Molecular Medicine

, Volume 21, Issue 1, pp 792–802 | Cite as

Differential Sensitivities of Fast- and Slow-Cycling Cancer Cells to Inosine Monophosphate Dehydrogenase 2 Inhibition by Mycophenolic Acid

  • Kan Chen
  • Wanlu Cao
  • Juan Li
  • Dave Sprengers
  • Pratika Y. Hernanda
  • Xiangdong Kong
  • Luc J. W. van der Laan
  • Kwan Man
  • Jaap Kwekkeboom
  • Herold J. Metselaar
  • Maikel P. Peppelenbosch
  • Qiuwei Pan
Research Article


As uncontrolled cell proliferation requires nucleotide biosynthesis, inhibiting enzymes that mediate nucleotide biosynthesis constitutes a rational approach to the management of oncological diseases. In practice, however, results of this strategy are mixed and thus elucidation of the mechanisms by which cancer cells evade the effect of nucleotide biosynthesis restriction is urgently needed. Here we explored the notion that intrinsic differences in cancer cell cycle velocity are important in the resistance toward inhibition of inosine monophosphate dehydrogenase (IMPDH) by mycophenolic acid (MPA). In short-term experiments, MPA treatment of fast-growing cancer cells effectively elicited G0/G1 arrest and provoked apoptosis, thus inhibiting cell proliferation and colony formation. Forced expression of a mutated IMPDH2, lacking a binding site for MPA but retaining enzymatic activity, resulted in complete resistance of cancer cells to MPA. In nude mice subcutaneously engrafted with HeLa cells, MPA moderately delayed tumor formation by inhibiting cell proliferation and inducing apoptosis. Importantly, we developed a lentiviral vector-based Tet-on label-retaining system that enables to identify, isolate and functionally characterize slow-cycling or so-called label-retaining cells (LRCs) in vitro and in vivo. We surprisingly found the presence of LRCs in fast-growing tumors. LRCs were superior in colony formation, tumor initiation and resistance to MPA as compared with fast-cycling cells. Thus, the slow-cycling compartment of cancer seems predominantly responsible for resistance to MPA.



The authors thank Lifeng Ni from the Animal Care at Hangzhou Normal University, Hangzhou, China, for helping with the animal experiments. We also thank Riccardo Fodde (Department of Pathology, Erasmus Medical Center Rotterdam, The Netherland) for providing plasmids pLV.EX3D/EF1A-rtTA (M2)-dsRed-Express2 and pLV.EX2D/TRE-eGFP. Our funding included the following: support from the Daniel den Hoed Foundation for Centennial Fellowship 2014, from the Netherlands Organization for Scientific Research (NWO/ZonMw) for a VENI grant (no. 916-13-032), and from the Dutch Digestive Foundation (MLDS) for a career development grant (no. CDG 1304) to Q Pan. Funding also came from the Zhejiang Provincial Top Key Discipline of Biology (no. 2014A09-C) to K Chen and from the National Natural Science Foundation of China (no. 51272236) to X Kong.

Supplementary material

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Supplementary material, approximately 4.44 MB.


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Authors and Affiliations

  • Kan Chen
    • 1
    • 2
  • Wanlu Cao
    • 1
  • Juan Li
    • 1
  • Dave Sprengers
    • 1
  • Pratika Y. Hernanda
    • 3
  • Xiangdong Kong
    • 2
  • Luc J. W. van der Laan
    • 4
  • Kwan Man
    • 5
  • Jaap Kwekkeboom
    • 1
  • Herold J. Metselaar
    • 1
  • Maikel P. Peppelenbosch
    • 1
  • Qiuwei Pan
    • 1
  1. 1.Department of Gastroenterology and Hepatology, Erasmus MC Cancer InstituteErasmus University Medical Center, room Na-617RotterdamThe Netherlands
  2. 2.Bio-X Center, College of Life SciencesZhejiang Sci-Tech UniversityHangzhouChina
  3. 3.Laboratory of Medical Genetics, Biomolecular Research CenterWijaya Kusuma UniversitySurabayaIndonesia
  4. 4.Department of SurgeryErasmus University Medical CenterRotterdamThe Netherlands
  5. 5.Department of SurgeryHong Kong UniversityHong KongChina

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