Galium Verum Aqueous Extract Strongly Inhibits the Motility of Head and Neck Cancer Cell Lines and Protects Mucosal Keratinocytes Against Toxic DNA Damage

1296 ONCOLOGY REPORTS 32: 1296-1302, 2014 Galium verum aqueous extract strongly inhibits the motility of head and neck cancer cell lines and protects mucosal keratinocytes against toxic DNA damage MARIANNE SCHMIDT, CHRISTINE POLEDNIK, JEANETTE ROLLER and RUDOLF HAGEN Department of Otorhinolaryngology, University of Wuerzburg, D-97080 Wuerzburg, Germany Received April 22, 2014; Accepted May 28, 2014 DOI: 10.3892/or.2014.3316 Abstract. Galium verum, also known as Lady's Bedstraw, is an geal and hypopharyngeal cancer, the functional and cosmetic herbaceous plant native to Europe and Asia, and has been used in deformations produced by surgery can be very disabling for traditional medicine as an anticancer medicine applied in most patients. Chemoradiation is meanwhile commonly used for cases as a decoction. The influence of a Galium verum decoc- advanced head and neck cancer in order to preserve laryngeal tion on the head and neck cancer cell lines HLaC78 and FADU and/or pharyngeal structures. Paclitaxel is one of the agents was analyzed and proved to be toxic in high doses on both cell used with high response rates; however, it failed to reach lines. Cytotoxicity appeared to be influenced by expression of local-regional tumour control in 12% of patients according to p-glycoprotein (MDR-1) in the carcinoma cell lines. Mucosal a previously published study (2). keratinocytes, although void of MDR-1 expression, showed only Galium verum, also known as Lady's Bedstraw, is an low sensitivity against high Galium concentrations. Sublethal herbaceous perennial plant of the family Rubiaceae, native doses of Galium extract acted as strong inhibitors of motility, to Europe and Asia. Studies on Galium verum predominantly as shown by a spheroid-based invasion analysis on Matrigel- originate from the Asian continent, where traditional medicine coated surfaces. Inhibition of invasion was significantly more is more frequently embedded in culture. However, in industrial pronounced in the invasive HLaC78 cell line. mRNA expres- nations traditional phytomedicine has gained more and more sion analysis of matrix metalloproteinases MMP-2 and MMP-9 attention, especially with respect to alternative treatments of and their inhibitors TIMP-1/-2 revealed significant TIMP-1 cancer. upregulation after an 8-h Galium exposition in FADU cells. The cut and dried aerial parts of Galium verum have been Gelatinolytic activity, however, was not influenced by Galium used for exogenous treatment of psoriasis or delayed wound extract in HLaC78, in the FADU cells MMP-2/-9 activity was healing or as a tea with diuretic effect for the cure of pyelitis or slightly increased after incubation with Galium extract. In cystitis (3). Today the use of Galium verum is considered to be primary mucosal keratinocytes, Galium decoction protected obsolete, although it is still mentioned in popular non-scientific DNA against benz[a]pyrene, one of the most DNA toxic agents publications and in internet platforms as an anticancer medicine. in cigarette smoke. In conclusion Galium extract may be useful On the scientific level, a variety of bioactive substances as a preventive and/or a concomitant therapeutic approach in have been identified in Galium verum plants such as iridoid head and neck cancer. glycosides (4-6), flavanoids (5,7,8), anthraquinones (9) and chlorogenic acid (10). Galium species are known to have Introduction antioxidant [Galium verum (11)], antimicrobial/antifungal [Galium tricornutum (12)], antifeedant [Galium aparine (13)] According to an analysis in 2009 of over 3,000 cases of and insecticidal [Galium melantherum (14)] properties. primary head and neck tumours in Germany, the outcome According to a detailed survey by Hartwell (15) Galium of this disease did not significantly improve from 1995 to verum has been traditionally used in Europe and Northern 2006, despite new treatment strategies. Particularly the 5-year America for the treatment of cancerous ulcers or breast cancer. overall survival rate for carcinomas of hypopharyngeal origin Amirghofran et al (16) showed a cytotoxic effect of Galium is extremely low at 27.2% (1). Moreover, in advanced laryn- mite methanolic extracts on K561 and Jurkat cells. Zhao et al isolated diosmetin from Galium verum plants and showed protective effects on the thymus of U14-bearing mice (17). In the present study, we tested the influence of a Galium Correspondence to: Dr Marianne Schmidt, Department of verum ‘tea’ (decoction) on the growth and behaviour of head Otorhinolaryngology, University of Wuerzburg, Josef-Schneider- and neck cancer cell lines and primary mucosal keratinocytes. Strasse 11, D-97080 Wuerzburg, Germany E-mail: [email protected] Materials and methods Key words: Galium verum, cancer, carcinoma, head and neck, Cell lines and cell culture. The cell line FADU originating paclitaxel, herbal drug, metastasis, in vitro, HNSCC from a hypopharyngeal carcinoma was grown in RPMI-1640 SCHMIDT et al: Galium verum AQUEOUS EXTRACT ON MOTILITY OF HEAD AND NECK CANCER CELL LINES 1297 medium (Seromed, Munich, Germany), supplemented with Slide preparation was performed as previously described by 10% fetal calf serum (FCS). The HLaC78 cell line originated Buehrlen et al (22). The evaluation of the slides was carried out from a larynx carcinoma (18) and was maintained similar to on a DMLB fluorescence microscope (Leica Microsystems, FADU cells in RPMI-1640 medium. Mucosal keratinocytes Wetzlar, Germany) with a filter system incorporating a green were prepared from tonsillar tissue according to standard excitation filter (515-560 nm band pass), a dichromatic beam protocols (19). In brief, the mucosa was cut into small pieces splitter (580 nm long pass), and an emission filter (590 nm and incubated overnight with 0.2% dispase (Sigma-Aldrich, long pass) at a magnification of x4,003. For every sample, Steinheim, Germany) in Dulbecco's modified Eagle's medium two slides with 50 randomly selected cells each were counted (DMEM; Seromed). The epithelium was separated with (total of 100 cells). For analysis of the DNA fragmentation the sterile forceps and digested with 0.1% trypsin (Seromed) for Comet 5.5 Image System (Kinetic Imaging, Liverpool, UK) 20 min at 37˚C. Residual trypsin was inactivated by addition was used. For analysis, the olive tail moment (OTM) as a of FCS. Mucosal keratinocytes were collected by centrifuga- product of the median migration distance and the percentage tion and cultured in defined keratinocyte serum-free medium of DNA in the tail was used (23). (Keratinocyte-SFM; Invitrogen, Karlsruhe, Germany). In vitro motility assays. Tumour spheroids were generated Galium verum decoction. Dried and cut Galium verum L. leaves by seeding 5,000 cells/well of HLaC78 and FADU cells on (Herba galii lutei) were kindly provided by Dr Ivo Pischel, ultra-low attachment (ULA) 96-well round-bottomed plates PhytoLab GmbH & Co. KG (Vestenbergsgreuth, Germany). (Corning, Amsterdam, The Netherlands) (24). The surface of Tea was prepared as follows: 100 ml boiling water was poured the flat-bottomed 96-well plates was coated with 125 µg/ml over 15 g of dried and powdered Galium leaves. After cooling, Matrigel® (Becton-Dickinson, Heidelberg, Germany) for 2 h the supernatant was cleared by centrifugation and sterile at room temperature. Wells were washed twice with phos- filtration. Aliquots were frozen at -80˚C. One batch of frozen phate-buffered saline (PBS) and subsequently blocked with Galium extract was used for all experiments. Identification of 1% bovine serum albumin in PBS for 1 h. For 3 days on the the extract ingredients is presented elsewhere (20). ULA (see above) plates, pre-cultivated spheroids (see above) of HLaC78 and FADU cell lines were transferred to the coated Real-time PCR. To measure gene expression rates, real-time wells with a multichannel pipette. Spheroids were incubated TaqMan® PCR (Applied Biosystems) was performed. RNA with or without the Galium decoction (33.3 µl/ml). Migration was isolated from cell lines and primary cells with the RNeasy was recorded by photographing spheroids after 1 and 18 h with kit (Qiagen, Hilden, Germany) according to the manufacturer's a Leica DMI 4000 inverted fluorescence microscope (Leica instructions. The High Capacity RNA-to-cDNA Master Mix Microsystems). Quantification of migrated cells was carried (Applied Biosystems, Darmstadt, Germany) was used for out using ImageJ software [National Institutes of Health cDNA reverse transcription. Real-time PCR was performed (NIH) USA]. in triplicates on a real-time PCR cycler (Applied Biosystems) using the TaqMan gene expression assays for MDR-1, Gelatin zymography. Cell lines were treated with 33.3 µl/ MMP-9/MMP-2 and TIMP-1/-2. Relative quantification was ml Galium verum extract for 48 h. After 48 h, the cells were calculated according to the 2-ΔΔCT method (21). Expression seeded after incubation with Galium extract at equal cell values were normalised to the expression of GAPDH as an numbers in multi-wall plates. Complete medium (MEM endogenous control which proved to be expressed most stably or RPMI) was replaced after attachment by Opti-MEM throughout the cell lines. (Invitrogen, Karlsruhe, Germany), which is a complete, serum- free medium. Conditioned medium was collected after 18 h Cell viability and proliferation assay. Cells were seeded at and concentrated using Amicon® Ultra-4 Centrifugal Filters 5,000 cells/well in 96-well plates. Cells were treated with (Merck Millipore, Darmstadt, Germany). Five microliters increasing

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