Research Papers:

The antihypertensive drug hydralazine activates the intrinsic pathway of apoptosis and causes DNA damage in leukemic T cells

María J. Ruiz-Magaña, Rocío Martínez-Aguilar, Estefanía Lucendo, Diana Campillo-Davo, Klaus Schulze-Osthoff and Carmen Ruiz-Ruiz _

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Oncotarget. 2016; 7:21875-21886. https://doi.org/10.18632/oncotarget.7871

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María J. Ruiz-Magaña1, Rocío Martínez-Aguilar1, Estefanía Lucendo1, Diana Campillo-Davo1, Klaus Schulze-Osthoff2,3 Carmen Ruiz-Ruiz1,4

1Unidad de Inmunología, IBIMER, Universidad de Granada, Granada, Spain

2Interfaculty Institute of Biochemistry, University of Tübingen, Tübingen, Germany

3German Cancer Consortium (DKTK) and German Research Cancer Center (DKFZ), Heidelberg, Germany

4Departamento de Bioquímica y Biología Molecular 3 e Inmunología, Facultad de Medicina, Universidad de Granada, Granada, Spain

Correspondence to:

Carmen Ruiz-Ruiz, e-mail: [email protected]

Keywords: hydralazine, apoptosis, mitochondria, DNA damage, leukemia

Received: September 03, 2015    Accepted: February 20, 2016    Published: March 03, 2016


Epigenetic therapies have emerged as promising anticancer approaches, since epigenetic modifications play a major role in tumor initiation and progression. Hydralazine, an approved vasodilator and antihypertensive drug, has been recently shown to act as a DNA methylation inhibitor. Even though hydralazine is already tested in clinical cancer trials, its mechanism of antitumor action remains undefined. Here, we show that hydralazine induced caspase-dependent apoptotic cell death in human p53-mutant leukemic T cells. Moreover, we demonstrate that hydralazine triggered the mitochondrial pathway of apoptosis by inducing Bak activation and loss of the mitochondrial membrane potential. Hydralazine treatment further resulted in the accumulation of reactive oxygen species, whereas a superoxide dismutase mimetic inhibited hydralazine-induced cell death. Interestingly, caspase-9-deficient Jurkat cells or Bcl-2- and Bcl-xL-overexpressing cells were strongly resistant to hydralazine treatment, thereby demonstrating the dependence of hydralazine-induced apoptosis on the mitochondrial death pathway. Furthermore, we demonstrate that hydralazine treatment triggered DNA damage which might contribute to its antitumor effect.

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