Abstract. Gastric cancer is the third most frequent cause of cancer-associated mortality and almost all patients who respond initially to cisplatin (DDP) later develop drug resistance, indicating multi-drug resistance (MDR) is an essential aspect of the failure of treatment. The natural diterpenoid component Oridonin (Ori) has exhibited efficient inhibition in several types of human cancer. However, the effect and potential mechanism of Ori-reversed MDR in human gastric cancer has not been fully elucidated. In the present study, it was found that Ori significantly suppressed DDP-resistant human SGC7901/DDP cell proliferation, growth and colony formation, causing increased caspase-dependent apoptosis, decreased expression of P-glycoprotein (P-gp), encoded by the MDR gene, multi-drug resistance-associated protein (MRP1), and cyclin D1. SGC7901/DDP cells were cultured with different groups of drugs (Ori, DDP alone, or the combination of Ori and DDP). The drug sensitivity, cell apoptosis and effects on MDR were detected by MTT assay and western blot analysis. The results revealed that Ori is able to reverse the DDP resistance and has a clear synergistic effect with DDP in SGC7901/DDP cells by decreasing the levels of P-gp, MRP1, cyclin D1 and cancerous inhibitor of protein phosphatase 2A. Thus, Ori may be a novel effective candidate to treat DDP-resistant human gastric cancer cells.
IntroductionGastric cancer is one of the most common cancers in Eastern Asia, including China, Japan and South Korea, and Eastern Europe (1). The incidence and mortality of gastric cancer have declined markedly over the past half-century in the majority of developed countries, but it remains the second most common cause of cancer-associated mortality in the world. An estimated 28,000 incident cases (17,750 in males and 10,250 in females) of gastric cancer will be diagnosed in 2017, and 10,960 mortalities (6,720 in males and 4,240 in females) are estimated to occur from the disease (2). In China, approximately two-thirds of patients develop advanced or metastatic disease, and >50% have recurrent disease following curative surgery (3). Systematic chemotherapy plays a critical role in the treatment of gastric cancer. Cisplatin (DDP) has been commonly used in the treatment of gastric cancer (4). Despite an initial response to surgical debulking and front-line platinum chemotherapy, the majority of tumors eventually develop a drug resistant relapse selected during the course of therapy. The reasons for drug resistance are complicated and several previous studies have aimed to explore the question (1). The development of multidrug resistance (MDR) to cancer chemotherapy is a major obstacle to the effective treatment of advanced gastric cancer (5). Additionally, the mechanism of MDR remains obscure. Mechanisms including increased expression of P-glycoprotein (P-gp) and MDR-associated protein (MRP), cell cycle arrest, increased DNA damage repair and resistance of tumor cells to apoptosis may account for MDR (6). Restoring DDP sensitivity by reve...