Melanoma is one of the most common and malignant forms of skin cancer that originates from melanocyte cells. Melanocytes are pigment-including skin cells that produce pigment in response to irritations such as UV radiation. These cells are responsible for the color of skin, eyes, and hair. Environmental and genetic factors are involved in their development (
32).
According to the World Health Organization (WHO), the incidence of melanoma is rapidly increasing in comparison to other skin cancers (
33). The conventional treatments for melanoma including immunotherapy, chemotherapy, radiotherapy, and surgery did not show promising results and had their limitations (
34). Recently, few effective treatments have been developed including immunotherapy with interferon (IFN) alfa-2b, interleukin (IL)-2, anti-CTLA-4, ipilimumab, and BRAF and MEK inhibitors. These treatments had many side effects, long-term responses, and were cost-effective (
35-
37). Due to these problems, alternative therapies are highly welcomed in this field (
38). In the present study,
Iris germanica L., known as Irsa, was selected to achieve an effective and less toxic treatment for melanoma.
In 2016, scientists at the Applied Medical Center of Korea showed that the ethanolic extract of
Gardenia jasminoides Ellis roasted fruit inhibited migration of metastatic melanoma pulmonary tumor cells and reduced angiogenesis (
39). In another study, herbal medicine from the ginseng family (Ginsenoside Rg3) was introduced to the scientific community as a unique product for the treatment of melanoma. This herbal medicine was able to inhibit mediators involved in tumor growth such as fucosyltransferase IV (FUT4) and induced apoptosis in a melanoma cell line (
40). Furthermore, Chinese scientists identified the molecular mechanisms implicated in cell cytotoxicity of the Physalin A on the A375-S2 human melanoma cell line. This compound is an active withanolide that is derived from the
physalis alkekengi L. and the Makino shrub called Jin Deng Long in Chinese traditional herbal medicine. The cytotoxic effect of the Jin Deng Long on the melanoma cell line has been investigated in previous studies (
41). In recent years, Chinese researchers have also investigated the cytotoxic effect and anti-tumor mechanism of Chinese traditional herbs and their derivatives on melanoma and pulmonary metastatic melanoma (
42-
45).
None of the studies have investigated the cytotoxicity effect of the herbs extract on the A375 cell line; therefore, no comparison can be performed with the current study. However, the cytotoxic effects of certain compounds of the Irsa extract on different cancer cell lines other than melanoma have been investigated in previous studies.
The protective effects of isoflavonoids of the Irsa rhizome extract on the inflammatory condition of the Hepa-1c1c7 cell line were evaluated. It was revealed that the compounds present in the Irsa extract could inhibit the activity of cytochrome P450 1A. In addition, isoflavone 2, 3, and 5 can induce NAD(P)H quinone reductase activity. The effects of Irsa on cancer cells are exerted through the activation of anti-inflammatory mechanisms (
46). The anticancer effects of isoflavonoids of the Irsa extract on the EAC cancer cell line have also been studied, and the results showed that this product could inhibit the proliferation of the cancer cells (
25).
In another study, the therapeutic effects of lipid compounds of the Irsa extract on the Hela cancer cell line were investigated. The study showed that the Irsa extract could inhibit migration of the cells and maintain cells in the G1 phase of the cell cycle. The Irsa extract prevents the migration of cancer cells by increasing adhesion molecules and producing more actin fibers (
47).
The superiority of triterpenoids of the Irsa extract to doxorubicin was demonstrated in the A2780 and K562 cancer cell lines. Although these cell lines are resistant to a large number of chemotherapy drugs, they respond properly and showed cytotoxicity against the Irsa extract (
48).
So far, no studies have been carried out to evaluate the Irsa extract therapeutic effects on the A375 melanoma cell line. Our study was performed for the first time to study the effects of the total Irsa extract on proliferation and apoptosis in the A375 melanoma cell line compared these effects with the AGO-1522 as a control cell line.
According to the present study, 0.0438 mg/mL of the Irsa extract destroys 50% of the A375 melanoma cell line, while no significant destructive effect on proliferation and viability of the AGO-1522 cell line was not observed.
Based on the flow cytometry results, the Irsa extract, similar to dacarbazine, lead to apoptosis in the melanoma cancer cells. Nonetheless, the Irsa extract, unlike dacarbazine, had no cytotoxic effect on normal cells. In addition, flow cytometry results showed that 0.125 mg/mL of Irsa extract had the most cytotoxic effect on the A375 cell line and the highest rate of apoptotic and necrotized cells were observed. According to the results, the best-recommended concentration for A375 melanoma and AGO-1522 control cell lines is 0.125 mg/mL of the Irsa extract. This concentration not only had the highest cytotoxic effects on the A375 melanoma cell line but also had the lowest cytotoxic effects on the AGO-1522 control cell line.
5.1. Conclusions
We evaluated cytotoxic effects and apoptosis induction of the Iris germanica L. total extract on the human skin melanoma cell line (A375) for the first time. Our results showed that 0.125 mg/mL of the Irsa extract significantly increase apoptosis in melanoma cancer cells, while it was entirely safe for the normal cell lines. Therefore, this compound can be considered a novel, side-effect-free treatment for human skin melanoma.