Adenosine deaminase, which catalyzes the deamination of adenosine and deoxyadenosine, plays a central role in purine metabolism. Indeed, its deficiency is associated with severe immunodeficiency and abnormalities in the functioning of many organs, including nervous system. We have mimicked an adenosine deaminase-deficient situation by incubating a human astrocytoma cell line in the presence of deoxycoformycin, a strong adenosine deaminase inhibitor, and deoxyadenosine, which accumulates in vivo when the enzyme is deficient, and have monitored the effect of the combination on cell viability, mitochondrial functions, and other metabolic features. Astrocytomas are the most common neoplastic transformations occurring in glial cell types, often characterized by a poor prognosis. Our experimental approach may provide evidence both for the response to a treatment affecting purine metabolism of a tumor reported to be particularly resistant to chemotherapeutic approaches and for the understanding of the molecular basis of neurological manifestations related to errors in purine metabolism. Cells incubated in the presence of the combination, but not those incubated with deoxyadenosine or deoxycoformycin alone, underwent apoptotic death, which appears to proceed through a mitochondrial pathway, since release of cytochrome c has been observed. The inhibition of adenosine deaminase increases both mitochondrial reactive oxygen species level and mitochondrial mass. A surprising effect of the combination is the significant reduction in lactate production, suggestive of a reduced glycolytic capacity, not ascribable to alterations in NAD⁺/NADH ratio, nor to a consumption of inorganic phosphate. This is a hitherto unknown effect presenting early during the incubation with deoxyadenosine and deoxycoformycin, which precedes their effect on cell viability.

Alterations in the functions of astrocytes contribute to the appearance of a variety of neurological pathologies. Gliomas, especially those of astrocytic origin, are particularly resistant to chemotherapy and are often characterized by a poor prognosis. Neuroblastoma is the tumour with the higher incidence in infants. Anticancer drugs can induce apoptosis and their cytotoxic effect is often mediated by this process. We have previously demonstrated that the combination of deoxycoformycin, a strong adenosine deaminase inhibitor, and deoxyadenosine is toxic for a human astrocytoma cell line. In fact, after 15 h of treatment, this combination increases both mitochondrial reactive oxygen species and mitochondrial mass, induces apoptosis as indicated by cytochrome c release from mitochondria and activation of caspase-3. These events are preceded by reduction in lactate release in the medium. In this work we demonstrate that after 8 h of incubation with deoxyadenosine and deoxycoformycin, caspase-8 is activated, mitochondrial mass increases and mitochondrial reactive oxygen species decrease. The addition of baicalein to the incubation medium reduces cell death and caspase-3 activity induced by deoxycoformycin and deoxyadenosine in combination. This protective effect is correlated to an increase of lactate released in the medium, a decrease in the intracellular levels of dATP, and an increase in ATP levels, as compared with the cells subjected to the treatment with deoxycoformycin and deoxyadenosine without any further addition. The effect of baicalein appears to be related to an inhibition of deoxyadenosine phosphorylation, rather than or in addition to the well known antioxidant activity of the compound. This work indicates that an astrocytoma cell line, reported to be resistant to mitochondria-dependent pathways of apoptosis, is indeed very sensitive to a manipulation affecting the balance of cellular purine metabolite concentrations. The same treatment is also cytotoxic on a neuroblastoma cell line, thus suggesting long term implications for cancer therapy.

Purine homeostasis is maintained by a purine cycle in which the regulated member is a cytosolic 5'-nucleotidase II (cN-II) hydrolyzing IMP and GMP. Its expression is particularly high in proliferating cells, indeed high cN-II activity or expression in hematological malignancy has been associated to poor prognosis and chemoresistance. Therefore, a strong interest has grown in developing cN-II inhibitors, as potential drugs alone or in combination with other compounds. As a model to study the effect of cN-II inhibition we utilized a lung carcinoma cell line (A549) in which the enzyme was partially silenced and its low activity conformation was stabilized through incubation with 2-deoxyglucose. We measured nucleotide content, reduced glutathione, activities of enzymes involved in glycolysis and Krebs cycle, protein synthesis, mitochondrial function, cellular proliferation, migration and viability. Our results demonstrate that high cN-II expression is associated with a glycolytic, highly proliferating phenotype, while silencing causes a reduction of proliferation, protein synthesis and migration ability, and an increase of oxidative performances. Similar results were obtained in a human astrocytoma cell line. Moreover, we demonstrate that cN-II silencing is concomitant with p53 phosphorylation, suggesting a possible involvement of this pathway in mediating some of cN-II roles in cancer cell biology.