Royal jelly induces ROS-mediated apoptosis in acute lymphoblastic leukemia (ALL)-derived Nalm-6 cells: Shedding light on novel therapeutic approaches for ALL

Document Type : Original Article

Authors

1 Laboratory Hematology and Blood Bank Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Laboratory Hematology and Blood Bank Department, School of Allied Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

3 Laboratory Hematology and Transfusion Medicine, Department of Pathology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

4 Laboratory Hematology and Transfusion Medicine, Department of Medical Laboratory Sciences, Faculty of Allied Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

5 Pediatric Congenital Hematologic Disorders Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

10.22038/ijbms.2024.76261.16498

Abstract

Objective(s): Until recently, a conventional chemotherapy regimen for Acute lymphoblastic leukemia (ALL) is considered an efficient therapeutic method in children. However, suboptimal long-term survival rates in adults, disease relapse, and drug-induced toxicities require novel therapeutic agents for ALL treatments. Today, natural products with pharmacological benefits play a significant role in treating different cancers. Among the most valued natural products, honey bees’ royal jelly (RJ) is one of the most appreciated which has revealed anti-tumor activity against different human cancers. This study aimed to evaluate anti-leukemic properties and the molecular mechanisms of RJ cytotoxicity on ALL-derived Nalm-6 cells.
Materials and Methods: The metabolic activity was measured by MTT assay. Apoptosis, cell distribution in the cell cycle, and intracellular reactive oxygen species (ROS) level were investigated using flow cytometry analysis. Moreover, quantitative real-time PCR (qRT-PCR) was performed to scrutinize the expression of various regulatory genes. 
Results: RJ significantly decreased the viability of Nalm-6 cells but had no cytotoxic effect on normal cells. In addition, RJ induced ROS-mediated apoptosis by up-regulating pro-apoptotic genes while decreasing anti-apoptotic gene expression. The results outlined that ROS-dependent up-regulation of FOXO4 and Sirt1 inhibits the cells’ transition to the S phase of the cell cycle through p21 up-regulation. The qRT-PCR analysis of autophagy-related gene expression also demonstrated that RJ induced BECN1 mediated autophagy in Naml-6 cells.
Conclusion: Taken together, this study showed that RJ can be utilized as a potent natural substance to induce ALL cells’ programmed cell death. However, further studies are required to examine this compound’s pharmaceutical application.  

Keywords

Main Subjects


1. Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J 2017; 7: 577.
2. Phelan KW, Advani AS. Novel therapies in acute lymphoblastic leukemia. Curr Hematol Malig Rep 2018;13:289-299. 
3. Huang FL, Yu SJ, Li CL. Role of autophagy and apoptosis in acute lymphoblastic leukemia. Cancer Control 2021; 28:1–8. 
4. Richard-Carpentier G, Kantarjian H, Jabbour E. Recent advances in adult acute lymphoblastic leukemia. Curr Hematol Malig Rep 2019; 14:106-118. 
5. Bhojwani D, Yang JJ, Pui CH. Biology of childhood acute lymphoblastic leukemia. Pediatr Clin North Am 2015;62:47-60. 
6. Sasaki K, Jabbour E, Short NJ, Jain N, Ravandi F, Pui CH, et al. Acute lymphoblastic leukemia: A population- based study of outcome in the United States based on the surveillance, epidemiology, and end results (SEER) database, 1980–2017. Am J Hematol 2021;96:650–658. 
7. Rafei H, Kantarjian HM, Jabbour EJ. Recent advances in the treatment of acute lymphoblastic leukemia. Leuk Lymphoma 2019;60:2606–2621.
8. Kızılocak H, Okcu F. Late Effects of therapy in childhood acute lymphoblastic leukemia survivors. Turkish J Haematol 2019;36:1–11. 
9. Hua F, Shang S, Hu ZW. Seeking new anti-cancer agents from autophagy-regulating natural products. J Asian Nat Prod Res 2017;19:305–313.
10. Pasupuleti VR, Sammugam L, Ramesh N, Gan SH. Honey, propolis, and royal Jelly: a comprehensive review of their biological actions and health benefits. Oxid Med Cell Longev 2017:1259510.
11. Ahmad S, Campos MG, Fratini F, Altaye SZ, Li J. New insights into the biological and pharmaceutical properties of royal jelly. Int J Mol Sci 2020;21:382. 
12. Khazaei M, Ansarian A, Ghanbari E. New findings on biological actions and clinical applications of royal jelly: A review. J Diet Suppl 2018;15:757–775.
13. Miyata Y, Sakai H. Anti-cancer and protective effects of royal jelly for therapy-induced toxicities in malignancies. Int J Mol Sci 2018;19: 3270. 
14. Karadeniz A, Simsek N, Karakus E, Yildirim S, Kara A, Can I, et al. Royal jelly modulates oxidative stress and apoptosis in liver and kidneys of rats treated with cisplatin. Oxid Med Cell Longev 2011:981793. 
15. Bincoletto C, Eberlin S, Figueiredo CA, Luengo MB QM. Effects produced by royal jelly on haematopoiesis: relation with host resistance against Ehrlich ascites tumour challenge. Int Immunopharmacol 2005;5:679–688. 
16. Kobayashi N, Unten S, Kakuta H, Komatsu N, Fujimaki M, Satoh K, et al. Diverse biological activities of healthy foods. In Vivo. 2001;15:17–23. 
17. Sabatini A.G, Marcazzan G.L, Caboni M.F, Bogdanov S, Almeida-Muradian L. Quality and standardisation of royal jelly. J ApiProduct ApiMedical Sci 2009;1:1–6. 
18. Hamledari A, Hasibi F, Hajibabaei K. Physicochemical characterization of Persian fresh royal jelly samples. J Apic Res 2023:1–9. 
19. Fazili N, Soheili ZS, Malekzadeh-shafaroudi S, Samiei S, Shamila D. Royal Jelly decreases MMP-9 expression and induces apoptosis in human 5637 bladder cancer cell. J Cell Mol Res  2021;13:36–43. 
20. Jovanovi MM, Maja ĐĆ, Nikodijevi DD, Milutinovi MG, Cvetkovi DM, Rakobradovi JD, et al. Effects of royal jelly on energy status and expression of apoptosis and biotransformation genes in normal fibroblast and colon cancer cells. Kragujev J Sci 2018;40:175–192. 
21.  Abandansari RM, Parsian H, Kazerouni F, Porbagher R, Zabihi E, Rahimipour A. Effect of simultaneous treatment with royal jelly and doxorubicin on the survival of the prostate cancer cell line                  (PC3): An In Vitro Study. Int J Cancer Manag 2018;11-16. 
22. Esmaeili S, Safaroghli-Azar A, Pourbagheri-Sigaroodi A, Salari S, Gharehbaghian A, Hamidpour M, et al. Stimulation of peroxisome proliferator-activated receptor-gamma (PPARγ) using pioglitazone decreases the survival of acute promyelocytic leukemia cells through up-regulation of PTEN expression. Anticancer Agents Med Chem 2021;21:108-119. 
23. Mobaraki RN, Karimi M, Alikarami F, Farhadi E, Amini A, Bashash D, et al. RITA induces apoptosis in p53-null K562 leukemia cells by inhibiting STAT5 , Akt , and NF- κ B signaling pathways. Anticancer Drugs. 2018 ;29:847-853. 
24. Zehtabcheh S, Yousef AM, Majid M, Bashash D. C-Myc inhibition intensified the anti-leukemic properties of Imatinib in chronic myeloid leukemia cells. Mol  Biol Rep 2023; 50: 10157-10167.
25. Kang YY, Sun FL, Zhang Y, Wang Z. SIRT1 acts as a potential tumor suppressor in oral squamous cell carcinoma. J Chin Med Assoc 2018;81:416-422. 
26. Gorji M, Farsani MA, Kargar M, Garavand J, Mohammadi MH. Investigating the multifaceted cooperation of autophagy, PI3K/AKT signaling pathways, and INPP4B gene in de novo acute myeloid leukemia patients. Curr Res Transl Med 2023;17:103429. 
27. Mohammadlou H, Hamzeloo-Moghadam M, Yami A, Feizi F, Moeinifard M, Gharehbaghian A. Britannin a sesquiterpene lactone from Inula aucheriana exerted an anti-leukemic effect in acute lymphoblastic leukemia (ALL) cells and enhanced the sensitivity of the cells to vincristine. Nutr Cancer 2022;74: 965-977. 
28. Karimian A, Ahmadi Y, Yousefi B. Multiple functions of p21 in cell cycle, apoptosis and transcriptional regulation after DNA damage. DNA Repair (Amst) 2016;42:63-71. 
29. Bretones G, Delgado MD, León J. Myc and cell cycle control. Biochim Biophys Acta 2015; 1849:506-516.
30. Lv M, Liu Y, Liu W, Xing Y, Zhang S. Immunotherapy for pediatric acute lymphoblastic leukemia : Recent advances and future perspectives. Front Immunol 2022;13:921894.
31. Huang M, Jian J, Jian L. Natural products in cancer therapy : past , present and future. Nat Products Bioprospect 2021; 11:5-13.
32.     Goel H, Kumar R, Tanwar P, Upadhyay TK, Khan F, Pandey P, et al. Unraveling the therapeutic potential of natural products in the prevention and treatment of leukemia. Biomed Pharmacother. 2023;160:114351. 
33. Nakaya M, Onda H, Sasaki K, Yukiyoshi A, Tachibana H, Yamada K. Effect of royal jelly on bisphenol A-induced proliferation of human breast cancer cells. Biosci Biotechnol Biochem 2007;71:253–255. 
34. Ayna A, Tunç A, Özbolat S, Bengü AŞ, Aykutoğlu G. Anticancer , and antioxidant activities of royal jelly on HT-29 colon cancer cells and melissopalynological analysis. Turk J Bot 2021;45:809–819. 
35. Lin X, Liu S, Luo Y, Xu W, Zhang Y, Zhang T, et al. 10-hda induces ROS-mediated apoptosis in a549 human lung cancer cells by regulating the MAPK , STAT3 , NF- κ B , and TGF- β 1 signaling pathways. Biomed Res Int 2020;2020:1-15. 
36. Bouamama S, Bouamama A, Merzouk H, Latrech H, Charif N. Royal jelly alleviates the detrimental effects of aging on immune functions by enhancing the in vitro cellular proliferation , cytokines , and nitric oxide release in aged human PBMCS. J Food Biochem 2021;45:e13619.
37. Vanesa S, Morales P, Iriondo-dehond A, Hospital XF, Fern M, Hierro E, et al. Differential apoptotic effects of bee product mixtures on normal and cancer hepatic cells. Antioxidants (Basel). 2023;12:615-644. 
38. Morita H, Ikeda T, Kajita K, Fujioka K, Mori I, Okada H, Uno Y IT. Effect of royal jelly ingestion for six months on healthy volunteers. Nutr J 2012;11:77-83. 
39. Nogueira V, Hay N. Molecular pathways: reactive oxygen species homeostasis in cancer cells and implications for cancer therapy. Clin Cancer Res 2013;19:4309-4314. 
40. Kamiya T, Watanabe M, Hara H, Mitsugi Y, Yamaguchi E, Itoh A AT. Induction of human-lung-cancer-A549-Cell apoptosis by 4‑Hydroperoxy-2-decenoic Acid Ethyl Ester through Intracellular ROS accumulation and the induction of proapoptotic CHOP expressiony. J Agric Food Chem 2018; 66:10741–10747. 
41. Jenkhetkan W, Thitiorul S, Jansom C, Ratanavalachai T. Molecular and cytogenetic effects of Thai royal jelly: Modulation through c-MYC, h-TERT, NRF2, HO-1, BCL2, BAX and cyclins in human lymphocytes in vitro. Mutagenesis 2017; 17;32:525-531.
42. Redza-Dutordoir M, Averill-Bates DA. Activation of apoptosis signalling pathways by reactive oxygen species. Biochim Biophys Acta 2016;1863:2977-2992.
43. Garrido C, Galluzzi L, Brunet M, Puig PE, Didelot C. Mechanisms of cytochrome c release from mitochondria. Cell Death Differ 2006;13:1423–1433. 
44. Farhan M, Wang H, Gaur U, Little PJ, Xu J, Zheng W. FOXO signaling pathways as therapeutic targets in cancer. Int J Biol Sci 2017;13:815-827. 
45. Kobayashi Y, Furukawa-Hibi Y, Chen C, Horio Y, Isobe K, Ikeda K, Motoyama N. SIRT1 is critical regulator of FOXO-mediated transcription in response to oxidative stress. Int J Mol Med 2005;16:237-243.
46. Wang W, Zhou PH, Hu W. Overexpression of FOXO4 induces apoptosis of clear-cell renal carcinoma cells through downregulation of Bim. Mol Med Rep 2016; 13:2229-2234. 
47. Giordano D, Scafuri B, Masi L De, Capasso L, Maresca V, Altucci L, et al. Sirtuin inhibitor cambinol induces cell differentiation and differently interferes with SIRT1 and 2 at the substrate binding site. Biomedicines 2023;11:1624. 
48. Redza-Dutordoir M, Averill-Bates DA. Interactions between reactive oxygen species and autophagy: Special issue: Death mechanisms in cellular homeostasis. Biochim Biophys Acta Mol Cell Res 2021;1868:119041. 
49. Menon MB, Dhamija S. Beclin 1 Phosphorylation – at the Center of Autophagy Regulation. Front Cell Dev Biol 2018;6:137.
50. You M, Miao Z, Sienkiewicz O, Jiang X, Zhao X. International immunopharmacology 10-Hydroxydecanoic acid inhibits LPS-induced in fl ammation by targeting p53 in microglial cells. Int Immunopharmacol 2020; 84:106501. 
51. You M, Miao Z, Tian J, Hu F. Trans-10-hydroxy-2-decenoic acid protects against LPS-induced neuroinflammation through FOXO1-mediated activation of autophagy. Eur J Nutr 2020; 59:2875-2892. 
52. Martínez-chacón G, Paredes-barquero M. Neuroprotective properties of queen bee acid by autophagy induction. Cell Biol Toxicol 2023;39:751-770. 
53. Simioni C, Cani A, Martelli AM, Zauli G, Tabellini G, McCubrey J, et al. Activity of the novel mTOR inhibitor Torin-2 in B-precursor acute lymphoblastic leukemia and its therapeutic potential to prevent Akt reactivation. Oncotarget 2014;5:10034–10047. 
54. Mehrpouri M, Safaroghli-Azar A, pourbagheri-Sigaroodi A, Momeny M, Bashash D. Anti-leukemic effects of histone deacetylase (HDAC) inhibition in acute lymphoblastic leukemia (ALL) cells: Shedding light on mitigating effects of NF-κB and autophagy on panobinostat cytotoxicity. Eur J Pharmacol 2020; 875:173050.