We have shown that PLGA-DTX was much more cytotoxic toward isolated rat hepatocytes than DTX alone. The EC
502h (2 h) concentration found for PLGA-DTX (i.e., 50% membrane lysis in 2 h) was 3 nM, while it was 6 nM for free docetaxel. As shown in
Table 1. both DTX and PLGA-DTX significantly (P < 0.05) increased hepatocyte membrane lysis as determined by trypan blue exclusion test.
Generation of ROS has been widely viewed as a common pathway of cell death from a variety of chemical agents (
29). Present work showed that, when hepatocytes were incubated with both DTX and PLGA-DTX at this EC
502h (in 2 h) concentration, reactive oxygen species formation determined by the oxidation of dichlorofluorescin (DCFH) to dichlorofluorescein (DCF) was also significantly (P < 0.05) increased. DTX and PLGA-DTX-induced cytotoxicity and reactive oxygen species formation were prevented by radical scavengers and antioxidants (mannitol and BHT), MPT pore sealing agents (carnitine and cyclosporine), lysosomtropic agents (methylamine, chloroquine, monensin) as well as by NADPH P450 reductase inhibitor (diphenyliodoniumchloride) and CYP2E1 inhibitors (phenylimidazole, methylpyrazole) (
Table 1).
The results presented here showed that in intact hepatocytes, both DTX and PLGA-DTX induced a decrease of mitochondrial membrane potential which was prevented by antioxidant and radical scavengers, indicating that mitochondrial membrane potential decrease was a consequence of reactive oxygen species formation (
Table 2).
In addition, DTX and PLGA-DTX induced lysosomal membrane leakiness, since acridine orange was significantly (P<0.05) released from lysosome to cytosol following incubation of DTX and PLGA-DTX in the acridine orange-loaded hepatocytes. Hepatocyte lysosomal leakiness occurred within 60 min following addition of DTX and PLGA-DTX, before toxicity ensued (
Table 3). As a consequence, the deadly digestive lysosomal enzyme (proteases/phospholipases) released to the cytosol. The release of this could then be the ultimate cause of the induction of cell death process.
We have shown that lysosomal leakiness prevents by hepatocyte lysosomotropic agents (methylamine, chloroquine and monensin) (
Table 3). These results suggest that DTX and PLGA-DTX induced hepatocyte toxicity involves oxidative stress and formation of reactive oxygen species.
Caspase-3 is the most notable among the executioner caspases. The major pathway for caspase-3 activation is MPT pore opening and release of cytochrome c from mitochondria. GSH depletion and lysosomal membrane leakage could also accelerate and exacerbate the MPT pore opening and cytochrome c release. In view of that, we measured the caspase-3 activity which was augmented in hepatocytes when incubated with DTX or PLGA-DTX.
Our results showed that PLGA-DTX and free docetaxel caused hepatocyte GSH depletion. However, these drugs showed different effects when incubated with GSH or GSH-depleted hepatocytes. GSH and GSH synthesis stimulator, trifluoperazine, prevented DTX-induced cytotoxicity, ROS generation, mitochondrial membrane damage, lysosomal membrane damage, ATP depletion and caspase-3 activity. In addition, depleting hepatocyte GSH beforehand potentiated hepatocyte susceptibility to DTX-induced cytotoxicity, ROS generation, mitochondrial membrane damage, lysosomal membrane damage, ATP depletion and caspase-3 activity.
On the other hand, cytotoxicity, ROS generation, mitochondrial membrane damage, lysosomal membrane damage, ATP depletion and caspase-3 activation induced by PLGA-DTX was interestingly potentiated by GSH and trifluoperazine. Besides, depleting hepatocyte GSH beforehand prevented the hepatocytes against PLGA-DTX-induced cytotoxicity, ROS generation, mitochondrial membrane damage, lysosomal membrane damage, ATP depletion and caspase-3 activity.
In this study, we evaluated the effects of CYP450s on DTX and PLGA-DTX toxicity. Our results showed that NADPH P450 reductase inhibitor, diphenyliodonium chloride, prevented both DTX and PLGA-DTX-induced cytotoxicity, which revealed that these compounds were activated by CYP450 mediated metabolisim. However, it was already proved that CYP450s have a major role in DTX metabolism. Our results showed that CYP3A4 inhibitors (ketoconazole, troleandamycin) exacerbated the toxic effect of both DTX and PLGA-DTX, but CYP2E1 inhibitors (phenylimidazole, methylpyrazole) prevented drug-induced toxicity. These findings confirmed that CYP2E1 is directly involved in metabolic activation of both PLGA-DTX and DTX while CYP3A4 acts as a detoxification system.
We also investigated the protective effect of silymarin (
30-
33) against DTX and PLGA-DTX in isolated rat hepatocytes. The interesting findings were that silymarin could significantly diminish cytotoxicity of PLGA loaded docetaxel but not free DTX (
Table 1). Silymarin also prevented apoptosis (
Figure 2) ROS generation, mitochondrial membrane damage, lysosomal membrane damage, ATP and GSH depletion induced by PLGA-DTX but not free docetaxel (
Table 1-
3). These effects must be the result of multi characteristic functions of this herb such, inhibition of hepatic cytochrome P450s (CYPs), acting as free radical scavenger and also inhibitor of drug resistance protein in cell membrane such as P-gp efflux pump present in the hepatocyte (34), leading to considerable enhancement in the bioavailability of docetaxel in hepatocytes. These results suggest that nano formulation of docetaxel (unlike free drug), perhaps doesn’t have significant affinity to P-gp efflux pump and achieve much more reliable concentration than free docetaxel in hepatocytes and thus inhibitory effect of silymarin doesn’t affect PLGA-DTX cellular bioavailability.
We have shown that lysosomal leakiness is prevented by the hepatocyte lysosomotropic agents (lysosomal inactivators) methylamine, chloroquine and monensin (
Table 3). These results suggest that DTX and PLGA-DTX-induced hepatocyte toxicity involves oxidative stress and formation of H
2O
2 which is a mobile reactive oxygen species which could easily diffuse inside the lysosomes and start the intralysosomal Fenton reaction with Fe
2+/Fe
3+ leading to hydroxyl radical formation and subsequent lysosomal membrane damage.
Quite unexpectedly, mitochondrial pore sealing agents (carnitin & cyclosporin) significantly (P < 0.05) inhibited release of acridine orange in hepatocytes treated with PLGA-DTX and also lysosomotropic agents (methylamine, chloroquine and monensin) prevented mitochondrial membrane damage merely in nano formulation. All these interesting events brought us to a conclusion that there is likely a cross-talk between mitochondria and lysosomes in PLGA-DTX toxicity but not in DTX.
We have also shown that both DTX and PLGA-DTX induced cytotoxic alterations were potentiated by preincubating with hypomethylating agent (DMSO). On the other hand, natural methyl donors (methionine, betaine and folic acid) prevented both DTX and PLGA-DTX-induced hepatocyte lysis, ROS formation, mitochondrial membrane potential decrease, lysosomal membrane leakiness GSH and ATP depletion. As a result, we suggested that both DTX and PLGA-DTX detoxification pathway in mammalian cells is surely metabolic methylation.
It is well known that glutathione (GSH) is a major antioxidant as well as redox and cell signaling regulator. We demonstrated that depleting hepatocyte GSH beforehand increased hepatocyte sensitivity to DTX-induced cytotoxicity, ROS formation, mitochondrial membrane damage, lysosomal membrane damage and caspase-3 activity. These effects could be attributed to the antioxidant effects of GSH. On the other hand, cytotoxicity, ROS generation and other toxic end points such as mitochondrial membrane potential decrease, lysosomal membrane damage, and caspase-3 activation induced by PLGA-DTX were all potentiated by GSH and trifluoperazine, a GSH synthesis stimulator. This could be attributed to the role of GSH in PLGA-DTX bioactivation (
Table 4).
Several experiments suggest that cellular ATP level is an important determinant for cell death, either by apoptosis or necrosis. It is proven that cells need a particular ATP level to stay alive, so if the amount of ATP falls below this level apoptosis or necrosis could occur (
35,
36). Our results also revealed that both DTX and PLGA-loaded DTX could reduce intracellular ATP level; and the effect of PLGA-DTX but not DTX was significantly inhibited by silymarin and GSH depleting agent (1-bromoheptane). All these data were consistent with our other findings about the role of depletion of GSH pool and oxidative stress in PLGA-DTX-induced toxicity.
In various investigations, researchers showed that cellular mortality of PLGA nanoparticles containing docetaxel was higher than free drug in various cancerous cell lines (
15,
37). Our results are in accordance with this work. However, we have also shown this formulation could also cause severe toxic effects in normal cells such as hepatocytes. Thus it is suggested that future administration in cancer patients should be carried out with caution.