Abstract
Background
The membrane transporters activated in cancer stem cells (CSCs) are the target of novel cancer therapies for gastric cancer. The present study investigated ion channel expression profiles in gastric CSCs (GCSCs).
Methods
Cells strongly expressing CD44 were separated from MKN74 cells, a human gastric cancer cell line, by fluorescence-activated cell sorting (FACS), and GCSCs were identified based on tumorsphere formation. Gene expression profiles in GCSCs were examined by a microarray analysis.
Results
Among MKN74 cells, CD44 messenger RNA levels were higher in CSCs than in non-CSCs. These CSCs also exhibited resistance to cisplatin. The microarray analysis revealed that the expression of several genes related to voltage-gated Ca2+ channels (VGCCs), including CACNA2D1 and CACNB4, was upregulated. The cytotoxicities of the CACNA2D1 inhibitor amlodipine and the CACNB4 inhibitor verapamil were greater at lower concentrations in CSCs than in non-CSCs, and markedly reduced tumorsphere numbers. Tumor volumes were significantly smaller in a xenograft nude mouse model treated with amlodipine or verapamil in combination with cisplatin than in that treated with cisplatin alone.
Conclusions
The present results indicate that VGCCs play a role in maintaining CSCs, and demonstrated the potential of their specific inhibitors, amlodipine and verapamil, as targeted therapeutic agents against gastric cancer.
This is a preview of subscription content, access via your institution.





References
- 1.
Hartgrink HH, Jansen EP, van Grieken NC, van de Velde CJ. Gastric cancer. Lancet. 2009;374(9688):477–90.
- 2.
Nashimoto A, Akazawa K, Isobe Y, et al. Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer. 2013;16(1):1–27.
- 3.
Visvader JE, Lindeman GJ. Cancer stem cells in solid tumours: accumulating evidence and unresolved questions. Nat Rev Cancer. 2008;8(10):755–68.
- 4.
Toh TB, Lim JJ, Chow EK. Epigenetics in cancer stem cells. Mol Cancer. 2017;16(1):29.
- 5.
Li Y, Rogoff HA, Keates S, et al. Suppression of cancer relapse and metastasis by inhibiting cancer stemness. Proc Natl Acad Sci USA. 2015;112(6):1839–44.
- 6.
Long A, Giroux V, Whelan KA, et al. WNT10A promotes an invasive and self-renewing phenotype in esophageal squamous cell carcinoma. Carcinogenesis. 2015;36(5):598–606.
- 7.
Ishimoto T, Nagano O, Yae T, et al. CD44 variant regulates redox status in cancer cells by stabilizing the xCT subunit of system xc(-) and thereby promotes tumor growth. Cancer Cell. 2011;19(3):387–400.
- 8.
Nagano O, Okazaki S, Saya H. Redox regulation in stem-like cancer cells by CD44 variant isoforms. Oncogene. 2013;32(44):5191–8.
- 9.
Shitara K, Doi T, Nagano O, et al. Dose-escalation study for the targeting of CD44v(+) cancer stem cells by sulfasalazine in patients with advanced gastric cancer (EPOC1205). Gastric Cancer. 2017;20(2):341-349.
- 10.
Shiozaki A, Ariyoshi Y, Iitaka D, et al. Functional analysis and clinical significance of sodium iodide symporter expression in gastric cancer. Gastric Cancer. 2019;22(3):473–85.
- 11.
Shiozaki A, Ichikawa D, Otsuji E, Marunaka Y. Cellular physiological approach for treatment of gastric cancer. World J Gastroenterol. 2014;20(33):11560–6.
- 12.
Darakhshan S, Pour AB. Tranilast: a review of its therapeutic applications. Pharmacol Res. 2015;91:15–28.
- 13.
Kudou M, Shiozaki A, Yamazato Y, et al. The expression and role of TRPV2 in esophageal squamous cell carcinoma. Sci Rep. 2019;9(1):16055.
- 14.
Shiozaki A, Kudou M, Ichikawa D, et al. Esophageal cancer stem cells are suppressed by tranilast, a TRPV2 channel inhibitor. J Gastroenterol. 2018;53(2):197–207.
- 15.
Fu L, Bu L, Yasuda T, et al. Gastric cancer stem cells: current insights into the immune microenvironment and therapeutic targets. Biomedicines. 2020;8(1):7.
- 16.
Nguyen PH, Giraud J, Chambonnier L, et al. Characterization of biomarkers of tumorigenic and chemoresistant cancer stem cells in human gastric carcinoma. Clin Cancer Res. 2017;23(6):1586–97.
- 17.
Takaishi S, Okumura T, Tu S, et al. Identification of gastric cancer stem cells using the cell surface marker CD44. Stem Cells. 2009;27(5):1006–20.
- 18.
Liu J, Ma L, Xu J, et al. Spheroid body-forming cells in the human gastric cancer cell line MKN-45 possess cancer stem cell properties. Int J Oncol. 2013;42(2):453–9.
- 19.
Yu D, Holm R, Goscinski MA, Trope CG, Nesland JM, Suo Z. Prognostic and clinicopathological significance of Cacna2d1 expression in epithelial ovarian cancers: a retrospective study. Am J Cancer Res. 2016;6(9):2088–97.
- 20.
Rima M, Daghsni M, Lopez A, et al. Down-regulation of the Wnt/beta-catenin signaling pathway by Cacnb4. Mol Biol Cell. 2017;28(25):3699–708.
- 21.
Anderson KJ, Cormier RT, Scott PM. Role of ion channels in gastrointestinal cancer. World J Gastroenterol. 2019;25(38):5732–72.
- 22.
Cui C, Merritt R, Fu L, Pan Z. Targeting calcium signaling in cancer therapy. Acta Pharm Sin B. 2017;7(1):3–17.
- 23.
Phan NN, Wang CY, Chen CF, Sun Z, Lai MD, Lin YC. Voltage-gated calcium channels: Novel targets for cancer therapy. Oncol Lett. 2017;14(2):2059–74.
- 24.
Cole RL, Lechner SM, Williams ME, et al. Differential distribution of voltage-gated calcium channel alpha-2 delta (alpha2delta) subunit mRNA-containing cells in the rat central nervous system and the dorsal root ganglia. J Comp Neurol. 2005;491(3):246–69.
- 25.
Ruan J, Liu X, Xiong X, et al. miR107 promotes the erythroid differentiation of leukemia cells via the downregulation of Cacna2d1. Mol Med Rep. 2015;11(2):1334–9.
- 26.
Bichet D, Cornet V, Geib S, et al. The I-II loop of the Ca2+ channel alpha1 subunit contains an endoplasmic reticulum retention signal antagonized by the beta subunit. Neuron. 2000;25(1):177–90.
- 27.
Rima M, Daghsni M, De Waard S, et al. The beta4 subunit of the voltage-gated calcium channel (Cacnb4) regulates the rate of cell proliferation in Chinese Hamster Ovary cells. Int J Biochem Cell Biol. 2017;89:57–70.
- 28.
Chung S, Low SK, Zembutsu H, et al. A genome-wide association study of chemotherapy-induced alopecia in breast cancer patients. Breast Cancer Res. 2013;15(5):R81.
- 29.
Zhao W, Wang L, Han H, et al. 1B50-1, a mAb raised against recurrent tumor cells, targets liver tumor-initiating cells by binding to the calcium channel alpha2delta1 subunit. Cancer Cell. 2013;23(4):541–56.
- 30.
Yu J, Wang S, Zhao W, et al. Mechanistic exploration of cancer stem cell marker voltage-dependent calcium channel alpha2delta1 subunit-mediated chemotherapy resistance in small-cell lung cancer. Clin Cancer Res. 2018;24(9):2148–58.
- 31.
Sui X, Geng JH, Li YH, Zhu GY, Wang WH. Calcium channel alpha2delta1 subunit (CACNA2D1) enhances radioresistance in cancer stem-like cells in non-small cell lung cancer cell lines. Cancer Manag Res. 2018;10:5009–18.
- 32.
Huang C, Li Y, Zhao W, et al. alpha2delta1 may be a potential marker for cancer stem cell in laryngeal squamous cell carcinoma. Cancer Biomark. 2019;24(1):97–107.
- 33.
Zhang Z, Zhao W, Lin X, Gao J, Zhang Z, Shen L. Voltage-dependent calcium channel alpha2delta1 subunit is a specific candidate marker for identifying gastric cancer stem cells. Cancer Manag Res. 2019;11:4707–18.
- 34.
Taylor JM, Simpson RU. Inhibition of cancer cell growth by calcium channel antagonists in the athymic mouse. Cancer Res. 1992;52(9):2413–8.
- 35.
Taghizadehghalehjoughi A, Sezen S, Hacimuftuoglu A, Gulluce M. Vincristine combination with Ca(+2) channel blocker increase antitumor effects. Mol Biol Rep. 2019;46(2):2523–8.
- 36.
Shchepotin IB, Shabahang M, Nauta RJ, Buras RR, Brenner RV, Evans SR. Antitumour activity of 5-fluorouracil, verapamil and hyperthermia against human gastric adenocarcinoma cell (AGS) in vitro. Surg Oncol. 1994;3(5):287–94.
- 37.
Fan GF, Pan JJ, Fan PS, et al. The clinical observation of verapamil in combination with interventional chemotherapy in advanced gastric cancer. Eur Rev Med Pharmacol Sci. 2018;22(17):5508–18.
- 38.
Ning Z, Chen D, Liu A, et al. Efficacy of chemotherapy combined with targeted arterial infusion of verapamil in patients with advanced gastric cancer. Cell Biochem Biophys. 2014;68(1):195–200.
- 39.
Guo Y, He W, Yang S, Zhao D, Li Z, Luan Y. Co-delivery of docetaxel and verapamil by reduction-sensitive PEG-PLGA-SS-DTX conjugate micelles to reverse the multi-drug resistance of breast cancer. Colloids Surf B Biointerfaces. 2017;151:119–27.
- 40.
Zheng W, Li M, Lin Y, Zhan X. Encapsulation of verapamil and doxorubicin by MPEG-PLA to reverse drug resistance in ovarian cancer. Biomed Pharmacother. 2018;108:565–73.
Acknowledgments
This study was supported by Grants-in-Aid for Scientific Research (C) [17K10602, 17K10710, 18K08628, 18K08689, 19K09202, and 19K09182] and a Grant-in-Aid for Young Scientists (19K18160) from the Japan Society for the Promotion of Science.
Author information
Affiliations
Contributions
AS, KK, MK, HS, TK, HI, TA, HK, SK, TK, HF, KO, and EO designed the research. AS, KK, and EO wrote the paper. AS, KK, MK, HS, and TK performed cell culture, molecular biology, and several experiments.
Corresponding author
Ethics declarations
Disclosures
Atsushi Shiozaki, Keita Katsurahara, Michihiro Kudou, Hiroki Shimizu, Toshiyuki Kosuga, Hiroshi Ito, Tomohiro Arita, Hirotaka Konishi, Shuhei Komatsu, Takeshi Kubota, Hitoshi Fujiwara, Kazuma Okamoto, and Eigo Otsuji have no conflicts of interest or financial ties to declare.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Rights and permissions
About this article
Cite this article
Shiozaki, A., Katsurahara, K., Kudou, M. et al. Amlodipine and Verapamil, Voltage-Gated Ca2+ Channel Inhibitors, Suppressed the Growth of Gastric Cancer Stem Cells. Ann Surg Oncol (2021). https://doi.org/10.1245/s10434-021-09645-0
Received:
Accepted:
Published: