Abstract. Choroidal melanoma is the most common primary intraocular tumor in adults. Cepharanthine (CEP), a natural alkaloid extracted from the roots of Stephania cepharantha Hayata, has been demonstrated to inhibit the proliferation of various cancer cells. However, its potential anticancer effect in choroidal melanoma has not been clarified yet. In the present study, it was identified that CEP may potently inhibit the proliferation of human choroidal melanoma cells, induce cell death and cell cycle arrest, and activate cellular apoptotic proteins, including Bcl-2-associated X protein, caspase and poly(ADP-ribose) polymerase. Results also revealed that CEP induced the cellular production of reactive oxygen species (ROS) and led to cytochrome c release, whereas concurrent treatment with N-acetyl-L-cysteine (a ROS scavenger) attenuated the situation. In addition, CEP was also revealed to activate c-Jun N-terminal kinase (JNK) 1 and 2, whereas inhibition of JNK1/2 partially abrogated the proliferation inhibitory effect of CEP, indicating that JNK1 and JNK2 were involved in CEP-triggered cellular apoptosis. In addition, the anticancer effects of CEP were also observed in a choroidal melanoma xenograft model. In summary, the results of the present study demonstrated that CEP is effective in suppressing human choroidal melanoma cell and tumor cell proliferation, and that CEP may therefore represent a potentially novel therapeutic agent for the treatment of choroidal melanoma.
IntroductionChoroidal melanoma is the most common primary intraocular tumor in adults (1,2). The mean incidence of choroidal melanoma in the USA is ~6 novel cases/10 6 people every year (3). Currently, there are several treatment protocols for primary choroidal melanoma, including surgery, radiation therapy, thermotherapy and external beam proton therapy (4-7). The 5-year relative survival rate of choroidal melanoma is ~80% when the tumors are confined to the eyes (3,8). However, patients with choroidal melanoma have a high risk of developing metastasis (typically to the liver), which is usually fatal with a median survival time of 6-9 months subsequent to the detection of liver metastasis (3,8). Therefore, development of novel effective therapies for choroidal melanoma is required urgently.Cepharanthine(CEP; 6',12'-dimethoxy-2,2'-dimethyl-6,7-[methylenebis(oxy)]oxyacanthan) is a biscoclaurine alkaloid extracted from the roots of the plant Stephania cepharantha Hayata, which has been broadly used in Japan for chemoprevention and treatment of numerous diseases by virtue of its anti-inflammatory and immunomodulatory activities (9,10). CEP has been reported to exert antitumor effects in numerous cancers by inhibiting cancer cell proliferation (11), cell cycle progression (12), tumor invasion (13), generating reactive oxygen species (ROS) (11,14), inducing cell apoptosis (11,14,15), regulating cell survival signaling pathways (16,17) and increasing the competence of the host (18,19). It was also identified to potentiate the anticancer effects of oth...