Int J Med Sci 2022; 19(1):175-185. doi:10.7150/ijms.66737 This issue

Research Paper

Cell death mechanisms induced by synergistic effects of halofuginone and artemisinin in colorectal cancer cells

Rui-Hong Gong1, Da-Jian Yang2, Hiu-Yee Kwan1, Ai-Ping Lyu1, Guo-Qing Chen3,4,5✉, Zhao-Xiang Bian1✉

1. Centre for Cancer and Inflammation Research (CCIR), School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong S.A.R., China
2. Chongqing Academy of Chinese Materia Medica, Chongqing 400065, China
3. State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation), Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
4. Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong S.A.R., China
5. Department of Applied Biology & Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong S.A.R., China

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Citation:
Gong RH, Yang DJ, Kwan HY, Lyu AP, Chen GQ, Bian ZX. Cell death mechanisms induced by synergistic effects of halofuginone and artemisinin in colorectal cancer cells. Int J Med Sci 2022; 19(1):175-185. doi:10.7150/ijms.66737. Available from https://www.medsci.org/v19p0175.htm

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Abstract

Graphic abstract

Our previous study found that the combination of halofuginone (HF) and artemisinin (ATS) synergistically arrest colorectal cancer (CRC) cells at the G1/G0 phase of the cell cycle; however, it remains unclear whether HF-ATS induces cell death. Here we report that HF-ATS synergistically induced caspase-dependent apoptosis in CRC cells. Specifically, both in vitro and in vivo experiments showed that HF or HF-ATS induces apoptosis via activation of caspase-9 and caspase-8 while only caspase-9 is involved in ATS-induced apoptosis. Furthermore, we found HF or HF-ATS induces autophagy; ATS can't induce autophagy until caspase-9 is blocked. Further analyzing the crosstalk between autophagic and caspase activation in CRC cells, we found autophagy is essential for activation of caspase-8, and ATS switches to activate capase-8 via induction of autophagy when caspase-9 is inhibited. When apoptosis is totally blocked, HF-ATS switches to induce autophagic cell death. This scenario was then confirmed in studies of chemoresistance CRC cells with defective apoptosis. Our results indicate that HF-ATS induces cell death via interaction between apoptosis and autophagy in CRC cells. These results highlight the value of continued investigation into the potential use of this combination in cancer therapy.

Keywords: halofuginone, artemisinin, synergy, colorectal cancer, apoptosis, autophagy