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Effects of Bufalin and Cinobufagin on the Androgen Dependent and Androgen Independent Prostate Cancer Cell Lines Ching-Han Yu, Hui-Wen Hsu, Pei-Chi Chen, and Paulus S. Wang. Department of Physiology, School of Medicine, National Yang-Ming University, Taipei (11221), Taiwan, Republic of China. Correspondence: Paulus S. Wang. Ph. D. Department of Physiology National Yang-Ming University Shih-Pai, Taipei, R. O. C. Tel: 886-2-28267082 Fax: 886-2-28264049 Email: [email protected] Running Title: BF & CB Inhibits Proliferation of Prostate Cancer Cells Key Words: Chan su, topoisomerase Ⅱ, Na+-K+-ATPase, prostate cancer, apoptosis ABSTRACT Purpose: It has been well known that the extracts of Chan-Su are cardiac glycosides, and were used as treatments for heart failure. Chan-Su has been known to induce cytostatic or oncolytic effects in several cancers, but few studies about Chan-Su on prostate cancer cells have been reported. This study was to evaluate the anti-proliferation effects and the underlying mechanisms of bufalin and cinobufagin, the bufadienolides extracts from Chan-Su, on the androgen-dependent and -independent prostate cancer cell lines. Experimental Design: Cell proliferation of three prostate cancer cell lines, LNCaP, DU145 and PC3, was measured by MTT assay, and calculated for 50% inhibition concentration (IC50) and doubling time (tD). Both western blot and colorimetric assay were used to analyze the protein expressions and activities of caspases. Other protein expressions of apoptosis modulators, such as mitochondrial Bax, and cytosolic cytochrome c, were also analyzed by western blot. Results: Bufalin and cinobufagin inhibited cell proliferation of all three prostate cancer cell lines in a dose-dependent manner. The IC50 of bufalin on prostate cancer cell lines was less than that of cinobufagin. Therefore, the cytotoxicity of bufalin was more serious than that of cinobufagin. In addition, bufalin and cinobufagin caused cell growth doubling time changes in three prostate cancer cell lines, which was greater than those in human glomerular cells (human mesangial cells, HMC). An increase of the active form of caspases expression was observed in the bufalin or cinobufagin-treated cells, while the caspase activities were also elevated. Protein expressions of upstream apoptosis modulators, Bax and cytochrome c, were increased. Conclusion: These results suggest that bufalin and cinobufagin suppress the proliferation and cause cell apoptosis in androgen-dependent and -independent prostate cancer cell lines via an increase of the expressions of a sequence of apoptosis modulators and effectors including Bax, cytochrome c, and a cascade of caspases. INTRODUCTION Prostate cancer has the highest incidence, and is the second most common cause of cancer death of men in the United States (1). In addition, the incidence and mortality of prostate cancer also increase in Asia countries for the past decade. Traditionally, radiation therapy and surgery are curative treatments for prostate cancer in situ. Androgen ablation is the mainstay treatment for metastatic prostate cancer; however, it results in the recurrence of androgen-independent cancer cells in 80% of patients, which has the median survival for six to nine months (2). There are still no effective chemotherapy drugs for hormone-refractory prostate cancer. Therefore, it is important to investigate a novel and effectual treatment for hormone-insensitive prostate cancer. Bufalin, one of the prominent components of Chan su extracts from the venom of Bufo bufo gargarizan, is reported as a Na+-K+-ATPase inhibitor which results in an elevation of intracellular calcium concentration (3). On the basis of this mechanism, bufalin may increase vasoconstriction and blood pressure, and be used as a treatment for heart failure in Chinese medicine. Disruption of intracellular calcium homeostasis induces apoptosis in diverse cell types (4). Our previous results have illustrated that bufalin, with digitalis-like activity, is able to induce the increase of intracellular calcium and cell apoptosis in prostate cancer cells, but the detail mechanism remains unclear (5). On the other hand, bufalin is also shown as a topoisomerase Ⅱ inhibitor. Topoisomerase Ⅱ is a nuclear enzyme that relaxes supercoiled DNA at the time of DNA replication. Topoisomerase Ⅱ inhibitors, such as etoposide and adriamycin, maintain the complex of topoisomerase Ⅱ and the 5'-cleaved ends of the DNA resulting in protein-linked DNA double strand breaks (6). Owing to the mechanism described above, bufalin may induce leukemia cell differentiation (7) and apoptosis (8). Furthermore, inhibition of solid tumor growth (9), and endothelial cell proliferation and angiogenesis caused by bufalin in vitro has also been reported (10). Since inhibitors of topoisomerase and Na+-K+-ATPase have been demonstrated to induce apoptosis in some cancer cell lines, it is interested to investigate the effects of bufalin and cinobufagin, another major component of Chan su, in androgen-dependet, LNCaP, and androgen-independent, DU145 and PC3, prostate cancer cell lines. Inducing cell apoptosis has been the target mechanism for chemotherapy drugs to treat a variety of cancer. Caspase cascade is a well known key pathway in the apoptotic signal transduction. Caspases are normally present in the cell as zymogens (procaspases), and could be divided into two types of subfamilies: upstream initiator caspases (caspase 8 and 9), which are involved in regulatory events, and downstream effector caspases (caspase 3, 6, and 7), which are directly response for the change of cell morphological events (11). There are two major apoptotic pathways on the upstream of caspase cascade to date, which are either the intrinsic pathway (the mitochondria) or the extrinsic pathway (the cell surface receptors) (12). Because of the character of bufalin as an inhibitor of topoisomerase Ⅱ, it may induce DNA damage and activate the mitochondrial pathway to regulate cell apoptosis. Bcl-2 family may be divided into two functional subfamilies such as pro-apoptotic proteins (Bax and Bid) and anti-apoptotic proteins (Bcl-2 and Bcl-xL). Bcl-2 family members translocate to mitochondria and mediate the membrane potential to induce cytochrome c release. The cytosolic cytochrome c is further involved in the signal transduction of caspase activation and finally cause cell apoptosis. The rationale to develop bufalin as a potential therapy for prostate cancer is based on its ability to increase intracellular calcium concentration and to activate mitochondria-mediated cell apoptosis in a variety of cancer cells. The principal objectives of the present study were to: (a) characterize the morphological transformation induced by bufalin or cinobufagin, as well as the IC 50 (50% of inhibition concentration) of both treatments in three prostate cancer cell lines; (b) determine the alteration of the doubling time (tD) generated by bufalin or cinobufagin during the time of cell proliferation in three kinds of prostate cancer cells and a normal human cell (human mesangial cells, HMC) for comparing the toxicity effects in normal cells with that in cancer cells; (c) explore the mechanism of antiproliferative effects occasioned by both bufadienolides depended on the measurement of caspase activation and protein expressions of caspases as well as the upstream molecules, Bax and cytochrome c. Such investigations may, in part, illustrate the antitumor effects of bufalin and cinobufagin in prostate cancer, and help to introduce a new treatment in cancer patients. MATERIALS AND METHODS Cells and Culture Conditions. Androgen dependent human prostate carcinoma cell line LNCaP was purchased from Culture Collection and Research Center (CCRC) of Food Industry Research and Development Institute (FIRDI), Taiwan, ROC. Androgen independent prostate cancer cell lines DU145 and PC3 were provided by Dr. C. R. Jan (Department of Medical Education and Research, Veterans General Hospital-Kaohsiung, Kaohsiung, Taiwan, ROC). The primary cultured human mesangial cells (HMC) were generously given by Dr. L. Y. Yang (Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC). Cell lines were maintained in RPMI 1640 (Gibco Laboratories, Buffalo, Grand Island, NY, USA)(LNCaP) or in Dulbecco’s Modified Eagle’s Media (DMEM, Gibco Laboratories, Buffalo, Grand Island, NY, USA)(DU145 and PC3) with 50 IU/ml potassium penicillin G (Sigma, St. Louis, MO, USA), 50 IU/ml streptomycin sulfate (Sigma, St. Louis, MO, USA) and 10% fetal calf serum (FCS, PAA, Pasching, Austria) as standard media in an atmosphere of 5 % CO2 at 37℃. HMC were cultured in RPMI 1640 media with the presence of 200 mM glutamine, 100 mM sodium-pyruvate, 10 mM nonessential amino acid, 100 IU/ml insulin, 4 mg/ml transferrin, 50 IU/ml potassium penicillin G, 50 IU/ml streptomycin sulfate, 250 μg/ml fungizone, and 10% FCS at 37℃ in an atmosphere of 5 % CO2. Cell Morphology Microscopy. Cancer cells grown in 10-cm dishes for 24 h (DU145 and PC3) or 48 h (LNCaP) were challenged with different concentration of drug or a drug-free medium (control condition). At certain time points, cultures were photographed with a phase contrast microscope (Nikon, Chiyoda-Ku, Tokyo, Japan). Cell Proliferation Assay. Cell proliferation was determined by the modified colorimetric 3-(4,5-dimethylthiazol-2-yle)-2,5- diphenyltetrazolium bromide (MTT) assay. Cells were dispensed at a density of 2000/well of 96-well microplates in 100 μl medium supplemented with 10% FBS. After cell attachment, the media were replaced by the new media containing different concentration of bufalin or cinobufagin (day 0). The MTT (Sigma, St. Louis, MO, USA) assay was performed on day 1, 2, 3, and 4 modified from Janssen, et al., 1996. Briefly, the media were supplanted by 50 l MTT solution (1 mg/ml in RPMI 1640 or DMEM). After 4-h incubation, the MTT solution was displaced by 50 l DMSO, and the plates were shaken for 1 min. The optical density of each plate was quantified for absorbance at a wavelength of 570 nm with a reference wavelength of 630 nm using a microplate reader (Dynatech Laboratories, Chantilly, VA, USA). Proliferation index of each day referred to the optical density of that day divided by the optical density of day 0. Each experimental condition was performed in three preparations and repeated by four times. Proliferation indexes of different concentration at day 1 to day 4 were calculated and plotted by fitting to the sigmoidal logistic four parameter nonlinear regression formula (SigmaPlot, Jandel Scientific Software, San Rafael, CA, USA) (14). IC50 value of each day was determined from plot of percent of untreated control cell growth versus the logarithm of the drug concentration. To find out the change of doubling time caused by bufalin or cinobufagin at the concentration of 0.1 M in HMC and three prostate cancer cell lines, the proliferation index were plotted on the common log scale and fit by linear regression using the equation: y = log(ODt/OD0) = (log2/tD)t, where ODt and OD0 represent the optical density at the day t or that at the day 0, respectively; tD represents for doubling time. The doubling time was calculated by tD = Log2/S (days), where S is the slope of the regression line (15). Caspase Activity Analysis. Caspase activation was measured in cytosolic extracts using the peptide substrates, DEVD-pNA, IETD-pNA, and LEHD-pNA, for caspase 3, 8, and 9, respectively (R&D System, Minneapolis, MN, USA). Concisely, the drug treated prostate cancer cells were harvested and washed by PBS for three times. Cell pellet was lysed on ice for 10 min, and then samples were centrifuged at 10,000 x g for 5 min. Protein content in the supernatants was measured using the Bradford reagent. Extracts were diluted to 4 g/l with dilution buffer, and loaded with 50 l for each reaction well of 96-well microplate. Each reaction also required 50 l of 2 x reaction buffer containing 10 mM of dithiothreitol and 5 l of caspase colorimetric substrate. After 2-h incubation at 37℃, absorbance was measured at 405 nm on a microplate reader. Results are expressed as absorbance percent relative to control group (100%). Each experimental condition was repeated by three times. Immunoblotting Assessment After culture under the treatment of bufalin or cinobufagin at certain time points, cells were harvested and washed twice by ice-cold PBS. Cells were lysed in RIPA buffer (50 mM Tri-HCl, pH 7.4, 1 % NP-40, 0.25 % Na-deoxycholate, 150 mM NaCl, 1 mM EDTA, l mM phenylmethylsulfonyl fluoride, 1 g/ml aprotinin, 1 g/ml leupeptin, 1 g/ml pepstatin, 1mM Na-orthovanadate, 1 mM NaF) for 30-min on ice. The lysate was centrifuged at 14,000×g in 4℃ for 15 min, and the supernatant was collected. Equal amount of cell extract proteins (50-100 g) were subjected to 10% (caspase 9) or 15% (caspase 3 and 8) SDS- polyacrylamide gel electrophoresis and transferred to nitrocellulose membranes (Schleicher & Schuell, Inc., Keene, NH, USA). Membranes were incubated in blocking solution (5% dry milk in TBST containing 20 mM Tris-HCl, 135 mM NaCl, 0.1 % Tween 20, pH 7.6) followed by incubation with primary antibody overnight. The following primary antibodies were used as 1 g/ml: caspase 3 from Imgenex (San Diego, CA, USA); caspase 8 from BioVion (Mountain View, CA, USA), caspase 9 from Medical and Biological Labortories (Nagoya, Japan); or β-actin from Sigma (St. Louis, MO, USA). After washing for three times by TBST, the blot was incubated with horseradish peroxidase-conjugated goat anti-mouse secondary antibody (1:20,000, Promega Corporation, Madison, WI, USA), and proteins were visualized using enhanced chemiluminescence detection (ECL, Western blotting reagents, Amersham International, Bucks, UK). Isolation of Cytosol and Mitochondrial Fractions Release of cytochrome c from mitochondria and translocation of bax to mitochondria was measured by immunoblotting essentially as described previously (16). Briefly, drug treated cancer cells were collected and washed twice by ice-cold PBS. The cell pellet was resuspended in 1 ml of extraction buffer (20 mM K+-Hepes, 250 mM sucrose, 10 mM KCl, 1.5 mM MgCl2 · 6H2O, 0.1 mM EDTA, 1 mM EGTA, and protease inhibitors). Cells were lysed by 40 passages through a 26-gauge needle, and homogenates were centrifuged at 1000 x g for 5 min. The supernatant was again centrifuged at 10,000 x g for 15 min following the separation of supernatant (cytosolic fraction) from pellet (mitochondrial fraction). Cytosolic fraction was then concentrated to 50-100 l using 10-kDa molecular mass centrifugal concentration device (microcon YM-10, Millipore Co., Bedford, MA, USA) according to the manufacturer’s instructions. The resulting mitochondrial pellets were resuspended in 50 l of cell lysis buffer (20 mM Tris, pH 7.5, 100 mM NaCl, 1% Triton, 1 mM phenylmethylsulfonyl fluride, and protease inhibitor mixture). These fractions were separated on 15% SDS-polyacrylamide electrophoresis gels with an equal amount of protein loaded onto each lane as determined by Bradford assay reagent. Cytochrome c and bax were detected by mouse monoclonal antibody at dilution of 1:400 from Santa Cruz Biotechnology (Santa Cruz, CA, USA). Each experimental condition was replicated by three times. Statistics All values are given as the mean standard error of the mean (SEM). In some cases, Student’s t test was used. Others, means were tested for homogeneity by one-way analysis of variance (ANOVA), and the difference between specific means was tested for significance by Duncan’s multiple-range test (17). The difference between two means was considered statistically significant when P<0.05. RESULTS Antiproliferative Effects of Bufalin and Cinobufagin on Human Prostate Cancer Cells Our previous results indicated that bufalin and cinobufagin inhibit the proliferation of human prostate cancer cells (5). In the present study, the detail mechanisms of antiproliferative effects of bufalin and cinobufagin were investigated. The change of cell morphology caused by bufalin or cinobufaogn was shown in figure 1 using phase contrast microscope with two hundred times of magnification. After a treatment with 10 M bufalin or cinobufagin for 24-h, the cell number of LNCaP and DU145 cells decreased, and the cells began to draw back their membranes and became a round shape. Some of these cells even rounded up from the dishes and floated in media, especially for the weak attachable LNCaP cells. However, the above phenomenon was found in PC3 cells after treatment for 48-h. In addition, bufalin is more effective than cinobufagin to inhibit the proliferation in these three prostate cancer cell lines. According to the different responses of these three prostate cancer cell lines, bufalin was used at the concentration of 0.01 to 1 M for LNCaP cells and 0.001 to 0.1 M for DU145 and PC3 cells. Concentration of 0.01 to 1 M of cinobufagin was used for three of the prostate cancer cells. Proliferation status was measured by MTT assay. Proliferation indexes of different concentrations at day 1 to day 4 were calculated and plotted to fit by linear regression analysis. IC50 value of each day was calculated from nonlinear regression equation of that specific day. (Table 1). In three prostate cancer cell lines, IC50 values of bufalin were less than that of cinobufagin from day 1 to day 4 (P<0.01). As the day of treatment increased, the IC50 values of both bufadienolides were decreased significantly as compared with day 1 in all three prostate cancer cells (P<0.01). Determination of IC50 values indicated that the androgen-independent prostate cancer cells, DU145 and PC3, were more sensitive to both bufadienolides, whereas those for the LNCaP cells were approximately 5 to 10 times more than that in DU145 and PC3 cells. The Change of Doubling Time Caused by Bufalin and Cinobufagin in HMC and Prostate Cancer Cells Previous results indicated that bufalin and cinobufagin have antiproliferative effects on prostate cacner cells. Thus, it is important to examine whether inhibition of proliferation could reveal in bufadienolides-treated normal human cells. In this study, the change of doubling time caused by bufalin or cinobufagin at the concentration of 0.1 M in HMC and three prostate cancer cell lines was determined by MTT assay. Proliferation indexes of day 1 to day 4 with or without treatment were fitted by linear regression equation (Fig. 2). Doubling times of control or drug-treated groups were computed from the regression equations. After the treatment of bufalin, the doubling time of LNCaP cells increased from 31 h to 105 h, and the similar effects could be found in cinobufagin treated LNCaP cells. The increase of doubling time by bufalin or cinobufagin in LNCaP cells was approximately 3.1 times (P<0.01). Nevertheless, bufalin and cinobufagin were more effective on prolonging the doubling time in DU145 and PC3 cells for 5.8 or 8.6 times, respectively (P<0.01). However, the lengthening of doubling times in HMC cells of bufalin or cinobufagin is slightly and not significantly. Consistent with our previous observations, the doubling time of bufalin-treated prostate cancer cells increased more than that of cinobufagin treatment. Effects of Bufalin and Cinobufagin on Proteolytic Processing of Caspases Our recent studies suggested that apoptosis mechanism was involved in the antiproliferation effects caused by bufalin and cinobufagin (5). To examine whether bufalin and cinobufagin activated the caspases cascade, proteases of the apoptotic pathway, we measured caspase 3, 8, and 9 activities at different time points in three types of prostate cancer cell lines (Fig. 3). Owing to the distinct nature of three prostate cancer cells, colorimetric caspase activity assay were performed after treatment in LNCaP and DU145 cells for 8-, 12-, 18-, and 24-h (Fig. 3a and 3b), whereas in PC3 cells were for 18-, 24-, 36-, and 48-h (Fig. 3c). In LNCaP cells, bufalin at the concentration of 10 M increased the activities of caspase 3, 8, and 9 from 200% to 250% (P<0.01) since treatment for 12-h, and the activity of effector caspase 3 was much than that in initiator caspase 8 and 9. The peak response appeared at the time point about treatment for 18-h. Moreover, at the concentration of 1 M of bufalin, elevated caspase activities from 150% to 250% (P<0.05) during the 12- and 24-h time points. Cinobufagin had similar effects as bufalin in LNCaP cells; only the increasing ranges were not as much as that caused by bufalin. Bufalin and cinobufagin induced resembling results in DU145 cells. In PC3 cells, bufalin at concentration of 1 and 10 M increased caspase 3 activity from 150% to 250% (P<0.01) since treatment for 18-h, and activities of caspase 8, and 9 were slightly increased. The peak response showed at the time point about treatment for 24-h. Cinobufagin had similar effects as bufalin in PC3 cells. In summary, bufalin was more effective on increasing caspase activity in LNCaP and DU145 cells than that of cinobufagin, whereas these two bufadienolides made no much different in PC3 cells. On the basis of these results described above, immunoblot analyses of whole cell lysates obtained from three kinds of prostate cancer cells undergoing apoptosis during treatment with bufalin or cinobufagin were performed using antibodies for caspase 3, 8, and 9 at the time point in peak response of the increasing of caspase activity (Fig. 4). Caspase exist as inactive zymogens in resting cells, and activation of a particular caspase will result in a reduction in its proenzyme form (18). We found that protein levels of procaspase 3, 8, and 9 were down regulated as increasing the concentration of bufalin or cinobufagin, meanwhile, the proteolytic cleavage of these caspases was detectable in cell lysates obtained after 18-, 18-, 24-h of treatment in LNCaP, DU145, and PC3 cells, respectively. Active forms of these caspases were elevated while concentration of treatment increased. Effects of Bufalin and Cinobufagin on Bax Translocation and Cytochrome c Release As noted above, caspase activation involved in apoptotic effects induced by the treatment of bufalin and cinobufagin. Alterations of mitochondria leading to the release of cytochrome c are thought to mediate caspase activation in many models of cell death programs. The role of mitochondria is crucial participants in cell apoptosis by targeting Bcl-2 family members to the outer membrane of mitochondrial (19). We used Western blotting to analyze the protein levels of mitochondrial bax, a proapoptotic molecule in Bcl-2 family, and cytosolic cytochrome c. Consistent with this mechanism, treatment of bufalin or cinobufagin resulted in an increase of bax in mitochondrial fraction, and in release of cytochrome c into cytosolic fraction of three prostate cancer cell lines (fig. 5). The first noted time points in LNCaP (fig. 5a), DU145 (fig. 5b), and PC3 (fig. 5c) cells were 8-, 8-, and 18-h, respectively. The increase of cytochrome c release and bax translocation is in a dose- and time-dependent manner. These results mentioned above appeared to precede activation of caspase 3, 8, and 9 (compare Figs. 3 and 5). DISCUSSION We have demonstrated the following phenomena: (a) bufalin and cinobufagin cause the morphological change (cell rounds up) and reducing cell number in androgen-dependent and -independent prostate cancer cell lines. (b) IC50 of treatment is relatively high in androgen-dependent, LNCaP, cells than in androgen-independent, DU145 and PC3, cells. Besides, prolongating the time of treatment declines the IC50 in three prostate cell lines. (c) bufalin and cinobufagin elongate the doubling time of cell proliferation selectively in prostate cancer cells rather than in HMC cells; (d) both bufadienolides induce prostate cancer cell apoptosis through caspase activation, and the peak responses are at the time points of 18-, 18-, and 24-h in LNCaP, DU145, and PC3 cells, respectively; (e) mitochondrial pathway is involved in the upstream of caspase cascade by releasing cytochrome c from mitochondria to cytosol, and the proapoptotic Bcl-2 family member, Bax, manipulates this phenomena. Nowadays, prostate cancer is a worldwide malignant and age-related cancer in men. Although PSA detection assay is used widespread to help the early diagnosis of prostate cancer, metastasis still occurs in about 30% of patients within 3 years of treatment (20). The nature history of prostate cancer follows a formation of progression from localized disease with androgen-dependent character to more accelerated, invasive and metastatic disease which often connects with gain of androgen-refractory capacity (21). Men with metastatic prostate cancer are prospected to survive for six to nine months by means. Therefore, it is essential to develop an efficacious therapy targeting to the character of prostate cancer and to eliminate the ravage cause by prostate cancer in men. Bufalin is a digitalis-like molecule of animal source and is also able to inhibit Na+-K+-ATPase by binding to this enzyme on the cellular membrane. The capacity of bufalin to inhibit Na+-K+-ATPase is much more than that in ouabain which is the most effective molecule among digitalis to induce the antiproliferative effects in prostate cancer cells (22, 23). On the basis of this mechanism, the influx of extracellular calcium results in an elevation of intracellular calcium concentration. Role of intracellular calcium have been well studied in prostate cells. Androgen ablation leads to apoptosis associated with calcium influx and calcium-regulated endonuclease activation in normal prostate cells (24). Besides, thapsigargin, a calcium ionophore, directly stimulates an increase of intracellular calcium, which triggers apoptosis in androgen-dependent and androgen-refractory prostate cancer cells (25). Importantly, prostate cancer cells express the Na+-K+-ATPase, which presents as the target for digitalis-like drugs (26). In addition to be an inhibitor of Na+-K+-ATPase, bufalin also functions as an inhibitor of topoisomerase Ⅱ. Topoisomerase Ⅱ is the target of several antitumor drugs, such as etoposide, adriamycin, genistein, and ICRF-193 (27). By blocking the enzyme function of topoisomerase Ⅱ, DNA double strand breaks remain, and DNA damage occurs. Cells are obviously able to recognize such DNA damage and to eliminate the over injured cells by apoptosis. On the basis of either increase intracellular calcium or stimulating DNA damage, bufalin may cause cell apoptosis. In this study, we use bufalin and another active component of Chan su, cinobufagin, to inspect the effects induced by both bufadienolides in androgen-dependent and -independent prostate cancer cells. Our result shown that bufalin and cinobufagin caused cell round up from the culture dish (Fig. 1). Because of the light-attached character in LNCaP cells, the appearance of LNCaP cells was totally unattached after treating with bufalin or cinobufagin. With the nature of tight attachment, longer time of treatment was demanded for PC3 cells to observe round up cells. Besides, the mechanism of caspase 3-mediated apoptosis was reported to process focal adhesion kinase (FAK), in turn, results in floating cells (28, 29). This signal transduction might be partly involved in the unattached cells treated by bufalin or cinobufagin. Digitalis, a drug family for congestive heart failure and supraventricular arrhythmias, has a narrow therapeutic range with plasma level from 0.8-2.0 ng/ml in patients (30). Bufalin, a digitalis-like molecule from the animal source, has a potential of fatal toxicity similar to digitalis, and can be eliminated with digitalis specific antibody fragment (Fab) (31). It is important to estimate the effective drug concentration on the antiproliferative efficacy in prostate cancer cells. Results of IC50 after treatment for 1 to 4 days in three prostate cancer cell lines were shown in Table 1. Although values of IC50 from day 1 to 4 were higher than the therapeutic range of digitalis (calculated as 2.1 to 5.2 nM for bufalin; 1.8 to 4.5 nM for cinobufagin), IC50 values declined significantly as prolonging the time of treatment. By means of this event, it is possible that bufalin and cinobufagin in the therapeutic range may cause prostate cancer cell death without poisoning the patient by prolonging the time of treatment. After a 24-h treatment, bufalin and cinobufagin at the concentration of 10 μM caused LNCaP cells round up from the dish completely. It seems that LNCaP cells are more sensitive to both bufadienolides compared with DU145 and PC3 cells. However, results of IC50 reflected that high doses of treatment of digitalis were required to reduce cell numbers to 50% of control cells in LNCaP cells. Combination of both phenomena, LNCaP cells were less sensitive to bufalin or cinobufagin, and the cell floating caused by treatments was probably owing to the nature of light-attached character. Since bufalin and cinobufagin might induce cell apoptosis in prostate cancer cells, the cytotoxic effects of treatments in normal human cells was expected to explore. The doubling time of cell proliferation was used to monitor the cytotoxicity in three prostate cancer cell lines and in normal human cells (HMC). Observations shown in figure 2 indicated that increase of doubling time was significantly in prostate cancer cells rather than in HMC cells with bufadienolides at the concentration of 0.1 μM. Moreover, elongation of doubling time in androgen-independent prostate cancer cells was much longer than that in androgen-dependent cells. After acting by a topoisomerase Ⅱ inhibitor, DNA breaks were formed in bufalin-treated cells at the time of DNA replication (6). With relatively short growth period, the formation of DNA damage in DU145 and PC3 cells would be more than that in LNCaP cells. Most of normal cells stay in the cell cycle at Go period, which will be less sensitive to proliferating cells-targeted chemotherapeutic agents. In human mesangial cells, the doubling time prolonged slightly with no significance. Similar results found previously demonstrated that digitalis had no particular effects in the normal glomerular epithelial cells (23). Although human mesangial and glomerular epithelial cells can not be represented for each kind of normal human cells, it is apparently that the antiproliferative effects of bufalin targets to proliferate cancer cells other than to normal cells with slow growth period. Caspase activation was involved in the apoptotic signal transduction induced by digitalis or bufalin (5, 32). We treated cancer cells with bufalin or cinobufagin at the concentration of 0, 0.1, 1, and 10 μM in order to examine the signal transduction of treatments, immediately. Figure 3 and 4 illustrated that the time point of the peak response of caspase procession differed in three kinds of prostate cancer cells. In LNCaP and DU145 cells, the peak response occurred around 18-h after treatment, whereas, in PC3 cells, it was slightly late (about 24-h). It have been reported that DNA damage might induce p53 activation and Bax translocation to mitochondria, in turn, resulted in release of cytochrome c (6, 33). We also investigated the effects of bufalin or cinobufagin on the upstream molecules of Bax and cytochrome c in mitochondrial pathway. The increase of protein expressions of Bax and cytochrome c in LNCaP and DU145 cells were observed after treatment for 8-h, whereas, those for PC3 cells were at 18-h. To conclude the circumstances found in bufalin treated LNCaP, DU145, and PC3 cells, it was easier to induce apoptotic signal transduction in LNCaP and DU145 cells than in PC3 cells. However, the results of IC50 and the change of doubling time indicated that bufalin is more effective in PC3 cells as prolonging the time of treatment. It might be resulted from the nature of these three prostate cancer cell lines. The fact that LNCaP cells which have wild type p53 and the character of releasing prostate specific antigen (PSA) are thought to be more sensitive to chemotherapeutic drugs than the androgen-independent prostate cancer cells with mutant type p53 (34, 35). It was also found that topoisomerase Ⅱ was expressed at the highest level in rapidly proliferating DU145 cells (36). Loss the enzyme activity by bufalin treatment resulted in dramatic DNA damage and cell apoptosis. These results in part explain the different effects caused by bufalin in three types of prostate cancer cell lines. Bufalin induce DNA double strand breaks with the function of topoisomerase Ⅱ inhibitor. DNA damage caused by topoisomerase Ⅱ inhibitor might induce the phosphorylation of p53. The active form of p53 prompted Bax translocation to mitochondria and cytochrome c release to cytosol (6, 33). The mechanism described above might be the signal transduction caused by bufalin in LNCaP cells with wild-type p53. We also found the protein expression of topoisomerase Ⅱ declined and that of p53 elevated as increase the concentration of bufalin and cinobufagin in LNCaP cells (data not shown). In DU145 and PC3 cells, which has mutant and null p53, c-Jun NH2-terminal kinas (JNK)-dependent Fas activation apoptosis may in place of the p53-dependent apoptotic pathway (26, 37). In Fas-manipulated apoptotic pathway, activated caspase 8 can directly activate the downstream caspase 3, and it can also cross talk with mitochondrial pathway through cleavage of Bid, a Bcl-2 family protein. Truncated Bid (tBid) translocates to mitochondria, inducing cytochrome c release, which sequentially activates caspase 9 and 3 (38). These investigations concluded that bufalin induced apoptosis, either via p53 or Fas, might results in Bax translocation, cytochrome c release, and caspase 3, 8, and 9 activation. It is known that bufalin induces cell apoptosis by blocking topoisomerase Ⅱ (8, 9) or by inhibiting Na+-K+-ATPase (5). However, Pastor et al. shown that inhibition of topoisomerase Ⅱ were not sufficient for bufalin to cause cell apoptosis. In addition, ouabain resistant cells would not go on apoptosis by blocking the Na+-K+-ATPase (40). It also demonstrated that intracellular calcium ions play an essential role in induction of apoptosis by inhibitors of topoisomerase (41). 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A comparative study of genotoxic effects of anti-topoisomerase Ⅱ drugs ICRF-193 and bufalin in Chinese hamster ovary cells. Mutat. Res., 515: 171-180, 2002. 40. Ho, C. K., Chen, S. M., and Wang, S. Y. Ouabain resistance of a human trophoblast cell line is not related to its reactivity to ouabain. Eur. J. Cell Bio., 79: 765-770, 2000. 41. Yoshida, A., Ueda, T., and Nakamura, T. DNA damage and cell killing by camptothecin and its derivative in human leukemia HL-60 cells. Jpn. J. Cancer Res., 84: 566-573, 1993. 42. Hashimoto, S., Jing, Y., Kawazoe, N., Masuda, Y., Nakajo, S., Yoshida, T., Kuroiwa, Y., and Nakaya, K. Bufalin reduces the level of topoisomerase Ⅱ in human leukemia cells and affects the cytotoxicity of anticancer drugs. Leuk. Res., 21: 875-883, 1997. FIGURE LEGENDS Fig. 1 Phase contrast microscopic photographs of LNCaP, DU145, and PC3 cells with bufalin or cinobufagin treatment. Cells were treated with bufalin or cinobufagin for 24-h (LNCaP and DU145) or 48-h (PC3) at the concentration of 10 μM, and were observed under a phase contrast microscope. Magnificaiton, 200X. Fig. 2 Effects of bufalin or cinobufagin on the change of doubling time in LNCaP, DU145, PC3 and human mesangial cells (HMC) cells following an incubation period from 1 to 4 days. The doubling time was calculated from the regression equation of the proliferation index (see Material and Method). Each value represents mean ± SEM. Fig. 3 Activities of caspase 3, 8, and 9 in LNCaP, DU145, and PC3 cell lines after administration of bufalin or cinobufagin. Caspase activities were assayed by a colorimetric kit (see Material and Method). a and b, represent for LNCaP and DU145 cells, respectively. To determine the caspase activation in both of the cell lines were after the treatment for 8-, 12-, 18-, and 24-h. c, caspase activities in PC3 cells were analyzed after the treatment for 18-, 24-, 36-, and 48-h. Each value represents mean ± SEM. Fig. 4 Effects of bufalin or cinobufagin on the protein expression of caspases in LNCaP, DU145, and PC3 cell lines. Cells were incubated with bufalin or cinobufagin for 18- (LNCaP and DU145) or 24-h (PC3). Cell lysates were resolved on 10% (caspase 9) or 15% (caspase 3, and 8) SDS-PAGE and analyzed by Western blotting. a, LNCaP cells; b, DU145 cells, c, PC3 cells. Each lane was loaded with 30 g protein of samples. Similar results were obtained in three other experiments. Fig. 5 Effects of bufalin or cinobufagin on the protein expressions of bax and cytochrome c in LNCaP, DU145, and PC3 cell lines. a, and b, LNCaP and DU145 cells were incubated with bufalin or cinobufagin for 8- and 12-h, whereas, c, PC3 cells were treated for 18- and 24-h. Cell lysates were separated as cytosolic and mitochondrial fractions. Samples were resolved on 15% SDS-PAGE and analyzed by Western blotting. Each lane was loaded with 40 μg protein of samples. Similar results were obtained in three other experiments. Table. 1. The IC50 of bufalin or cinobufagin on LNCaP, DU145 and PC3 cells. The incubation period was from 1 to 4 days. IC50 was calculated from the regression equation of the proliferation index each incubation day. a Mean ± SEM, b P<0.05 compared with cinobufagin treatment, c P<0.01 compared with incubation of time day 1. Incubation Time (day) LNCaP 1 2 3 4 DU145 1 2 3 4 PC3 1 2 3 4 a Bufalin, IC50 (nM) 832.22 ± 28.49a, b 298.46 ± 24.49c 90.51 ± 19.74c 63.71 ± 8.43c 85.76 ± 2.41b 15.12 ± 2.71b, c 14.28 ± 1.51b, c 13.59 ± 2.32b, c 92.68 ± 4.60 12.73 ± 2.22b, c 10.10 ± 0.79b, c 8.96 ± 1.24b,c Cinobufagin, IC50 (nM) 1061.71 ± 44.81 299.80 ± 28.22c 128.74 ± 16.86c 74.90 ± 7.61c 108.76 ± 1.67 30.86 ± 1.54c 27.88 ± 1.47c 25.25 ± 1.20c 100.11 ± 2.01 21.56 ± 1.39c 18.92 ± 1.16c 17.46 ± 1.53c Mean ± SEM b P<0.01 compared with cinobufagin treatment c P<0.01 compared with incubation time of day 1 Fig. 1 Bufalin 0.1 M Vehicle Cinobufagin Vehicle 0.1 M LNCaP (n=4) LNCaP (n=4) 10 tD(Control)=32 hr Value of Cell Proliferation Index to Control Cells at Day 0 tD(Control)=31 hr tD(0.1 M)=91 hr tD(0.1 M)=105 hr 1 DU145 (n=4) DU145 (n=4) 10 tD(Control)=25 hr tD(Control)=25 hr tD(0.1 M)=156 hr tD(0.1 M)=134 hr 1 PC3 (n=4) PC3 (n=4) 10 tD(Control)=26 hr tD(Control)=26 hr tD(0.1 M)=216 hr tD(0.1 M)=231 hr 1 HMC (n=3) HMC (n=3) 10 tD(Control)=58 hr tD(Control)=56 hr tD(0.1 M)=79 hr 1 1 2 3 4 tD(0.1 M)=65 hr 1 Incubation Time (day) Fig. 2 2 3 4 % of Caspase Activity Relative to Control Group a LNCaP 0M 300 Cinobufagin Bufalin 0.1 M 1 M 10 M 0M 0.1 M Caspase 3 (n=3) Caspase 3 (n=3) Caspase 8 (n=3) Caspase 8 (n=3) Caspase 9 (n=3) Caspase 9 (n=3) 1 M 10 M 200 100 0 300 200 100 0 300 200 100 0 8 12 18 24 8 12 18 24 Incubation Time (h) % of Caspase Activity Relative to Control Group b DU145 Bufalin 0M 300 0.1 M Cinobufagin 1 M 10 M 0M 0.1 M Caspase 3 (n=3) Caspase 3 (n=3) Caspase 8 (n=3) Caspase 8 (n=3) Caspase 9 (n=3) Caspase 9 (n=3) 1 M 10 M 200 100 0 300 200 100 0 300 200 100 0 8 12 18 24 8 12 18 24 Incubation Time (h) % of Caspase Activity Relative to Control Group c PC3 Bufalin 0M 0.1 M Cinobufagin 1 M 10 M 0M Caspase 3 (n=3) Caspase 3 (n=3) Caspase 8 (n=3) Caspase 8 (n=3) Caspase 9 (n=3) Caspase 9 (n=3) 10 M 10 M 200 100 0 200 100 0 200 100 0 18 24 36 48 18 Incubation Time (h) Fig. 3 0.1 M 24 36 48 Fig. 4 Fig. 5