Colon cancer is a leading cause of cancer-related deaths worldwide. The epithelial-mesenchymal transition (EMT) plays an important role in tumor metastasis of colon cancer. We first evaluated the effects of EMT-related transcription factors on the prognosis of colon cancer through analysis the data obtained from The Cancer Genome Atlas (TCGA). And then we screened a series of Chinese medicine monomers to find effect EMT inhibitors. First, Snail is a more important EMT transcription factors for colon cancer prognosis, compared with Twist and Slug. Then, we found that apigenin effectively inhibits the activity of Snail. Apigenin could inhibit the EMT, migration, and invasion of human colon cancer cells in vitro and in vivo through the NF-κB/Snail pathway. Snail is a key regulator of EMT in colon cancer and Snail inhibitor apigenin may be a therapeutic application for patients with colon cancer.
Colon cancer is a leading cause of cancer-related deaths worldwide. This disease is usually diagnosed at its advanced stage . The 5-year survival rate of stage IV colon cancer is less than 10%. Colon metastases readily develop through the epithelial-mesenchymal transition (EMT) of epithelial cells, a key process that supports tumor metastasis.
In the process of EMT, epithelial cells lose their typical epithelial characteristics and acquire mesenchymal traits. Cancer cells lose their cell–cell connection, cell-matrix contact, and normal epithelial polarity while gaining mesenchymal characteristics, which enhance the migratory and invasive ability of cancer cells. EMT is an integral component of colorectal cancer progression. So targetting EMT will be beneficial for prognosis and therapy of colorectal cancer [2,3].
Natural products (animals, plants, and other pharmacologically active ingredients present in nature) are important sources for prevention and treatment of diseases. The drugs used in various traditional medicines in the world almost belong to natural sources. The chemical substances from natural chemicals are also more than 30% in modern medicine applications. And more drugs are produced by structural modification of the natural products (paclitaxel, vincristine, artemisinin, etc.). According to a review by Newman et al., about 61% of the 877 new small chemical drugs introduced in the world between 1981 and 2002 were derived from natural products or the derivatives of natural products . At present, as the development of synthetic drugs becomes more and more difficult, scientists have refocussed the development of new drugs on natural products. Chinese herbal monomers, such as the flavonoid monomers, have extensive pharmacological activity  (antitumor, anti-inflammatory, immune regulation, etc.), which has attracted more and more attention.
Some transcription factors, such as zinc-finger proteins of the Snail/Slug family and Twist Family BHLH Transcription Factor 1 (Twist1), have been proved to regulate the EMT . In order to find effect EMT inhibitor in colorectal cancer, we first evaluated the effects of these transcription factors on the prognosis of colon cancer through analysis the data obtained from The Cancer Genome Atlas (TCGA). And then we screened a series of Chinese medicine monomer to find effect EMT inhibitors through detecting the promoter activity of the prognosis-related transcription factor. The antitumor effects of the screened inhibitor (apigenin) were further evaluated in vitro and in vivo.
Materials and methods
Chemicals and antibodies
Primary antibodies including vimentin (1:1000), E-cadherin (1:1000) and GAPDH (1:5000), NF-κB (1:1000), and Snail (1:1000) were supplied by Affinty (CO, U.S.A.). Secondary antibodies included FITC-labeled goat-antimouse lgG and TRITC-labeled goat anti-rabbit IgG were obtained from EarthOx (San Francisco, CA, U.S.A.). Apigenin and other flavanoid derivates were obtained from PUSH BIO-TECHNOLOGY (Chengdu, China). Matrigel and transwell chambers were purchased from BD Biosciences (San Jose, CA, U.S.A.).
Human colon carcinoma cell lines HCT-116 and LOVO, purchased from KeyGen Biotech (Nanjing, China), were maintained according to ATCC’s recommendation. The cells were grown in DMEM (for HCT-116) or RPMI 1640 (for LOVO) medium supplemented with 10% FBS (Hyclone, U.S.A.) in a humidified atmosphere of 37°C, 5% CO2.
HCT-116 and LOVO cells were seeded in six-well plates. The next day, a sterile 200 µl pipette tip was used to draw a straight line when the whole plates were covered with cells. Then the cells were washed with PBS for three times. After that different concentration of apigenin were added to DMEM mediums for 24 h. The distance of the scratch was calculated at different time points with microscope (Olympus CX31).
Cell invasion assays
HCT-116 and LOVO cells were cultured to near 90–100% confluence. Then the cells were digested and seeded on the upper chamber (8.0 µm) of the transwell cultured with containing different concentrations of apigenin, which were coated with matrigel. The lower compartment of the chamber was added 0.5 ml of medium supplemented with 10% FBS. After treatment for 48 h, the medium was removed and the cells were washed with PBS for three times. Subsequently, the cells were fixed with precooled methanol and then the cells were stained with crystal violet for 10 min at room temperature. Finally, the stained cells were evaluated with the microscope.
HCT-116 cells (4 × 104 cells/ml) were pretreated with 10 or 20 μM apigenin for 48 h and then the cells were seeded on the chamber slides of 24-well culture plates. After 24 h, the cells were fixed with 4% paraformaldehyde about 30 min, following permeation with 1% Trition X-100 dissolved in PBS. Then the nonspecific binding was blocked with 5% BSA in TBS and incubated with primary antibodies (E-Cadherin and vimentin were 1:100 dilution respectively) for 1 h at 4°C overnight. Slides were washed with PBS and incubated at 37°C for 45 min with secondary antibodies conjugated to fluorescein isothiocyanate. Then the cells were washed with PBS. DAPI were used to monitor nuclear integrity. Finally, the cells were examined using Nikon confocal microscopy.
The BALB/c nu/nu mice were well taken care under pathogen-free conditions in accordance with institutional guidelines. Studies were carried out in accordance with National Institutes of Health Animal Use Guidelines and the current Chinese Regulations and Standards for the Use of Laboratory Animals. The mice were subcutaneously injected with 100 µl resuspended HCT-116 cells (2 × 106 cells) via a sterile microsyringe. After the tumor volume reached about 40 mm3, the mice were randomly assigned to control or apigenin treatment groups. Control group was treated with equal volume saline, and treatment groups were intragastrically administered with different concentrations apigenin (low dose of 200 mg/kg and high dose of 300 mg/kg). Mice weight and tumor size were recorded every 2 days. The tumor volumes were measured using calipers and calculated with the formula V = length × width2/2. After treatment for 2 weeks, the mice were killed. Tumor weight was recorded and the tissues were fixed in 10% formlinata solution and then embedded by paraffin.
The fixed tissues were used for immunohistochemistry staining. About 3 μm thick paraffin sections were deparaffinized with xylene, dehydrated in ethanol in a concentration gradient, and followed by incubation with 3% hydrogen peroxide at room temperature for 10 min to quench endogeneous peroxidase. Total 10 mM citrate buffer (pH 6.0) was used to antigen retrieval in a microwave about 10 min. Nonspecific-binding sites were blocked with normal goat serum for 30 min. The paraffin slices were incubated with the primary antibodies anti-E-cadherin (rabbit polyclonal, 1;100) and antivimentin (mouse polyclonal, 1:100) in 1% BSA overnight at 4°C. The tissues were washed in PBS for three times. Then antimouse IgG and antirabbit lgG (diluted 1:200) was added to the paraffin slices for 30 min. DAB substrate was utilized for color development.
Data are represented as means ± S.D. by three independent experiments. The statistical significance of different groups was analyzed by one-way ANOVA following SPSS 17.0 software. The P values <0.05 were considered significant difference existence.
Snail is associated with prognosis of colon cancer
The survival analysis of EMT-related transcription factors, Snail, Slug, Twist1, and Twist2, is shown in Figure 1A). Patients with higher expression of Snail had shorter survival time (***P<0.0005) AMONGST all the factors, which showed that Snail is the key driver of EMT in colon cancer. Snail as a poor prognosis gene were highly expressed in colon cancer tissues from the results of immunohistochemical staining (Figure 1B). The patient data were all derived from the TCGA database.
Snail is a key regulator of EMT in colon cancer
Apigenin effectively inhibits the transcription activity of snail
In order to find the inhibitor of Snail, we then screened dozens of Chinese herbal monomers. The inhibitors of snail transcription activity were screened using the dual luciferase reporter assay system. We found several Chinese herbal monomers had regulatory effect on Snail and apigenin had the best effect (Figure 1C).
Apigenin inhibits the proliferation of human colon cancer cells
The cytotoxicity of apigenin was detected by MTT. The results showed that apigenin can inhibit the proliferation of HCT116 and LOVO in a dose-dependent manner (Figure 2A,B). The half-maximal inhibitory concentrations (IC50) of HCT-116 and LOVO were 47.33 and 34.45 µM respectively. The morphology of colon cancer cells changed significantly after treatment with apigenin, and the cells exhibited low viability after exposed to apigenin at different concentrations.
Effect of apigenin on cell viability, invasion, and metastasis of HCT-116 and LOVO cells
Apigenin inhibits migration and invasion in human colon cancer cells
We detected the effect of apigenin on invasion and metastasis activity of cancer cells through wound-healing and transwell experiments. The wound-healing experiments showed that both 10 and 20 µM apigenin could inhibit the migration of HCT-116 and LOVO cells comparing with the control groups (Figure 2C,D).
Matrigel-coated transwell chambers were used to verify the invasive ability of colon cancer cells after apigenin treatment. The potential metastatic capacity of tumor cells can be represented by its invasiveness. In the apigenin-treated group, the number of cells that invading the basement membrane of the transwell chamber is significantly reduced compared with the control group, and it was concentration dependent in HCT-116 and LOVO cells (Figure 2E,F).
Apigenin reversed changes in E-cadherin and vimentin expression in human colon cancer cells
When EMT occurs in tumor cells, the expression of E-Cadherin is down-regulated and the expression of vimentin is up-regulated. Cells treated with apigenin displayed distinct morphological changes compared with untreated cells. Pseudopodia increased significantly after apigenin treatment. We performed immunofluorescence double staining on EMT markers E-Cadherin and vimentin, and found that E-Cadherin levels increased and vimentin levels decreased in the apigenin treatment groups (Figure 3A,B).
Apigenin reverses changes of EMT biomarkers in HCT-116 cells
Apigenin inhibits NF-κB expression and Snail transcriptional activation in colon cancer
Based on the above experimental results, we learned that apigenin could inhibit EMT by inhibiting the activity of Snail in colon cancer cells. NF-κB could regulate the activity of Snail. In order to detect the effect of apigenin on NF-κB, we performed a dual luciferase reporter gene assay experiment. The results showed that apigenin could also inhibit the transcriptional activity of NF-κB (Figure 4A). We also validated the inhibit effect of apigenin on the transcriptional activity of Snail (Figure 4A). Apigenin inhibited the transcriptional activity of Snail in a dose dependent manner.
Apigenin inhibits NF-κB and Snail in human colon cancer cells
The expression of transcription factors, NF-κB and Snail which related to EMT, were significantly up-regulated in tumor cells. After apigenin treatment, the transcription activity of NF-κB and Snail (Figure 4B-D) were significantly down-regulated. We also examined the expression of NF-κB and Snail in the nucleus, and it was proved that the change of protein level consistent with the trend of NF-κB and Snail in the cytoplasm. After apigenin treatment, the expression of both NF-κB and Snail decreased in the cytosol and nucleus. These results showed that apigenin could inhibit EMT of colon cancer cells through NF-κB/Snail pathway.
Apigenin inhibits the metastasis of HCT-116 cells in xenograft model nude mice
The effect of apigenin on animal body weight was not significant (Figure 5A). Our results showed that after drug treatment, the tumor volume of mice treated with apigenin was decreased compared with control group (Figure 5B,C). In vivo experiments showed that apigenin could effectively reduce the tumor volume.
Effect of apigenin on HCT-116 xenograft model
We further performed immunohistochemical staining on the fixed tissue cells. The expression of the EMT markers in colon tissue was evaluated. Our results demonstrated that E-Cadherin and occludin expression were up-regulated after apigenin treatment, while vimentin and N-cadherin expression were down-regulated after apigenin treatment (Figure 6A,B). We then performed immunohistochemical staining analysis of EMT-related transcription factors and found that the expression of NF-κB and Snail was down-regulated after apigenin treatment, which indicated that apigenin treatment could inhibit the expression of EMT-related transcription factors. Besides, apigenin treatment could also inhibit the expression of Ki-67 and NF-kB signaling proteins such as p65 and IKK (Figure 6C,D), suggesting that apigenin might inhibit EMT of colon cancer cells through NF-kB/Snail signaling pathways.
Effect of apigenin on NF-κB, Snail, Ki-67, NF-κB p65 IKK, and EMT protein levels
Since colon cancer is a leading cause of cancer-related deaths worldwide , search for effective drugs is crucial for the treatment of colon carcinoma [8–10]. EMT promotes epithelial tumor invasion and transformation toward malignant disease . The phenotype of EMT is mainly embodied in the cell–cell adhesion systems down-regulation, loss of epithelial polarity, and the acquisition of a mesenchymal phenotype, which lead to migration and movement of epithelial cells . Thus, targetting EMT is beneficial for inhibition of carcinoma progression . So in this work we screened the EMT inhibitors for colon carcinoma. In this work, we found that the expression of Snail1 has correlation with the prognosis of colon cancer patients. And we screened a series of flavonoid Chinese herbal monomers to find Snail1 transcription activity inhibitors. We found that apigenin had good inhibitory activity for Snail1, so we further evaluated its antitumor effect on human colon cancer cells.
Snail, Slug, and Twist1 are important transcription factors for the regulation of the EMT in tumor cells. The first discovered transcriptional repressor of E-cadherin was Snail [14,15], which plays a fundamental role in EMT. The data analysis obtained from TCGA database revealed that the expression of Snail1 has correlation with the prognosis of colon cancer patients. Patients with high expression of Snail have shorter survival. The transcriptional factors of Slug and Twist1 have no correlation with the prognosis of colon cancer patients. These findings reveal the importance of Snail1 in the malignant evolution of colon cancer. And Snail1 is a marker of poor prognosis of colon cancer.
E-cadherin and vimentin are important markers of EMT. Studies on E-cadherin behavior provided considerable insights into carcinoma progression . In addition, altered E-cadherin expression is associated with tumor stage and increased lymph node metastasis [17,18]. Vimentin acts as an intermediate filament protein, which forms the cytoskeleton along with microtubules and actin filaments. In this work, we found that apigenin increased the expression levels of E-cadherin but decreased the expression levels of vimentin. These results suggest that apigenin suppresses EMT of colon carcinoma cells. The results of the HCT-116 xenografts in nude mice also validated the effect of apigenin on EMT. Apigenin also inhibited the migration and invasion of tumor cells, which could be promoted by EMT of tumor cells. The mechanism of apigenin in the treatment of colon cancer can be explained by EMT.
Studies show that the nuclear factor-κB (NF-κB)-mediated activation of Snail transcription plays an important role in the regulation of EMT in tumor cells [19–21]. NF-κB pathway regulates Snail expression through transcriptional and post-translational mechanisms, and NF-κB increases the transcription of Snail . In this work, we found that NF-κB expression and activity decreased following apigenin treatment in colon carcinoma cells. Apigenin also inhibited the relocation of NF-κB to the nucleus. NF-κB expression and activity decreased following apigenin treatment in colon carcinoma cells. Apigenin also inhibited the relocation of NF-κB and Snail to the nucleus. This result is consistent with the earlier finding that NF-κB/Snail is crucial to the ability of apigenin to inhibit tumor progression.
Apigenin is a nontoxic, naturally occurring dietary flavonoid, which is abundant in vegetables, fruits, and beans . Many researches show that apigenin has anti-inflammatory, antioxidant, and anticancer properties [24,25]. Because apigenin is plant-derived natural compound, it may be an ideal and safe antitumor agent . Studies show that apigenin has good antitumor activities in vitro and in vivo [27–30] and inhibits the growth of various cancer cell lines . Different studies have found various molecular mechanisms underlying the anticancer effect of apigenin . Apigenin can strongly inhibit the growth of breast cancer cells, including HER2-positive cells  and suppress the metastasis of human hepatocellular carcinoma by inhibiting EMT . Although some researchers indicate that apigenin can induce apoptosis and autophagy in HCT116 colon cancer cells , the effect of apigenin on the EMT of colon cancer remains unclear to date. Accordingly, the present study evaluated the effect of apigenin on EMT of colon cancer cells in vitro and in vivo and clarified the mechanism of apigenin regulating EMT of colon cancer cells. We found that apigenin inhibited migration and invasion of colon carcinoma cells. Apigenin inhibited the EMT of HCT-116 and LOVO human colon cancer cells through NF-κB/Snail signaling pathway. The present study evaluated the efficacy of apigenin in the treatment of colorectal cancer at the animal level by establishing xenografts on Balbc nude mice. Actually, PDX (patient derived xenografts) model is closer to the characteristics of clinical tumor samples. In the future, we will further evaluate the efficacy of apigenin in the treatment of colorectal cancer based on PDX model.
In summary, we found that Snail is a more important EMT transcription factors for colon cancer prognosis, compared with Twist1 and Slug. After screening a series of flavonoid Chinese herbal monomers, we found that apigenin effectively inhibited the activity of Snail. And we found that apigenin suppressed the EMT, migration, and invasion of human colon cancer by inhibiting the NF-κB/Snail pathway. Our results provide a new mechanistic basis for the therapeutic application of apigenin in patients with colon cancer. Further exploration of apigenin and its mechanisms could lead to the development of a new therapeutic approach to treating colon cancer.
The present study was funded by Foundation of Shanghai Municipal Science and Technology Commission Project: Prevention and Treatment of Colorectal Cancer by TCM syndrome differentiation [grant number 17dz2307500] and Clinical Study on Chang Ji Tai Combined with Auricular Acupuncture in Treating Postoperative Cancer-related fatigue of Postoperative colorectal cancer, Special item of Shanghai Integrative Medicine [grant number ZY(2018-2020)-FWTX-3016].
The authors declare that there are no competing interests associated with the manuscript.
J.T. was focussed on the integrity of the entire study, study concepts, manuscript editing and manuscript review. Y.S. and Z.Z. were involved in the study design, data acquisition, and statistical analysis. Y.H. and X.Z. were dedicated to the literature research and data analysis. L.H. carried out the manuscript preparation and manuscript review. All authors have read and approved this article.
These authors contribute equally to this work