Possible mechanisms for tumour cell sensitivity to TNF-alpha and potential therapeutic applications

TNF is a macrophage/monocyte-derived cytokine with cytostatic and cytotoxic anti-tumour activity. TNF-alpha can cause haemorrhagic necrosis and regression of experimental tumours. Nevertheless, the TNF-alpha doses required to cure tumour-bearing mice lead to injury of normal tissues and, eventually, may cause a lethal shock syndrome. This toxicity implies severe limitations for the therapeutic use of TNF-alpha. Reactive oxygen intermediates (ROls) are involved in TNF-alpha-induced cell killing. Different studies are consistent with the hypothesis that tumour cell sensitivity to TNF-alpha is related to its capacity to buffer oxidative attack. Recently, we have demonstrated that the sensitivity of Ehrlich ascites tumor (EAT) cells to TNF depends on their glutathione (GSH, the most prevalent nonprotein thiol in mammalian cells) content and their rate of proliferation. This is important because tumour cell populations under active proliferative states may show higher GSH levels, and drug- and/or radiation-resistant tumours have increased cellular levels of GSH. TNF-alpha induces a shift towards oxidation in the mitochondrial glutathione (mtGSH) status, a fact that is consistent with the hypothesis that mtGSH plays a key role in scavenging TNF-induced ROIs. GSH, which is not synthesized within mitochondria but is neccessary for their normal function, needs to be taken up from the cytosol through a high affinity multicomponent transport system. In consequence, different approaches that lead to depletion of mtGSH may improve the anticancer efficacy of TNF-alpha both in vitro and in vivo. As an example, EAT-bearing mice fed a glutamine-enriched diet (GED) show a selective increase of glutamate content witihin the tumour cells. Glutamate inhibits GSH uptake by tumour mitochondria and leads to a selective depletion of mtGSH content (not found in mitochondria of normal cells) to approx. 57% of the level found in tumour mitochondria of mice fed a standard diet (SD). Administration of rhTNF-alpha, which increases generation of mitochondrial ROIs, to EAT-bearing mice fed a SD does not affect significantly the rate of tumour growth. However, when tumour-bearing mice fed a GED where treated with rhTNF-alpha the number of viable tumour cells was decreased to approx. 38% of controls.