Synergism between arsenite and proteasome inhibitor MG132 over cell death in myeloid leukaemic cells U937 and the induction of low levels of intracellular superoxide anion

Increased oxygen species production has often been cited as a mechanism determining synergism on cell death and growth inhibition effects of arsenic-combined drugs. However the net effect of drug combination may not be easily anticipated solely from available knowledge of drug-induced death mechanisms. We evaluated the combined effect of sodium arsenite with the proteasome inhibitor MG132, and the anti-leukaemic agent CAPE, on growth-inhibition and cell death effect in acute myeloid leukaemic cells U937 and Burkitt's lymphoma-derived Raji cells, by the Chou–Talalay method. In addition we explored the association of cytotoxic effect of drugs with changes in intracellular superoxide anion (O2−) levels. Our results showed that combined arsenite + MG132 produced low levels of O2− at 6 h and 24 h after exposure and were synergic on cell death induction in U937 cells over the whole dose range, although the combination was antagonistic on growth inhibition effect. Exposure to a constant non-cytotoxic dose of 80 μM hydrogen peroxide together with arsenite + MG132 changed synergism on cell death to antagonism at all effect levels while increasing O2− levels. Arsenite + hydrogen peroxide also resulted in antagonism with increased O2− levels in U937 cells. In Raji cells, arsenite + MG132 also produced low levels of O2− at 6 h and 24 h but resulted in antagonism on cell death and growth inhibition. By contrast, the combination arsenite + CAPE showed high levels of O2− production at 6 h and 24 h post exposure but resulted in antagonism over cell death and growth inhibition effects in U937 and Raji cells. We conclude that synergism between arsenite and MG132 in U937 cells is negatively associated to O2− levels at early time points after exposure.

► Arsenic combined cytotoxic and anti-proliferative effects by Chou–Talalay method.
► Cytotoxic effect associated with superoxide levels as assessed by flow cytometry.
► Synergism between arsenite and MG132 in U937 leukemia cell line.
► Synergism turned into antagonism by low levels of hydrogen peroxide.
► Resistance to arsenic cytotoxicity linked to early superoxide anion increased levels.