Synergistic induction of apoptosis by sulindac and simvastatin in A549 human lung cancer cells via reactive oxygen species-dependent mitochondrial dysfunction

Hwang,Ki-Eun; Park,Chul; Kwon,Su-Jin; Kim,Young-Suk; Park,Do-Sim; Lee,Mi-Kyung; Kim,Byoung-Ryun; Park,Seong-Hoon; Yoon,Kwon-Ha; Jeong,Eun-Taik; Kim,Hak-Ryul

doi:10.3892/ijo.2013.1933

Synergistic induction of apoptosis by sulindac and simvastatin in A549 human lung cancer cells via reactive oxygen species-dependent mitochondrial dysfunction

Authors:
- Ki-Eun Hwang
- Chul Park
- Su-Jin Kwon
- Young-Suk Kim
- Do-Sim Park
- Mi-Kyung Lee
- Byoung-Ryun Kim
- Seong-Hoon Park
- Kwon-Ha Yoon
- Eun-Taik Jeong
- Hak-Ryul Kim
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Affiliations: Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine, Iksan, Jeonbuk 570-749, Republic of Korea, Laboratory Medicine, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine, Iksan, Jeonbuk 570-749, Republic of Korea, Department of Thoracic and Cardiovascular Surgery, Wonkwang University, School of Medicine, Iksan, Jeonbuk 570-749, Republic of Korea, Department of Obstetrics and Gynecology, Wonkwang University, School of Medicine, Iksan, Jeonbuk 570-749, Republic of Korea, Department of Radiology, Wonkwang University, School of Medicine, Iksan, Jeonbuk 570-749, Republic of Korea
Published online on: May 9, 2013 https://doi.org/10.3892/ijo.2013.1933
Pages: 262-270

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Abstract

Prevention of lung cancer is more feasible and holds greater promise when different agents are used in combination to target multiple processes during carcinogenesis. The mechanisms by which non-steroidal anti-inflammatory drugs and statins inhibit cancer cell growth and induce apoptosis are not fully understood. This study was designed to investigate lung cancer chemoprevention through a mechanism-based approach using sulindac at low doses in combination with simvastatin. We found that sulindac-induced cytotoxicity was significantly enhanced in the presence of simvastatin. The combination of sulindac and simvastatin induced more extensive caspase-dependent apoptosis in A549 cells compared to that induced with either drug alone. The combination of sulindac and simvastatin also increased the loss of mitochondrial transmembrane potential (∆Ψm) and the cytosolic release of cytochrome c. In addition, ROS generation in cells treated with both sulindac and simvastatin was markedly increased compared to cells treated with either sulindac or simvastatin alone. The enhancement of ROS generation by sulindac and simvastatin was abrogated by pretreatment with NAC, which also prevented apoptosis and mitochondrial dysfunction induced by sulindac and simvastatin. These results suggest that sulindac and simvastatin-induced ROS generation in A549 lung cancer cells causes their accumulation in mitochondria, triggering the release of apoptogenic molecules from the mitochondria to the cytosol, and thus leading to caspase activation and cell death.

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