PDAC is a very malignant tumor. Although medical science has made great progress in recent years, especially in tumor chemotherapy, the overall survival rate of patients with PDAC has not improved significantly, with the 5-year survival rate less than 5–7 % [1]. In the past few years, the use of the deoxycytidine analog gemcitabine has been shown to have some clinical benefit and slightly extend the average survival time. Therefore, gemcitabine has become a first-line chemotherapy drug for PDAC. However, studies have shown that long-term exposure to gemcitabine can lead to acquired resistance [2]. Among the causes of chemotherapy resistance, apoptotic defects are considered to be the main reason, because many chemotherapeutic drugs work by inducing apoptosis [2]. Therefore, the resistance of tumor cells to cytotoxic drugs may be attributed to resistance to apoptosis. It is of great significance to explore the molecular determinants of apoptosis resistance in PDAC cells for the development of new and more effective treatment strategies. In this study, from the new perspective of Livin as a target gene for apoptosis resistance, RNA interference (RNAi) was used to effectively silence Livin gene expression, and combined with gemcitabine to treat PDAC. This study firstly proved that the combined treatment of Livin knockdown and gemcitabine had synergistic sensitization effect on PDAC in vitro.
Livin is a new member of the IAPs family. It is highly expressed in transformed cells and a variety of malignancies, but it is not expressed in most normal differentiated tissues except placenta, normal testes, and spinal cord [3]. According to reports, Livin's anti-apoptotic mechanism is mainly inhibiting the activity of the mitochondrial apoptotic signaling pathway molecules caspase 3, 7 and 9. They can activate transforming growth factor β-activated kinase1 and its binding protein to mediate mitogen-activated protein kinases pathways, and play the role of apoptosis mediated by tumor necrosis factor-alpha and interleukin 1β converting enzyme [7]. In addition, Livin can inhibit E3 ubiquitin ligase-like activity. It promotes the degradation of Smac / DIABLO, which is a key endogenous regulator of all IAPs [7]. It has been proved that Livin can improve the viability of cancer cells, and make it easy for cancer cells to avoid immune surveillance and cytotoxin effects. Its expression level is closely related to the biological behavior of tumor, sensitivity of radiotherapy and chemotherapy and prognosis, and can inhibit the apoptosis induced by chemotherapy drugs [8].
In view of Livin's overexpression in multidrug-resistant tumor cells, tumor treatment with Livin as target has attracted more and more attention. Studies have shown that down-regulating Livin gene expression by RNAi or antisense oligonucleotides can inhibit the growth of cancer cells and allow tumor cells to redifferentiate towards proapoptotic anticancer drugs [6–8]. Wang H et al. conducted in vitro and in vivo studies using human malignant melanoma cell lines (LiBr), which showed that down-regulation of Livin expression by siRNA could significantly inhibit cell proliferation and induce apoptosis [6]. RNAi is a strategy for suppressing gene expression after highly specific transcriptionMore specifically, siRNA, as a means of reducing the expression of specific proteins in vitro and in vivo, makes almost all protein targets be inhibited by these sequences. The use of siRNA for silencing of the Livin gene is well established. This study designed two pairs of siRNAs based on Livin sequences, which showed differences in silencing efficiency. We chose the one with better efficiency for subsequent experiments. It was successfully transfected into PANC1 cells. the level of Livin mRNA and protein transcription in the stable transfection group was significantly reduced. The results suggest that Livin-siRNA can specifically down-regulate the expression of Livin in PANC1 cells, and the siRNA silencing efficiency of different parts of the same target mRNA may be different.
The concentration of gemcitabine used in the treatment of PANC1 cells in this experiment showed that the apoptosis induced by gemcitabine at 50 nM was more significant than that at 25 nM. But the apoptosis induced by 100 nM gemcitabine was not changed from 50 nM. This indicates that there may be an upper limit for the concentration of gemcitabine and chemotherapy resistance. After Livin knockdown in PANC1 cells, the apoptosis induced by gemcitabine was enhanced at both 25 nM and 50 nM, which indicates that Livin-siRNA targeted silencing of Livin gene expression combined with gemcitabine has a synergistic effect on PDAC. Liu Y et al. found that siRNA-Livin could reduce the multidrug resistance-related protein gene expression in glioblastoma cell lines (U251 cells and U251 stem cells) to reduce the resistance of glioblastoma to chemotherapy [10]. Wang Z et al. found that silencing Livin could induce apoptosis and autophagic death of renal cancer cells, and improve the sensitivity of renal cancer cells to cisplatin [11]. Oh BY et al. found that siRNA-mediated down-regulation of Livin gene expression could significantly inhibit the growth of colon cancer cell lines (HCT116) and enhance the cytotoxic effect of anti-cancer drugs such as 5-fluorouracil [12]. Our results are consistent with these research. As for the exact mechanism of how Livin down-regulation can enhance the chemosensitivity of gemcitabine, it is currently believed that Livin down-regulates cell death through the mitochondrial signaling pathway or increases cell death through the death receptor pathway. Our study also showed that Livin knockdown induced apoptosis by activating caspase 3 and PARP. Yoon TM et al. showed that siRNA-mediated Livin gene knockdown resulted in the down-regulation of Livin expression and the increase of apoptosis in three human head and neck squamous cell carcinoma cell lines (SNU1041, PCI1 and PCI50 cells). It was caused by the activation of mitochondrial apoptotic signaling pathways caspase-3 and caspase-7. At the same time, the knockdown of Livin gene increased the sensitivity of here cell lines to cisplatin, 5-fluorouracil and docetaxel [5]. This is basically consistent with our results. These results indicate that Livin may be an important determinant of tumorigenesis. And RNAi targeting Livin is expected to be a new strategy for chemotherapy sensitization on PDAC.
In conclusion, Livin-siRNA can effectively silence the overexpression of Livin gene in pancreatic cancer PANCl cells, and regulate the apoptosis of PANCl cells through PARP and caspase-3 proteolytic pathway. Livin-targeted RNAi can significantly promote the apoptosis of PANC1 cells in vitro and increase its sensitivity to gemcitabine. Therefore, the combined application of RNAi targeting Livin and gemcitabine may be an effective and safe strategy for PDAC treatment.