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We deter-mined the effect of DHEA on cell proliferation, the cell cycle and cell death in three cell lines derived from human uterine cervical cancers infected or not with human papillom

Trang 1

induces the death of HPV-positive and HPV-negative

cervical cancer cells through an androgen- and

estrogen-receptor independent mechanism

Roma A Giro´n1, Luis F Montan˜o2, Marı´a L Escobar3and Rebeca Lo´pez-Marure1

1 Departamento de Biologı´a Celular, Instituto Nacional de Cardiologı´a ‘Ignacio Cha´vez’, Me´xico D.F., Me´xico

2 Laboratorio de Inmunobiologı´a, Departamento de Biologı´a Celular y Tisular, Facultad de Medicina, Universidad Nacional Autonoma de Me´xico (UNAM), Me´xico

3 Departamento de Biologı´a Celular, Facultad de Ciencias, Universidad Nacional Autonoma de Me´xico (UNAM), Me´xico

Introduction

Dehydroepiandrosterone (DHEA) is an adrenal steroid

hormone, a precursor of sex steroids [1], with a wide

variety of biological effects both in vivo and in vitro however, its physiological role remains unknown

Keywords

androgen receptor; cell proliferation; DHEA;

estrogen-receptor; HPV

Correspondence

R Lo´pez-Marure, Departamento de Biologı´a

Celular, Instituto Nacional de Cardiologı´a

‘Ignacio Cha´vez’, Juan Badiano No 1,

Colonia Seccio´n 16, Tlalpan, C.P 14080,

Me´xico D.F., Mexico

Fax: +52 55 73 09 26

Tel: +52 55 73 29 11 ext 1337

E-mail: rlmarure@yahoo.com.mx

(Received 3 June 2009, revised 21 July

2009, accepted 30 July 2009)

doi:10.1111/j.1742-4658.2009.07253.x

Dehydroepiandrosterone (DHEA) has a protective role against epithelial-derived carcinomas; however, the mechanisms remain unknown We deter-mined the effect of DHEA on cell proliferation, the cell cycle and cell death in three cell lines derived from human uterine cervical cancers infected or not with human papilloma virus (HPV) We also determined whether DHEA effects are mediated by estrogen and androgen receptors Proliferation of C33A (HPV-negative), CASKI (HPV16-positive) and HeLa (HPV18-positive) cells was evaluated by violet crystal staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) reduction Flow cytometry was used to evaluate the phases of the cell cycle, and cell death was detected using a commercially available carboxyfluorescein apop-tosis detection kit that determines caspase activation DNA fragmentation was determined using the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay Flutamide and ICI 182,780 were used to inhibit androgen and estrogen receptors, respectively, and letrozol was used

to inhibit the conversion of DHEA to estradiol Our results show that DHEA inhibited cell proliferation in a dose-dependent manner in the three cell lines; the DHEA IC50doses were 50, 60 and 70 lm for C33A, CASKI and HeLa cells, respectively The antiproliferative effect was not abrogated

by inhibitors of androgen and estrogen receptors or by an inhibitor of the conversion of testosterone to estradiol, and this effect was associated with

an increase in necrotic cell death in HPV-negative cells and apoptosis in HPV-positive cells These results suggest that DHEA strongly inhibits the proliferation of cervical cancer cells, but its effect is not mediated by androgen or estrogen receptor pathways DHEA could therefore be used as

an alternative in the treatment of cervical cancer

Abbreviations

DHEA, dehydroepiandrosterone; FLICA, fluorochrome-labeled inhibitors of caspases; HPV, human papilloma virus; MTT, 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide; PI, propidium iodide; TUNEL, terminal deoxynucleotidyl transferase dUTP nick-end labeling.

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DHEA is considered to exert its action through

con-version to other steroids [1], but there is evidence

showing that DHEA activity is estrogen-independent

[2–4] In animal models, DHEA has been shown to

have chemoprotective properties against a variety of

diseases: obesity, diabetes, immune disorders, cancer

and atherosclerosis [5,6], as a result of its

antiprolifera-tive, anti-inflammatory and anti-oxidant effects [7–9]

DHEA is a powerful inhibitor of carcinogenesis, in

the early- and late-progression stages, of liver, colon,

lung, skin, thyroid, mammary and prostate cancers

[10–16] DHEA also decreases the incidence of

sponta-neous breast cancer development in C3H female mice

[17] and the spontaneous emergence of lymphomas in

p53-negative mice [18], and inhibits partially cervical

carcinogenesis induced by methylcholanthrene in mice

[19] Long-term use of intravaginal DHEA (150 mg

per day) promoted regression of low-grade cervical

dysplasia in 83% of the patients; its local application

was shown to be safe and well tolerated [20]

Cervical cancer is the most common gynecological

cancer in women between 25 and 55 years old, and it

is the second most common cause of death from

can-cer among Mexican women [21] Therefore, the aim of

this work was to evaluate the effect of pharmacological

doses of DHEA on the proliferation and death of

three cell lines derived from human cervical cancers

associated with human papilloma virus (HPV) and

positive for the estrogen receptor, and to determine

whether the effect of DHEA was dependent on its

conversion into testosterone or estradiol

We found that DHEA inhibits the proliferation of

HPV-positive and HPV-negative cervical cancer cell

lines independently of its conversion to testosterone or

estradiol, and also found that DHEA induces

apopto-tic and necroapopto-tic cell death Taken together, these

results suggest that DHEA could be used in the

treat-ment of cervical cancer

Results

DHEA inhibited cell proliferation and decreased

cell viability

Three cell lines were evaluated: non-HPV-infected cells

(C33A) and cells infected with human papilloma virus

type 16 (CASKI) or type 18 (HeLa) DHEA inhibited

the proliferation of all the cell lines It induced a 40%

decrease at 25 lm concentration in C33A cells; higher

concentrations of DHEA were required in the

HPV-positive cell lines to achieve a similar inhibitory

decrease (Fig 1) The effect of DHEA was

dose-depen-dent, with half maximal inhibitory concentrations

(IC50) of 50, 60 and 70 lm for C33A, CASKI and HeLa cells, respectively The sulfate ester form of DHEA had no effect on proliferation (data not shown)

As shown in Fig 2, treatment of cells with DHEA inhibited the reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) The inhibi-tory effect commenced in the 25 lm range in all three cell lines, indicating a decrease in cell viability This

120

140

160

60

80

100

CASKI HeLa C33A

*

*

*

*

*

*

*

0

20

40

*

*

* *

Fig 1 DHEA inhibits cell proliferation Cervical cancer cell lines were treated with 6.25, 12.5, 25, 50, 70, 100 or 200 lM of DHEA for 48 h Cell proliferation was evaluated by crystal violet staining

as described in Experimental procedures The results are expressed

as percentages with respect to untreated cells (0) The results shown are for an experiment representative of three independent assays Asterisks indicate P values < 0.01 compared with control cells.

120

140

60

80

100

CASKI HeLa C33A

*

*

*

0

20

40

0 6.25 12.5 25 50 70 100 200

Fig 2 DHEA decreases cell viability Cells were cultured without and with DHEA at concentrations of 6.25, 12.5, 25, 50, 70, 100 and

200 lM The percentage MTT reduction was evaluated 48 h later,

as described in Experimental procedures The results are expressed

as percentages with respect to untreated cells (0) The results shown are for an experiment representative of three independent assays Asterisks indicate P values < 0.01 compared with control cells.

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DHEA concentration induced a 50% inhibitory effect,

but a three-fold increase in DHEA concentration was

needed to obtain 75% inhibition

The antiproliferative effect induced by DHEA is

independent of androgen and estrogen receptors

DHEA is converted to sex steroids, and cervical cancer

cell lines have estrogen and progesterone receptors

[1,22]; therefore, we evaluated whether the DHEA

antiproliferative effect was related to possible

conver-sion to testosterone or estradiol In order to assess

this, antagonists to androgen and estrogen receptors

(flutamide and ICI 182,780, respectively), and an

inhib-itor of the aromatase responsible for conversion of

androgen to estrogen (letrozol), were used alone or in

combination with DHEA before evaluation of cell

proliferation Our results showed that, at the highest concentration, letrozol modified the cell proliferation

in the three cell lines, but not significantly (Fig 3) Androgen and estrogen receptor inhibitors did affect proliferation but not significantly, and there was no difference between the response of each cell line When the inhibitors were used in combination with DHEA, none of them was able to abrogate the inhibition induced by DHEA, indicating that DHEA has a direct effect on the proliferation independent of its conver-sion to other metabolites (Fig 3)

DHEA did not induce cell-cycle arrest Figure 4 and Table 1 show that DHEA decreased the percentage of cells in the G1 phase of the cell cycle compared with non-DHEA-treated cell lines This

C33A

80

100

120

* * * * * * * * * * * *

0

20

40

60

ICI Flutamide Letrozol

* *

*

ICI Flutamide Letrozol

CASKI

80

100

120

0

20

40

60

* * * * * * * * * * * *

ICI Flutamide Letrozol

HeLa

80

100

120

* * * * * * * * * *

0

20

40

* * * * * *

A

B

C

Fig 3 The antiproliferative effect induced

by DHEA is independent of androgen and estrogen receptors C33A (A), CASKI (B) and HeLa (C) cells were cultured with half the maximal inhibitory concentration of DHEA (IC50) alone or in combination with flutamide, ICI 182,780 or letrozol at 1, 10 and 100 nM Cell proliferation was measured

by crystal violet staining 48 h later, and the results of the experiments are expressed as percentages with respect to untreated cells (0) All inhibitors were added 2 h before DHEA D, DHEA *P < 0.01 compared with the control.

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decrease was associated with an increase in the

per-centage of cells with a smaller amount of DNA in the

so-called sub-G1 phase, thus indicating cell death

CASKI cells were the most responsive to the toxic

effect induced by DHEA, with an increase of cells in

the sub-G1 phase of 34%; interestingly, C33A

(HPV-negative) and HeLa cells (HPV-positive) showed a

lower percentage of cell death in comparison with

con-trol cells (Table 1) These results suggest that the effect

of DHEA upon CASKI cells is more cytotoxic than

cytostatic

DHEA induces apoptotic and necrotic death

To determine the type of death induced by DHEA,

cells were analyzed for apoptosis using the terminal

deoxynucleotidyl transferase dUTP nick-end labeling

(TUNEL) assay Cisplatin was used as a positive

con-trol to induce apoptotic cell death Cisplatin and

DHEA treatments resulted in apoptosis of both

HPV-positive cells and C33A cells, in comparison with

untreated cells (Fig 5) The morphology of CASKI and C33A cells changed strongly after treatment with cisplatin or DHEA, and the cell number was reduced dramatically (Fig 5A,B), whereas HeLa cells showed fewer morphological modifications and were more resistant to treatment with cisplatin and DHEA (Fig 5C) Because the TUNEL assay detects DNA fragmentation, which can occur as a result of necrotic

Control DHEA

G1

C33A

S G2/M

CD

CASKI

HeLa

0 200 400 600

FL2-A

FL2-A

800 1000

0 200 400 600

FL2-A

FL2-A

800 1000

0 200 400 600

FL2-A

FL2-A

800 1000

Fig 4 DHEA does not induce cell-cycle

arrest Cells were cultured with and without

(control) DHEA (IC50) for 48 h Histograms

show the percentage of cells in each phase

of the cell cycle as evaluated by flow

cytom-etry (see Experimental procedures) The

percentage of cells in each phase of the cell

cycle was analyzed using Modift software

(Becton Dickinson) The results shown are

for an experiment representative of three

independent assays CD, cell death.

Table 1 Percentage of cells in each phase of the cell cycle as evaluated by flow cytometry.

Percentage of cells in the phases of the cell cycle

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A

B

C

C33A

Phase contrast

Cisplatin

DHEA

CASKI

Control

Cisplatin

DHEA

Control

HeLa

Cisplatin

DHEA

Fig 5 DHEA induces apoptotic death C33A (A), CASKI (B) and HeLa (C) cells were cultured with and without DHEA (IC 50 ) for 48 h Cisplatin (40 nM) was used as a positive control to induce death DNA fragmentation was detected by TUNEL assay as described in Experimental proce-dures Cells were counterstained with 4¢,6-diamidino-2-phenylindole The images were obtained using a phase contrast microscope, and correspond to an experi-ment representative of three independent assays.

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as well as apoptotic degradation, the type of cell death

was determined using fluorochrome-labeled inhibitors

of caspases (FLICA) and propidium iodide, which can

distinguish between apoptotic and necrotic cells,

respectively In C33A cells, DHEA was a more potent

inducer of cell death by necrosis than cisplatin was

(Fig 6) On the other hand, CASKI and HeLa cells

showed higher early and late apoptosis than C33A

cells (Table 2) These results indicate that DHEA can

induce early and late apoptosis and also necrosis

Discussion

DHEA is an intermediate in the biosynthesis of

andro-gen and estroandro-gen hormones It was originally isolated

from the adrenal gland, but it is also synthesized in

extra-adrenal tissues such as the ovary and testis; due

to its solubility, it diffuses into the bloodstream where

it is found in equilibrium with its sulfated form [1] The

levels of DHEA and sulfated DHEA decline dramati-cally with age in humans of both sexes, as the incidence

of most cancers rises Low levels of these adrenal steroids have been associated with the presence and risk

of development of cancer Oral administration of DHEA to mice inhibits spontaneous breast cancer and chemically induced tumors of the lung and colon [7]; however, its effect in cervical cancer remains unknown Therefore, we evaluated the effect of DHEA on three cell lines of cervical cancer that are positive to estrogen receptor [22]: (a) an invasive carcinoma of the cervix, with poorly differentiated cells but negative for HPV (C33A), (b) a small bowel metastasis of an epidermoid carcinoma of the cervix, which was HPV16-positive (CASKI), and (c) an epithelial-like cell line derived from an cervical adenocarcinoma at IV-B metastatic stage and positive for HPV type 18 (HeLa)

The results show that DHEA strongly inhibits the proliferation of all cell lines, as determined by violet

C33A

CASKI

HeLa

FL1-H

10 4

10 2 10 3

10 1

10 0

4

10 2 10 3

10 1

10 0

4

10 2 10 3

10 1

10 0

4

102 103

101

100

4

10 2 10 3

10 1

10 0

FL1-H

10 4

10 2 10 3

10 1

10 0

4

10 2 10 3

10 1

10 0

FL1-H

10 4

10 2 10 3

10 1

10 0

FL1-H

10 4

10 2 10 3

10 1

10 0

Fig 6 DHEA also induces necrotic death Cells were cultured with and without DHEA (IC 50 ) for 48 h Cisplatin (40 nM) was used as a positive control to induce cell death Cells were labeled with FLICA (FL1-H) and propidium iodide (PI) (FL2-H) Left lower panels, living cells (LC); right lower panels, early apoptotic cells (EAC); left upper panels, necrotic cells (NC); right upper panels, late apoptotic cells (LAC) Non-stained cells served as negative control Results correspond to an experiment representative of three independent assays.

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crystal staining and MTT reduction, independently of

the HPV type Several studies have found an

antipro-liferative effect induced by DHEA in normal cells such

as T lymphocytes, isolated neurons and endothelial

cells, or malignant cell lines such as human

hepatoblas-toma cells (HepG2), colon adenocarcinoma cells

(HT-29) and breast cancer cells (MCF-7) [3,23–26]

Our results are the first evidence for an

antiprolifera-tive effect of DHEA on cervical tumor cells There was

a non-statistically significant difference in the response

of the cell lines to treatment with DHEA C33A and

CASKI cells were more responsive to DHEA, and

HeLa cells were the most resistant This might be

related to the malignant state of the cells HeLa cells

are an advanced-stage cervical cell carcinoma [27], in

comparison with the other cell lines used for which no

stage is specified; therefore, HeLa cells could be more

resistant to antiproliferative factors The E6 protein

from HPV18 is related to the regulation of G0⁄ G1

phases in the cell cycle; this effect is altered by

muta-tions in p53 [28] C33A cells are known to have a

non-functional p53 protein due to mutations [29], whereas

CASKI and HeLa cells possess a non-mutant p53

protein Given that p53 is associated with an

antipro-liferative effect, the high resistance of both cell lines to

DHEA might be associated with a non-p53-related

mechanism It has been shown that p53 protein levels

are quite low in cell lines derived from cervical tumors

[30] DHEA-induced cellular effects in hyperplastic

and premalignant (carcinoma in situ) lesions in

mam-mary gland of rats are associated with increased

expression of p16 and p21, but not p53, implying a

p53-independent mechanism of action [31] It will be

interesting to determine whether other proteins that

control the cell cycle are involved in the effects induced

by DHEA in cervical cancer

It has been suggested that HPV18 increases the

susceptibility of cells to inhibitory factors Similarly,

immortalization is dramatically increased in HPV16-infected human keratinocytes [32] It is probable that our HPV-infected cell lines could not respond to low DHEA concentrations because of the presence of a multidrug resistance gene that is expressed in a differ-ent way [33] Nevertheless, it is interesting to observe that HeLa cells, which are HPV18-positive are also resistant to the antiproliferative effect of ceramide [34] Resistance to apoptosis and radiation in cervical can-cers are also determined by transcription factors such

as hypoxia inducible factor-1 alpha [35], and DHEA is known to alter this transcription factor, decreasing its accumulation in human pulmonary artery cells [36] DHEA can be converted to testosterone and then to estradiol by the P450 aromatase It has been shown that approximately 35% of cervical carcinomas express aromatase [37] and that DHEA binds to the androgen receptor and estrogen receptors a or b [38–41] DHEA

at 30 nm is sufficient to activate transcription of estro-gen receptor b to the same degree as estroestro-gen at its circulating concentration [42] We showed that the inhibition of proliferation induced by DHEA is inde-pendent of its conversion to estrogen and androgen, because use of antagonists to androgen and estrogen receptors (flutamide and ICI 182,780, respectively), and letrozol, an inhibitor of the aromatase responsible for converting androgen to estrogen, did not abrogate the antiproliferative effect induced by DHEA; how-ever, our results cannot discount the possible conver-sion of DHEA to 5-androstenediol, a steroid that has been demonstrated to be a biologically active estrogen [43,44] Despite the fact that the cervical cancer cell lines used in this investigation express estrogen recep-tor and progesterone receprecep-tor genes [45,46], our results showed that DHEA does have a direct inhibitory effect

in these cells A direct effect of DHEA is supported by the fact that progesterone and estradiol have an oppo-site effect on the growth of cervical cancer, i.e they induce their proliferation [47]

DHEA can exert various effects depending on its concentration In this work, the effects induced by DHEA were seen at concentrations between 50 and

70 lm We also observed that low concentrations of DHEA (physiological concentrations) increased the proliferation of CASKI cells We previously showed that DHEA plays differential roles depending on its concentration In MCF-7 cells, DHEA at 100 lm inhibits cell proliferation, but has a proliferative effect

at physiological concentrations Other studies have also shown that DHEA at concentrations of 25–50 lm inhibits the proliferation of MCF-7 cells [48], and that lower concentrations induce stimulation [49,50]; how-ever, the mechanism of this differential effect is

Table 2 Percentage of cells alive and dead as determined by flow

cytometry.

Percentage of cells Alive Early apoptosis Late apoptosis Necrosis

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unknown This differences have also been observed in

neuronal cell cultures, in which DHEA has a

protec-tive role at concentrations ranging from 0.1–1 lm, but

a pro-oxidant⁄ cytotoxic effect is seen at higher

concen-trations [25] It has been shown that the HPV status in

cervical cancer cell lines is related to a differential

expression of IGF/insulin receptors [51] We previously

showed that the antiproliferative effect induced by

DHEA in MCF-7 cells is also androgen and estrogen

receptor-independent [3] These results indicate that

DHEA acts through activation of a putative receptor

rather than through conversion to other steroid

hor-mones Recently, Liu et al [4] showed a cytoprotective

role of DHEA on endothelial cells which is estrogen

receptor-independent They also showed that DHEA

binds to specific receptors on plasma membranes of

endothelial cells, and that this receptor activates

intra-cellular G proteins (specifically Gai2 and Gai3) and

endothelial nitric oxide synthase [52] There is evidence

showing that the binding of [3H]-DHEA to plasma

membranes is highly specific [53] Closely related

ste-roid structures such as sulfated DHEA,

androstenedi-one, 17a-hydroxypregnenalone, testosterone and

17b-estradiol did not compete with [3H]-DHEA for

binding at various concentrations The absence of

competition between DHEA and sulfated DHEA

sug-gests that the 3-position of the A ring may be an

important component of the functional group for this

receptor [39] More recently, it has been shown that

the anti-atherogenesis effect of dehydroepiandrosterone

does not occur via its conversion to estrogen [53]

These results support the conclusion that DHEA is the

active form and can act in a direct way, independent

of whether it is bound to androgen or estrogen

recep-tors or is converted to other metabolites

The antiproliferative effect of DHEA has been

asso-ciated with an arrest of the cell cycle and cell death in

BV-2 cells, a murine microglial cell line, in hepatoma

cell lines and in HepG2 cells [25,54,55] Our results

showed that pharmacological concentrations of DHEA

interfere with cell proliferation by inducing cell death

without inducing cell-cycle arrest In contrast, a

protec-tive role against apoptosis has been shown at

physio-logical concentrations of DHEA in neurons [56];

similar DHEA concentrations act as a survival factor

in endothelial cells by triggering the G-alpha-1

G-pro-tein-phosphoinositide 3-kinase/AKT protein

family-Bcl-2 protein (Gai-PI3K⁄ Akt-Bcl-2) pathway to protect

cells against apoptosis [4] An interesting observation

was that, in the HPV-negative cell line, cell death was

primarily due to necrosis, whereas the death was

secondary to apoptosis in both HPVpositive cell lines

It is not known whether HPV infection confers some

kind of resistance to the necrotic process, although one would imagine that HPV-infected cells possess mecha-nisms that immortalize them more easily than non-HPV-infected cells It has recently been demonstrated that HPV protein E7 induce S-phase entry in keratino-cytes [57], thus favoring activated proliferation of the cells, and thus major resistance to the cytotoxic effects

of DHEA

Our results suggest that the cell-death mechanism in cervical cancer is dependent on the presence or not of HPV, and also demonstrate that DHEA is highly effective in non-HPV-infected cancer cells We there-fore believe that alternative therapeutic approaches should be considered in the treatment of cervical can-cer DHEA could be useful in the treatment of cervical cancer, either alone or in synergy with other drugs, depending on the HPV status

Experimental procedures

Materials RPMI-1640, Dulbecco’s modified Eagle’s medium and

USA) Fetal bovine serum was purchased from HyClone (Loga, UT, USA) The carboxyfluorescein FLICA apopto-sis detection kit was purchased from Immunology Techno-logies (Bloomington, MN, USA) Sterile plastic material for tissue culture was purchased from NUNC (Rochester, NY, USA) and COSTAR (Lowell, MA, USA) Flow cytometry reagents were purchased from Becton Dickinson Immuno-cytometry Systems (San Jose´, CA, USA) ICI 182,780 was purchased from Tocris Cookson Inc (Ellisville, MO, USA) and letrozol from Novartis (Me´xico City, Me´xico) The Apoptag Red in situ apoptosis detection kit was obtained

DHEA and all other chemicals were purchased from Sigma Aldrich (St Louis, MO, USA)

Cell culture CASKI, HeLa and C33A cells were purchased from the American Type Culture Collection (Manassas, VA, USA) CASKI and HeLa cell lines were maintained in RPMI-1640 medium and C33A cells in Dulbecco’s modified Eagle’s medium, both supplemented with 5% fetal bovine serum and l-glutamine (2 mm) Cells used for the experiments were cultured in their respective medium supplemented with 5% charcoal-stripped serum and without red phenol

Cell proliferation The number of cells was evaluated by crystal violet stain-ing Cells were plated in 96-well plates and cultured with

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various concentrations of DHEA alone or in combination

with either the androgen or the estrogen receptor inhibitor

After 48-h incubation, cells were fixed with 100 lL of

Plates were washed three times by immersion in de-ionized

water, air-dried and stained for 20 min with 100 lL of a

0.1% crystal violet solution (in 200 mm phosphoric acid

buffer, pH 6) After careful aspiration of the crystal violet

solution, the plates were extensively washed with de-ionized

water, and air-dried prior to solubilization of the bound

dye with 100 lL of a 10% acetic acid solution for 30 min

The absorbance was measured at 595 nm using a multiplate

spectrophotometer (EL311; Bio-Tek Instruments, Winooski,

VT, USA)

Cell viability assay

Cell viability was determined using the

3-(4,5-dimethylthiaz-oil-2-yl)-2,5-diphenyltentrazolium bromide (MTT) reduction

assay MTT is reduced in metabolically active cells to yield

an insoluble purple formazan product Cells were cultured

in 96-well culture dishes with DHEA for 48 h Then 20 lL

hours later, the supernatants were discarded and 100 lL of

acidic isopropyl alcohol (HCl 0.04 N) per well were added

to dissolve the formazan The absorbance was measured

using a multiplate spectrophotometer (Bio-Tek Instruments)

at 570 nm against a reference wavelength (630 nm) The

background absorbance (630 nm) was subtracted before

calculating MTT reduction (MTTR) according to the

tested cells⁄ mean absorbance of control cells) · 100

Determination of the phases of the cell cycle

DNA content was analyzed by propidium iodide staining

followed by cytometric analysis using the DNA reagent kit

from Becton Dickinson Cells were treated with the

for 48 h Then, cells were trypsinized and fixed with 50%

using a Becton Dickinson Facscalibur instrument

Cell death assay

Cell death was evaluated using the carboxyfluorescein

FLICA apoptosis detection kit Cells were treated with the

IC50previously determined for each cell line in the

prolifera-tion assays for 48 h Then cells were recovered from the

cellsÆmL)1in NaCl⁄ Pibefore transferring 300 lL of each cell suspension to sterile tubes, to which 10 lL of a 30· FLICA solution were added The tubes were covered with alum

2 mL of wash buffer were added to each tube Cells were mixed and centrifuged at 180 g for 5 min at room tempera-ture The cell pellet was resuspended in 1 mL of wash buffer, centrifuged at 180 g at room temperature for 5 min and resuspended again in 400 lL of wash buffer Cells were

analyzed by flow cytometer using the cell quest software program (Becton Dickinson, Franklin Lakes, NJ, USA) Detection of DNA fragmentation was performed by TUNEL assay using the Apoptag Red in situ apoptosis detection kit Cells were cultured on cover slips and treated with cisplatin (40 nm) as a positive control and DHEA for

48 h Afterwards, the cells were fixed with 2% paraformal-dehyde for 20 min, washed three times, permeabilized with

and labeled with biotin-dUTP by incubation with reaction

detected using streptavidin conjugated with rhodamine Cells were counterstained using 4¢,6-diamidino-2-phenylin-dole to determine DNA distribution Cell fluorescence was determined using an E600 Nikon Eclipse microscope (Melville, NY, USA) with red and blue filters

Statistical analysis All experiments were performed in triplicate in at least three independent trials The results are expressed as the mean ± standard deviation of the mean Student’s t, ANOVA and Bonferroni tests were used to determine statistical signifi-cance, with a P value < 0.01 spss software (release 12; SPSS Inc., Chicago, IL, USA) was used

Acknowledgements

R.A.G is a postgraduate student at the Universidad Nacional Auto´noma de Me´xico, and is supported by a postgraduate scholarship from the Consejo Nacional

de Ciencia y Tecnologı´a (CONACyT)

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NK, Sumi D, Jayachandran M & Iguchi A (2000) Dehy-droepiandrosterone retards atherosclerosis formation through its conversion to estrogen: the possible role of nitric oxide Arterioscler Thromb Vasc Biol 20, 782–792

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