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Article history: Cancer is the leading cause of mortality in Canada and other industrialized nations; the development of new/im-
Received 9 January 2017 proved cancer therapies is desperately needed and continues to be a major focus of cancer research. Flavonoids,
Received in revised form 6 March 2017 which are found in high levels in onions, have been shown to exert antiproliferative and potentially anti-cancer
Accepted 10 March 2017
activities. To test their therapeutic potential, we assessed the antiproliferative, cytotoxic, apoptosis-inducing, and
Available online 11 March 2017
anti-migratory activities of ve onion varieties grown in Ontario against human adenocarcinoma (Caco-2) cells.
Keywords:
The properties of onion extracts were compared to pure extracts of avonoids known to exhibit antiproliferative
Caco-2 cells effects (quercetin, myricetin, and kaempferol). We compared more than one variety of onion, as agronomic and
Onion extracts genetic factors inuence the composition, as well as the quality of phytochemicals (e.g. avonoids) in plant cul-
Pressurized low polarity water tivars. We found that all onion varieties exhibited antiproliferative activity similar to puried avonoids. The cy-
Apoptosis totoxic effects of the Stanley and Fortress onion varieties were strongest among the selected cultivars, as
Anti-migratory determined via lactate dehydrogenase (LDH) assays, while Safrane extracts showed the weakest activity. The
Stanley and Lasalle cultivar extracts also had strong anti-migratory effects. Altogether these onion extracts
may contain one or more compounds that may be effective anti-cancer therapies, while the Stanley extract
showed the most comprehensive biological activities against Caco-2 cells.
2017 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.foodres.2017.03.017
0963-9969/ 2017 Elsevier Ltd. All rights reserved.
A.I. Murayyan et al. / Food Research International 96 (2017) 1218 13
negatively impacting the health-promoting benets that these nutri- propagated in a 75-cm2 culture ask at 37 C and 5% CO2 in a humidied
ents provide. Therefore, it is possible that the benets reported in on- atmosphere. Media was refreshed three times per week, and cells were
ions grown outside of Canada may not necessarily apply to the locally passaged at approximately 80% conuency. Cells were harvested using
grown varieties, as the cultivars and growing conditions are different Tryple Express and then collected using centrifugation at 200 g for
between locals. Accordingly, an investigation on the health promoting 5 min. Cells at passage numbers 1820 were used for the experiments.
properties of Ontario grown onions, specically in regards to their cyto-
toxic and cytostatic bioactivity, is merited. Caco-2 as our cell line of in- 2.5. Colorimetric quantication of Caco-2 cell proliferation
terest because it is extensively used as a model for human intestinal
epithelium and is the work horse of the pharmaceutical industry for The cytostatic capacities of the onion extracts were determined by
in-vitro toxicology studies (Sambuy et al., 2005; Yamazaki et al., measuring Caco-2 proliferation using the MTS colorimetric assay. Brief-
2014). Therefore, we investigated the bioactive properties of ve Ontar- ly, Caco-2 cells were seeded in a tissue culture-treated 96-well plate at a
io grown varieties of onion and assessed their capacity to exert cytostat- density of 1.5 104 cells per well. Cells were left undisturbed for 24 h to
ic/cytotoxic effects on a relevant human colorectal cancer cell line. allow for attachment. After 24 h, a total of 100 L of the sample extracts
containing the growth media were subsequently added. Flavonoids
2. Materials and methods quercetin, myricetin, and kaempferol were used as positive controls to
assess the cytostatic properties of the onion extracts. The concentration
2.1. Materials of pure avonoids used for the present study was 100 M. The avo-
noids were dissolved in DMSO and further diluted in cell culture
Quercetin (purity: pharmaceutical secondary standard), myricetin media. The nal concentration of DMSO was 0.5% (v/v). The 96-well
(purity 96%), kaempferol (purity N 98%), MEM (minimum essential plate was incubated for 72 h and was gently washed with PBS prior to
medium), FBS (fetal bovine serum), L-glutamine, and D-glucose were the addition of the MTS dye. Absorbance was measured at 490 nm
purchased from Sigma Aldrich (St Louis, MO). Phenol free DMEM using an xMark spectrophotometer (Bio-rad; Hercules, CA) after a 3 h
(Dulbeccos' modied eagle's medium) and 100 penicillin-streptomy- incubation period with MTS dye.
cin solution were obtained from GE Healthcare Life Sciences (Logan,
UT). Lactate dehydrogenase (LDH) cytotoxicity and MTS cell prolifera- 2.6. Determination of cytotoxicity and cytolysis
tion assay kits were purchased from BioVision Inc. (Milipitas, CA). A
TrypLE express and Image-iT lipid peroxidation kit was purchased Lactate dehydrogenase (LDH) supernatant levels were assessed as
from Invitrogen (Carlsbad, CA). The ORIS cell migration assay kit an indicator of Caco-2 cell death and were used as a measure of cytotox-
was acquired from Platypus Technologies (Madison, WI). Five Ontario icity activity. Caco-2 cells were seeded into a tissue culture-treated, 96-
grown onion varieties were graciously donated by the Holland Marsh well plate at a density of 1.5 104 cells per well. The plate was undis-
Growers' Association (Bradford, Ontario). turbed for 24 h to allow for cell attachment. The media was then aspirat-
ed and replaced with media containing onion extracts at different
2.2. Phytochemical extraction using pressurized low polarity water concentrations. LDH activity was determined 72 h post-treatment. The
plate was centrifuged at 600g for 10 min to precipitate any cells and
Low polarity water extractions of ve Ontario grown onion varieties cellular debris. Ten L of the debris free medium was transferred to a
(Lasalle, Fortress, Safrane, Stanely, and Ruby Ring) were performed. 96-well plate. To assess LDH levels, 100 L of a reaction mixture solution
Chopped onions were lyophilized, and 5 g of freeze-dried onion powder containing a water soluble tetrazolium salt dye was added to the super-
was mixed with 80 mL of 0.1% formic acid in milliQ water (v/v). An au- natant samples. Absorbance was read using an xMark spectrophotome-
tomated Speed SFE NP model 7100 instrument (Applied Separation Inc., ter (Bio-rad; Hercules, CA) after a 30 min incubation period at 450 nm.
Allentown, PA) equipped with a module 7100 pump and a 10 mL thick-
walled stainless cylindrical extractor vessel was used for the extractions. 2.7. Induction of apoptosis in Caco-2 cells
Phytochemical extraction of the onions using pressurized low polarity
water extraction was performed under the following conditions: 60 C Expression of the executioner caspases, caspases 3 and 7, was used
at 150 bar for 60 min. to determine the presence of bioactive properties capable of inducing
apoptosis. Briey, cells were seeded in a black, clear bottom 96 well
2.3. Total avonoid content plate at 1.5 104 cells per well. The plate was left undisturbed for
48 h, after which the media was aspirated. Media containing the various
The total avonoid content assay was performed by aluminum chlo- extract treatments was added as previously described. After 24 h treat-
ride colorimetric assay. 0.5 mL of the total extracted onion test samples ment incubation, the treatment medium was replaced with 100 L of
were mixed with 0.1 mL of 10% aluminum chloride and 0.1 mL of 1 M phenol free RPMI:F12 (1:1 ratio) medium supplemented with 5% FBS,
potassium acetate. Followed by the addition of 2.8 mL of deionized 2 mM L-glutamine, and the CellEvent Caspase-3/7 Green Detection
water. The test samples were then kept for incubation at room temper- Agent at a nal concentration of 7.5 M. Cells were incubated for
ature for 30 min. The optical density (OD) was then measured using 96 30 min. High content imaging was performed using a Cytation 5 multi-
well plate by a plate reader (ELISA plate reader (Amersham Biosciences mode plate reader (Biotek, Winooski, VT).
Corp., USA) at 415 nm. The total avonoid content was expressed as mg
quercetin equivalent (QE)/g dry plant sample. 2.8. Cell migration
2.4. Cell culture Measurements of cell motility were used to determine the efcacy of
extract treatments in inhibiting the invasive progression of Caco-2 cells.
The Caco-2 strain, a human colorectal adenocarcinoma cell line, was The Oris cell migration assay kit consists of a 96-well plate with round
purchased from the American Type Culture Collection (Rockville, MD). bottom silicone stoppers which create a 2 mm diameter exclusion zone.
Cells were maintained in MEM media supplemented with 4 mM L-glu- Caco-2 cells were seeded at 1 105 cells/well and were allowed to at-
tamine, 1% non-essential amino acids, 10% heat inactivated fetal bovine tach for 24 h. After the incubation period, the silicone stoppers were
serum, and 1% 100 penstrep solution (nal concentration of gently removed, and the plate was imaged to capture the exclusion
100 IU/mL penicillin and 100 g/mL streptomycin). D-glucose was sup- zone at time 0. Media containing the extract treatments was then
plemented at a nal concentration of 4 g/L. Caco-2 cells were added to the growth media. The plate was incubated for another 72 h,
14 A.I. Murayyan et al. / Food Research International 96 (2017) 1218
after which high content imaging of the exclusion zones was performed
using the Cytation 5 multimode plate reader.
ultimately cell viability. In the MTS proliferation assay, MTS is converted 3.4. Induction of apoptosis in Caco-2 cells
by viable cells into a compound measureable by absorbance reading.
Therefore, a reduction in absorbance in the MTS assay with onion ex- Although LDH assays are reasonable measures of cell viability, they
tract treatment could also denote changes in cell viability. As expected, do not directly quantify the number of apoptotic cells/events. Apoptosis,
we found that LDH levels increased with onion extract treatment (ver- or programmed cell death, is a highly organized and tightly regulated
sus untreated controls), indicating that these extracts also possess cyto- sequence of biochemical events leading to morphological changes and
toxic effects. Similar to results from the proliferation assays, the extracts eventually cell death. The activation of executioner protease caspases,
were most effective at a 1:10 dilution (Fig. 3), showing no signicant namely caspases 3 and 7, is key path shared by both the intrinsic and ex-
differences at a 1:50 or 1:100 dilutions (data not shown). A 125228% trinsic apoptotic pathways (Reed, 2003; Boatright & Salvesen, 2003).
increase in LDH release was observed for treatments prepared at a The evasion of programmed cell death, due to oncogenic mutations in
1:10 dilution. However, unlike the proliferation assays, we found malignant cells, is one of the hallmarks of cancer (Hanahan &
measureable differences in the cytotoxic effects among the ve onion Weinberg, 2011). These mutations result in defects in the signaling
varieties, which may reect extract composition. A 228% increase in transduction pathway of the apoptosis signaling cascade, giving rise to
the ratio of LDH release was induced by Fortress and Stanley extracts, the chemotherapeutic resistance of malignant cells (Johnstone, Ruei,
which represented the most potent cytotoxic extracts. This ratio was & Lowe, 2002; Lowe & Lin, 2000). Consequently, induction of apoptosis
similar to that exhibited by the control avonoids quercetin and by a therapeutic agent would likely be instrumental in controlling the
kaempferol. The remaining three onion variety extracts exhibited a proliferation and metastasis of cancer cells. If a greater number of can-
lower LDH release ratio, which was similar to the myricetin-treated cerous cells are pushed down the apoptotic pathway, this would help
cells, although all extracts induced a signicant amount of cytotoxicity to stop proliferation and neoplastic growth. Therefore, we also assessed
compared to untreated controls. the ability of our onion extracts to induce the apoptosis of Caco-2 cells.
The differences in total avonoid content among the tested onion We found that all extracts were successful in inducing apoptosis at a di-
varieties cannot fully account for why the Fortress variety, with contains lution of 1:10 compared to the untreated or DMSO control (Fig. 4). Con-
only half as much total avonoid content as the Stanley variety, has a sistent with previous assays, 1:50 and 1:100 dilutions of our extracts did
similar effect on cell viability as assessed by LDH assay. Furthermore, not signicantly induce apoptosis (data not shown). Overall, a 3.54-
the Ruby Ring extract performed similarly to varieties with the lowest fold increase in the number of apoptotic cells was observed for nearly
total avonoid content, although it contains one of the highest concen- all treatments (versus untreated control). The Stanley extract was
trations of avonoids. Therefore, it is very likely that other bioactive most potent at inducing cell death and was followed by the Lasalle,
compounds, such as organosulfur and/or phenolic compounds contrib- Ruby Ring, Fortress, and Safrane extracts. A very promising nding
ute to avonoid effects or may have a more pronounced effect than the was that on average, the number of apoptotic events induced by the ex-
avonoids themselves. Due to the heterogeneous nature of the extracts, tract treatments was higher than the number of events induced by our
it may also be possible that the presence of a currently unidentied phy- positive controls quercetin and myricetin.
tochemical may play a role in exerting these effects. Future studies could Several proposed mechanisms of actions for phytochemicals, which
be performed to isolate the active components in these extracts, which affect the transduction signaling pathways involved in apoptosis, have
may have more potent effects when administered in higher concentra- been documented in literature and are dependent not only on the cellu-
tions as pure compounds. However, as far as a therapeutic is concerned, lar model, but on the phytochemical involved in the study. Dietary a-
isolated compounds may be signicantly less cost effective and may not vonoids found in onions have been shown to down-regulate the
show greater efcacy; some natural product extracts are more effective elevated levels of fatty acid synthase expression in cancer cells,
as mixtures, due to the potential synergistic or additive effects of the in- compromising their ability to convert acetyl-CoA to fatty acids and neg-
dividual compounds present within the mixture (Liu et al., 2014). atively impacting cell membrane functions leading to cell death
Fig. 4. The number of apoptotic cells after treatment with onion extracts (1:10 dilution).
Wells were seeded with 1.5 104 cells and left undisturbed for 48 h. Following this
Fig. 3. Cytotoxic effect for UNTRT: Untreated; LAS: Lasalle; RR: Ruby Ring; FOR: Fortress; incubation period, the number of apoptotic cells were measured after a 24-h dosing
STA: Stanley; SAF: Safrane; QUE: Quercetin (100 M); MYR: Myricetin (100 M); KAE: period. UNTRT: Untreated; LAS: Lasalle; RR: Ruby Ring; FOR: Fortress; STA: Stanley; SAF:
Kaempferol (100 M); Data shown as means S.D. (n = 3). Treatments not sharing a Safrane; QUE: Quercetin (100 M); MYR: Myricetin (100 M); Data shown as means
common letter differ signicantly from each other (P b 0.05) by one-way ANOVA S.D. (n = 6). Treatments not sharing a common letter differ signicantly from each
followed by Tukey's post hoc test. other (P b 0.05) by one-way ANOVA followed by Tukey's post hoc test.
16 A.I. Murayyan et al. / Food Research International 96 (2017) 1218
Fig. 6. Cell migration assay. Figure shows cells (green) migrating the exclusion zone A) Exclusion zone of untreated cells at 0 h B) Caco2 cells treated with Lasalle at 0 h D) Caco2 cells
treated with Quercetin at 0 h E) untreated cells at 72 h F) Caco2 cells treated with Lasalle at 72 h G) Caco2 cells treated with Quercetin at 72 h. (For interpretation of the references to
colour in this gure legend, the reader is referred to the web version of this article.)
Acknowledgments Johnstone, R. W., Ruei, A. A., & Lowe, S. W. (2002). Apoptosis: A link between cancer ge-
netics and chemotherapy. Cell, 108, 153164.
Linsalata, M., Orlando, A., Messa, C., Refolo, M. G., & Russo, F. (2010). Quercetin inhibits
The authors sincerely thank the Natural Sciences and Engineering human DLD-1 colon cancer cell growth and polyamine biosynthesis. Anticancer
Research Council of Canada (Grant 400929) and the Ontario Ministry Research, 30, 35013507.
Liu, Y., Zhan, J., Liu, X., Wang, Y., Ji, J., & He, Q. (2014). Dietary avonoids intake and risk of
of Agriculture, Food and Rural Affairs (Grant 300513) for funding this type 2 diabetes: A meta-analysis of prospective cohort studies. Clinical Nutrition, 33,
study. The authors also thank the Holland Marsh Growers Association 5963.
for providing Onion samples. The authors appreciate the onion extracts Lowe, S. W., & Lin, A. W. (2000). Apoptosis in cancer. Carcinogenesis, 21, 485495.
Manach, C., Scalbert, A., Morand, C., Rmsy, C., & Jime, L. (2004). Polyphenols: Food
samples provided by Dr. John Shi of the Agriculture and Agri-Food
sources and bioavailability. The American Journal of Clinical Nutrition, 79, 727747.
Canada. Manohar, C. M., Xue, J., Murayyan, A., Neethirajan, S., & Shi, J. (2017). Antioxidant activity of
polyphenols from Ontario grown onion varieties using pressurized low polarity water
technology. Journal of Functional Foods, 31, 5262.
References
Mehlen, P., & Puisieux, A. (2006). Metastasis: A question of life or death. Nature Reviews
Cancer, 6, 449458.
Ban, J. O., Hwang, I. G., Kim, T. M., Hwang, B. Y., Lee, U. S., Jeong, H. S., ... Hong, J. T. (2007). Monteiro, J., & Fodde, R. (2010). Cancer stemness and metastasis: Therapeutic conse-
Anti-proliferate and pro-apoptotic effects of 2,3-dihydro-3,5-dihydroxy-6-methyl- quences and perspectives. European Journal of Cancer, 46, 11981203.
4H-pyranone through inactivation of NF-kappaB in human colon cancer cells. Nguyen, D. X., Bos, P. D., & Massaque, J. (2009). Metastasis: From dissemination to organ-
Archives of Pharmacal Research, 30, 14551463. specic colonization. Nature Reviews Cancer, 9, 274284.
Boatright, K. M., & Salvesen, G. S. (2003). Mechanisms of caspase activation. Current Nicastro, H. L., Ross, S. A., & Milner, J. A. (2015). Garlic and onions: Their cancer prevention
Opinion in Cell Biology, 15, 725731. properties. Cancer Prevention Research (Philadelphia, Pa.), 8, 181189.
Brusselmans, K., Vrolix, R., Verhoeven, G., & Swinnen, J. V. (2005). Induction of cancer cell Ovadje, P., Roma, A., Steckle, M., Nicoletti, L., Arnason, J. T., & Pandey, S. (2015). Advances
apoptosis by avonoids is associated with their ability to inhibit fatty acid synthase in the research and development of natural health products as main stream cancer
activity. The Journal of Biological Chemistry, 280, 56365645. therapeutics. Evidence-based Complementary and Alternative Medicine, 2015, 112.
Caltagirone, S., Rossi, C., Poggi, A., Ranelletti, F. O., Natali, P. G., Brunetti, M., ... Piantelli, M. Pan, M. H., Lai, C. S., Wu, J. C., & Ho, C. T. (2011). Molecular mechanisms for chemoprevention
(2000). Flavonoids apigenin and quercetin inhibit melanoma growth and metastatic of colorectal cancer by natural dietary compounds. Molecular Nutrition & Food Research,
potential. International Journal of Cancer, 87, 595600. 55, 3245.
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., ... Bray, F. Park, C. H., Chang, J. Y., Hahm, E. R., Park, S., Kim, H. K., & Yang, C. H. (2005). Quercetin, a
(2015). Cancer incidence and mortality worldwide: Sources, methods and potent inhibitor against beta-catenin/Tcf signaling in SW480 colon cancer cells.
major patterns in GLOBOCAN 2012. International Journal of Cancer, 136, Biochemical and Biophysical Research Communications, 328, 227234.
E359E386. Peng, I. W., & Kuo, S. M. (2003). Flavonoid structure affects the inhibition of lipid perox-
Guercio, V., Turati, F., La Vecchia, C., Galeone, C., & Tavani, A. (2016). Allium vegetables idation in Caco-2 intestinal cells at physiological concentrations. The Journal of
and upper aerodigestive tract cancers: A meta-analysis of observational studies. Nutrition, 133, 21842187.
Molecular Nutrition & Food Research, 60, 212222. Psahoulia, F. H., Moumtzi, S., Roberts, M. L., Sasazuki, T., Shirasawa, S., & Pintzas, A. (2007).
Gupta, K., & Panda, D. (2002). Perturbation of microtubule polymerization by quercetin Quercetin mediates preferential degradation of oncogenic Ras and causes autophagy
through tubulin binding: A novel mechanism of its antiproliferative activity. in Ha-RAS-transformed human colon cells. Carcinogenesis, 28, 10211031.
Biochemistry, 41, 1302913038. Reed, J. C. (2003). Apoptosis-targeted therapies for cancer. Cancer Cell, 3, 1722.
Hanahan, D., & Weinberg, R. A. (2011). Hallmarks of cancer: The next generation. Cell, 144, Sambuy, Y., De Angelis, I., Ranaldi, G., Scarino, M. L., Stammati, A., & Zucco, F. (2005). The
646674. Caco-2 cell line as a model of the intestinal barrier: Inuence of cell and culture-related
He, Y., Jin, H., Gong, W., Zhang, C., & Zhou, A. (2014). Effect of onion avonoids on colorectal factors on Caco-2 cell functional characteristics. Cell Biology and Toxicology, 21(1), 126.
cancer with hyperlipidemia: An in vivo study. Onco Targets and Therapy, 7, 101110. Schreiner, M., & Huyskens-Keil, S. (2006). Phytochemicals in fruit and vegetables: Health
Herman-antosiewicz, A., & Singh, S. V. (2004). Signal transduction pathways leading to promotion and postharvest elicitors. Critical Reviews in Plant Sciences, 25, 267278.
cell cycle arrest and apoptosis induction in cancer cells by Allium vegetable-derived Sellappan, S., & Akoh, C. C. (2002). Flavonoids and antioxidant capacity of Georgia-grown
organosulfur compounds: A review. Mutation Research, Fundamental and Molecular Vidalia onions. Journal of Agricultural and Food Chemistry, 50, 53385342.
Mechanisms of Mutagenesis, 555, 121131. Slimestad, R., Fossen, T., & Vgen, I. M. (2007). Onions: A source of unique dietary avo-
Hui, C., Qi, X., Qianyong, Z., Xiaoli, P., Jundong, Z., & Mantian, M. (2013). Flavonoids, avo- noids. Journal of Agricultural and Food Chemistry, 55, 1006710080.
noid subclasses and breast cancer risk: A meta-analysis of epidemiologic studies. PloS Spano, D., Heck, C., De Antonellis, P., Christofori, G., & Zollo, M. (2012). Molecular net-
One, 8, 18. works that regulate cancer metastasis. Seminars in Cancer Biology, 22, 234249.
Jeong, J. H., An, J. Y., Kwon, Y. T., Rhee, J. G., & Lee, Y. J. (2009). Effects of low dose querce- Statistics Canada (2012). Table 102-0561 - Leading causes of death, total population, by
tin: Cancer cell-specic inhibition of cell cycle progression. Journal of Cellular age group and sex, Canada, annual, CANSIM (database). http://www5.statcan.gc.ca/
Biochemistry, 106, 7382. cansim/a05?lang=eng&id=1020561#F15 Accessed 06.01.2017
18 A.I. Murayyan et al. / Food Research International 96 (2017) 1218
Suleria, H. A., Butt, M. S., Anjum, F. A., Saeed, F., & Khalid, N. (2015). Onion: Nature protec- Xiao, D., Pinto, J. T., Gundersen, G. G., & Weinstein, I. B. (2005). Effects of a series of
tion against physiological threats. Critical Reviews in Food Science and Nutrition, 55, organosulfur compounds on mitotic arrest and induction of apoptosis in colon cancer
5066. cells. Molecular Cancer Therapeutics, 4, 13881398.
Tomas-Bareberan, F. R., & Espin, J. C. (2001). Phenolic compounds and related enzymes as Yamazaki, S., Miyoshi, N., Kawabata, K., Yasuda, M., & Shimoi, K. (2014). Quercetin-3-O-
determinants of quality in fruits and vegetables. Journal of the Science of Food and glucuronide inhibits noradrenaline-promoted invasion of MDA-MB-231 human
Agriculture, 81, 853876. breast cancer cells by blocking -adrenergic signaling. Archives of Biochemistry and
Weng, C. J., & Yen, G. C. (2012). Flavonoids, a ubiquitous dietary phenolic subclass, exert Biophysics, 557, 1827.
extensive in vitro anti-invasive and in vivo anti-metastatic activities. Cancer Yang, J., Meyers, K. J., Heide, V. D., & Liu, R. H. (2004). Varietal differences in phenolic con-
Metastasis Reviews, 31, 323351. tent and antioxidant and antiproliferative activities of onions. Journal of Agricultural
Wenzel, U., Kuntz, S., Brendel, M. D., & Daniel, H. (2000). Dietary avone is a potent apo- and Food Chemistry, 52, 67876793.
ptosis inducer in human colon carcinoma cells. Cancer Research, 60, 38233831.