Andrea Speciale, Alberto Izzotti, Chiara De Ciucis, Renata Colla, Anna Lisa Furfaro, Alessandra Pulliero, Nicola Traverso, Barbara Marengo, Silvia Ravera, Daniela Fenoglio, Maria Adelaide Pronzato, Mario Passalacqua, Cinzia Domenicotti, and Roberta Ricciarelli
// Renata Colla 1 , Alberto Izzotti 2, 3 , Chiara De Ciucis 1 , Daniela Fenoglio 4 , Silvia Ravera 5 , Andrea Speciale 1 , Roberta Ricciarelli 1 , Anna Lisa Furfaro 6 , Alessandra Pulliero 2 , Mario Passalacqua 1 , Nicola Traverso 1 , Maria Adelaide Pronzato 1 , Cinzia Domenicotti 1 , Barbara Marengo 1 1 Department of Experimental Medicine, University of Genova, Genova, Italy 2 Department of Health Sciences, University of Genova, Genova, Italy 3 IRCCS AOU San Martino IST Genova, Genova, Italy 4 Center of Excellence for Biomedical Research, Department of Internal Medicine, University of Genova, Genova, Italy 5 Department of Pharmacy, University of Genova, Genova, Italy 6 Giannina Gaslini Institute, Genova, Italy Correspondence to: Barbara Marengo, email: Barbara.Marengo@unige.it Keywords: neuroblastoma, multi-drug resistance, glutathione, antioxidants, aerobic metabolism Received: March 18, 2016 Accepted: September 13, 2016 Published: September 23, 2016 ABSTRACT Neuroblastoma, a paediatric malignant tumor, is initially sensitive to etoposide, a drug to which many patients develop chemoresistance. In order to investigate the molecular mechanisms responsible for etoposide chemoresistance, HTLA-230, a human MYCN-amplified neuroblastoma cell line, was chronically treated with etoposide at a concentration that in vitro mimics the clinically-used dose. The selected cells (HTLA-Chr) acquire multi-drug resistance (MDR), becoming less sensitive than parental cells to high doses of etoposide or doxorubicin. MDR is due to several mechanisms that together contribute to maintaining non-toxic levels of H 2 O 2 . In fact, HTLA-Chr cells, while having an efficient aerobic metabolism, are also characterized by an up-regulation of catalase activity and higher levels of reduced glutathione (GSH), a thiol antioxidant compound. The combination of such mechanisms contributes to prevent membrane lipoperoxidation and cell death. Treatment of HTLA-Chr cells with L-Buthionine-sulfoximine, an inhibitor of GSH biosynthesis, markedly reduces their tumorigenic potential that is instead enhanced by the exposure to N-Acetylcysteine, able to promote GSH synthesis. Collectively, these results demonstrate that GSH and GSH-related responses play a crucial role in the acquisition of MDR and suggest that GSH level monitoring is an efficient strategy to early identify the onset of drug resistance and to control the patient’s response to therapy.