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G6PD and Cancer Pathways
G6PD and Cancer Pathways
G6PD and Cancer Pathways
Dear Editor,
Please find in the attachment a manuscript entitled "New specific G6PD inhibitors reduces
viability, induce cell cycle arrest and promote apoptosis in cancer cells”. This manuscript was
written by Surabhi Mishra, Roldán Cortés, Jaime Rubio, and Marta Cascante. This manuscript
describes a the biological effects of a set of four previously designed and synthesized small
molecules (named 1, 2, 3 and 4) over cell viability, G6PD activity, cell cycle phase distribution
and apoptotic state of three different cancer cell lines: A549 (lung), SKOV-3 (ovary) and SW-
1990 (pancreas). Our study evidenced that these compounds, which were designed to inhibit
G6PDH following in silico studies, are able to inhibit the enzyme’s activity in all three cell lines,
which is concomitant with the inhibition of cell viability through arrest of the cell cycle and,
eventually, the induction of apoptosis. G6PD is the main regulatory enzyme of the pentose
phosphate pathway, and our results help to better understand the relationship between this
pathway and the accelerated proliferation rates characteristic of cancer cells. Furthermore, they
reinforce the utility of exploiting vulnerabilities associated to cancer metabolic reprogramming
as a promising strategy to impair tumor proliferation, and open new avenues to improve the
design and synthesis of a new family of metabolic inhibitors as putative therapeutic agents in
cancer treatment.
For all these reasons, we would like to have this manuscript considered for publication in
Biochemical Pharmacology and we look forward to learning your decision.
Sincerely yours,
martacascante@ub.edu
New specific G6PD inhibitors reduces
1
Department of Biochemistry and Molecular Biology, Faculty of Biology, and IBUB, Universitat de
Barcelona, Unit Associated with CSIC Diagonal 645, E-08028-Barcelona, Spain. E-mail:
martacascante@ub.edu
2
Institut d’Investigacions Biome`diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
3
Universitat de Barcelona, Facultat de Quimica, Departament de Química Física, Martí i Franqués
pentose phosphate pathway, which is essential for cell proliferation and therefore commonly up-
regulated in cancer cells. Here we present a study of the biological activity of four previously
synthesized small molecules (compounds 1, 2, 3 and 4)which were designed to inhibit the
formation of the active G6PD dimer and, therefore, inhibit the enzyme’s activity. The activity of
the compounds was tested over three different tumor cell lines: A549 (lung cancer), SKOV-3
(ovarian cancer) and SW-1990 (pancreatic cancer). Obtained results evidenced that this family of
compounds is able to inhibit the enzyme’s activity in all three cell lines, which is concomitant
with the observed inhibition of cell viability through the arrest of the cell cycle and, eventually,
the induction of apoptosis. Results help to better understand the relationship between the activity
of G6PD and the accelerated proliferation rates which are characteristic of cancer cells.
Furthermore, they reinforce the utility of exploiting vulnerabilities associated to cancer metabolic
reprogramming as a promising strategy to impair tumor proliferation, and open new avenues to
improve the design and synthesis of a new family of metabolic inhibitors as putative therapeutic
without control and are able to invade other tissues. In 2012, more than14.6 million new cases of
cancer were diagnosed and around 8.2 million cancer deaths were registered worldwide[1]. The
development and progression of cancer requires that malignant cells acquire certain capabilities
along the carcinogenic process. These required capabilities, which are known as the hallmarks of
growth suppressors, invasivity, and metastasis. Over the last few years, cancer research has
promoted the appearance of an emergent new hallmark of cancer: the reprogramming of cancer
metabolism. In order to maintain an accelerated proliferation rate, cancer cells must reorganize
Pentose Phosphate Pathway (PPP) is one of the metabolic pathways with higher impact in cell
proliferation. The pathway comprises two different phases, named the oxidative phase(non
reversible) and the non-oxidative phase (reversible). Both phases of the PPP produce of 5 carbon
sugars(pentoses), and therefore the pathway is essential pathway for nucleotide (and therefore
DNA) production. Besides, the oxidative phase leads to the reduction of NADP into NADPH
[3], whose reductive power is essential not only in the protection against ROS, but also in the
synthesis of biomolecules such as fatty acids[4]. Because of this essential role in cell
cancer types. The pathway is connected to the regulation of many aspects of tumor biology such
radiotherapy, and it has been reported that enhanced activation of the entire PPP can be regarded
as one of the hallmarks of cell transformation [5]. G6PD is considered to be the main controlling
enzyme of metabolic flux through the oxidative phase of PPP [6]. The enzyme works at a low
basal rate in non transformed cells but it exerts a strong proliferative role when it becomes
deregulated [7, 8]. The increase in its activity inhibits apoptosis [5], and its inhibition slows
Lung cancer is the most common cancer in the world, with 1.8 million new cases diagnosed in
2012 alone [1]. 85% of lung tumors are non-small cell lung cancer (NSCLC), with
adenocarcinoma as the most common type of cancer both in smoker and non-smoker groups. It is
one of the most aggressive cancer types, with 50% of mortality one year after diagnosis, and a 5-
year survival rate below 15%. Platinum-based chemotherapy, which remains the main option for
more than 80% of patients diagnosed with advanced NSCLC, is characterized by great
heterogeneity both in terms of efficacy and toxicity, and its long-term effectiveness is generally
three to seven months, and a median overall survival of less than one year[10]. Pancreatic cancer
remains one of the challenging disease because of its late diagnosis and a short survival rate of
the patient [11] . It is one of the 4 deadliest cancer types, with a survival rate close to zero[12].
The 3 year survival rate for these patients is 3% while 5 year survival rate has increased to a still
low 20%, the cancer spreads very quickly in the body and its recurrence is likely to happen[13].
Gemcitabine and Marimastat constitute the first-line therapy for patients with unrespectable
pancreatic cancer[14][15][16]. Their effectiveness is very limited, since they usually increase the
life expectancy by one year maximum. Epithelial ovarian cancer is the most common cause of
gynecological cancer and has high incidence of death among women[17]. Its frequency varies
among different ethnic groups, but the risk of having an ovarian cancer increases with age [18].
fertility, and loss of taste and appetite. The 5 year survival rate of a ovarian cancer patient is
40%, and therefore both optimization of efficacy and tolerability remain important issues to be
solved.
All these problems highlight the need to find new therapeutical targets that can be exploited in
novel treatments against these cancer types. Since G6PD activity in tumors has been shown to be
significantly different from that of normal cells, and considering how essential PPP metabolic
pathway is for cell proliferation, the enzyme can be an interesting target whose inhibition could
be exploited to impair proliferation rates in these cancer tissues. In order to validate this
hypothesis, in this study we have evaluated the effect of putative G6PD inhibitors over the
phenotype of three cancerous cell lines:A549 (lung), SW1990 (pancreas), and SKOV3 (ovary).
These inhibitors (compounds 1, 2, 3, and 4)have been developed by Dr. Jaime Rubio’s team by
using structural based virtual screening, which focused on mimicking the protein protein
interaction of the homodimer of the G6PDH.The evaluation of the effect of the compounds over
cell viability, G6PD activity, cell cycle phase distribution and apoptosis induction has been
conducted in the present study. Results show that the inhibition of G6PD is a promising strategy
human ovarian adenocarcinoma epithelial cell line SKOV3 (ATCC® HTB-77™), and human
from American Type Culture Collection (Manassas, VA, U.S.A). A549 and SKOV 3 cell lines
were cultured in DMEM (Sigma-Aldrich) supplemented with 10% fetal bovine serum and 0.5%
supplemented with 10% fetal bovine serum and 0.5% penicillin/streptomycin. All cell lines were
cultured under standard culture conditions (humidified air with 5% CO2 at 37˚C).
4 compounds, referred as 1, 2, 3 and 4, were used in the cell viability tests Stock solutions of
or 33 mM (compounds 2 and 4), depending on their solubility. To obtain the final assay
concentrations, compounds were diluted in DMEM (for assays over A549 and SKOV3 cell lines)
or RPMI (for assays over SW1990 cell line) immediately before the start of the incubation
period. Final concentration of DMSO was identical for all conditions, and was always kept lower
than 1%. The assay was performed by a variation of the MTT assay described by Mosmann[19]
as specified by Matito and coworkers [20], which is based on the ability of live cells to cleave
the tetrazolium ring of the MTT thus producing formazan, which absorbs at 550 nm. In brief, a
fixed number of cells (2500 cells/well for A549, 4000 cells/well for SKOV3, and 4500 cells/well
for SW1990) were seeded in 96 well plates 24hr before the addition of the different compounds,
in triplicate. Once the compounds were added, cells were cultured for an additional 72h,
supernatant was aspired and 100µL of filtered MTT (0.5 mg/ml) were added to each well.
Following 1 h of incubation with the MTT, the supernatant was removed and the precipitated
formazan was dissolved in 100µL DMSO. Relative cell viability, compared to the viability of
untreated cells, was measured by absorbance at 550 nm on an ELISA plate reader (Tecan Sunrise
MR20-301, TECAN, Salzburg, Austria). Concentrations that inhibited cell growth by 50% (IC 50)
cell culture extracts in two independent experiments performed in triplicate. Cell extracts were
prepared and enzyme activities were measured on the Roche Cobas Mira Plus chemistry analyzer
from the rate of production of NADPH from NADP. Each enzyme activity was normalized by
determining the protein concentration using BCA method (Thermo Fisher Scientific, IL, U. S.
A.). Enzyme activities are expressed as milliunits per milligram of protein (mU/mg prot).
Cell cycle was analyzed by using a fluorescence activated cell sorter (FACS). A fixed number of
cells (45000 cells/well for A549, 59000 cells/well for SKOV3, and 167000 cells/well for
SW1990) were seeded in 6 well plates with 2ml of medium, in duplicate. After 24h, compound 1
was added at their IC50 value (2.8 µM for A549, 1.40 µM for SKOV3, and 4.65 µM for
SW1990) and twice their IC50 value (5.6 µM, 2.8 µM, and 9.3 µM). After 72h of incubation,
cells were harvested by trypsinization followed by centrifugation. The resulting pellet was
resuspended in 50% Tris buffered saline (TBS) and 50% Vindelov Buffer (which contained 50
µg/ml Propidium Iodide, 10 µg/ml DNAse-free RNase and 0.1% Igepal CA-630). The cells were
then incubated for 30 min at 4˚C, and then FACS analysis was carried out at 488nm in an Epics
XL flow cytometer (Coulter Corporation, Hialeah, FL). Data were analyzed using the Multicycle
exposed to the outside surface of the cells during the first stages of the apoptotic process. A fixed
number of cells (45000 cells/well for A549, 59000 cells/well for SKOV3, and 167000 cells/well
for SW1990) were seeded in 6 well plates with 2ml of medium, in duplicate. After 24h,
compound1 was added at their IC50 value (2.8 µM for A549, 1.40 µM for SKOV3, and 4.65 µM
for SW1990) and twice their IC50 value (5.6 µM, 2.8 µM, and 9.3 µM). After 72h of incubation,
cells were harvested by trypsinization followed by centrifugation. The resulting pellet was
resuspended in 95µL of binding buffer (10mM HEPES/NaOH, 140mM NaCl, and 2.5mM CaCl 2,
pH 7.4) 3µL of Annexin-V FITC conjugate (1 µg/ml) were then added and the suspension was
kept in dark for and incubated for 30 minutes at 4˚C. Just before analysis, 500 µL of binding
buffer and 10 µL of PI (1mg/ml) were added to each sample. The sample was then analyzed via
FACS.
3. Results
Antiproliferative activity of the compounds 1,2,3 and 4 was evaluated invitro by performing
viability assays against human lung, ovarian and pancreatic cancer cell lines (A549, SKOV3, and
SW1990 respectively). The effect of the compounds on the growth rate of the selected cell lines
was evaluated after 72h (see Figure 1), and IC50 values (which indicate the needed concentration
to inhibit 50% of the viability of the control condition) were obtained (see Table 1). All four
compounds are able to inhibit cell viability in all the lines tested, with IC50 values in the lower
compared to compounds 2,3 and 4:it has considerably lower IC50 values in all the three cell lines.
IC50 values for compound 1 are 6 times lower inA549 cells, 17 times lower in SKOV3 cells, and
5 times lower in SW1990 cells when compared to compound 3, which is the second most potent
The principal intracellular reductant is NADPH, which is mainly produced by the pentose
phosphate pathway through the actions of glucose-6-phosphate dehydrogenase (G6PD), the rate-
limiting enzyme of the pentose phosphate pathway. G6PD activity plays a critical role in cell
growth by providing NADPH for redox regulation and macromolecule synthesis and, through the
PPP, by providing pentoses to synthesize nucleid acids. Since all tested compounds were initially
designed to inhibit G6PD, we assessed whether the effect over cell viability was related to a
reduction in the enzyme’s activity. Compound 1, which was the compound with a higher
biological activity over cell viability in all cell lines tested, was selected for this evaluation.
Compound 1’s effect over G6PD activity was tested in all three cell lines. Enzyme activities
were normalized by total protein concentration, which was determined using BCA method.
Normalized enzyme activities are represented in Figure 2. Results show how G6PD enzyme
activity decreased after the cells incubation with compound 1 at its IC50(2.8µM) and 2xIC50
(5.6µM) concentrations. It was observed in SKOV3 and SW1990 that the decrease of 20% in
enzyme activity can be achieved at their IC50. This effect was even higher and was around 30%
Cell cycle is typically divided into mitosis and interphase, which is further divided into quiescent
and gap 1(G0/G1 phase), synthesis(S phase) and gap 2 (G2 phase). One of the main hallmarks of
cancer is cell cycle dysregulation. To study the effect of compound 1 on the distribution of tumor
cells in each phase of the cell cycle, A549, SKOV3 and SW1990 cells were treated with the
compound (at a concentration equal to its IC50 and at twice its IC50 values) for 72h and then
analyzed by FACS.
As seen in Figure 3, treatment with compound 1 provokes a redistribution of the percentage of
cells in each phase of cell cycle. A significant increase of cells in G0/G1 phase was seen in A549
cells treated with IC50(2.8µM) and 2xIC50(5.6 µM) concentrations of compound 1. Changes in
cell distribution were even more apparent in SKOV3 cells, but in this case the cells were arrested
When the cells get arrested in a particular phase of the cell cycle and they are not able to cross
the cell cycle checkpoints, they get accumulated in the phase before that checkpoint. This arrest
of cell cycle can sometime lead to apoptosis, so after assessing compound 1’s clear effect over
cell cycle distribution, apoptotic assays were performed to see whether apoptosis was involved in
the antiproliferative effect of compound 1. When the apoptotic process begins, cell membrane
loses its symmetry, which entails a translocation of phosphatidylserine from the inner membrane
to the outer membrane. Once phosphatidylserine is exposed to the external cell environment, it
can bind to the annexin V-FITC conjugate, for which it has high affinity. Once the cells reaches
the final apoptitic stages, cell membranes completely lose their integrity, which gives propidium
iodide (a nucleotide binding dye which intercalates between the DNA bases) access to the
nucleus. Flourescence activated cell sorting(FACS) was used together with annexin V-FITC and
Propidum Iodide staining in order to differentiate non apoptotic cells (annexin V- and PI-) from
early apoptotic cells (annexin V+ and PI-) and necrotic or late apoptotic cells (PI+). After
incubating the cells with compound 1, we could see a decrease in the number of healthy cells and
an increase in the number of early apoptotic and late apoptotic/necrotic cells (see Figure 4). This
effect was hardly evident at 24h, but became more and more apparent with longer incubation
times, which indicates that the mechanism of action of compound 1 may not be directly related
to apoptosis, but rather that arises as a consequence of the compound’s effect over cell cycle
arrest (accumulation of cells in one of the cell cycle phases eventually leads to the induction of
4. Discussion
The current study focuses on validating the biological effects of four compounds (1, 2, 3 and 4)
which were previously designed to prevent the G6PD dimer formation by inhibiting its protein-
protein interaction. The activity of these four compounds, whose structure is tailored to inhibit
the hydrophobic contact points as well as the van der Waals contact points while also targeting
hydrogen bond donor and acceptor in G410, was tested on three cancer in vitro models: lung
cancer cell line (A549), ovarian cancer cell line (SKOV3) and pancreatic cancer cell line
(SW1990). Since G6PD is the enzyme controlling the oxidative phase of PPP (one of the most
important metabolic pathways for tumor proliferation), our goal was to assess whether
incubating cancer cells with these inhibitors was able to inhibit their proliferation rate. Therefore,
first we decided to assess the antiproliferative potential of the four molecules, which were
selected previously amongst other candidates after molecular dynamic stimulation and structural
It was found that all four compounds exhibit antiproliferative activity. After 72h of incubation,
drastic reductions in cell viability were observed in the three cancer cell lines. The difference in
the observed IC50 values could be associated with the different proliferative behavior of these cell
lines, but in any case those were not very important and IC50 values were found to be in the low
micromolar range in all cases. 1 showed to be the most potent of the four tested compounds, as it
had the lowest IC50 value in all three cell lines(2.8µM in A549, 1.4µM in SKOV3 and 4.65 µM
groups can evoke a particular biological activity. Since we know that the compound 1 is the most
potent, its structure can be used as a starting point for the development of a new family of more
Once the existence of an antiproliferative effect was established, and considering the compounds
were designed to inhibit the formation of the active G6PD dimer, we decided to assess the effect
of the most potent compound (compound 1) over G6PD activity in all three cancer cell lines.
This would also help us establish if there is any relationship between the viability of the cells and
the levels of G6PD activity. It was found that the levels of G6PD activity decreased significantly
in all cell lines after their incubation with compound 1. The decrease in enzyme activity after
cells incubation with compound 1 at its IC50 concentration was of 20% for SKOV3 and SW1990
cell lines, and 30% in the case of A549 cell line. Although other factors (such as unspecific
inhibitions of other enzymes) might be involved in the antiproliferative effect of the compounds,
this result points out to the existence of a direct relationship between G6PD activity and cell
viability in the three cell lines, especially considering that the molecules were specifically
designed to inhibit G6PD dimer formation. Interestingly, decreases of around 20% in G6PD
activity were related to a decrease of around 50% in cell viability, highlighting the key play
G6PD protein plays in cancer proliferation. The effect of compound 1 was over G6PD activity
was not evaluated over a dilution of the pure G6PD enzyme for two reasons. First, human G6PD
is not available commercially. Second, these compounds are designed to inhibit the formation of
dimer, so when the cells are incubated with the compound the formation of the dimer throughout
the incubation time is hindered. The compound would not be able to cause the same effect to a
dilution of commercially obtained pure enzyme, since the dimer would be already formed and
Considering G6PD’s relationship with cell cycle regulation [21], and since one of the important
hallmarks of cancer is the dysregulation of cell cycle [22], we then checked whether compound 1
could lead to a redistribution of the cells in the different phase of the cell cycle. In the case of
A549 cells, flow cytometery analysis showed a significant (p<0.05) increase in G0/G1
population after treatment with compound 1 when compared to control conditions. This result
suggests that compound 1 induces cell cycle arrest in G0/G1 phase, which would explain the
decrease in cell proliferation observed in the viability assays. The arrest in G0/G1 is concordant
with the inhibition of the enzyme G6PD, since PPP is essential to produce the nucleotides that
are needed in DNA synthesis. Without those nucleotides, S phase of the cell cycle can’t take
place, and over time cells accumulate over time in the previous phase of the cell cycle (G1). In
the case of SKOV3, however, the cell cycle arrest after incubation with compound 1 was seen in
G2/M phase, and not in G0/G1 phase. A possible explanation could be that the metabolism of
ovarian cancer cells lines is more prepared to use the non-oxidative branch of pentose phosphate
pathway, and therefore they can synthesize nucleotides (and, through them, DNA) even if G6PD
is inhibited. This would allow the cells to go through G1 and S phases, but since G6PD is also
required for NADPH production, a lack of NADPH would still prevent those cells to support the
production of macromolecules such as fatty acids, needed to generate cell membrane just before
mitotic division. In this case, even if SKOV3 cells are able to avoid G1 arrest, they could not go
through the mitotic phase, and therefore would accumulate over time in the G2 phase of the cell
cycle, which agrees with our observed results. The fact that ovarian cancer cells overexpress
TKT (a key enzyme in the non-oxidative branch of the PPP) while lung cancer cells overexpress
G6PD support this hypothesis about their divergent capacities to avoid G1 phase arrest after
G6PD has also been previously connected to apoptosis inhibition [24], so we decided to check
whether compound 1 was able to induce apoptosis in the tested cancer cell lines. When. So it was
checked if the compound was only cytostatic in nature or it was cytotoxic too. Results show that
when cells were incubated with the compound 1 for 24 hours, there was no significant changes in
the apoptotic state of the cells, which suggests that the compound does not exercise its
antiproliferative effect through induction of apoptosis. However, after 48h of incubation the
number of early apoptotic and late apoptotic/necrotic cells was increased, an effect that was even
more noticeable after 72h of incubation. This suggests that compound 1 is not directly cytotoxic,
but rather that the arrest and accumulation of the cells in one of the phases of the cell cycle due
to compound 1’s effect, which is already evident after 24h, eventually entails their cell death
through apoptosis.
In any case, our results prove that the previously synthesized compounds are able to inhibit
G6PD activity, and that this is related with a decreased of the viability of cancer cells through
cell cycle arrest, which eventually leads to apoptosis induction. This reinforces the utility of
to impair tumor proliferation, and opens new avenues to improve the design and synthesis of a
IC50 values for compounds 1, 2, 3 and 4 over A549 lung, SKOV3 ovarian and SW1990
pancreatic cancer cell lines. Data are represented as the mean values for a minimum of three
Cell viability assay for compounds 1, 2, 3 and 4 over A549 lung cancer cell line, SKOV3
ovarian cancer cell line and SW1990 pancreatic cancer cell line. The graphs were made by using
Graphpad Prism 6. (A) represents the effect of the compounds (1, 2, 3 and 4) on A549 lung
cancer cell line, (B) represents the effect of the compounds (1, 2, 3 and 4) SKOV3 ovarian
cancer cell line and (C)represents the effect of the compounds (1, 2, 3 and 4) SW1990 pancreatic
cancer cell line. Compound 1 showed to be most potent with least IC50 value in micromolar
range.
Figure 2: Compound 1’s effect over G6PD activity for A549, SKOV3 and SW1990 cell
lines.
All the represented graphs were made by using the data collected after G6PD assay which were
normalized by doing a BCA assay. Figure(A) represents the change in the levels of G6PD when
compounds are administered to A549 cells at a concentration of 2.8µM (IC50 value)and 5.6
µM(2x IC50 ) Figure(B) represents the change in the levels of G6PD when compounds are
administered to SKOV-3 cells at a concentration of 1.4 (IC50 value)and 2.8 µM(2x IC50 ).
Figure(C) represents the change in the levels of G6PD when compounds are administered to
SW-1990 cells at a concentration of 2.8µM (IC50 value)and 5.6 µM(2x IC50 ). (Mean ± SD). p <
0.05 (*); p < 0.01 (**); p < 0.001 (***) were considered to indicate statistic significant
Figure 3. Cytometeric plots of A549, SKOV-3 and SW-1990 for cell cycle assay
(A) Representative flow cytometric plots showing the distribution of SKOV3 cells in the
different phases of the cell cycle after 24h incubation with compound 1. (B)Bar graphs depicting
the % of cells in each phase of the cell cycle for A549, SKOV3 and SW1990 cells
untreated(control) and treated with compound 1 at its IC50 and 2xIC50concentrations for 24h, 48h
and 72h. (Mean ± SD). p < 0.05 (*); p < 0.01 (**); p < 0.001 (***) were considered to indicate
Figure 4: Cytometeric plots of A549, SKOV-3 and SW-1990 for apoptosis assay
different phases of the cell cycle after 72h incubation with compound 1. Quadrants 1 and 2
contain late apoptotic /necrotic cells, Quadrant 3 contains early apoptotic cells and quadrant 4
contains unaffected/healthy cells. Figure(B) Bar graphs depicting % of healthy, early apoptotic
and late apoptotic/necrotic A549, SKOV3 and SW1990 cellsuntreated (control) and treated with
compound 1 at its IC50 and 2xIC50 concentrations for 24 h, 48 h and 72 h. (Mean ± SD). p <
0.05 (*); p < 0.01 (**); p < 0.001 (***) were considered to indicate statistic significant
CellLines
Compounds A549 SKOV3 SW1990
Figure 2:
Figure 3:
Figure 4: