Suicide gene therapy is one of the interesting methods of gene therapy that recently has drawn lots of interest to itself in research. By definition suicide gene therapy is a method in which vector containing killer gene is transferred into the target cell and after the gene expression in the given cell, the cell is moved toward apoptosis or necrosis (
1). Of different types of killer genes identified up to now, the genes encoding proteins such as P53, E1A, P202, PEA3, BAX, Bik and enzymes metabolizing drugs such as thymidine kinas and cytosine deaminase (
2,
3).
Bax is a proapoptotic gene that causes apoptosis when over-expressed in cell lines such as prostate, colon, cervical, and ovarian cancers (
4).
Although lots of research has been done related to the suicide gene therapy, there are different challenges to overcome. The limitation of expression of killer genes in tumor cells is one of these challenges. One of the applied solutions is the use of specific promoters of tissue and tumor like human telomerase reverse transcriptase (
5) and Survivin (
6). However, the main problem of these promoters is their low efficiency. Some researchers are working on virus promoters like SV40 and CMV that benefits of high efficiency (
7). However, these promoters do not have any specific targeting for tumor cell. It is activated in all tissues to some extent. To have a specific promoter, Hypoxia-responsive element (HRE) can be attached to virus promotores. HRE sequences are sequences that are located upstream or downstream of different genes and function as enhancers in hypoxia conditions on downstream and upstream promoters (
8).
Binley et al. could achieved a targeted and specific expression of human cytochrome p450 in breast tumors in hypoxia conditions through the combination of HRE element and SV40 promoters (
9).
Hypoxia is a common phenomenon in solid tumors that lead to changes in tumors Microenvironment (
10), when the size of tumor reaches to 44 mm in tumor cells this phenomenon occurs (
11). Factor HIF-1 provides molecular basis for cancer cells’ adaptation under hypoxia conditions that are necessary for tumor progression in becoming malignant (
12,
13).
Under normal oxygen conditions, HIF-1α (Hypoxia-inducible factor 1-alpha) is rapidly degraded by Pathway, but under hypoxic conditions this action is prevented and results in HIF-1α accumulation in the nucleus. HIF-1α and HIF-1β form heterodimer and are attached to hypoxia response element (HRE) which consequently activates more than 50 genes that have HRE in upstream or downstream of their gene sequence and facilitate the genes’ transcription (
8), for example, nitric oxide, vascular endothelial growth factor (VEGF) (
13), DEC1, DEC2 (
14), Nitric Oxide (
15), Nuclear Clustrin (
16), human plasminogen activator inhibitor-1 (PAI-1) (
17), erythropoietin (EPO), glucose transporter-1 (GLUT-1) and phosphoglycerate kinase (PGK) (
18). The HRE-inducible sequence allows a tight regulation of events, switching-on at low oxygen tension but switching-off under reoxygenation (
19).
The balance between poroapoptotic molecules like BAX and anti-apoptotic ones like BCL-2 play an important role in forming apoptosis in cancer cells. In order to enhance specifically the expression of Bax gene in MCF-7 cell line in hypoxic condition. we used 3HRE sequence (GTCGTGCAGGACGTGACATCTAGT) (
18) for the first time to specify CMV promoter action to express BAX gene in cancer cells that have suffered from hypoxia.