Cedrol, a Sesquiterpene Alcohol, Enhances the Anticancer Efficacy of Temozolomide in Attenuating Drug Resistance via Regulation of the DNA Damage Response and MGMT Expression

J Nat Prod. 2020 Oct 23;83(10):3021-3029. doi: 10.1021/acs.jnatprod.0c00580. Epub 2020 Sep 22.

Abstract

Glioblastoma (GBM) is a common and aggressive brain tumor with a median survival of 12-15 months. Temozolomide (TMZ) is a first-line chemotherapeutic agent used in GBM therapy, but the occurrence of drug resistance limits its antitumor activity. The natural compound cedrol has remarkable antitumor activity and is derived from Cedrus atlantica. In this study, we investigated the combined effect of TMZ and cedrol in GBM cells in vitro and in vivo. The TMZ and cedrol combination treatment resulted in consistently higher suppression of cell proliferation via regulation of the AKT and MAPK signaling pathways in GBM cells. The combination treatment induced cell cycle arrest, cell apoptosis, and DNA damage better than either drug alone. Furthermore, cedrol reduced the expression of proteins associated with drug resistance, including O6-methlyguanine-DNA-methyltransferase (MGMT), multidrug resistance protein 1 (MDR1), and CD133 in TMZ-treated GBM cells. In the animal study, the combination treatment significantly suppressed tumor growth through the induction of cell apoptosis and decreased TMZ drug resistance. Moreover, cedrol-treated mice exhibited no significant differences in body weight and improved TMZ-induced liver damage. These results imply that cedrol may be a potential novel agent for combination treatment with TMZ for GBM therapy that deserves further investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents, Alkylating / pharmacology*
  • Antineoplastic Agents, Alkylating / toxicity
  • Antineoplastic Agents, Phytogenic / pharmacology*
  • Apoptosis / drug effects
  • Cedrus / chemistry
  • Cell Cycle Checkpoints / drug effects
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Chemical and Drug Induced Liver Injury / prevention & control
  • DNA Damage*
  • DNA Modification Methylases / biosynthesis*
  • DNA Modification Methylases / genetics
  • DNA Repair Enzymes / biosynthesis*
  • DNA Repair Enzymes / genetics
  • Drug Resistance, Neoplasm / drug effects*
  • Drug Synergism
  • Humans
  • MAP Kinase Signaling System / drug effects
  • Mice
  • Molecular Structure
  • Oncogene Protein v-akt / drug effects
  • Polycyclic Sesquiterpenes / pharmacology*
  • Temozolomide / pharmacology*
  • Temozolomide / toxicity
  • Tumor Suppressor Proteins / biosynthesis*
  • Tumor Suppressor Proteins / genetics
  • Xenograft Model Antitumor Assays

Substances

  • Antineoplastic Agents, Alkylating
  • Antineoplastic Agents, Phytogenic
  • Polycyclic Sesquiterpenes
  • Tumor Suppressor Proteins
  • cedrol
  • DNA Modification Methylases
  • MGMT protein, mouse
  • Oncogene Protein v-akt
  • DNA Repair Enzymes
  • Temozolomide