Background. Temozolomide (TMZ) is a methylating drug that is commonly used in the treatment of glioma. Although many features are still unclear, its general mechanism of action is well described. TMZ induces O6-methylguanine (O6MeG) lesions in DNA, which, in the absence of repair by O6-methylguanine methyltransferase (MGMT), mispair with thymine and start a futile cycle of repair-resynthesis events. The resultant DNA double-strand breaks (DSBs) activate the components of G2 checkpoint, and cells with a 4N DNA content accumulate and remain arrested at the G2/M boundary for several days. Cell death subsequently occurs by senescence, necrosis, or mitotic catastrophe, while apoptosis has been ruled out in many studies. Moreover, the effect of multiple TMZ treatments on G2 arrest and apoptosis induction is not clear. Repair of methylating drug-induced DNA lesions requires monoubiquitination of PCNA and FANCD2. Loss of either protein or inhibition of their monoubiquitination increases drug toxicity. USP1 is a hydrolase that removes monoubiquitin from PCNA and FANCD2, and can potentially play a role in TMZ mechanism of action.
Materials and methods. U87, U251 (TMZ-sensitive, low MGMT), and GBM8 (TMZ-resistant, high MGMT) cell lines were used for experiments. The treatment was scheduled with 100μM TMZ for 3 hours for 1, 2, or 3 consecutive days. Cell cycle progression was studied with both FACS-based analysis and a novel time-lapse microscopic real-time analysis using FUCCI (Fluorescent Ubiquitination-based Cell Cycle Indicator), and apoptosis was measured with FACS-based Annexin V-PI analysis. To address the possible role of USP1 in TMZ action, we examined expression of USP1 at the mRNA levels in expression microarray databases derived from primary GBM. We also used siRNA targeting USP1 to modulate USP1 expression, and studied the effect of USP1 downregulation on TMZ-induced G2 arrest, cell death, and clonogenicity.
Results. Compared to single treatment, multiple TMZ treatments cause a significant reduction of clonogenicity in TMZ-sensitive cells and induce a significant increase of apoptosis, particularly in a late stage. However, multiple treatments don’t have any major effect on cell cycle profile. Time-lapse microscopic analysis with FUCCI system showed that TMZ-sensitive glioma cells arrest at the G2 checkpoint for less than 48 hours and, in the presence of an activated G2 checkpoint, they replicate their DNA without cellular division, re-enter the cell cycle at the next G1 phase, and repeat the cycle, ultimately giving rise to polyploid cells. siRNA-mediated suppression of USP1 had no effect on cell cycle progression or the extent of temozolomide-induced G2 arrest. However, while USP1 knockdown alone had minimal effect on cell death, it increased temozolomide-induced loss of clonagenicity both in TMZ-sensitive and TMZ-resistant cells. Further examination of the mechanism of cell death suggested that while control cells, control cells exposed to TMZ, or USP1-suppressed cells rarely underwent apoptotic cell death, temozolomide-treated cells in which USP1 levels were suppressed underwent high rates of apoptosis.
Conclusions. The present studies show that TMZ can induce apoptosis in TMZ-sensitive glioma cells, which is visible after 3 days but significant after 7 days. Multiple TMZ treatments don’t affect cell cycle profile, but significantly increase apoptosis. Moreover, time-lapse studies suggest a novel mechanism of action for TMZ, alternative to the one commonly accepted. These results have significant implications for the development of TMZ resistance. Furthermore, rather than sensitizing cells to DNA damaging agents, USP1 appears to suppress latent apoptotic pathways and to protect cells from temozolomide-induced apoptosis. These results identify a new function for USP1 and suggest that suppression of USP1 and/or USP1 controlled pathway may be a means to enhance the cytotoxic potential of temozolomide and to sensitize TMZ-resistant GBM cell
