Abstract. The aim of the present study was to determine whether kaempferol has a radiosensitization potential for lung cancer in vitro and in vivo. The in vitro radio-sensitization activity of kaempferol was elucidated in A-549 lung cancer cells by using an MTT (3-(4 5-dimethylthiazol-2-yl)-25-diphenyl tetrazolium bromide) assay, cell cycle analysis and clonogenic assay. The in vivo activity was evaluated in the BALB/c nude mouse xenograft model of A-549 cells by hematoxylin and eosin staining and immunohistochemistry, and the tumor volume was recorded. Protein levels of the apoptotic pathway were detected by western blot analysis. Treatment with kaempferol inhibited the growth of A-549 cells through activation of apoptotic pathway. However, the same doses did not affect HFL1 normal lung cell growth. Kaempferol induced G2/M cell cycle arrest and the enhancement of radiation-induced death and clonogenic survival inhibition. The in vivo data showed that kaempferol increased tumor cell apoptosis and killing of radiation. In conclusion, the findings demonstrated that kaempferol increased tumor cell killing by radiation in vitro and in vivo through inhibition of the AKT/PI3K and ERK pathways and activation of the mitochondria apoptosis pathway. The results of the present study provided solid evidence that kaempferol is a safe and potential radiosensitizer.
IntroductionLung cancer is the leading cause of cancer-associated mortalities worldwide, with an estimated 1.61 million new cases and 1.38 million mortailies in 2008 (1,2). Approximately 85% of primary lung cancer patients have non-small-cell lung cancer (NSCLC) (3). Surgery is the standard treatment for early-stage NSCLC. However, the majority of patients diagnosed at an advanced stage are unsuitable for surgical resection or extensive mediastinal lymphadenopathy (4,5). Chemo-and radiotherapy are the current standard of care for patients with unresectable advanced NSCLC (6,7). However, there are several limiting factors of chemo-and radiotherapy, including dose tolerance limitation of normal tissue and tumor radioresistance (8). Accordingly, identifying effective agents for enhancing tumor sensitivity to radiation and reducing adverse effects on normal tissues are crucial.Acting as radiosensitizers, drugs can accelerate the killing of cancer cells by increasing the effectiveness of radiation with little effect on normal cells (9). The PI3K/Akt and ERK pathways play an essential role in confirming sensitivity or resistance to radiation by inhibiting a survival pathway that induces cell apoptosis (10,11). Previous studies also showed that treatment with the ERK inhibitor can reduce radioresistance and suppressed activation of PI3K/Akt can promote radiosentization (12,13). Inhibition of growth of cancer cells and the induction of apoptosis are important determinants of the response to anticancer therapy (14).Bioflavonoids, which are the phytochemicals that are abundant in a variety of plants have a vital role in cancer prevention as they can scavenge free radicals (1...