Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis

Abstract The application of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs), such as gefitinib, has shifted lung cancer treatment from empirical chemotherapy to targeted molecular therapy. However, acquired drug resistance is inevitable in almost all non‐small cell lung cance...

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Main Authors: Xiang‐Yu Lai, Yu‐Mei Shi, Ming‐Ming Zhou
Format: Article
Language:English
Published: Wiley 2023-07-01
Series:Kaohsiung Journal of Medical Sciences
Subjects:
Online Access:https://doi.org/10.1002/kjm2.12684
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author Xiang‐Yu Lai
Yu‐Mei Shi
Ming‐Ming Zhou
author_facet Xiang‐Yu Lai
Yu‐Mei Shi
Ming‐Ming Zhou
author_sort Xiang‐Yu Lai
collection DOAJ
description Abstract The application of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs), such as gefitinib, has shifted lung cancer treatment from empirical chemotherapy to targeted molecular therapy. However, acquired drug resistance is inevitable in almost all non‐small cell lung cancer (NSCLC) patients treated with gefitinib. Combined treatment with dihydroartemisinin (DHA) and gefitinib produced a better inhibitory effect on lung adenocarcinoma than gefitinib treatment alone; however, the specific mechanism remains unclear. In this study, we aimed to assess the underlying mechanism of this combination treatment. We prepared gefitinib‐resistant A549 cells and investigated whether apoptosis and ferroptosis were involved in the sensitizing effect of DHA. Treatment with 5 μM gefitinib resulted in rupturing and floatation of A549 cells in the medium, while A549‐GR cells were found to be insusceptible to gefitinib. However, treatment with DHA substantially inhibited the proliferation of A549‐GR cells in a dose‐dependent manner accompanied by increased apoptosis and ferroptosis. The accumulated reactive oxygen species (ROS) was crucial for the inhibitory effect of DHA on A549‐GR cells. Moreover, cellular autophagy was significantly upregulated post‐DHA treatment. The combined treatment of DHA and gefitinib resulted in inhibition of proliferation of A549, H1975, and HCC827 cells, and ROS accumulation and a remarkable induction of apoptosis was observed in A549‐GR cells. DHA significantly induced apoptosis and ferroptosis in a dose‐dependent manner and exhibited high cellular toxicity on A549‐GR cells when combined with gefitinib.
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spelling doaj.art-948dac18733948da97f31322c92a15f02023-07-13T17:14:42ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502023-07-0139769970910.1002/kjm2.12684Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosisXiang‐Yu Lai0Yu‐Mei Shi1Ming‐Ming Zhou2Department of Pharmacy Chongqing University Cancer Hospital Chongqing ChinaDepartment of Medical Oncology Chongqing University Cancer Hospital Chongqing ChinaDepartment of Critical Care Medicine Chongqing University Cancer Hospital Chongqing ChinaAbstract The application of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs), such as gefitinib, has shifted lung cancer treatment from empirical chemotherapy to targeted molecular therapy. However, acquired drug resistance is inevitable in almost all non‐small cell lung cancer (NSCLC) patients treated with gefitinib. Combined treatment with dihydroartemisinin (DHA) and gefitinib produced a better inhibitory effect on lung adenocarcinoma than gefitinib treatment alone; however, the specific mechanism remains unclear. In this study, we aimed to assess the underlying mechanism of this combination treatment. We prepared gefitinib‐resistant A549 cells and investigated whether apoptosis and ferroptosis were involved in the sensitizing effect of DHA. Treatment with 5 μM gefitinib resulted in rupturing and floatation of A549 cells in the medium, while A549‐GR cells were found to be insusceptible to gefitinib. However, treatment with DHA substantially inhibited the proliferation of A549‐GR cells in a dose‐dependent manner accompanied by increased apoptosis and ferroptosis. The accumulated reactive oxygen species (ROS) was crucial for the inhibitory effect of DHA on A549‐GR cells. Moreover, cellular autophagy was significantly upregulated post‐DHA treatment. The combined treatment of DHA and gefitinib resulted in inhibition of proliferation of A549, H1975, and HCC827 cells, and ROS accumulation and a remarkable induction of apoptosis was observed in A549‐GR cells. DHA significantly induced apoptosis and ferroptosis in a dose‐dependent manner and exhibited high cellular toxicity on A549‐GR cells when combined with gefitinib.https://doi.org/10.1002/kjm2.12684DHAEGFR‐TKIsFerroptosisNSCLCROS
spellingShingle Xiang‐Yu Lai
Yu‐Mei Shi
Ming‐Ming Zhou
Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis
Kaohsiung Journal of Medical Sciences
DHA
EGFR‐TKIs
Ferroptosis
NSCLC
ROS
title Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis
title_full Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis
title_fullStr Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis
title_full_unstemmed Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis
title_short Dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ROS‐dependent apoptosis and ferroptosis
title_sort dihydroartemisinin enhances gefitinib cytotoxicity against lung adenocarcinoma cells by inducing ros dependent apoptosis and ferroptosis
topic DHA
EGFR‐TKIs
Ferroptosis
NSCLC
ROS
url https://doi.org/10.1002/kjm2.12684
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