In this work, the effect of AMSC-Se on HT-29 cell growth has been explored. The results indicated that AMSC-Se significantly diminished proliferation and enhanced apoptosis of HT-29 cells. In line with these results, Zhu et al. revealed that the factors secreted by AMSCs could suppress the survival and proliferation of the K562 leukemia cells (
16). Also, Ryu et al. reported that AMSCs conditioned medium prevents breast cancer cell growth (
17). Adipose mesenchymal stem cells suppressed the growth of SKBR3 (a breast malignant cell line) cells in direct co-cultures (
18). In another investigation, AMSC-Se reduced bladder cancer cell viability and decreased its resistance to ciprofloxacin (
7).
In contrast, some reports have demonstrated that secretome from AMSCs promotes the proliferation of breast cancer cells (
19,
20). Conditioned medium from AMSCs significantly enhanced hepatocellular carcinoma invasion (
21). In another study, AMSC-Se promoted the growth of prostate cancer cells (
22). These controversial results may be due to the variability of MSC sources or cancer cell types.
Flow cytometry method was used in this study to explore the relationship of anti-proliferating impact of AMSC-Se with apoptosis. The AMSC-Se-treated cells exhibited more apoptosis than the untreated cancerous cells. Previous studies showed that conditioned medium from AMSCs induces apoptosis in the cancerous cells (
23,
24). In this regard, AMSCs increased apoptosis along with proliferation inhibition in hepatocellular carcinoma cell lines (
25). Direct co-culture of SKBR3 cancer cells with AMSCs increased chemosensitivity and enhanced apoptosis in response to 5-fluorouracil and doxorubicin (
18). Adipose mesenchymal stem cells-derived secretome also prevented melanoma proliferation by inducing apoptosis
in vitro (
24). As shown in flow cytometry results, the necrosis percentage did not change by the AMSC-Se, which revealed a critical role of apoptosis in reducing the survival of the malignant cells of the AMSC-Se.
Protein and mRNA levels of Bcl-2 and Bax, and caspases activity were assessed in the current work to confirm the involvement of apoptosis in AMSC-Se-reduced growth of the cancer cells. Adipose mesenchymal stem cells-derived secretome enhanced the Bax level, while the Bcl-2 level was reduced within the HT-29 cells. These genes are the main regulators of the intrinsic apoptotic pathway. The enhanced Bax/Bcl-2 ratio expression activates caspase-3 and caspase-9 via cytochrome-c release and eventually induces apoptosis (
25). Our results demonstrated the treatment AMSC-Se considerably enhanced the activity of caspase-3 and caspase-9. The activated caspase-9 can activate effector caspases and initiate the intrinsic apoptotic pathway.
Conditioned media from human AMSCs could elevate the activities of caspase-3 and caspase-9 and lead to apoptosis in the human U251 glioma cells (
26). Therefore, these results suggest that AMSC-Se stimulates the intrinsic pathway of apoptotic to enhance cancer cell death. The secretome of the MSCs has biological components, such as cytokines, growth factors, angiogenic factors, micro RNAs, anticancer molecules, and exosomes (
27-
34). A number of studies evaluated the effects of the secreted molecules from the MSCs. Bone marrow MSCs-derived cytokine-induced neutrophil chemoattractant-1 and tissue inhibitor of metalloproteinases-1 could prevent the proliferation of the myeloid leukemia cells by suppressing the caspase-3 pathway (
35). TRAIL can initiate the caspase-8 cascade and promote the extrinsic apoptotic pathway (
36).