
[Cancer Research 60, 5815-5824, October 15, 2000]
© 2000 American Association for Cancer Research
Molecular Biology and Genetics |
Apoptosis Induced by DNA Damage O6 -Methylguanine Is Bcl-2 and Caspase-9/3 Regulated and Fas/Caspase-8 Independent,1
Kirsten Ochs and
Bernd Kaina2
Division of Applied Toxicology, Institute of Toxicology, University of Mainz, D-55131 Mainz, Germany
 |
ABSTRACT
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In the therapy of various kinds of tumors, methylating agents generating
O6-methylguanine
(O6MeG) in DNA are used. We studied the
molecular mechanism of cell death induced by these agents by comparing
isogenic cell lines proficient (MGMT+) and deficient (MGMT-) for the
DNA repair protein alkyltransferase and exhibiting the tolerance
phenotype. Hypersensitivity to methylation-induced cell killing of
MGMT- cells is attributable to the potent induction of apoptosis. We
show that apoptosis is a late event occurring >48 h after
methylation. It was preceded by decrease in Bcl-2 protein level and
accompanied by activation of caspase-9 and caspase-3. We also observed
cytochrome c release and hypophosphorylation of Bad.
Other members of the Bcl-2 family (Bag-1, Bak, Bax, and
Bcl-xL) were not altered in expression. Transfection of
MGMT- cells with bcl-2 protected against
methylation-induced apoptosis, indicating that Bcl-2 plays a key role
in the response. Induction of apoptosis in MGMT- cells was not
triggered by Fas and Fas ligand (CD95, Apo-1) because both proteins
remained unaltered in expression and receptor-proximal caspase-8 was
not activated after methylation. Also, inhibition of caspase-8 was
ineffective in modifying the apoptotic response, whereas inhibition of
caspase-3 and caspase-9 blocked apoptosis. Tolerant cells that are
unable to repair O6MeG and are impaired in
mismatch repair were less sensitive regarding the induction of
apoptosis and Bcl-2 decline, supporting the view that
O6MeG-induced apoptosis requires mismatch
repair. The ultimate O6MeG-derived lesions
triggering the apoptotic pathway are likely to be DNA double-strand
breaks, which were significantly formed in MGMT- but not in MGMT+ and
tolerant cells and which preceded apoptosis. Overall, the data indicate
that O6MeG induces apoptosis via secondary
lesions that trigger Bcl-2 decline, cytochrome c
release, and caspase-9 and caspase-3 activation independently of
Fas/Fas ligand and p53, for which the cells are mutated.
 |
INTRODUCTION
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In the therapy of various kinds of tumors, alkylating agents are
commonly used because of their potent cytotoxic activity toward
proliferating tissues (1)
. A subgroup of alkylating
anticancer drugs exhibits methylating and chloroethylating properties.
These drugs are especially applied in the therapy of brain tumors,
ovarian cancer, malignant melanomas, and various hematological tumors
(2
, 3) . Some of these recently developed drugs
(e.g., temozolomide and fotemustine) are currently under
trial also for the therapy of various other solid tumors
(4)
. It is generally accepted that the main target for
alkylating anticancer agents is genomic DNA. Minor DNA damage induced
by the agents is O6
-alkylguanine (0.3
up to 8% of total DNA alkylations; Ref. 5
), which is
considered to be the preponderant pretoxic lesion (reviewed in Ref.
6
). O6
-Alkylguanine is
also a highly mutagenic, carcinogenic, and recombinogenic lesion, which
was inferred from studies with cells in vitro and mice
overexpressing or lacking the DNA repair protein
MGMT3
(alkyltransferase; Refs. 6, 7, 8, 9, 10, 11
). This protein specifically
removes alkyl groups from the
O6
-position of guanine by transferring
them to an active center of its own; thereby, the protein becomes
inactivated, and guanine in DNA is restored (12)
.
Expression of MGMT very efficiently protects against the cytotoxic,
sister chromatid exchange-inducing, clastogenic and carcinogenic
activity of O6
-alkylguanine-generating
agents, which provides the strongest support for the paradigm that
O6
-alkylguanine is the primary cause
of the induction of these biologically highly relevant end points.
For methylating agents inducing O6
MeG
in DNA, evidence is available to show that the lesion pairs with
thymine, forming a mispair that is subjected to MMR (13
, 14)
. It is believed that, because of faulty repetitive repair
cycles, secondary lesions are generated, leading ultimately to
reproductive cell death and chromosomal damage (15, 16, 17)
.
This is in line with the finding that cells that are defective in MMR
are more resistant to methylating agents inducing
O6
MeG, although these cells do not
express MGMT (so-called tolerant cells; Refs.18, 19, 20, 21
).
Overall, as regards O6
MeG as the
primary critical DNA damage, both the efficiency of prereplicative
repair by MGMT and the postreplicative DNA MMR determine the level of
cell killing and chromosomal damage.
Whereas mutations, chromosomal aberrations, and malignant
transformation induced by O6
MeG have
been studied in detail, the molecular mechanism of cell death is only
rudimentarily understood. A deeper insight into cell killing processes
would be especially desirable in view of modifying cell death functions
to optimize tumor therapy. Recently, it has been shown that
MGMT-deficient cells are more sensitive than MGMT-proficient cells in
the induction of apoptosis, indicating that alkylation-induced
cell killing is largely attributable to apoptosis and that
O6
MeG acts as a trigger of this toxic
response (15
, 22
, 23)
. Apoptosis induced by
O6
MeG is likely to be mediated by the
same or a similar pathway acting on damaged DNA, which generates
genotoxic effects, i.e., by the participation of MMR. This
has recently been supported by demonstrating that in hamster and human
cells, MutS
, a mismatch-binding heterodimeric protein complex
composed of MSH2 and MSH6, is required for the initiation of apoptosis
in response to methylation (24)
. The apoptotic signaling,
however, i.e., the activation or inhibition of apoptotic
functions in response to O6
MeG, is
completely unknown. In the present study, we investigated the
expression of relevant apoptotic proteins and their significance for
O6
MeG-triggered apoptosis by comparing
isogenic Chinese hamster cell lines that are MGMT deficient (MGMT-),
MGMT proficient (MGMT+), and that exhibit the tolerance phenotype
(i.e., MGMT-, MMR compromised cells) upon exposure to a
potent DNA-methylating agent.
 |
MATERIALS AND METHODS
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Drugs
MNNG (Sigma Chemical Co.) and
O6
-BG (synthesized by H. Kunz,
Institute of Organic Chemistry, Mainz, Germany) were dissolved in DMSO.
MNNG was further diluted with sterile distilled water and stored in
batches at -80°C.
Cell Culture
The cell lines neo-C5 (here briefly designated as MGMT-)
and AT17-C3 (designated as MGMT+) are derivatives of CHO-9 and were
generated by transfection with pSV2neo and pSV2neo + pSV2
MGMT, respectively (7)
. MGMT- cells have no detectable
MGMT activity. MGMT+ cells express 750 fmol/mg protein. The line
TK22-cos9-5-1/2-C1-M (here designated as tolerant) is also a derivative
of CHO-9, which was generated as described previously
(18)
. The cells are MGMT deficient and resistant to the
cytotoxic and clastogenic effects of
O6
MeG-generating compounds. They are
cross-resistant to 6-thioguanine and display reduced G-T binding
activity and MSH2 level (18)
. Therefore, they are clearly
representative of the so-called tolerance phenotype. All cell lines
were maintained in DMEM:F-12 (1:1) supplemented with 10% inactivated
FCS containing 1.5 mg/ml G418. The addition of G418 was omitted during
the experiments.
Transfection Experiments
To overexpress Bcl-2, CHO-9 cells were stably transfected with
the expression vector pcDNA3.1(-)Myc-His harboring wild-type
bcl-2 under the transcriptional control of the
cytomegalovirus promoter (25)
. Transfection was performed
using Lipofectamine (Life Technologies, Inc.). Cells were selected with
G418 (1.5 mg/ml), and individual clones were checked for Bcl-2
expression by Western blot analysis.
Cell Death Analysis
MTT Assay.
Cell growth and cytotoxicity after treatment with MNNG was tested using
the MTT assay. Cells (1,500/well), grown in 24-well plates, were
treated with different doses of MNNG 24 h after seeding. After
incubation for 96 h, their potential to metabolize MTT was
quantitated as described (26)
with some modifications. MTT
(50 µl/500 µl of medium) dissolved in PBS (5 mg/ml) was added to
each well and incubated for 3 h at 37°C. After discarding
supernatants, 0.2 ml of 96% ethanol was added to dissolve formazan
crystals, and absorbance (A) was measured at 540 and
690 nm for reference. Results are expressed as the ratio of
A per treatment level/A of untreated control.
Clonogenic Survival Assays.
Reproductive cell death was assayed by measuring colony formation
with and without MNNG treatment as described (7)
.
Apoptosis and Necrosis.
The frequency of apoptosis and necrosis in untreated cell populations
and after their treatment with MNNG was determined using Annexin V and
flow cytometry (27)
. In this assay, unfixed cells were
double-stained with Annexin V and propidium iodide, which allows the
quantitation of both apoptotic and necrotic cells. Exponentially
growing cells were treated with MNNG, harvested by gentle
trypsinization (0.025% trypsin containing EDTA), washed with cold PBS,
subjected to Annexin V and propidium iodide staining (according to the
manufacturers protocol; Annexin V-FITC; PharMingen) and to flow
cytometric measurement. Evaluation of cell populations was performed
using a computer-based program (Cell Quest; Becton Dickinson).
 |
Preparation of Cell Extracts and Western Blotting
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Nuclear cell extracts were prepared as described
(28)
in the presence of 1 mM
phenylmethylsulfonyl fluoride and 10 µg/ml aprotinin, 10
µM bestatin, 10 µM leupeptin, 1
µM pepstatin, and 0.1 mM phenylmethylsulfonyl
fluoride. Whole-cell extracts were prepared by lysis of PBS washed
cells (105
cells/10 µl) in ice-cold sample
buffer containing 25 mM Tris-HCl (pH 6.8), 1% SDS, 5%
glycerol, and 2.5% 2-mercaptoethanol, followed by sonification
(Branson sonifier, 30 KHz, 3 x 10 s) on ice. The
mitochondrial and cytosolic extracts were isolated by differential
centrifugation as described (29)
. For detection of Bcl-2
family proteins (Bcl-2, Bad, Bak, Bax, Bag-1, and
Bcl-xL) and Fas-L, whole-cell extracts were
separated onto 0.1% SDS, 12% polyacrylamide gels and subjected to
Western blotting as described (30)
. The mitochondrial and
cytosolic extracts for the detection of cytochrome c were
fractionated onto 0.1% SDS, 15% polyacrylamide, and the nuclear
extracts for PARP were fractionated onto 0.1% SDS, 7% polyacrylamide
gels. Proteins were visualized by ECL or ECL Plus (Amersham).
 |
Antibodies
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Monoclonal and polyclonal antibodies against Bcl-2 and
polyclonal antibodies against Bad, Bak, Bax, Bag-1, cytochrome
c, and ERK-2 were obtained from Santa Cruz Biotechnology.
The polyclonal antibody against Bcl-xL and the
monoclonal antibody against Fas-L were purchased from Transduction
Laboratories, Inc.
 |
Measurement of Caspase Activities
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The caspase activity assays are based on spectrophotometric
detection of the chromatophore pNA after cleavage from the labeled
substrate LEHD-pNA by caspase-9 protease, DEVD-pNA by caspase-3-like
proteases, and IETD-pNA by caspase-8 protease. Assays were performed
with the CPP32/caspase-3 resp. FLICE/caspase-8 colorimetric kit
(Chemicon) or the caspase-9, caspase-3 resp. caspase-8 colorimetric kit
(R&D Systems) according to the manufacturers protocol.
 |
Caspase Inhibitors
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The caspase inhibitory peptides Z-VAD-FMK and Z-DEVD-FMK were
obtained from Calbiochem, and the protease inhibitor Ac-DEVD-CHO was
purchased from Alexis, Inc. The inhibitors Z-IETD-FMK and Z-LEHD-FMK
were from Enzyme System Products.
 |
Neutral Single-Cell Gel Electrophoresis
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The procedure originally described for the neutral single-cell
gel electrophoresis for detection of DNA dsb on individual cell level
(31)
was modified as follows. Cells (2 x 105
) were seeded per 5-cm dish and treated
24 h later with 10 µM MNNG. At various times after
treatment, cells were trypsinized, washed with cold PBS, and kept on
ice until assayed. Cells were embedded in 0.5% low melting
point agarose, and microscope slides were immersed in ice-cold lysis
solution [2.5 M NaCl, 100 mM EDTA, 10
mM Tris, 1% sodium laurylsarcosine (pH 7), 1% Triton
X-100, and 10% DMSO were added freshly] and kept at 4°C for 1 h. After lysis, electrophoresis (25 V) was carried out at 4°C for 15
min in 90 mM Tris, 90 mM boric acid, and 2
mM EDTA. The fixed and ethidium bromide stained slides were
analyzed using a fluorescence microscope. Analysis of DNA migration was
performed by image analysis system (Kinetic Imaging Ltd.; Komet 4.0.2;
Optilas) determining the median tail moment (percentage of DNA in the
tail x tail length) of 50 cells/sample.
 |
RESULTS
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Apoptosis in MGMT-deficient and Methylation-tolerant Cells.
The cell lines used in this study were isogenic Chinese hamster (CHO)
cells that are either MGMT deficient (here designated as MGMT-), MGMT
proficient (MGMT+), or exhibit the tolerance phenotype (designated as
tolerant). MGMT- cells exhibit a reduced cell survival, as measured by
colony formation after treatment with DNA methylating agents, compared
with MGMT+ and tolerant cells (7
, 15
, 18)
. To determine
how apoptosis contributes to the observed hypersensitivity of
MGMT-deficient cells, the yield of apoptosis was measured after
treatment with MNNG. In MGMT- cells, apoptosis was significantly
induced and increased as a function of dose of the mutagen (Fig. 1A)
. Tolerant cells showed a clearly lower frequency of
apoptosis than MGMT- cells. It was only slightly enhanced above the
level of MGMT+ cells, which did not show significant apoptosis within
the dose range of the mutagen applied (Fig. 1A)
. Time course
experiments revealed that induction of apoptosis is a late event.
Increase of apoptosis was found only at stages later than 48 h
after pulse treatment with MNNG. Thereafter, the frequency of apoptosis
increased gradually with a high yield observed 96 and 120 h after
treatment (Fig. 1B)
. Again, in the time course experiments,
MGMT+ and tolerant cells showed lower levels of apoptosis than MGMT-
cells (Fig. 1B)
. The yield of apoptosis was higher than the
level of necrosis with all doses and times tested (<15%; data not
shown), indicating that apoptosis is the major cause of
O6
MeG-induced cytotoxicity in MGMT-
cells.

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Fig. 1. Induction of apoptosis in MGMT-deficient
(MGMT-), MGMT-proficient (MGMT+), and
methylation-tolerant (Tol) cells by MNNG.
A, frequency of apoptosis 72 h after treatment with
different doses of MNNG. B, frequency of apoptosis as a
function of time after treatment with 5 and 20 µM MNNG,
respectively. Apoptosis was measured as described in "Materials and
Methods." Data points are the means of four independent experiments;
bars, SD.
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Reduced Bcl-2 Protein Level in Response to MNNG Treatment in MGMT-
Cells.
To investigate the role of pro- and antiapoptotic members of the Bcl-2
family in the induction of apoptosis in MGMT- cells, we determined
their expression in untreated and MNNG-treated cells by Western blot
analysis of total cell extracts. As shown in Fig. 2
A, MNNG provoked a lower level of expression of Bcl-2 in
MGMT- cells but not in MGMT+ cells, as measured 72 and 96 h after
treatment. Decline in Bcl-2 level was dose dependent (Fig. 2
D,
left panel). Time course analysis revealed that it did not occur
before 24 h after treatment. A decline in Bcl-2 started at 48 h after MNNG exposure and continued (reaching 25% of the control
level) up to 120 h after treatment (Fig. 2, B
and
D, right panel). Interestingly, MGMT+ cells showed a slight
up-regulation of the Bcl-2 protein level (1.8-fold) when treated with a
moderate dose of MNNG (10 µM; Fig. 2, A and D
). Tolerant cells showed nearly no
reduction of Bcl-2 as compared with MGMT- cells upon MNNG treatment
(Fig. 2C)
. The expression levels of proapoptotic Bak (Fig. 2A)
and Bax (Fig. 2B)
remained unchanged in both
MGMT- and MGMT+ cells. Overall, the results show that
O6
MeG-induced apoptosis in MGMT-
cells is associated with a reduced Bcl-2 protein level, whereas the
enhanced apoptotic resistance of MGMT+ and tolerant cells is related to
nearly unchanged Bcl-2 expression.

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Fig. 2. Levels of Bcl-2, Bak, and Bax after MNNG treatment.
A, expression of Bcl-2 and Bak in MGMT- and MGMT+ cells
untreated (Con) and 72 resp. 96 h after treatment
with 10 µM MNNG. B, expression of Bcl-2
and Bax in MGMT- cells untreated (Con) and treated with
MNNG (15 µM) as measured various times after methylation.
C, expression of Bcl-2 in tolerant cells
(Tol) as compared with MGMT- cells 72 and 96 h
after treatment with 15 µM MNNG. All filters were
reincubated with ERK-2 antibody, which served as a loading control for
quantitation. D, relative Bcl-2 expression in MGMT- and
MGMT+ cells after treatment with MNNG as a function of dose
(left panel) and, for MGMT- cells treated with 15 and
20 µM MNNG, as a function of time (right
panel). The relative expression levels of Bcl-2 in MNNG-treated
cells were determined by quantitation of Bcl-2 signals, which were set
in relation to ERK-2. Data are from Western blots shown in
AC and further data not shown.
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Depletion of MGMT in MGMT+ Cells Results in Induction of Apoptosis
and Decrease in Bcl-2 after MNNG Treatment.
To check whether the expression of MGMT (and not the cellular
background) was responsible for the low yield of MNNG-induced
apoptosis, we depleted MGMT activity by feeding MGMT+ cells with
the potent MGMT inhibitor O6
-BG. The
addition of O6
-BG 2 h prior to
MNNG treatment caused nearly complete inactivation of MGMT (750 fmol/mg
protein in control and 15 fmol/mg in
O6
-BG-exposed cells). Under these
conditions, cells exhibited a significant increase in the frequency of
MNNG-induced apoptosis (Fig. 3A)
. Furthermore, MGMT-depleted cells showed a clearly reduced
level of expression of Bcl-2, as measured 72 h after treatment
with MNNG (Fig. 3B)
. The data support the conclusion that
unrepaired O6
MeG leads to a decline of
Bcl-2 and the induction of apoptosis.

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Fig. 3. Apoptosis and Bcl-2 decline in MGMT proficient (MGMT+)
cells depleted for MGMT activity. A, frequency of
apoptosis in MGMT+ cells not treated (-) and treated (+) with MNNG (10
µM) and/or O6-BG (15
µM). For complete depletion of MGMT activity,
O6-BG was added to the cells 2 h before
treating them with MNNG. Data are the means of three independent
experiments; bars, SD. B, expression of
Bcl-2 in MGMT+ cells not treated and treated with MNNG and not
pretreated and pretreated with O6-BG (15
µM). Western blot analysis of 30 µg of total cell
extracts/lane is shown. The relative expression levels of Bcl-2 were
determined in relation to ERK-2 and shown on the bottom
of the blot.
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Overexpression of Bcl-2 Protects MGMT- Cells from MNNG-induced
Apoptosis and Cytotoxicity.
Having shown that MNNG-induced apoptosis in MGMT- cells is associated
with a reduced Bcl-2 level, we next investigated whether enhanced
expression of Bcl-2 protects against MNNG-induced apoptosis in this
cell system. To this end, we stably transfected MGMT- CHO cells with
Myc-tagged Bcl-2 or, as a control, with a vector carrying the
neo gene only. Several G418-resistant clones were
screened by Western blot analysis with anti-Myc antibody. Two
Bcl-2-overexpressing clones were selected (designated as
MGMT-/bcl-2wt/10 and MGMT-/bcl-2wt/20) and examined for MNNG-induced
apoptosis. As shown in Fig. 4
A, both Bcl-2 overexpressing clones exhibited clearly reduced
frequencies of apoptosis, compared with the control. Bcl-2
overexpression also improved viability of MNNG-treated cells, as
measured by the MTT assay (data not shown) and colony formation (Fig. 4B)
. This indicates that cells overexpressing Bcl-2 were not
only protected against apoptosis but were also able to proliferate,
forming colonies. Western blot analysis revealed that transfection of
Bcl-2 did not block MNNG-induced decline of the endogenous Bcl-2. Thus,
Bcl-2 both in the control and the transfectant wt/20 decreased in
amount after treatment with MNNG (Fig. 4C)
. There was also
reduction of the transfected Myc-tagged Bcl-2, which followed a similar
dose-response as observed for the endogenous protein (Fig. 4C)
. The data indicate that the endogenous and the
transfected Bcl-2 protein are subject to destruction. They also show
that overexpressed Bcl-2 compensates for the degraded endogenous
protein, thus promoting survival.

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Fig. 4. Effect of overexpression of Bcl-2 in MGMT- cells on
apoptosis, cell survival, and Bcl-2 level after MNNG treatment.
MGMT-deficient cells were stably transfected with an expression vector
encoding myc-tagged wild-type Bcl-2 (to be able to distinguish between
transfected and endogenous Bcl-2). A, frequency of
apoptosis in Bcl-2-overexpressing MGMT- cell clones
(bcl-2wt/10 and bcl-2wt/20), as compared
with the corresponding neo-transfected MGMT- cells and tolerant cells
(Tol), as a function of dose 96 h after treatment
with MNNG. Data are the means of at least three independent
experiments; bars, SD. B, reproductive
cell death, as measured by loss of colony-forming ability, after
treatment with different doses of MNNG. Data are the means of three
independent experiments; bars, SD. C,
expression of myc-tagged Bcl-2 and endogenous Bcl-2 in MGMT-/bcl-2wt/20
cells which were untreated (Con) and treated with
different doses of MNNG, as compared with neo-transfected MGMT- cells.
Total cell extracts were prepared 96 h after treatment and subjected to
Western blot analysis. The relative expression levels of myc-tagged
Bcl-2 and endogenous Bcl-2 were determined by densitometric measurement
and plotted as a function of dose of MNNG. The nontreated control was
set to 100%.
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Bad Becomes Hypophosphorylated in Apoptotic MGMT- Cells.
Phosphorylated and thereby inactivated Bad is known to be bound by
14-3-3 protein, thus liberating Bcl-xL and Bcl-2,
which promote cell survival (32, 33, 34)
. To determine whether
Bad participates in the initiation of apoptosis in MGMT- cells,
Western blot analysis of total cell extracts was performed. Fig. 5
illustrates that Bad is present mainly in its hyperphosphorylated form
in untreated MGMT+ and MGMT- cells. MGMT- but not MGMT+ cells treated
with MNNG showed accumulation of hypophosphorylated Bad, as detected 96
and 120 h after treatment. Expression of antiapoptotic Bag-1 and
Bcl-xL remained unaltered. Thus, it appears that
in MGMT- cells treated with MNNG, the decline of Bcl-2 protein is
followed by accumulation of hypophosphorylated Bad.

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Fig. 5. Expression of Bad, Bag-1, and Bcl-xL upon MNNG
treatment. The level of the Bcl-2 family members Bad, Bag-1, and
Bcl-xL in MGMT+ and MGMT- cells was determined 72, 96, and
120 h after treatment with 15 µM MNNG. Western blot
analysis was performed with 30 µg of total cell extract/lane.
Arrows, phosphorylated and nonphosphorylated form of
Bad. For Bag-1 only, the Mr 32,000 protein
was detectable in CHO cells. Con, nontreated control.
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Apoptosis in MGMT- Cells Is Associated with Release of Cytochrome
c, Activation of Caspase-9 and Caspase-3, and Cleavage
of PARP.
The mitochondrial matrix protein cytochrome c translocates
to the cytosol in cells undergoing apoptosis and is known to be a
direct participant in the activation of caspases (35)
.
Therefore, we determined whether
O6
MeG-induced Bcl-2 decline and
apoptosis is accompanied by release of cytochrome c and
caspase activation. Mitochondrial and cytosolic extracts were isolated
by differential centrifugation and subjected to Western blot analysis.
Release of mitochondrial cytochrome c occurred in MGMT-
cells between 48 and 72 h after treatment with MNNG (not shown).
This led to an increase in the cytosolic cytochrome c level,
which was still detectable 96 h after methylation (Fig. 6A)
. Under the same treatment conditions, MNNG did not provoke
cytochrome c release in MGMT+ cells (Fig. 6A)
.
Regarding caspases, we found an increase in the activity of caspase-9
and caspase-3 in MGMT- cells 4896 h after treatment with MNNG,
whereas in MGMT+ cells, both caspases remained largely unaffected (Fig. 6B)
. The Mr 85,000
breakdown product of PARP was detectable in MGMT- cells at the
earliest stage 78 h after MNNG treatment. Cleavage culminated at
96 h after treatment (Fig. 6C)
. Collectively, the data
show that CHO cells undergoing MNNG-induced apoptosis exhibit
cytochrome c release from mitochondria, activation of
caspase-9 and caspase-3, and cleavage of PARP.

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Fig. 6. Cytochrome c release, caspase-9, and
caspase-3 activity and cleavage of PARP in MNNG-treated MGMT- cells.
A, Western blot analysis of cytochrome c
expression in the cytosol of untreated (Con) and treated
MGMT- and MGMT+ cells after treatment with 15 µM MNNG.
B, extracts of untreated cells and of cells treated with
15 µM MNNG (for 60 min) were assayed for LEHD (caspase-9)
and DEVD (caspase-3-like proteases) activity as a function of time
after treatment. The caspase activity of untreated cells was set to
100%. The values are derived from two to three independent
experiments, each performed in duplicate; bars, SD.
C, expression and cleavage of PARP. Western blot
analysis of nuclear cell extracts (50 µg each) of MGMT- and MGMT+
cells at different times after treatment with 15 µM MNNG.
Arrows, uncleaved form of PARP and the
Mr 85,000 cleavage product.
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Induction of Apoptosis in MGMT- Cells Is Not Related to Altered
Fas/Fas-L Expression.
Activation of the apoptotic pathway may occur via Fas-L/Fas-R
(36)
and activation of the downstream caspase-8
(37)
. To determine whether Fas-R/Fas-L is involved in O6
MeG-induced apoptosis, we
investigated Fas-L expression and assayed the activity of caspase-8 in
MGMT+ and MGMT- cells. As shown in Fig. 7
A, Fas-L was expressed in untreated CHO cells and remained
unaltered in both cell types after MNNG treatment. Incubation of
untreated and MNNG-treated MGMT- cells with anti-Fas-R-FITC-conjugated
antibody and subsequent flow cytometric measurement revealed that the
same was true for the Fas-R, i.e., the expression of Fas-R
was not changed (not shown). Also, the receptor proximal caspase-8 was
not activated in either MGMT- or MGMT+ cells treated with MNNG (Fig. 7B)
. For control, Jurkat cells were treated with
doxorubicin, which caused a nearly 3-fold induction of caspase-8,
compared with the untreated control, which is in line with a previous
report (38)
. On the basis of this data, we conclude that
MNNG induces apoptosis in MGMT- cells without triggering the
Fas-R/Fas-L system.

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Fig. 7. Fas-L and caspase-8 in MGMT- cells upon methylation.
A, expression of Fas-L in MGMT+ and MGMT- cells at
various times after treatment with 15 µM MNNG, as
determined by Western blot analysis (30 µg of total cell
extract/lane). B, relative IETD (caspase-8) cleavage
activity in extracts of MGMT- and MGMT+ cells as a function of time
after treatment with 15 µM MNNG. Caspase activity of
untreated cells was set to 100%. For comparison, the activation of
caspase-8 was assayed in Jurkat T leukemia cells after treatment with
doxorubicin (100 ng/ml; 15 h after treatment). Data were obtained
from two independent experiments performed in duplicate;
bars, SD.
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Inhibitors of Caspase-3-like Proteases and Caspase-9, but not
Caspase-8, Abrogate Apoptosis in MGMT- Cells.
To analyze the role of caspase activation in
O6
MeG-induced apoptosis, we incubated
MGMT- cells with MNNG either in the absence or presence of caspase
inhibitors and determined the frequency of apoptosis 72 h later.
The results are shown in Fig. 8
. Z-VAD-FMK, a general caspase inhibitor, showed the most efficient
inhibition of apoptosis (up to 70%). Z-DEVD-FMK and Ac-DEVD-CHO, which
are selective inhibitors of the caspase-3 subfamily, and Z-LEHD-FMK, a
specific inhibitor of caspase-9, also inhibited MNNG-induced apoptosis.
In contrast, Z-IETD-FMK, a specific inhibitor of caspase-8, was
completely ineffective in protecting MGMT- cells against
MNNGinduced apoptosis. Similar results have been obtained when
apoptosis was measured 96 h after MNNG treatment (not shown). The
results support the conclusion drawn above that caspase-9 and
caspase-3, but not caspase-8, are required for
O6
MeG-induced apoptosis in CHO cells.

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Fig. 8. Effect of caspase inhibitors on MNNG-induced
apoptosis in MGMT- cells. Cells were treated with 10 µM
MNNG in the absence or presence of caspase inhibitors: Z-LEHD-FMK
(caspase-9); Ac-DEVD-CHO and Z-DEVD-FMK (caspase-3-like proteases);
Z-IETD-FMK (caspase-8); and Z-VAD-FMK (general caspase inhibitor).
Caspase inhibitors were used at a concentration of 40 and 100
µM. Apoptosis was measured 72 h after treatment with
MNNG as described above. The frequency of apoptosis in MGMT- cells
treated with 10 µM MNNG in the absence of inhibitors was
set to 100%. Control indicates apoptosis in untreated cells. Data are
the means of three independent experiments; bars, SD.
|
|
Generation of DNA dsb in MGMT- Cells Precedes Apoptosis.
Because O6
MeG is a critical primary
lesion that requires MMR to induce apoptosis ( Ref. 24
and
this work), the question arises as to the ultimate trigger of the
apoptotic pathway. The distal DNA damage triggering the response was
previously hypothesized to be DNA breaks arising from faulty MMR
(15)
. As shown in Fig. 9
, significant induction of DNA dsb was observed in MGMT- cells but not
in MGMT+ and tolerant cells. The frequency of dsb strongly increased
2448 h after MNNG treatment and thus clearly preceded the induction
of apoptosis (Fig. 10)
. The finding that in tolerant cells dsb were not generated after MNNG
treatment indicates that MMR is involved in the induction of DNA breaks
by unrepaired O6
MeG.

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Fig. 9. DNA dsb in MGMT-, MGMT+, and tolerant cells after MNNG
exposure. The dsb level was determined in the cell lines at various
times after pulse treatment (60 min) with 10 µM MNNG by
neutral single-cell gel electrophoresis, as described in "Materials
and Methods." Data are the means of at least four independent
experiments for each cell line; bars, SD.
|
|
 |
DISCUSSION
|
|---|
This study was performed to gain insight into the molecular
mechanism of O6
MeG-induced cell
killing by analyzing the apoptotic pathway in cells either proficient
or deficient for the DNA repair protein MGMT and exhibiting the
tolerance phenotype. CHO cells deficient for MGMT and thereby unable to
repair O6
MeG are dramatically more
sensitive than MGMT-expressing cells to the induction of apoptosis,
exhibiting a linear dose-response upon treatment with MNNG.
Theoretically, necrosis could also account for increased cell killing.
However, the frequency of necrotic cells (which we measured parallel to
apoptosis in the same cell population) was rather low (<15% with the
highest dose of MNNG). This confirms that apoptosis largely accounts
for the hypersensitivity of MGMT-deficient cells as to reproductive
cell death (7
, 39)
. As shown in time course experiments,
apoptotic cells were detected not earlier than 72 h after pulse
treatment with MNNG, and maximal yields of apoptosis were induced as
late as 96 and 120 h after treatment. This indicates that
O6
MeG-induced apoptosis is a late
event. Tolerant cells were nearly completely resistant to MNNG-induced
apoptosis when treated with low doses of the agent that were still
effective in MGMT- cells (510 µM). They
exhibited only slightly enhanced rates of apoptosis on treatment with
higher doses (1525 µM). The tolerant cells
used here are derivatives of CHO-9 that do not express MGMT; they are
resistant to O6
MeG-generating agents
because of reduced G-T mismatch binding activity and MSH2 protein level
(18)
. The low apoptotic response of these cells is
consistent with the hypothesis that O6
MeG-T mispairs, resulting from
replication of unrepaired O6
MeG in
DNA, are subject to MMR, which triggers apoptosis (15
, 24)
. It should be noted that the mere presence of
O6
MeG in DNA is not sufficient for
eliciting apoptotic activity because nondividing cells treated with
MNNG do not respond with induction of
apoptosis.4
Obviously, DNA replication, the formation of
O6
MeG-T mispairs, and their processing
by MMR are essentially involved. This is in line with a recent study
showing MutS
to be required for apoptosis in MGMT-deficient cells
(24)
. Overall, the data reported here support previous
findings that O6
MeG is a potent
apoptosis-inducing DNA lesion and that compromised MMR on
O6
MeG-T sites protects cells from
apoptosis (15
, 22
, 23)
.
Mismatch repair at O6
MeG-T sites takes
place both in the first (after DNA replication) and in the second
posttreatment cycle. Abortive MMR, i.e., repetitive
misincorporation of thymine opposite to O6
MeG, may create DNA
single-strand gaps leading to chromosomal breakage in the subsequent
S-phase. This model of formation of MMR-derived secondary lesions
resulting in chromosomal aberrations (15
, 40, 41, 42)
gains
support here by showing that DNA dsb were formed in replicating
MGMT-deficient cells after MNNG treatment. Interestingly, tolerant
cells as well as MGMT+ cells showed no induction of dsb and apoptosis
when treated with MNNG, indicating that formation of dsb is involved in
the initiation of apoptosis. This is further supported by findings that
show: (a) cells out of the exposure cycle do not undergo
apoptosis after MNNG treatment, although O6
MeG-T mismatches were formed in
S-phase; (b) the formation of dsb precedes the appearance of
apoptotic cells (see Fig. 10
); and (c) electroporation of
cells with restriction enzymes specifically provokes the formation of
dsb and induces decline in Bcl-2 and apoptosis as a delayed
response.5
To address the question of the apoptotic pathway that becomes activated
in response to O6
MeG, we analyzed
various apoptosis-regulating proteins. DNA-damaging agents may induce
apoptosis by activating p53-dependent functions via death receptors
(such as tumor necrosis factor receptor-1, Fas, or DR5; Refs.
43, 44, 45
) and/or by mitochondrial damage (46
, 47)
. Our data show that expression of Fas (CD95, Apo-1) receptor
and Fas ligand is not altered in MGMT- CHO cells upon methylation.
More importantly, caspase-8, the most proximal caspase in Fas receptor
signaling, was not activated, and inhibition of caspase-8 by Z-IETD-FMK
did not block apoptosis. We thus conclude that
O6
MeG does not trigger apoptosis via
Fas receptor signaling. We should note that CHO cells are mutated for
p53 (48
, 49)
, which was shown to up-regulate the Fas-R in
response to DNA damage (45)
. p53 was also reported to
up-regulate Bax (50)
and to turn on redox-related genes,
leading to the generation of reactive oxygen species and mitochondrial
damage (51)
. Despite the central role p53 is ascribed in
apoptosis, its involvement appears to be dependent on cell type and the
inducing agent. Clearly, apoptosis in the cell system we were working
with does not require p53, and therefore, we can conclude that
O6
MeG leads to apoptosis in CHO cells
independently of p53. The p53-independent apoptotic pathway seems to
play an important role especially in fibroblasts, which is supported by
data obtained with p53 knockout fibroblasts from mice. These cells are
highly sensitive to the induction of apoptosis by alkylating agents,
suggesting that in fibroblasts p53 is not required for apoptosis; it
rather protects against it, very likely because of prereplicative DNA
repair.6
However, in other cell types, notably lymphoblastoid and liver cells,
DNA damage-induced apoptosis is dependent on functional p53 and
Fas-R/caspase-8 (52
, 53)
. Therefore, in these cell types
DNA damage-induced signaling is likely to be different from that in
fibroblasts.
We show that a hallmark of
O6
MeG-induced apoptosis is the
reduction of the expression level of the antiapoptotic protein Bcl-2.
Bcl-2 decline was observed prior to and concurrent with the induction
of apoptosis in MGMT-deficient cells (and in MGMT- depleted cells upon
incubation with the MGMT inhibitor
O6
-benzylguanine) but not in
MGMT-proficient and -tolerant cells. To our knowledge, this is the
first report demonstrating reduced expression of Bcl-2 in response to
unrepaired O6
MeG. Furthermore, the
results obtained with the tolerant cells demonstrate that protection
from induction of apoptosis by defective MMR is associated with steady
expression of Bcl-2. To further prove the participation of Bcl-2 in
regulation of apoptosis in this cell system, we stably transfected
MGMT-deficient cells with wild-type Bcl-2. Overexpression of Bcl-2
blocked MNNG-induced apoptosis by >60% and reduced MNNG cytotoxicity.
Overall, the findings strongly indicate that Bcl-2 acts at a proximal
step in O6
MeG-triggered
apoptosis. The ability of Bcl-2 to protect cells against the induction
of apoptosis was also shown for ionizing radiation, alkylating agents,
and various chemotherapeutic drugs (22
, 54, 55, 56)
. While
studying apoptosis in response to the chemotherapeutic agents
vincristine and etoposide, Zhang et al. (56)
reported a protection by Bcl-2 overexpression but stated that Bcl-2
fails to maintain the ability of the cells to proliferate. In contrast,
in our experiments Bcl-2-overexpressing cells deficient for MGMT
exhibited a clearly enhanced colony-forming ability upon treatment with
MNNG and continued to proliferate. We should note that none of the
Bcl-2-overexpressing cell clones we isolated became as resistant as the
wild-type when treated with MNNG. This indicates that the signal
triggered by O6
MeG-derived lesions
must be very strong; it cannot be completely alleviated by Bcl-2
overexpression. It should also be noted that decline of endogenous
Bcl-2 still occurred in Bcl-2-overexpressing cells, and that, at the
same time, the level of the transfected Bcl-2 was reduced as well. This
may be taken to indicate that decline in Bcl-2 level is not
attributable to down-regulation of Bcl-2 gene expression but
rather is a posttranslational phenomenon. Future work will focus on the
mechanism of Bcl-2 down-modulation. It has been shown that inhibitors
of microtubuli formation, such as Taxol and vincristine, induce
phosphorylation of Bcl-2, which neutralizes the antiapoptotic function
of the protein (57)
. Whether Bcl-2 phosphorylation
provokes Bcl-2 instability is unknown. It will be interesting to see
whether a Bcl-2 decline in MGMT- cells upon alkylation is attributable
to protein instability or controlled degradation.
Bcl-2 is known to target the protein kinase Raf-1 to mitochondria,
allowing the kinase to phosphorylate and thereby inactivate
proapoptotic Bad (33
, 58)
. Our studies revealed an
accumulation of hypophosphorylated Bad after decline of Bcl-2 in
apoptotic MGMT-deficient cells. This finding corresponds to the
reported ability of hypo- and unphosphorylated Bad to dimerize with
Bcl-xL and thereby displace Bax, which then
promotes cell death (34)
. This is in line with our finding
of a reinforcement of apoptosis when the hypophosphorylated form of Bad
was dominating (96 h after treatment). From this we conclude that Bad
participates in controlling
O6
MeG-triggered apoptosis by directly
amplifying Bcl-2-mediated signaling.
Damage to mitochondria can result in release of cytochrome c
to the cytosol (59)
. Cytochrome c causes
caspase activation by forming a complex with Apaf-1 and procaspase-9,
leading to activation of caspase-9, which in turn activates
procaspase-3 (60
, 61)
. In this process, Bcl-2 is thought
to be involved by preventing the release of cytochrome c
from mitochondria and thereby the activation of caspases (35
, 62)
. We show that decline of Bcl-2 triggered by
O6
MeG in MGMT- cells is accompanied
by accumulation of cytosolic cytochrome c and activation of
caspase-9 and caspase-3. Caspase-9 and caspase-3 activation clearly
preceded O6
MeG-induced apoptosis (Fig. 10)
, indicating that mitochondria-mediated caspase activation is
decisively involved. Experiments with caspase inhibitors confirmed
this. Both the general caspase inhibitor Z-VAD-FMK and the specific
caspase-9 inhibitor Z-LEHD-FMK, as well as the inhibitors of
caspase-3-like proteases, Z-DEVD-FMK and Ac-DEVD-CHO, significantly
reduced apoptosis in response to
O6
MeG. Contrary to this, no inhibition
of apoptosis was achieved with Z-IETD-FMK, a specific inhibitor of
caspase-8. This supports the conclusion that activation of caspase-9
and caspase-3 is important for
O6
MeG-triggered apoptosis, whereas
caspase-8 is not essential.
We did not observe a change in the level of
Bcl-xL and Bax, which heterodimerizes with Bcl-2
and forms dimers with itself (63, 64, 65)
. A decline in Bcl-2
level in MGMT- cells after MNNG treatment may result in increased
formation of Bax homodimers. Its generation in apoptotic MGMT- cells
is likely further enhanced by lack of Bcl-2-mediated
hyperphosphorylation of Bad, which binds to
Bcl-xL, thus setting Bax free. Overall, our data
are consistent with the model that apoptosis induced by
O6
MeG is triggered by reduction of the
relative ratio of Bcl-2/Bax, causing cytochrome c liberation
from mitochondria. It should be noted that lack of cytochrome
c in mitochondria may lead to uncoupling of electron chain
transport, yielding a burst of reactive oxygen radicals that further
damage the cell (64)
. Reactive oxygen radicals, however,
are not likely to be important for O6
MeG-triggered apoptosis because
incubation of MGMT-deficient cells treated with MNNG with various
antioxidants completely failed to inhibit apoptosis (data not shown).
We should note that only a small proportion of cytochrome c
from mitochondria was found to be released. It therefore appears that
sufficient cytochrome c still remains within mitochondria,
thus maintaining electron transport.
We also show that activation of caspase-9 and caspase-3 after MNNG
treatment of MGMT-deficient cells results in cleavage of PARP. Whether
PARP cleavage is directly involved in the induction of apoptosis is
still unclear. It is unlikely, however, that it is an essential step in
O6
MeG-induced apoptosis because it
started to take place at a time (>78 h after treatment with MNNG) when
apoptotic cells were already appearing. Thus, it seems that PARP
cleavage is a late side effect of caspase-9 and caspase-3 activation.
The time sequence of the main apoptotic functions measured in MGMT-
cells upon treatment with MNNG is summarized in Fig. 10
. It is
interesting to note that the formation of dsb precedes the decline of
Bcl-2 and the activation of caspase-9 and caspase-3. Although the data
do not reject the hypothesis that faulty MMR directly activates
apoptotic functions, they support the view that dsb are involved in
triggering the decline of Bcl-2. A model for
O6
MeG-induced apoptosis based on
the available data is shown in Fig. 11
. In summary, O6
MeG induces apoptosis
via mispairs, which are subject to MMR. The repair intermediates
(possibly nonsealed, gapped DNA) may lead to DNA dsb (e.g.,
by nuclease attack at stalled replication forks), which finally
activate functions that down-modulate Bcl-2. This leads to leakiness of
mitochondria, cytochrome c release, and finally activation
of downstream caspase-9 and caspase-3. Decline of Bcl-2 appears to play
a major role in DNA damage-induced, p53/Fas-R/caspase-8-independent
apoptosis in fibroblasts because we observed it not only in
MGMT-deficient cells but also in other hypersensitive cell lines
characterized by defective DNA repair, such as base excision
repair-defective mouse fibroblasts and nucleotide excision
repair-defective Chinese hamster
cells.7

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Fig. 11. A model of induction of apoptosis by
O6 MeG in MGMT- cells. The formation of
O6 MeG-T mispairs, their processing by MMR,
and the generation of dsb can be considered as part of the initiation
phase. Signaling from the ultimate DNA damage leading to decline of
Bcl-2 is part of the regulative phase. This is followed by caspase
activation, executing the final stage of the apoptotic program. For
further explanation, see "Discussion."
|
|
The finding that O6
MeG-triggered
apoptosis in fibroblasts is independent of p53 and Fas-R/caspase-8 and
involves caspase-9/3 activation may bear implications for cancer
chemotherapy. Thus, it is reasonable to suppose that the efficiency of
antineoplastic drugs exhibiting methylating properties
(streptozotocine, DTIC, procarbazine, temozolomide, and others)
on various tumor types is not dependent on the p53 status of the tumor
but rather on the level of MGMT, which efficiently removes the
apoptosis-initiating signal. We should note that
5% of tumors are
lacking MGMT (65)
; these tumors are likely to be highly
responsive to methylating agents. On the other hand, there is a
tendency toward increase in the MGMT level in tumors with increasing
malignancy (65
, 66) . Interestingly, p53 is involved in
regulation of basal MGMT gene activity (66, 67, 68)
and thus, indirectly, may exert influence on methylating drug
resistance. Nevertheless, because
O6
MeG is a very powerful
apoptosis-inducing lesion, it would be desirable to inhibit its repair
specifically in tumor cells. Selective, highly specific repair
inhibitors of MGMT are available (69)
, and attempts are
currently being made to target them to tumor cells. Because MMR is
essential for O6
MeG-triggered
apoptosis, information on the MMR status of tumors could also be of
predictive value. Also, in view of the decisive role of Bcl-2 in O6
MeG-induced apoptosis, it would
be of interest to develop strategies to inhibit Bcl-2 expression in
tumor cells. A future chemotherapy might thus be based on a combination
of inhibition of DNA repair and amplification of apoptotic signaling in
tumors.
 |
ACKNOWLEDGMENTS
|
|---|
We gratefully acknowledge a gift of Bcl-2 expression plasmid
from Dr. S. Dimmeler (University of Frankfurt, Frankfurt, Germany). We
thank Erato Bey and Jochen Lips for assistance with the neutral comet
assay, Uta Eichhorn for technical assistance, and Dr. Gerhard Fritz for
critical reading.
 |
FOOTNOTES
|
|---|
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
1 This work was supported by the Deutsche
Forschungsgemeinschaft SFB 519/B4 and Stiftung Rheinland-Pfalz. 
2 To whom requests for reprints should be
addressed, at Division of Applied Toxicology, Institute of Toxicology,
University of Mainz, Obere Zahlbacher Strasse 67, D-55131 Mainz,
Germany. Phone: 49-6131-393-3246; Fax: 49-6131-393-3421; E-mail: Kaina{at}mail.uni-mainz.de 
3 The abbreviations used are: MGMT,
O6-methylguanine-DNA methyltransferase;
MGMT+, MGMT proficient; MGMT-, MGMT deficient; MNNG,
N-methyl-N'-nitro-N-nitrosoguanidine;
O6 MeG,
O6-methylguanine;
O6-BG,
O6-benzylguanine; dsb, DNA double-strand
breaks; PARP, poly(ADP-ribose) polymerase; Fas-L, Fas ligand; Fas-R,
Fas receptor; MMR, mismatch repair; MTT,
3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; pNA,
paranitroanilide; CHO, Chinese hamster ovary; Z-VAD-FMK,
benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone; Z-DEVD-FMK,
Z-Asp-Glu-Val-Asp-FMK; Ac-DEVD-CHO,
N-acetyl-Ile-Glu-Thr-Asp-CHO(aldehyde); Z-IETD-FMK,
Z-Ile-Glu(OMe)-Thr-Asp(OMe)-FMK; Z-LEHD-FMK,
Z-Leu-Glu(OMe)-HisAsp(OMe)-FMK. 
4 T. Dunkern and B. Kaina, unpublished
data. 
5 J. Lips and B. Kaina, unpublished data. 
6 D. Lackinger and B. Kaina, Primary mouse
fibroblasts deficient for c-Fos, p53, or for both proteins are
hypersensitive to UV light and alkylating agent-induced chromosomal
breakage and apoptosis, Mutation Res., in press. 
7 Unpublished data. 
Received 1/21/00.
Accepted 8/14/00.
 |
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