ABSTRACTbeen reported following proteasome inhibition in cells treated with H 2 O 2 and nitric oxide generators. 13,14 Ferritin might undergo proteasomal degradation to recycle stored iron in cells pre-loaded with ferric ammonium citrate (FAC) 15 in conditions of decreased cell iron content 16,17 or in the presence of oxidative stress stimuli. 18 Here we report the analysis of iron metabolism and the effects of iron manipulation in MM cell lines and primary cells of patients treated with bortezomib. We observed that the basal iron storage capacity of MM cell lines directly correlates with bortezomib resistance and that bortezomib sensitizes MM cells to iron toxicity. Manipulation of iron homeostasis might be a tool to increase the susceptibility of MM cells to the effect of bortezomib and to overcome bortezomib resistance.
Design and Methods
Cell culture and cellular extractsCell culture media and reagents were from Invitrogen (Karlsruhe, Germany) and from Sigma-Aldrich (St. Louis, MO, USA). Bortezomib was purchased from LC Laboratories (Wobun, MA, USA). Patient-derived plasma cells were purified from bone marrow aspirates by density gradient centrifugation and then by CD138 immunomagnetic positive selection (Miltenyi Biotec, Bergisch Gladbach, Germany). Samples from Patient 2 were collected both at diagnosis (sample a) and relapse (sample b). Informed consent was obtained in accordance with the Declaration of Helsinki and the approval for use of primary samples was obtained from the Institutional Review Board of the San Raffaele Scientific Institute. MM cell lines and primary cells were cultured in RPMI medium supplemented with 10% fetal bovine serum (FBS), 100 units/mL penicillin, 100 mg/mL streptomycin and 2 mM L-glutamine.Cellular extracts were prepared as described in the Online Supplementary Appendix.
Iron manipulationsIron removal was obtained by addition of deferoxamine (DFO; Biofutura Pharma, Milan, Italy). Ferric ammonium citrate (FAC), holo-transferrin (FeTf) (Sigma-Aldrich) and N-acetyl Cysteine (NAC) (Sigma-Aldrich) were used for iron loading experiments. FAC and 55 FeAC were prepared by mixing FeCl 3 -HCl (Merk Millipore, Billerica, MA, USA) or 55 FeCl 3 -HCl (PerkinElmer, Monza, Italy) with citric acid at 1:2 ratios and then by adjusting pH to 7.4 with NH 4 OH.To estimate ferritin content in patients' cells, cellular extracts were incubated in vitro with a molar excess of 55 FeAC plus ascorbic acid. Then extracts were loaded without heating on sodium dodecylsulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and exposed to autoradiography.
Cell viabilityCell viability was determined by measuring the reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) (Sigma-Aldrich). Briefly, cells were seeded in 96-well plates and assay performed on at least three wells for every condition. MTT was then added for 3 h at a final concentration of 0.25 mg/mL. Plates were centrifuged at 3200g for 5 min and the soluble fraction decanted. Crystal pellets were suspended in DMSO a...