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Apoptotic morphology of A549 cells treated with bufalin. A549 cells were treated with vehicle (a) or 100 nmol/L bufalin (b) for 48 h and stained by Giemsa staining. cytoplasmic shrinkage, nuclear condensation and the formation of apoptotic bodies were observed in (b). Shown are representative images of three independent experiments. Scale bar: 40 μm.

Apoptotic morphology of A549 cells treated with bufalin. A549 cells were treated with vehicle (a) or 100 nmol/L bufalin (b) for 48 h and stained by Giemsa staining. cytoplasmic shrinkage, nuclear condensation and the formation of apoptotic bodies were observed in (b). Shown are representative images of three independent experiments. Scale bar: 40 μm.

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Bufalin is a class of toxic steroids which could induce the differentiation and apoptosis of leukemia cells, and induce the apoptosis of gastric, colon and breast cancer cells. However, the anti-tumor effects of bufalin have not been demonstrated in lung cancer. In this study we used A549 human lung adenocarcinoma epithelial cell line as the experi...

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... confirm that bufalin induces the morphology of apoptosis in A549 cells, we treated A549 cells with 100 nmol/L bufalin for 48 h and then performed Giemsa staining. The apoptotic morphology was obviously observed in bufalin treated cells under a microscope at 200× magnification, including cytoplasmic shrinkage, nuclear condensation and the formation of apoptotic bodies (Figure 2). However, no apoptotic morphology was observed in control treated cells. ...

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... In this review, we would like to have an overview of bufalin, the most studied bufadienolide, in treating refractory and resistant cancers. Bufalin has been shown significant therapeutic effects in lung cancer (Zhu et al., 2012), bladder cancer (Hong and Choi, 2012), breast cancer (Yan et al., 2012a), oral cancer (Tsai et al., 2012), colon cancer (Xie et al., 2011), gastric cancer (Li et al., 2009), ovarian cancer (Takai et al., 2008), suggesting it is a broad-spectrum anticancer agent. Of note, bufalin has been extensively studied after 2012, especially in drug-resistant or refractory cancers. ...
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Profound progress has been made in cancer treatment in the past three decades. However, drug resistance remains prevalent and a critical challenge. Drug resistance can be attributed to oncogenes mutations, activated defensive mechanisms, ATP-bind cassette transporters overexpression, cancer stem cells, etc. Chinese traditional medicine toad venom has been used for centuries for different diseases, including resistant cancers. Bufalin is one of the bufadienolides in toad venom that has been extensively studied for its potential in refractory and drug-resistant cancer treatments in vitro and in vivo . In this work, we would like to critically review the progress made in the past decade (2013–2022) of bufalin in overcoming drug resistance in cancers. Generally, bufalin shows high potential in killing certain refractory and resistant cancer cells via multiple mechanisms. More importantly, bufalin can work as a chemo-sensitizer that enhances the sensitivity of certain conventional and targeted therapies at low concentrations. In addition, the development of bufalin derivatives was also briefly summarized and discussed. We also analyzed the obstacles and challenges and provided possible solutions for future perspectives. We hope that the collective information may help evoke more effort for more in-depth studies and evaluation of bufalin in both lab and possible clinical trials.
... sensitive and/or resistant to commercially available drugs in vitro and in vivo [1,2,9]. Mechanistic studies have shown that bufadienolides induce various cell death mechanisms such as apoptosis, autophagy and ferroptosis [10][11][12][13]. They also act as antiangiogenic and immunosuppressants [14]. ...
... The cytotoxic effect of bufadienolides on A549 cells has been extensively studied [6,7,10,13,50]. Bufotalin induces ferroptosis in A549 cells by accelerating the degradation of GPX4 and raising the intracellular Fe 2+ ; however, the IC 50 value for cell viability/metabolism [13] is orders of magnitude higher than that obtained in the present study; the reason for this discrepancy is unknown. Other bufadienolides also induce cell death in A549 cells through apoptosis [10][11][12]. ...
... Bufotalin induces ferroptosis in A549 cells by accelerating the degradation of GPX4 and raising the intracellular Fe 2+ ; however, the IC 50 value for cell viability/metabolism [13] is orders of magnitude higher than that obtained in the present study; the reason for this discrepancy is unknown. Other bufadienolides also induce cell death in A549 cells through apoptosis [10][11][12]. On the other hand, the combination of bufalin with sorafenib results in a greater cytotoxic effect on cell viability/metabolism and cell death in the lung cell line H292 [52]; these results are the consequence of enhanced chromatin condensation and increased apoptosis, compared to individual treatments. ...
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... In the aspect of antitumor, Bufalin can inhibit the growth of tumor cells, promote the differentiation of tumor cells and induce the apoptosis of tumor cells (53). Bufalin can inhibit tumor cell proliferation by blocking phosphatidylinositol-3kinase/serine protein kinase signal pathway, and induce tumor cell apoptosis through mitochondrial or death receptor-mediated pathway (54), which can reverse the drug resistance of hepatocellular carcinoma cells to fluorouracil (22 (56). It has been found that Bufalin can effectively inhibit the metastasis of lung cancer NCI-H460 cells, which may be related to the inhibition of matrix metalloproteinase-9 (MMP-9) activity, the decrease of cytoplasmic NF-κB production and the reduction of NF-κB nuclear translocation (57). ...
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... Besides, cinobufacini injection also effectively protects liver function in moderate and advanced primary liver cancer. Experimental studies have shown that bufalin exerts antitumor activities in various cancer cells including HL-60, A549 and HCT116 [25][26][27] . In particular, bufalin induces apoptosis and inhibits migration and invasion in human HCC cell lines [28][29][30][31] . ...
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Characterization and determination of metabolites to monitor metabolic pathways play a paramount role in evaluating the efficacy and safety of medicines. However, the separation and quantification of metabolites are rather difficult due to their limited contents in vivo, especially in the case of Chinese medicine, due to its complexity. In this study, an effective and convenient method was developed to simultaneously quantify bufalin and its nine metabolites (semi-quantitation) in rat plasma after an oral administration of 10 mg/kg to rats. The prototype and metabolites that were identified were subsequently quantified using positive electrospray ionization in multiple reaction monitoring (MRM) mode with transitions of m/z 387.4→369.6 and 387.4→351.3 for bufalin, m/z 513.7→145.3 for IS, and 387.4→369.6, 419.2→365.2, and 403.2→349.2 for the main metabolites (3-epi-bufalin, dihydroxylated bufalin, and hydroxylated bufalin, respectively). The method was validated over the calibration curve range of 1.00–100 ng/mL with a limit of quantitation (LOQ) of 1 ng/mL for bufalin. No obvious matrix effect was observed, and the intra- and inter-day precisions, as well as accuracy, were all within the acceptable criteria in this method. Then, this method was successfully applied in metabolic profiling and a pharmacokinetic study of bufalin after an oral administration of 10 mg/kg to rats. The method of simultaneous determination of bufalin and its nine metabolites in rat plasma could be useful for pharmacokinetic–pharmacodynamic relationship research of bufalin, providing experimental evidence for explaining the occurrence of some adverse effects of Venenum Bufonis and its related preparations.
... For example, oleandrin induces apoptosis by the activation of caspases and upregulation of Bax expression in colon cancer cells [13]. In addition, digoxin, bufalin, and ouabain have been reported to inhibit cell growth by regulating multiple signaling pathways including topoisomerases I and II [15], hypoxia-inducible factor 1 [16], PI3K/Akt [17], and Bcl-2/Bax [18]. Furthermore, PBI-0524 and Anvirzel have been evaluated for their antitumor potency in clinical trials for the treatment of solid tumors and have been proven to be safe and effective [19,20]. ...
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Cardiac glycosides (CGs), prescribed to treat congestive heart failure and arrhythmias, exert potent antitumor activity. In this study, divaricoside (DIV), a CG isolated from Strophanthus divaricatus was examined for its antitumor potency in oral squamous cell carcinoma (OSCC) cells. Cell growth was inhibited by DIV in a dose- and time-dependent manner in SCC2095 and OECM-1 OSCC cells using MTT assays. DIV induced S and G2/M phase arrest accompanied by downregulation of phosphorylated CDC25C, CDC25C, and CDC2 in SCC2095 cells. In addition, DIV induced apoptosis by activating caspase-3 and downregulating the expression of Mcl-1. Furthermore, overexpression of Mcl-1 partially reversed DIV-induced death in SCC2095 cells. Additionally, western blot and transmission electron microscopy analyses also indicated that DIV induced autophagy in SCC2095 cells. However, the combination of autophagy inhibitor did not affect DIV-mediated apoptosis in SCC2095 cells. Together, these findings suggest that translational potential of DIV to be developed as a therapeutic agent for OSCC treatment.
... Owing to the similarity in the chemical structure between bufalin and digoxin, bufalin is expected to have a digoxin-like function (5,6). Bufalin has been shown to induce apoptosis in leukemia and solid tumor cells (5)(6)(7)(8)(9)(10). In recent years, studies have revealed that bufalin could effectively inhibit the proliferation of tumor cells, and also assessed its possible molecular mechanism (6)(7)(8). ...
... Bufalin has been shown to induce apoptosis in leukemia and solid tumor cells (5)(6)(7)(8)(9)(10). In recent years, studies have revealed that bufalin could effectively inhibit the proliferation of tumor cells, and also assessed its possible molecular mechanism (6)(7)(8). The results of previous research also demonstrated that bufalin could inhibit the activation of ERK pathway, accordingly inhibit the proliferation and migration of esophageal carcinoma cells (11); however, the mechanism of inducing apoptosis has remained unclear. ...
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The present study examined whether bufalin could induce human esophageal carcinoma ECA109 cells apoptosis via inhibiting the activation of mechanistic target of rapamycin (mTOR)/p70 S6 kinase (p70S6K) pathway is discussed in this article. The present study used the esophageal squamous cell carcinoma ECA109 cell line to assess the apoptosis-inducing effects of bufalin via inhibition of the mTOR/p70S6K pathways. A plasmid containing the wild-type mTOR gene (wtmTOR) was transfected into ECA109 cells. The levels of p70S6K, phosphorylated (p)-p70S6K, cellular inhibitor of apoptosis-1 (cIAP-1) and Bcl-2-associated death promoter (BAD) in ECA109 cells were examined by western blot analysis, and apoptosis was detected by flow cytometry analysis and Giemsa staining. The results revealed that the expression of p-p70S6K was increased as the time progressed (at 0, 12 and 24 h), and then decreased at 30, 36, 42 and 48 h after transfection. The expression of cIAP-1 was significantly decreased as time progressed following the addition of bufalin, whereas that of BAD was increased. The levels of p-p70S6K and cIAP-1 were significantly higher in the wtmTOR-transfected group than in the control and empty vector-transfected groups, and then reduced following addition of bufalin; however, BAD expression was significantly lower in the wtmTOR-transfected group. The results of flow cytometry revealed the cell cycle of ECA109 was arrested at G2/M phase and the apoptotic rate was significantly lower in the wtmTOR-transfected group than in the control and empty vector-transfected groups, and then increased following addition of bufalin. In conclusion, the findings of the present study demonstrated that bufalin induced apoptosis in esophageal carcinoma cells via the inhibition of the mTOR/p70S6K pathway and indicated that treatment with bufalin could be combined with chemotherapy to overcome the resistance of esophageal carcinoma cells to chemotherapeutic-induced apoptosis.
... In recent years, bufalin have been reported to exert significant anti-cancer effects in a variety of tumor cells, including gynecologic cancers [17], HCC cells [18], lung cancer [19,20] , breast cancer [21], colon cancer [22], and osteosarcoma [23]. The mechanisms underlying bufalin induction of cancer cell apoptosis are documented to be correlated with upregulation of Bax, downregulation of Bcl-2, activation of caspase cascade, and inhibition of PI3K/AKT pathway [19,24,25]. Recently, we determined that bufalin could induce apoptosis in NSCLC cells by down-regulating Mcl-1 [19]. ...