly prevented the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) by H<sub>2</sub>O<sub>2</sub> (<xref rid="f3-or-31-05-2413" ref-type="fig">Fig. 3E</xref>). In relation to the 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub>-treated HeLa cells, 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> seemed to slightly increase the numbers of sub-G1 cells at 6, 12 and 24 h but not at 1 h (data not shown). Z-VAD did not decrease the numbers at these times but instead it increased the number at 12 h (data not shown). In addition, H<sub>2</sub>O<sub>2</sub> increased the numbers of Annexin V-FITC-positive cells in the HeLa cells at 6, 12 and 24 h (data not shown). Z-VAD did not reduce the percentages of Annexin V-FITC-positive cells in the 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub>-treated HeLa cells but it increased the number of Annexin V-FITC-positive cells in these cells at 24 h (data not shown). These results indicated that the caspase inhibitors did not protect HeLa cell death induced by 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub>.</p></sec>
<sec>
<title>Effects of H<sub>2</sub>O<sub>2</sub> on intracellular ROS and GSH levels in HeLa cells</title>
<p>To assess the intracellular ROS levels in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells, H<sub>2</sub>DCFDA and DHE dyes were used. All the tested doses of H<sub>2</sub>O<sub>2</sub> increased the ROS (DCF) level in the HeLa cells at 24 h (<xref rid="f4-or-31-05-2413" ref-type="fig">Fig. 4A</xref>). The level of DHE fluorescence dye, which specifically reflects O<sub>2</sub><sup>&#x02022;&#x02212;</sup> accumulation in cells, was also increased in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells (<xref rid="f4-or-31-05-2413" ref-type="fig">Fig. 4B</xref>). Furthermore, the activities of SOD and catalase in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells were measured. As shown in <xref rid="f4-or-31-05-2413" ref-type="fig">Fig. 4C</xref>, 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> increased the activity of catalase but did not alter the activity of SOD. Following the measurement of intracellular GSH levels in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells using a CMFDA dye, 100 or 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> increased the GSH-depleted cell number in HeLa cells at 24 h while 50 &#x003BC;M H<sub>2</sub>O<sub>2</sub> did not significantly induce GSH depletion (<xref rid="f4-or-31-05-2413" ref-type="fig">Fig. 4D</xref>).</p></sec>
<sec>
<title>Effects of caspase inhibitors on ROS and GSH levels in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells</title>
<p>To determine whether the levels of intracellular ROS and GSH in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells were altered by treatment with each caspase inhibitor, ROS and GSH levels in the HeLa cells were assessed at the early time point of 1 h and at the extended time point of 24 h (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5</xref>). The intracellular ROS (DCF) level was increased in the H<sub>2</sub>O<sub>2</sub>-treated cells at 1 h (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5A</xref>). Z-VAD, caspase-3 and -9 inhibitors seemed to attenuate the increased ROS (DCF) level by H<sub>2</sub>O<sub>2</sub>, and all the caspase inhibitors decreased the basal level of ROS (DCF) in the HeLa control cells (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5A</xref>). At 24 h, none of the caspase inhibitors significantly affected the ROS (DCF) level in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5D</xref>). Additionally, Z-VAD did not attenuate the increased ROS (DCF) level by H<sub>2</sub>O<sub>2</sub> at 6 and 12 h (data not shown). Treatment with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> did not alter the DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) level in the HeLa cells at 1 h (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5B</xref>). Z-VAD decreased the DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) level in the H<sub>2</sub>O<sub>2</sub>-treated and -untreated HeLa cells at 1 h, and other caspase inhibitors reduced the basal level of DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) in the HeLa control cells (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5B</xref>). In addition, Z-VAD among the caspase inhibitors decreased the DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) level in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells at 24 h (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5E</xref>). In regards to the GSH levels, 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> decreased the GSH level in HeLa cells at 1 h (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5C</xref>). Caspase-3 and -9 inhibitors including Z-VAD attenuated the decreased GSH level by H<sub>2</sub>O<sub>2</sub>, and all inhibitors except the caspase-9 inhibitor reduced the basal level of GSH in the HeLa control cells at 1 h (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5C</xref>). At 24 h, Z-VAD prevented GSH depletion in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells (<xref rid="f5-or-31-05-2413" ref-type="fig">Fig. 5F</xref>).</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Exogenous H<sub>2</sub>O<sub>2</sub> was applied for inducing oxidative stress in HeLa cervical cancer cells. After exposure to H<sub>2</sub>O<sub>2</sub> for 24 h, the IC<sub>50</sub> value in the HeLa cells was ~75 &#x003BC;M based on MTT assays. H<sub>2</sub>O<sub>2</sub> dose-dependently increased the number of dead cells and Annexin V-FITC-positive cells in the HeLa cells, suggesting that H<sub>2</sub>O<sub>2</sub>-induced HeLa cell death occurred via apoptosis. Evidently, H<sub>2</sub>O<sub>2</sub> decreased the level of pro-caspase-3 and induced the cleavage of PARP proteins in the HeLa cells. The activity of caspase-3 was also increased in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. However, 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> did not significantly increase the percentages of sub-G1 cells in the HeLa cells, implying that the relatively higher dose of H<sub>2</sub>O<sub>2</sub> fixed HeLa cells similar to ethanol or methanol. In addition, 100 or 250 &#x003BC;M H<sub>2</sub>O<sub>2</sub> significantly induced LDH release in the HeLa cells at 24 h. Therefore, H<sub>2</sub>O<sub>2</sub> appeared to provoke HeLa cell death via apoptosis as well as necrosis depending on its concentration. Moreover, autophagy appeared to be involved in H<sub>2</sub>O<sub>2</sub>-induced HeLa cell death since LC3-I was converted to LC3-II in these cells. Apoptosis is closely related to the collapse of MMP (&#x00394;&#x003A8;<sub>m</sub>) (<xref rid="b24-or-31-05-2413" ref-type="bibr">24</xref>). This result demonstrated that H<sub>2</sub>O<sub>2</sub> triggered the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) in HeLa cells in a dose-dependent manner, suggesting that HeLa cell death by H<sub>2</sub>O<sub>2</sub> was tightly correlated with the collapse of MMP (&#x00394;&#x003A8;<sub>m</sub>). Moreover, it has been reported that ROS may have roles in cell cycle arrest and progression via regulating cell cycle-related proteins (<xref rid="b25-or-31-05-2413" ref-type="bibr">25</xref>,<xref rid="b26-or-31-05-2413" ref-type="bibr">26</xref>). However, H<sub>2</sub>O<sub>2</sub> did not induce any specific phase arrest of the cell cycle in HeLa cells, suggesting that H<sub>2</sub>O<sub>2</sub>-induced oxidative stress did not have an effect on particular proteins related to cell cycle arrest and progression.</p>
<p>Treatment with the caspase inhibitors tested in this experiment significantly prevented HeLa cell death by H<sub>2</sub>O<sub>2</sub>, and Z-VAD showed a stronger effect on reducing apoptosis. In particular, although H<sub>2</sub>O<sub>2</sub> slightly increased the activity of caspase-8, its inhibitor significantly prevented HeLa cell death by H<sub>2</sub>O<sub>2</sub>. Thus, a subtle change in the activity of caspase-8 seemed to strongly affect the pro-apoptotic pathway in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. These data suggest that the mitochondrial pathway and cell death receptor pathway are together necessary for the complete induction of apoptosis in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. However, Wu <italic>et al</italic> suggested that H<sub>2</sub>O<sub>2</sub>-induced apoptosis in HeLa cells is not through mitochondria-dependent caspase-9 activation (<xref rid="b27-or-31-05-2413" ref-type="bibr">27</xref>). The exact apoptotic pathway(s) and the caspase(s) directly involved in the H<sub>2</sub>O<sub>2</sub>-induced apoptosis in HeLa cells warrant further studied. With regard to the MMP (&#x00394;&#x003A8;<sub>m</sub>), caspase inhibitors did not prevent the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) induced by H<sub>2</sub>O<sub>2</sub>. In addition, caspase inhibitors also did not recover the decreased MMP (&#x00394;&#x003A8;<sub>m</sub>) level in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells (data not shown). These results imply that the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) following treatment with H<sub>2</sub>O<sub>2</sub> activated caspases and consequently induced apoptosis. In addition, the activation of caspase by H<sub>2</sub>O<sub>2</sub> did not positively intensify the MMP (&#x00394;&#x003A8;<sub>m</sub>) loss. Furthermore, the loss of MMP (&#x00394;&#x003A8;<sub>m</sub>) by H<sub>2</sub>O<sub>2</sub> may not be enough to fully trigger apoptosis in HeLa cells under the inhibition of caspase activity.</p>
<p>The ROS level was significantly increased in HeLa cells treated with H<sub>2</sub>O<sub>2</sub> at 24 h. Since H<sub>2</sub>O<sub>2</sub> did not decrease the activity of SOD and increased the activity of catalase at 24 h, increases in ROS levels including O<sub>2</sub><sup>&#x02022;&#x02212;</sup> were likely to occur via their strong generation rather than the lack of scavenging them. In addition, it is possible that exogenous H<sub>2</sub>O<sub>2</sub> strongly generates O<sub>2</sub><sup>&#x02022;&#x02212;</sup> via the damage of mitochondria, and both H<sub>2</sub>O<sub>2</sub> and O<sub>2</sub><sup>&#x02022;&#x02212;</sup> can be efficiently converted into the toxic <sup>&#x02022;</sup>OH via the Fenton reaction to kill HeLa cells. However, H<sub>2</sub>O<sub>2</sub> did not increase the O<sub>2</sub><sup>&#x02022;&#x02212;</sup> (DHE) level in HeLa cells at 1 h, suggesting that it did not affect the mitochondrial respiratory transport chain and the activity of various oxidases to generate O<sub>2</sub><sup>&#x02022;&#x02212;</sup> within this early time point. Moreover, caspase inhibitors showing the prevention of H<sub>2</sub>O<sub>2</sub>-induced cell death failed to significantly decrease the ROS level including O<sub>2</sub><sup>&#x02022;&#x02212;</sup> at 6, 12 and 24 h. However, Z-VAD, caspase-3 and -8 inhibitors appeared to attenuate the increased ROS (DCF) level by H<sub>2</sub>O<sub>2</sub> at 1 h. In addition, all of the caspase inhibitors decreased the basal level of ROS including O<sub>2</sub><sup>&#x02022;&#x02212;</sup> in the HeLa control cells. It is conceivable that the reduced basal activity of caspase by their inhibitors improves the reliability of antioxidant-related enzymes to strongly scavenge basal intracellular ROS in HeLa cells. Therefore, the early suppression of H<sub>2</sub>O<sub>2</sub>-induced oxidative stress by caspase inhibitors seems to be crucial for the protection of HeLa cells against it. The exact role of each caspase inhibitor in preventing H<sub>2</sub>O<sub>2</sub>-induced HeLa cell death still needs to be defined further.</p>
<p>GSH is a main non-protein antioxidant in cells. Apoptotic effects are inversely comparable to the GSH content (<xref rid="b28-or-31-05-2413" ref-type="bibr">28</xref>&#x02013;<xref rid="b30-or-31-05-2413" ref-type="bibr">30</xref>). Likewise, H<sub>2</sub>O<sub>2</sub> was found to increase the number of GSH-depleted cells in HeLa cells at 24 h. In addition, Z-VAD partially prevented GSH depletion in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. These results support the notion that the intracellular GSH content has a decisive effect on cell death (<xref rid="b29-or-31-05-2413" ref-type="bibr">29</xref>,<xref rid="b31-or-31-05-2413" ref-type="bibr">31</xref>,<xref rid="b32-or-31-05-2413" ref-type="bibr">32</xref>). However, 50 &#x003BC;M H<sub>2</sub>O<sub>2</sub>, the dose at which apoptosis is induced in HeLa cells, did not significantly allow GSH depletion in these cells. Moreover, the other caspase inhibitors except Z-VAD failed to prevent GSH depletion in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. Therefore, the loss of GSH content seemed to be necessary but not sufficient for the induction of apoptosis in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. Treatment with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> decreased the GSH level at 1 h. The decreased GSH level was likely to be due to its use for the decrease in ROS (DCF) level at this time. In addition, caspase-3 and -9 inhibitors partially recovered the GSH level in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells, implying that these caspase inhibitors seemed to positively maintain the GSH content in these cells. Without the incubation of H<sub>2</sub>O<sub>2</sub>, caspase inhibitors except for the caspase-9 inhibitor reduced the basal level of GSH in the HeLa control cells at 1 h. Thus, these results suggest that each caspase inhibitor differentially regulated the intracellular GSH levels in HeLa cells depending on the presence or absence of H<sub>2</sub>O<sub>2</sub>.</p>
<p>In conclusion, H<sub>2</sub>O<sub>2</sub> inhibited the growth of HeLa cells via apoptosis and/or necrosis, which was accompanied by intracellular ROS increase and GSH depletion. The anti-apoptotic effect of caspase inhibitors on H<sub>2</sub>O<sub>2</sub>-induced HeLa cell death may result from the early suppression of H<sub>2</sub>O<sub>2</sub>-induced oxidative stress. The present data provide useful information for the understanding of the toxicological effect of exogenous H<sub>2</sub>O<sub>2</sub> on HeLa cells.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>This study was supported by the National Research Foundation of Korea (NRF), a grant funded by the Korean government (MSIP) (no. 2008-0062279), and supported by the Basic Science Research Program through the NRF funded by the Ministry of Education (2013006279).</p></ack>
<glossary>
<title>Abbreviations</title>
<def-list>
<def-item>
<term id="G1">ROS</term>
<def>
<p>reactive oxygen species</p></def></def-item>
<def-item>
<term id="G2">GSH</term>
<def>
<p>glutathione</p></def></def-item>
<def-item>
<term id="G3">LDH</term>
<def>
<p>lactate dehydrogenase</p></def></def-item>
<def-item>
<term id="G4">Z-VAD-FMK</term>
<def>
<p>benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketon</p></def></def-item>
<def-item>
<term id="G5">Z-DEVD-FMK</term>
<def>
<p>benzyloxycarbonyl-Asp- Glu-Val-Asp-fluoromethylketon</p></def></def-item>
<def-item>
<term id="G6">Z-IETD-FMK</term>
<def>
<p>benzyloxycarbonyl- Ile-Glu-Thr-Asp-fluoromethylketon</p></def></def-item>
<def-item>
<term id="G7">Z-LEHD-FMK</term>
<def>
<p>be oxycarbonyl- Leu-Glu-His-Asp-fluoromethylketon</p></def></def-item>
<def-item>
<term id="G8">SOD</term>
<def>
<p>superoxide dismutase</p></def></def-item>
<def-item>
<term id="G9">MMP (&#x00394;&#x003A8;<sub>m</sub>)</term>
<def>
<p>mitochondrial membrane potential</p></def></def-item>
<def-item>
<term id="G10">FITC</term>
<def>
<p>fluorescein isothiocyanate</p></def></def-item>
<def-item>
<term id="G11">PI</term>
<def>
<p>propidium iodide</p></def></def-item>
<def-item>
<term id="G12">H<sub>2</sub>DCFDA</term>
<def>
<p>2&#x02032;,7&#x02032;-dichlorodihydrofluorescein diacetate</p></def></def-item>
<def-item>
<term id="G13">DHE</term>
<def>
<p>dihydroethidium</p></def></def-item>
<def-item>
<term id="G14">CMFDA</term>
<def>
<p>5-chloromethylfluorescein diacetate</p></def></def-item>
<def-item>
<term id="G15">MTT</term>
<def>
<p>3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide</p></def></def-item></def-list></glossary>
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<floats-group>
<fig id="f1-or-31-05-2413" position="float">
<label>Figure 1</label>
<caption>
<p>Effects of H<sub>2</sub>O<sub>2</sub> on the cell growth in HeLa cells. Exponentially growing cells were treated with the indicated concentrations of H<sub>2</sub>O<sub>2</sub> for 24 h. (A) The graph shows the numbers of viable (trypan blue-negative) and dead (trypan blue-positive) cells in the HeLa cells. (B) The graph shows the cellular growth changes in HeLa cells as assessed by MTT assays. (C) The graph shows the cell cycle distribution in HeLa cells as measured by a FACStar flow cytometer. <sup>&#x0002A;</sup>p&lt;0.05 compared with the control group.</p></caption>
<graphic xlink:href="OR-31-05-2413-g00.gif"/></fig>
<fig id="f2-or-31-05-2413" position="float">
<label>Figure 2</label>
<caption>
<p>Effects of H<sub>2</sub>O<sub>2</sub> on cell death and MMP (&#x00394;&#x003A8;<sub>m</sub>) in HeLa cells. Exponentially growing cells were treated with the indicated concentrations of H<sub>2</sub>O<sub>2</sub> for 24 h. (A) The graph shows the percentages of sub-G1 cells in the HeLa cells as measured by FACStar flow cytometer. (B) The graph shows the percentage of LDH release when compared with that in the control cells. (C) The graph shows the percentages of Annexin V-FITC-positive cells as measured by FACStar flow cytometer. (D) The graph shows the percentages of Rhodamine 123-negative &#x0005B;MMP (&#x00394;&#x003A8;<sub>m</sub>) loss&#x0005D; cells as measured by FACStar flow cytometer. (E) Western blot data of the levels of pro-caspase-3, PARP and LC3 in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. (F) The graphs show the activities of caspase-3 and -8 in the H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. <sup>&#x0002A;</sup>p&lt;0.05 compared with the control group. MMP, mitochondrial membrane potential; LDH, lactate dehydrogenase.</p></caption>
<graphic xlink:href="OR-31-05-2413-g01.gif"/></fig>
<fig id="f3-or-31-05-2413" position="float">
<label>Figure 3</label>
<caption>
<p>Effects of caspase inhibitors on apoptosis in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. Exponentially growing cells were treated with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> for the indicated times following 1 h of pre-incubation with 15 &#x003BC;M of a caspase inhibitor. (A and C) The graphs show the percentages of sub-G1 cells. (B and D) The graphs show the percentages of Annexin V-FITC-positive cells. (E) The graph shows the percentages of Rhodamine 123-negative &#x0005B;MMP (&#x00394;&#x003A8;<sub>m</sub>) loss&#x0005D; cells. <sup>&#x0002A;</sup>p&lt;0.05 compared with the control group. <sup>&#x00023;</sup>p&lt;0.05 compared with cells treated with H<sub>2</sub>O<sub>2</sub> only. Z-VAD; pan-caspase inhibitor, Z-DEVD; caspase 3 inhibitor, Z-IETD; caspase 8 inhibitor, Z-LEHD; caspase 9 inhibitor. MMP, mitochondrial membrane potential.</p></caption>
<graphic xlink:href="OR-31-05-2413-g02.gif"/></fig>
<fig id="f4-or-31-05-2413" position="float">
<label>Figure 4</label>
<caption>
<p>Effects of H<sub>2</sub>O<sub>2</sub> on ROS and GSH levels in HeLa cells. Exponentially growing cells were treated with the indicated concentrations of H<sub>2</sub>O<sub>2</sub> for 24 h. ROS and GSH levels in the HeLa cells were measured using a FACStar flow cytometer. (A) The graph indicates DCF (ROS) levels (&#x00025;). (B) The graph indicates DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) levels (&#x00025;). (C) The activities of catalase and SOD were measured as described in Materials and methods. The graphs show changes in catalase and SOD activities following exposure to 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub>. (D) The graph indicates the (-) CMF (GSH-depleted) cells (&#x00025;) in the HeLa cells when compared with the control cell group. <sup>&#x0002A;</sup>p&lt;0.05 compared with the control group. ROS, reactive oxygen species; GSH, glutathione.</p></caption>
<graphic xlink:href="OR-31-05-2413-g03.gif"/></fig>
<fig id="f5-or-31-05-2413" position="float">
<label>Figure 5</label>
<caption>
<p>Effects of caspase inhibitors on ROS and GSH levels in H<sub>2</sub>O<sub>2</sub>-treated HeLa cells. Exponentially growing cells were treated with 100 &#x003BC;M H<sub>2</sub>O<sub>2</sub> for 1 or 24 h following 1 h pre-incubation of 15 &#x003BC;M of a caspase inhibitor. ROS and GSH levels in HeLa cells were measured using a FACStar flow cytometer. (A and D) Graphs indicate DCF (ROS) levels (&#x00025;) at (A) 1 h and (D) 24 h. (B and E) Graphs indicate DHE (O<sub>2</sub><sup>&#x02022;&#x02212;</sup>) levels (&#x00025;) at (B) 1 h and (E) 24 h. (C and F) The graphs indicate mean CMF (GSH) levels (&#x00025;) at (C) 1 h and (-) CMF (GSH-depleted) cells (&#x00025;) in HeLa cells compared with control cell group at (F) 24 h. <sup>&#x0002A;</sup>p&lt;0.05 compared with the control group. <sup>&#x00023;</sup>p&lt;0.05 compared with cells treated with H<sub>2</sub>O<sub>2</sub> only. ROS, reactive oxygen species; GSH, glutathione.</p></caption>
<graphic xlink:href="OR-31-05-2413-g04.gif"/></fig></floats-group></article>
