Anticancer Effect of Puerarin on Ovarian Cancer Progression Contributes to the Tumor Suppressor Gene Expression and Gut Microbiota Modulation
Yongju Ye
Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorYang Gao
Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorYuan Fang
Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorLixia Xu
Clinical laboratory, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorCorresponding Author
Fule He
Zhejiang Chinese Medicine Museum, Zhejiang Chinese Medical University, Hangzhou City, 310053 Zhejiang Province, China zcmu.edu.cn
Search for more papers by this authorYongju Ye
Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorYang Gao
Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorYuan Fang
Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorLixia Xu
Clinical laboratory, Lishui Hospital of Traditional Chinese Medicine, Lishui City, 323000 Zhejiang Province, China guahao.zjol.com.cn
Search for more papers by this authorCorresponding Author
Fule He
Zhejiang Chinese Medicine Museum, Zhejiang Chinese Medical University, Hangzhou City, 310053 Zhejiang Province, China zcmu.edu.cn
Search for more papers by this authorAbstract
Ovarian cancer (OC) causes more deaths than any other cancer of the female reproductive system due to its late presentation and malignant nature. Although significant progress has been made in the diagnosis and treatment of OC over the last decade, chemotherapeutic drug resistance and cancer recurrence remain serious challenges in OC management. In the field of cancer therapy, traditional Chinese herbal medicines and their active compounds have been widely reported to have favorable therapeutic effects on cancer. Recent studies have also revealed the protective effect of puerarin in cancer, but the exact role and underlying mechanism of puerarin in OC remain unclear. Here, we established in vivo and in vitro OC models to evaluate the anticancer effect of puerarin. It was found that puerarin significantly inhibited OC cell viability and proliferation and induced cell apoptosis. In OC model mice, puerarin treatment suppressed tumor formation and modulated the gut microbiome. In addition, the expression of tumor suppressor genes was activated by puerarin in vitro and in vivo. These findings add to the existing knowledge on the usefulness of herbal active ingredients for the prevention and treatment of OC and provide a new perspective regarding the therapeutic potential of puerarin in cancer.
Conflicts of Interest
The authors declare that they have no conflict of interest.
Open Research
Data Availability
The data used to support the findings of this study are available from the corresponding author upon request.
Supporting Information
Filename | Description |
---|---|
jimr4472509-sup-0001-f1.docWord document, 87.5 KB | Supplementary Materials Supplementary Table 1: 49 markedly changed gut microbes were identified by LEfSe analysis. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1 Torre L. A., Trabert B., DeSantis C. E., Miller K. D., Samimi G., Runowicz C. D., Gaudet M. M., Jemal A., and Siegel R. L., Ovarian cancer statistics, 2018, CA: a Cancer Journal for Clinicians. (2018) 68, no. 4, 284–296, https://doi.org/10.3322/caac.21456, 2-s2.0-85047663692, 29809280.
- 2 Sung H., Ferlay J., Siegel R. L., Laversanne M., Soerjomataram I., Jemal A., and Bray F., Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries, CA: a Cancer Journal for Clinicians. (2021) 71, no. 3, 209–249, https://doi.org/10.3322/caac.21660.
- 3 Fillon M., Opportunistic salpingectomy may reduce ovarian cancer risk, CA: a Cancer Journal for Clinicians. (2022) 72, no. 2, 97–99, https://doi.org/10.3322/caac.21716, 35020193.
- 4 Jayson G. C., Kohn E. C., Kitchener H. C., and Ledermann J. A., Ovarian cancer, Lancet. (2014) 384, no. 9951, 1376–1388, https://doi.org/10.1016/S0140-6736(13)62146-7, 2-s2.0-84908173579.
- 5 Falzone L., Scandurra G., Lombardo V., Gattuso G., Lavoro A., Distefano A., Scibilia G., and Scollo P., A multidisciplinary approach remains the best strategy to improve and strengthen the management of ovarian cancer (review), International Journal of Oncology. (2021) 59, no. 1, https://doi.org/10.3892/ijo.2021.5233, 34132354.
- 6 Lee J. M., Minasian L., and Kohn E. C., New strategies in ovarian cancer treatment, Cancer. (2019) 125, no. Suppl 24, 4623–4629, https://doi.org/10.1002/cncr.32544, 31967682.
- 7 Arend R., Martinez A., Szul T., and Birrer M. J., Biomarkers in ovarian cancer: to be or not to be, Cancer. (2019) 125, no. Suppl 24, 4563–4572, https://doi.org/10.1002/cncr.32595.
- 8 Bykov V. J. N., Eriksson S. E., Bianchi J., and Wiman K. G., Targeting mutant p53 for efficient cancer therapy, Nature Reviews. Cancer. (2018) 18, no. 2, 89–102, https://doi.org/10.1038/nrc.2017.109, 2-s2.0-85041095694, 29242642.
- 9 Lee Y. R., Chen M., and Pandolfi P. P., The functions and regulation of the PTEN tumour suppressor: new modes and prospects, Nature Reviews. Molecular Cell Biology. (2018) 19, no. 9, 547–562, https://doi.org/10.1038/s41580-018-0015-0, 2-s2.0-85047933979, 29858604.
- 10 Martins F. C., Couturier D. L., Paterson A., Karnezis A. N., Chow C., Nazeran T. M., Odunsi A., Gentry-Maharaj A., Vrvilo A., Hein A., Talhouk A., Osorio A., Hartkopf A. D., Brooks-Wilson A., DeFazio A., Fischer A., Hartmann A., Hernandez B. Y., McCauley B. M., Karpinskyj C., de Sousa C. B., Høgdall C., Tiezzi D. G., Herpel E., Taran F. A., Modugno F., Keeney G., Nelson G., Steed H., Song H., Luk H., Benitez J., Alsop J., Koziak J. M., Lester J., Rothstein J. H., de Andrade J. M., Lundvall L., Paz-Ares L., Robles-Díaz L., Wilkens L. R., Garcia M. J., Intermaggio M. P., Alcaraz M. L., Brett M. A., Beckmann M. W., Jimenez-Linan M., Anglesio M., Carney M. E., Schneider M., Traficante N., Pejovic N., Singh N., le N., Sinn P., Ghatage P., Erber R., Edwards R., Vierkant R., Ness R. B., Leung S., Orsulic S., Brucker S. Y., Kaufmann S. H., Fereday S., Gayther S., Winham S. J., Kommoss S., Pejovic T., Longacre T. A., McGuire V., Rhenius V., Sieh W., Shvetsov Y. B., Whittemore A. S., Staebler A., Karlan B. Y., Rodriguez-Antona C., Bowtell D. D., Goode E. L., Høgdall E., Candido dos Reis F. J., Gronwald J., Chang-Claude J., Moysich K. B., Kelemen L. E., Cook L. S., Goodman M. T., Fasching P. A., Crawford R., Deen S., Menon U., Huntsman D. G., Köbel M., Ramus S. J., Pharoah P. D. P., and Brenton J. D., Clinical and pathological associations of PTEN expression in ovarian cancer: a multicentre study from the Ovarian Tumour Tissue Analysis Consortium, British Journal of Cancer. (2020) 123, no. 5, 793–802, https://doi.org/10.1038/s41416-020-0900-0, 32555365.
- 11 Ramraj S. K., Elayapillai S. P., Pelikan R. C., Zhao Y. D., Isingizwe Z. R., Kennedy A. L., Lightfoot S. A., and Benbrook D. M., Novel ovarian cancer maintenance therapy targeted at mortalin and mutant p53, International Journal of Cancer. (2020) 147, no. 4, 1086–1097, https://doi.org/10.1002/ijc.32830, 31845320.
- 12 Conciatori F., Bazzichetto C., Falcone I., Ciuffreda L., Ferretti G., Vari S., Ferraresi V., Cognetti F., and Milella M., PTEN function at the interface between cancer and tumor microenvironment: implications for response to immunotherapy, International Journal of Molecular Sciences. (2020) 21, no. 15, https://doi.org/10.3390/ijms21155337, 32727102.
- 13 Wang B., Lim C. B., Yan J., Li L., Wang J., Little J. B., and Yuan Z. M., MDMX phosphorylation-dependent p53 downregulation contributes to an immunosuppressive tumor microenvironment, Journal of Molecular Cell Biology. (2020) 12, no. 9, 713–722, https://doi.org/10.1093/jmcb/mjaa038, 32706867.
- 14 Wang K., Chen Q., Shao Y., Yin S., Liu C., Liu Y., Wang R., Wang T., Qiu Y., and Yu H., Anticancer activities of TCM and their active components against tumor metastasis, Biomedicine & Pharmacotherapy. (2021) 133, article 111044, https://doi.org/10.1016/j.biopha.2020.111044, 33378952.
- 15 Zhou Y. X., Zhang H., and Peng C., Puerarin: a review of pharmacological effects, Phytotherapy Research. (2014) 28, no. 7, 961–975, https://doi.org/10.1002/ptr.5083, 2-s2.0-84904262184.
- 16 Ahmad B., Khan S., Liu Y., Xue M., Nabi G., Kumar S., Alshwmi M., and Qarluq A. W., Molecular mechanisms of anticancer activities of puerarin, Cancer Management and Research. (2020) 12, 79–90, https://doi.org/10.2147/cmar.s233567.
- 17 Duan J., Yin M., Shao Y., Zheng J., and Nie S., Puerarin induces platinum-resistant epithelial ovarian cancer cell apoptosis by targeting SIRT1, The Journal of International Medical Research. (2021) 49, no. 9, article 3000605211040762, https://doi.org/10.1177/03000605211040762, 34590923.
- 18 Yang M., Zhu S. J., Shen C., Zhai R., Li D. D., Fang M., Xu J. N., Gan Y. N., Yang L., Ren Z. Y., Zheng R. X., Robinson N., and Liu J. P., Clinical application of Chinese herbal injection for cancer care: evidence-mapping of the systematic reviews, meta-analyses, and randomized controlled trials, Frontiers in Pharmacology. (2021) 12, article 666368, https://doi.org/10.3389/fphar.2021.666368, 34025425.
- 19
Liu B.,
Tan Y.,
Wang D.,
Liu M., and
Cochrane Stroke Group, Puerarin for ischaemic stroke, Cochrane Database of Systematic Reviews. (2016) 2, article Cd004955, https://doi.org/10.1002/14651858.CD004955.pub3, 2-s2.0-84960540204.
10.1002/14651858.CD004955.pub3 Google Scholar
- 20 Murahari M., Singh V., Chaubey P., and Suvarna V., A critical review on anticancer mechanisms of natural flavonoid puerarin, Anti-Cancer Agents in Medicinal Chemistry. (2020) 20, no. 6, 678–686, https://doi.org/10.2174/1871520620666200227091811, 32106804.
- 21 Yu Z. and Li W., Induction of apoptosis by puerarin in colon cancer HT-29 cells, Cancer Letters. (2006) 238, no. 1, 53–60, https://doi.org/10.1016/j.canlet.2005.06.022, 2-s2.0-33744936020.
- 22 Li J., Xiong C., Xu P., Luo Q., and Zhang R., Puerarin induces apoptosis in prostate cancer cells via inactivation of the Keap1/Nrf2/ARE signaling pathway, Bioengineered. (2021) 12, no. 1, 402–413, https://doi.org/10.1080/21655979.2020.1868733.
- 23 Kang H., Zhang J., Wang B., Liu M., Zhao J., Yang M., and Li Y., Puerarin inhibits M2 polarization and metastasis of tumor-associated macrophages from NSCLC xenograft model via inactivating MEK/ERK 1/2 pathway, International Journal of Oncology. (2017) 50, no. 2, 545–554, https://doi.org/10.3892/ijo.2017.3841, 2-s2.0-85013116256.
- 24 Liu X., Zhao W., Wang W., Lin S., and Yang L., Puerarin suppresses LPS-induced breast cancer cell migration, invasion and adhesion by blockage NF-κB and Erk pathway, Biomedicine & Pharmacotherapy. (2017) 92, 429–436, https://doi.org/10.1016/j.biopha.2017.05.102, 2-s2.0-85019936575.
- 25 Blyuss O., Burnell M., Ryan A., Gentry-Maharaj A., Mariño I. P., Kalsi J., Manchanda R., Timms J. F., Parmar M., Skates S. J., Jacobs I., Zaikin A., and Menon U., Comparison of longitudinal CA125 algorithms as a first-line screen for ovarian cancer in the general population, Clinical Cancer Research. (2018) 24, no. 19, 4726–4733, https://doi.org/10.1158/1078-0432.CCR-18-0208, 2-s2.0-85049940234, 30084833.
- 26 Dochez V., Randet M., Renaudeau C., Dimet J., le Thuaut A., Winer N., Thubert T., Vaucel E., Caillon H., and Ducarme G., Efficacy of HE4, CA125, risk of malignancy index and risk of ovarian malignancy index to detect ovarian cancer in women with presumed benign ovarian tumours: a prospective, multicentre trial, Journal of Clinical Medicine. (2019) 8, no. 11, https://doi.org/10.3390/jcm8111784, 31699959.
- 27 Zhang M., Cheng S., Jin Y., Zhao Y., and Wang Y., Roles of CA125 in diagnosis, prediction, and oncogenesis of ovarian cancer, Biochimica et Biophysica Acta (BBA) - Reviews on Cancer. (2021) 1875, no. 2, article 188503, https://doi.org/10.1016/j.bbcan.2021.188503.
- 28 Kontomanolis E. N., Koutras A., Syllaios A., Schizas D., Mastoraki A., Garmpis N., Diakosavvas M., Angelou K., Tsatsaris G., Pagkalos A., and Ntounis T., Role of oncogenes and tumor-suppressor genes in carcinogenesis: a review, Anticancer Research. (2020) 40, no. 11, 6009–6015, https://doi.org/10.21873/anticanres.14622.
- 29 Yang W. L., Gentry-Maharaj A., Simmons A., Ryan A., Fourkala E. O., Lu Z., Baggerly K. A., Zhao Y., Lu K. H., Bowtell D., Jacobs I., Skates S. J., He W. W., Menon U., Bast RC Jr, and AOCS Study Group, Elevation of TP53 autoantibody before CA125 in preclinical invasive epithelial ovarian cancer, Clinical Cancer Research. (2017) 23, no. 19, 5912–5922, https://doi.org/10.1158/1078-0432.CCR-17-0284, 2-s2.0-85032014376, 28637689.
- 30 Harris H. R., Rice M. S., Shafrir A. L., Poole E. M., Gupta M., Hecht J. L., Terry K. L., and Tworoger S. S., Lifestyle and reproductive factors and ovarian cancer risk by p53 and MAPK expression, Cancer Epidemiology, Biomarkers & Prevention. (2018) 27, no. 1, 96–102, https://doi.org/10.1158/1055-9965.EPI-17-0609, 2-s2.0-85040510476, 29133366.
- 31 Swisher E. M., Wollan M., Mahtani S. M., Willner J. B., Garcia R., Goff B. A., and King M. C., Tumor-specific p53 sequences in blood and peritoneal fluid of women with epithelial ovarian cancer, American Journal of Obstetrics and Gynecology. (2005) 193, no. 3, 662–667, https://doi.org/10.1016/j.ajog.2005.01.054, 2-s2.0-24344497920, 16150257.
- 32 Zhou Y., Lian H., Liu K., Wang D., Xiu X., and Sun Z., Puerarin improves graft bone defect through microRNA‑155‑3p‑mediated p53/TNF‑α/STAT1 signaling pathway, International Journal of Molecular Medicine. (2020) 46, no. 1, 239–251, https://doi.org/10.3892/ijmm.2020.4595, 32377717.
- 33 Zhu G., Wang X., Wu S., and Li Q., Involvement of activation of PI3K/Akt pathway in the protective effects of puerarin against MPP+-induced human neuroblastoma SH- SY5Y cell death, Neurochemistry International. (2012) 60, no. 4, 400–408, https://doi.org/10.1016/j.neuint.2012.01.003, 2-s2.0-84862785124, 22265823.
- 34 Zhou Y., Xue R., Wang J., and Ren H., Puerarin inhibits hepatocellular carcinoma invasion and metastasis through miR-21-mediated PTEN/AKT signaling to suppress the epithelial-mesenchymal transition, Brazilian Journal of Medical and Biological Research. (2020) 53, no. 4, article e8882, https://doi.org/10.1590/1414-431x20198882, 32294699.
- 35 Yang S., Wang S., Sun F., Zhang M., Wu F., Xu F., and Ding Z., Protective effects of puerarin against tetrabromobisphenol A-induced apoptosis and cardiac developmental toxicity in zebrafish embryo-larvae, Environmental Toxicology. (2015) 30, no. 9, 1014–1023, https://doi.org/10.1002/tox.21975, 2-s2.0-84994181980, 24596333.
- 36 Zeimet A. G. and Marth C., Why did _p53_ gene therapy fail in ovarian cancer?, The Lancet Oncology. (2003) 4, no. 7, 415–422, https://doi.org/10.1016/S1470-2045(03)01139-2, 2-s2.0-0037627875, 12850192.
- 37 Sipos A., Ujlaki G., Mikó E., Maka E., Szabó J., Uray K., Krasznai Z., and Bai P., The role of the microbiome in ovarian cancer: mechanistic insights into oncobiosis and to bacterial metabolite signaling, Molecular Medicine. (2021) 27, no. 1, https://doi.org/10.1186/s10020-021-00295-2, 33794773.
- 38 Giudice E., Salutari V., Ricci C., Nero C., Carbone M. V., Ghizzoni V., Musacchio L., Landolfo C., Perri M. T., Camarda F., Scambia G., and Lorusso D., Gut microbiota and its influence on ovarian cancer carcinogenesis, anticancer therapy and surgical treatment: a literature review, Critical Reviews in Oncology/Hematology. (2021) 168, article 103542, https://doi.org/10.1016/j.critrevonc.2021.103542, 34801701.
- 39 Dai D., Liu L., Huang H., Chen S., Chen B., Cao J., Luo X., Wang F., Luo R., and Liu J., Nomograms to predict the density of tumor-infiltrating lymphocytes in patients with high-grade serous ovarian cancer, Frontiers in Oncology. (2021) 11, article 590414, https://doi.org/10.3389/fonc.2021.590414, 33718143.
- 40 Stumpf M., Hasenburg A., Riener M. O., Jütting U., Wang C., Shen Y., Orlowska-Volk M., Fisch P., Wang Z., Gitsch G., Werner M., and Lassmann S., Intraepithelial CD8-positive T lymphocytes predict survival for patients with serous stage III ovarian carcinomas: relevance of clonal selection of T lymphocytes, British Journal of Cancer. (2009) 101, no. 9, 1513–1521, https://doi.org/10.1038/sj.bjc.6605274, 2-s2.0-70350657101, 19861998.