Research Papers:

Sensitization of multidrug-resistant cancer cells to Hsp90 inhibitors by NSAIDs-induced apoptotic and autophagic cell death

Hyun-Jung Moon _, Hak-Bong Kim, Su-Hoon Lee, So-Eun Jeun, Chi-Dug Kang and Sun-Hee Kim

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Oncotarget. 2018; 9:11303-11321. https://doi.org/10.18632/oncotarget.24130

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Hyun-Jung Moon1, Hak-Bong Kim1, Su-Hoon Lee1, So-Eun Jeun1, Chi-Dug Kang1 and Sun-Hee Kim1

1Department of Biochemistry, Pusan National University School of Medicine, Yangsan 626-870, Korea

Correspondence to:

Chi-Dug Kang, email: [email protected]

Sun-Hee Kim, email: [email protected]

Keywords: Hsp90 inhibitor; NSAID; MDR; autophagy; apoptosis

Received: August 09, 2017     Accepted: December 03, 2017     Published: January 10, 2018


NSAIDs (non-steroidal anti-inflammatory drugs) have potential use as anticancer agents, either alone or in combination with other cancer therapies. We found that NSAIDs including celecoxib (CCB) and ibuprofen (IBU) significantly potentiated the cytotoxicity of Hsp90 inhibitors in human multidrug-resistant (MDR) cells expressing high levels of mutant p53 (mutp53) protein and P-glycoprotein (P-gp), and reversed Hsp90 inhibitor resistance caused by activation of heat shock factor 1 (HSF1) and by up-regulation of heat shock proteins (Hsps) and P-gp. Inhibition of Akt/mTOR and STAT3 pathways by CCB induced autophagy, which promoted the degradation of mutp53, one of Hsp90 client proteins, and subsequently down-regulated HSF1/Hsps and P-gp. Inhibition of autophagy prevented mutp53 degradation and CCB-induced apoptosis, and inhibition of caspase-3-mediated apoptotic pathway by Z-DEVD-FMK did not completely block CCB-induced cell death in MDR cells, suggesting that autophagic and apoptotic cell death may contribute to CCB-induced cytotoxicity in MDR cells. Furthermore, CCB and IBU suppressed Hsp90 inhibitor-induced HSF1/Hsp70/P-gp activity and mutp53 expression in MDR cells. Our results suggest that NSAIDs can be used as potential Hsp90 inhibitor chemosensitizers and reverse resistance of MDR cells to Hsp90 inhibitors via induction of apoptosis and autophagy. These results might enable the use of lower, less toxic doses of Hsp90 inhibitors and facilitate the design of practically applicable, novel combination therapy for the treatment of MDR cancer.

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