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1 advances.sciencemag.org/cgi/content/full/2/12/e /dc1 Supplementary Materials for Syrosingopine sensitizes cancer cells to killing by metformin Don Benjamin, Marco Colombi, Sravanth K. Hindupur, Charles Betz, Heidi A. Lane, Mahmoud Y. M. El-Shemerly, Min Lu, Luca Quagliata, Luigi Terracciano, Suzette Moes, Timothy Sharpe, Aleksandra Wodnar-Filipowicz, Christoph Moroni, Michael N. Hall This PDF file includes: Published 23 December 2016, Sci. Adv. 2, e (2016) DOI: /sciadv fig. S1. Optimization of metformin concentration for codrug screen. fig. S2. Effect of metformin on cell survival in leukemic blasts. fig. S3. Syrosingopine-metformin titration in leukemic blasts. fig. S4. Effect of drug combination on 2D and 3D culture conditions. fig. S5. Effect of syrosingopine with phenformin and other mitochondrial inhibitors. fig. S6. Syrosingopine strongly potentiates the effect of mitochondrial inhibitors. fig. S7. Syrosingopine-metformin titrations of Eno2-expressing and Eno2- nonexpressing cells. fig. S8. Eno2 knockout does not confer sensitivity to drug combination. table S1. Panel of cancer cell lines tested for syrosingopine-metformin induced synthetic lethality.

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3 fig. S1. Optimization of metformin concentration for codrug screen. (A) Metformin titration in cell lines shown in Fig. 1A-D to determine optimal metformin concentration (dotted red line) for co-treatment with syrosingopine. In all titrations, proliferation was determined by measuring resazurin conversion after 3 days of treatment. Growth was normalized to untreated controls, each data point was performed in triplicate. (B) Structure of syrosingopine and its parent compound reserpine. (C) Chemical structure of tetrabenazine.

4 fig. S2. Effect of metformin on cell survival in leukemic blasts. (A) Metformin titration of ex-vivo leukemic blasts to determine optimal metformin concentration (red dashed lines) to employ for co-treatment with syrosingopine. AML8124 was moderately metformin sensitive. (B) Leukemic blasts that were sensitive to metformin and unable to be used for co-titration with syrosingopine. (C) Metformin titration on peripheral blood cells from a healthy donor. For all titrations, end point cell numbers were determined by a resazurin assay after 3 days of treatment. Cell numbers were normalized to untreated controls and each data point was performed in triplicate.

5 fig. S3. Syrosingopine-metformin titration in leukemic blasts. (A) Treatment of ex-vivo primary leukemic blasts from 12 patients with syrosingopine (blue lines), and syrosingopine in the presence of 5mM metformin (red lines). (B) Similar titration with peripheral blood cells from a healthy donor. (C) Normal untransformed primary skin fibroblasts from two healthy individuals areinsensitive to the drug combination.

6 fig. S4. Effect of drug combination on 2D and 3D culture conditions. (A) A cytotoxicity/viability/apoptosis assay (Apotox-Glo Triplex assay, Promega) on HL60 cells treated for 48hours with syrosingopine (5M) and in combination with metformin (4mM). (B) Hepatospheres of HepG2 hepatocellular carcinoma cells treated with syrosingopine and metformin as indicated. Right panel shows quantitation of sphere forming efficiency and survival by resazurin staining.

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8 fig. S5. Effect of syrosingopine with phenformin and other mitochondrial inhibitors. (A, B) Titration in 6.5 cells of syrosingopine (blue lines), and syrosingopine in combination with various mitochondrial inhibitors (red lines): phenformin (40M), rotenone (50nM), thenoyl trifluoroacetone (100M) and potassium cyanide (5mM). Proliferation was determined by measuring resazurin conversion after 3 days of treatment. Non-normalized data are shown in relative fluorescence units (RFU) and the intercept at the y-axis shows the lack of effect on cell growth of the mitochondrial inhibitor by itself in the absence of syrosingopine. Each data point was performed in triplicate.

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10 fig. S6. Syrosingopine strongly potentiates the effect of mitochondrial inhibitors. (A) 6.5 cells titrated with various mitochondrial inhibitors in the absence (blue lines) and in the presence of 5M syrosingopine (red lines). Data shown are non-normalized and the intercept at the y-axis shows the lack of effect on cell growth of the mitochondrial inhibitor by itself in the absence of syrosingopine. Proliferation was determined by measuring resazurin conversion after 3 days of treatment. Each data point was performed in triplicate. (B) Mitochondrial membrane potential of permeabilized HL60r0 cells treated with the indicated drugs measured by TMRM staining.

11 fig. S7. Syrosingopine-metformin titrations of Eno2-expressing and Eno2- nonexpressing cells. (A) Proliferation assay of 6.5 cells titrated with NaF in the presence or absence of 4mM metformin for 3 days. (B) Responsiveness profiles to syrosingopine-metformin treatment of cell lines presented in Fig 7A.

12 fig. S8. Eno2 knockout does not confer sensitivity to drug combination. (A) Immunoblot for -enolase levels in CRISPR-Eno2 deleted derivatives in HT1080 and NA8. (EV: empty vector control). (B) Syrosingopine-metformin titration in HT1080 and NA8 empty vector and Eno2 deleted lines. Growth was measured after 5 days of treatment.

13 table S1. Panel of cancer cell lines tested for syrosingopine-metformin induced synthetic lethality. Proliferation assays were performed as described in the text and growth measured after 3 days of treatment (suspension cell lines) or 5 days of treatment (adherent cell lines) with a resazurin proliferation assay. Each cell line was tested at least twice with every data point performed in triplicate. (S: sensitive to metformin-syrosingopine treatment, NS: non-sensitive). Cell line Origin LD50 S M) LD50 S+M M) Responsiveness HeLa Cervical cancer >10 4 S A549 NSCLC >10 4 S H1299 NSCLC > S OPM1 Multiple myeloma >10 4 S OPM2 Multiple myeloma 10 2 S RPMI8226 Multiple myeloma 3 1 S Jurkat T cell leukemia >10 2 S U937 Lymphoma S KG1 AML S HL60 Promyelocytic leukemia > S K562 CML 10 3 S MOLT4 ALL S SW480 Colon >10 4 S SW620 Colon > S HT29 Colon S HCT116 Colon >10 5 S LS180 Colon >10 3 S LoVo Colon 10 3 S Colo-201 Colon > S Colo-205 Colon > S HepG2 Hepatocellular >10 3 S carcinoma Huh7 Hepatocellular >10 2 S carcinoma MiaPaCa2 Pancreatic cancer 10 5 S Panc1 Pancreatic cancer >10 3 S AsPC1 Pancreatic cancer > S Su86.86 Pancreatic cancer >10 5 S CaPan2 Pancreatic cancer > S AN3CA Endometrial cancer >10 5 S

14 MDA-468 Breast cancer >10 4 S Juso Melanoma >10 3 S DU145 Prostate >10 3 S LnCAP Prostate 5 1 S PC3 Prostate 10 5 S LN229 Glioblastoma >10 4 S BxPC3 Pancreatic cancer > S U87 Glioblastoma NS WPE1NA22 Prostate >10 >10 NS MDA-231 Breast cancer >10 >10 NS HT1080 Fibrosarcoma >10 >10 NS NA8 Melanoma >10 >10 NS ME59 Melanoma NS CaPan1 Pancreatic cancer >10 9 NS LS174 Colon > NS