Abstract
Background: Combination of fasting with chemotherapy has been drawn an increasing attention because of the encouraging efficacy. SLC7A11 is frequently over-expressed in most of cancer cells, and elevated expression of SLC7A11 renders cancer cells more susceptible to glucose starvation owing to SLC7A11-mediated redox collapse. Selenite is a representative inorganic form of selenium, and is preferentially accumulated in tumors. This selenophilic peculiarity of cancer cells is closely associated with the elevated expression of SLC7A11. Given the established the link among glucose deprivation, SLC7A11, oxidative stress and selenite, we hypothesized that glucose starvation could specifically sensitize cancer cells to selenite-mediated cytotoxic effect. Methods: The cytotoxic effect of combining selenite with glucose starvation on cancer cell was assessed by crystal violet staining and Annexin V/PI staining. Flow cytometry were employed to assess intracellular ROS levels, labile iron pool and lipid peroxidation. Xenograft models were used to test its in vivo antitumor activity. Commercial assay kit, LC-MS, RNA interference and western blot were applied to investigate the mechanism underlying synergistic effect.Results: It showed that cytotoxic effect of selenite on cancer cells, but not on normal cells, was significantly enhanced in response to the combination of selenite and glucose limitation. Furthermore, in vivo therapeutic efficacy of combining selenite with fasting was dramatically improved in xenograft models of lung and colon cancer. Mechanistically, we found that SLC7A11 expression in cancer cells was up-regulated by selenite both in vitro and in vivo. The elevated SLC7A11 led to accumulation of cystine, depletion of NADPH, and inhibition of cystine to cysteine conversion, which in turn boosted selenite-mediated reactive oxygen species (ROS), followed by enhancement of selenite-mediated cytotoxic effect. Conclusion: The findings of the present study provide an effective and practical approach for increasing the therapeutic window of selenite, and imply that combination of selenite with fasting holds promising potential to be developed a clinically useful regimen for treating certain types of cancer.