NETRIN-4 Protects Glioblastoma Cells FROM Temozolomide Induced Senescence

Glioblastoma multiforme is the most common primary tumor of the central nervous system. The drug temozolomide (TMZ) prolongs lifespan in many glioblastoma patients. The sensitivity of glioblastoma cells to TMZ is interfered by many factors, such as the expression of O-6-methylguanine-DNA methyltransferase (MGMT) and activation of AKT signaling. We have recently identified the interaction between netrin-4 (NTN4) and integrin beta-4 (ITGB4), which promotes glioblastoma cell proliferation via activating AKT-mTOR signaling pathway. In the current work we have explored the effect of NTN4/ITGB4 interaction on TMZ induced glioblastoma cell senescence. We report here that the suppression of either ITGB4 or NTN4 in glioblastoma cell lines significantly enhances cellular senescence. The sensitivity of GBM cells to TMZ was primarily determined by the expression of MGMT. To omit the effect of MGMT, we concentrated on the cell lines devoid of expression of MGMT. NTN4 partially inhibited TMZ induced cell senescence and rescued AKT from dephosphorylation in U251MG cells, a cell line bearing decent levels of ITGB4. However, addition of exogenous NTN4 displayed no significant effect on TMZ induced senescence rescue or AKT activation in U87MG cells, which expressed ITGB4 at low levels. Furthermore, overexpression of ITGB4 combined with exogenous NTN4 significantly attenuated U87MG cell senescence induced by TMZ. These data suggest that NTN4 protects glioblastoma cells from TMZ induced senescence, probably via rescuing TMZ triggered ITGB4 dependent AKT dephosphorylation. This suggests that interfering the interaction between NTN4 and ITGB4 or concomitant use of the inhibitors of the AKT pathway may improve the therapeutic efficiency of TMZ.     

Effect of Combination Treatment of Rapamycin and Isoflavones on mTOR Pathway in Human Glioblastoma (U87) Cells

Glioblastoma Multiforme (GBM) is a malignant primary brain tumor associated with poor survival rate. PI3K/Akt pathway is highly upregulated in gliomas due to deletion or mutation of PTEN and its activation is associated with tumor grade. mTOR is downstream from PI3K/Akt pathway and it initiates translation through its action on S6K and 4E-BP1. mTOR is an important therapeutic target in many cancers, including glioblastomas. Rapamycin and its analogues are known to inhibit mTOR pathway; however, they also show simultaneous upregulation of Akt and eIF4E survival pathways on inhibition of mTOR, rendering cells more resistant to rapamycin treatment. In this study we investigated the effect of combination treatment of rapamycin with isoflavones such as genistein and biochanin A on mTOR pathway and activation of Akt and eIF4E in human glioblastoma (U87) cells. Our results show that combination treatment of rapamycin with isoflavones, especially biochanin A at 50 μM, decreased the phosphorylation of Akt and eIF4E proteins and rendered U87 cells more sensitive to rapamycin treatment when compared to cells treated with rapamycin alone. These results suggest the importance of combining chemopreventive with chemotherapeutic agents in order to increase the efficacy of chemotherapeutic drugs.     

多甲氧基黄酮对人胶质母细胞瘤细胞系生物学特性的影响

目的：多甲氧基黄酮（PMFs）因其抗氧化、抗癌、抗炎及抗动脉粥样硬化等多样的生物学活性受到国内外学者的广泛关注,但其在神经胶质瘤治疗中的潜在作用尚未见报道。本研究对多甲氧基黄酮处理人胶质母细胞瘤细胞系对其生物学特性的影响,初步探讨PMFs在神经胶质瘤治疗中的潜在应用。方法：不同浓度（0,20,40,60,80,100μg／mL）的PMFs处理人胶质母细胞瘤细胞系U251不同时间后．分别用Annexinv／PI双染法检测细胞凋亡的变化,MTT法检细胞活力的变化,Transwell小室实验检测细胞侵袭能力的变化。结果：随着多甲氧基黄酮的浓度及处理时间的增加,细胞的增殖明显受到抑制,同时诱导细胞大量凋亡,促使细胞生长停滞于G2／M期;此外,多甲氧基黄酮剂量依赖性的抑制胶质瘤细胞的侵袭。结论：PMFs能剂量和时间依赖性降低人胶质母细胞瘤细胞系U251的,同时显著诱导细胞瘤的凋亡和侵袭能力,提示PMFs可能对神经胶质瘤的高增殖性和侵袭性有一定的抑制作用,因此可能具有成为治疗神经胶质瘤药物的潜在应用价值。     

The Effect of Z-Ligustilide on the Mobility of Human Glioblastoma T98G Cells

Z-ligustilide (LIG), an essential oil extract from Radix Angelica sinensis, has broad pharmaceutical applications in treating cardio-vascular diseases and ischemic brain injury. Recently, LIG has been connected to Glioblastoma multiforme (GBM) because of its structural similarity to 3-n-alkyphthalide (NBP), which is specifically cytotoxic to GBM cells. Hence, we investigated LIG’s effect on GBM T98G cells. The study shows that LIG can significantly reduce T98G cells’ migration in a dose-dependent manner. Furthermore, the attenuation of cellular mobility can be linked to the activity of the Rho GTPases (RhoA, Rac1 and Cdc42), the three critical molecular switches governing cytoskeleton remodeling; thus, regulating cell migration. LIG significantly reduces the expression of RhoA and affects in a milder manner the expression of Cdc42 and Rac1.     

Elimination of Cancer Stem-Like Cells and Potentiation of Temozolomide Sensitivity by Honokiol in Glioblastoma Multiforme Cells

Glioblastoma multiforme (GBM) is the most common adult malignant glioma with poor prognosis due to the resistance to radiotherapy and chemotherapy, which might be critically involved in the repopulation of cancer stem cells (CSCs) after treatment. We had investigated the characteristics of cancer stem-like side population (SP) cells sorted from GBM cells, and studied the effect of Honokiol targeting on CSCs. GBM8401 SP cells possessed the stem cell markers, such as nestin, CD133 and Oct4, and the expressions of self-renewal related stemness genes, such as SMO, Notch3 and IHH (Indian Hedgehog). Honokiol inhibited the proliferation of both GBM8401 parental cells and SP cells in a dose-dependent manner, the IC₅₀ were 5.3±0.72 and 11±1.1 μM, respectively. The proportions of SP in GBM8401 cells were diminished by Honokiol from 1.5±0.22% down to 0.3±0.02% and 0.2±0.01% at doses of 2.5 μM and 5 μM, respectively. The SP cells appeared to have higher expression of O ⁶-methylguanine-DNA methyltransferase (MGMT) and be more resistant to Temozolomide (TMZ). The resistance to TMZ could be only slightly reversed by MGMT inhibitor O ⁶-benzylguanine (O ⁶-BG), but markedly further enhanced by Honokiol addition. Such significant enhancement was accompanied with the higher induction of apoptosis, greater down-regulation of Notch3 as well as its downstream Hes1 expressions in SP cells. Our data indicate that Honokiol might have clinical benefits for the GBM patients who are refractory to TMZ treatment.     

可溶性重组hTRAIL蛋白抑制U251细胞生长

肿瘤坏死因子相关凋亡诱导配体(TNF-related apoptosis inducing ligand, TRAIL) 是TNF超家族中的成员,能够广泛诱导肿瘤细胞凋亡,对正常细胞无明显毒副作用. TRAIL已成为肿瘤治疗领域的研究热点.人脑胶质瘤是神经系统肿瘤中最常见类型, 占颅内肿瘤50%~60%,5年存活率为20%~30%. 本研究探讨可溶性TRAIL蛋白对人脑胶质瘤细胞（U251）的抑制作用. 由大肠杆菌表达系统表达的TRAIL多为包涵体,为获得可溶性的蛋白,将hTRAIL95~281功能区基因片段插入到pHisSUMO表达载体,经IPTG低温诱导表达,Ni-NTA Agarose纯化后获得可溶性SUMO-hTRAIL,经SUMO ProteaseⅠ切去SUMO融合标签后获得成熟可溶hTRAIL蛋白. 以U251细胞为靶细胞,通过MTT法检测TRAIL对肿瘤细胞的抑制作用.结果证明,TRAIL对U251细胞的抑制呈剂量依赖关系,最大抑制率为53.9%.流式细胞仪检测TRAIL诱导U251细胞凋亡实验中,对照组细胞存活率为92.2±0.8％,实验组细胞存活率为35.5±1.2%,证明重组蛋白具有生物学活性,并在体外能明显诱导U251肿瘤细胞发生死亡.本研究结果为TRAIL蛋白在临床上应用于肿瘤治疗奠定了基础.     

Brefeldin A通过内质网应激途径协同增强顺铂的抗肺癌细胞GLC-82作用

已有研究证明,内质网应激（endoplasmic reticulum stress,ERS）启动的未折叠蛋白质反应（unfolded protein response,UPR）信号途径有助细胞存活;然而,长时间剧烈ERS可诱导细胞凋亡,因此,ERS是肿瘤治疗的新靶点。抗癌药物具有严重的毒副作用,而药物的协同作用是减少抗癌药物使用剂量、减少毒副作用的重要手段之一。本研究证明布雷菲德菌素A（brefeldin A,BFA）与顺铂（cis dichlorodiamine platinum,CDDP）的协同抗肺癌细胞的作用。MTT试验显示,单独应用BFA和顺铂时,它们抑制肺癌细胞GLC 82生长的半数有效浓度（IC50）分别是100 ng/mL和4 μg/mL;而采用半量的BFA和CDDP联合处理GLC 82细胞 24 h后,其抑制生长作用进一步加强;等效线图解法及联合作用指数分析进一步证明二者具有协同作用。两药的这种协同作用进一步被形态学检查证明——与单独用药比较,除了细胞皱缩,出现了更多的染色质固缩,细胞质及细胞核裂解碎片,乃至形成凋亡小体,提示细胞凋亡的发生。实时定量PCR及蛋白质印迹证明,与单独用药比较,联合用药导致内质网应激标志分子GRP78、CHOP表达水平明显增加,提示有内质网应激通路激活。上述结果证明,BFA与CDDP联合用药可增强对肺癌细胞GLC 82的生长抑制作用,其协同机制可能与内质网应激通路的激活有关。我们的结果支持“ERS是肿瘤治疗新靶点”学说,对肺癌的新化疗方案有一定的指导意义。     

单纯疱疹病毒胸苷激酶基因对人胶质母细胞瘤细胞的杀伤效应研究

目的　研究单纯疱疹病毒胸苷激酶 (HSV1 TK)基因转染并联合抗病毒药更昔洛韦 (Ganciclovir ,GCV)对人胶质母细胞瘤细胞的杀伤效应。方法　采用基因工程技术构建带HSV1-TK基因的逆转录病毒重组体pLX SN TK ,采用脂质体介导入PA317包装细胞 ,建立重组逆转录病毒载体分泌细胞株PA317 TK ;用该细胞上清液转导人胶质母细胞瘤细胞 ,用不同浓度GCV作用人胶质母细胞瘤细胞SW0 38 C2 TK和野生型SW0 38 C2 ,采用噻唑蓝(MTT)比色法检测 72h后细胞存活率 ,并求出半杀伤浓度。结果　重组逆转录病毒载体pLXSN TK能有效地将TK基因导入SW0 38-C2细胞内 ,并使其获得对GCV的敏感性 ;体外细胞毒实验 :在 2 0 μmol LGCV存在的情况下 ,野生型细胞无明显改变 ,而实验组细胞明显死亡 ,半杀伤浓度IC50 为 0 8μmol L ,与SW0 38 C2相比 ,对GCV的敏感性提高了 6 0 0倍 ,旁杀效果也较明显。结论　SW0 38 C2转染TK基因后 ,能有效地被GCV杀灭。显示了其潜在的临床应用价值     

二甲双胍对胶质母细胞瘤细胞的抑制作用研究

为了探究二甲双胍对不同胶质母细胞瘤U87细胞、GL261细胞及C6细胞增殖的影响,选取小鼠GBM细胞GL261细胞系、大鼠GBM细胞C6细胞系及人源GBM细胞U87MG细胞系,使用二甲双胍处理,通过CCK-8法检测细胞增殖活性;细胞实时荧光检测细胞凋亡水平;平板克隆实验检测GBM细胞克隆形成能力;CCK-L法检测胞内ATP水平;Western blot检测Akt及其磷酸化水平。结果显示,与对照组相比,随着作用浓度增加,二甲双胍显著抑制GBM细胞增殖活性,影响细胞形态;与对照组相比,同一作用浓度下,二甲双胍提高了GBM细胞凋亡水平,抑制了GBM细胞克隆形成能力,降低了GBM胞内ATP的产生;二甲双胍处理24 h后,GBM细胞内p-Akt表达显著下调,Akt无明显变化。结果表明,二甲双胍在体外可抑制多种GBM细胞的增殖、克隆,降低胞内ATP水平,其机制可能与Akt磷酸化水平相关,研究结果为进一步探索二甲双胍对胶质母细胞瘤的作用机制提供了体外研究理论基础。     

The Antiapoptotic Effect of Galectin-3 in Human Endometrial Cells under the Regulation of Estrogen and Progesterone

Galectin-3 (Gal-3), a ubiquitously expressed gene involved in many cellular processes, has been recently recognized as a factor related to endometrial receptivity. However, the precise biological function of Gal-3 in the endometrium and its regulation is still unclear. In this study, we detected the antiapoptotic role of Gal-3 in endometrial cells and the expression of Gal-3 regulated by estrogen and progesterone. We found that expression of Gal-3 increased when exposed to the apoptosis inducer staurosporine. Gal-3-silenced endometrial cells were more sensitive to the apoptosis inducer. Estradiol (E2) and progesterone (P4) up-regulated Gal-3 expression, which in turn decreased the apoptotic rate of endometrial cells. Our results strongly suggested that hormonal activation of Gal-3 by E2 and P4 is involved in inhibiting endometrial cell apoptosis, playing key roles in embryo implantation.     

Metformin Inhibits Growth of Human Glioblastoma Cells and Enhances Therapeutic Response

High-grade gliomas, glioblastomas (GB), are refractory to conventional treatment combining surgery, chemotherapy, mainly temozolomide, and radiotherapy. This highlights an urgent need to develop novel therapies and increase the efficacy of radio/chemotherapy for these very aggressive and malignant brain tumors. Recently, tumor metabolism became an interesting potential therapeutic target in various cancers. Accordingly, combining drugs targeting cell metabolism with appropriate chemotherapeutic agents or radiotherapy has become attractive. In light of these perspectives, we were particularly interested in the anti-cancer properties of a biguanide molecule used for type 2 diabetes treatment, metformin. In our present work, we demonstrate that metformin decreases mitochondrial-dependent ATP production and oxygen consumption and increases lactate and glycolytic ATP production. We show that metformin induces decreased proliferation, cell cycle arrest, autophagy, apoptosis and cell death in vitro with a concomitant activation of AMPK, Redd1 and inhibition of the mTOR pathway. Cell sensitivity to metformin also depends on the genetic and mutational backgrounds of the different GB cells used in this study, particularly their PTEN status. Interestingly, knockdown of AMPK and Redd1 with siRNA partially, but incompletely, abrogates the induction of apoptosis by metformin suggesting both AMPK/Redd1-dependent and –independent effects. However, the primary determinant of the effect of metformin on cell growth is the genetic and mutational backgrounds of the glioma cells. We further demonstrate that metformin treatment in combination with temozolomide and/or irradiation induces a synergistic anti-tumoral response in glioma cell lines. Xenografts performed in nude mice demonstrate in vivo that metformin delays tumor growth. As current treatments for GB commonly fail to cure, the need for more effective therapeutic options is overwhelming. Based on these results, metformin could represent a potential enhancer of the cytotoxic effects of temozolomide and/or radiotherapy.     

豹蛙核酸酶与斑蝥酸钠对肺腺癌细胞增殖的协同抑制作用

豹蛙核酸酶(onconase,Onc)是从美洲北方豹蛙卵母细胞中提取的一种核糖核酸酶,对许多肿瘤细胞都具有杀伤作用。斑蝥素(cantharidin)是存在于芫青科昆虫斑蝥体内的一种天然防御性毒素,斑蝥酸钠(sodium cantharidate,SCA)是斑蝥素半合成衍生物。鉴于Onc与SCA对非小细胞肺癌都具有杀伤作用,采用MTT法测定Onc与SCA单独与联合作用于两株肺腺癌细胞的IC50值,运用联合作用指数(combination index,CI)和等效线分析评价两者联合作用的效果。结果表明,Onc与SCA联合作用时,CI值均小于0.7,等效线分析图显示,代表Onc与SCA联合作用的点均位于加成线下方,Onc与SCA对肺腺癌SPC-A-1、A549细胞株增殖的抑制作用具有协同效应。用流式细胞仪进行的凋亡细胞检测结果也支持上述"Onc/SCA联合使用具有协同抗癌作用"的结论。     

Carnosine Inhibits Growth of Cells Isolated from Human Glioblastoma Multiforme

The present study evaluates the effect of the naturally occurring dipeptide carnosine on primary cell cultures established from patients with glioblastoma multiforme. Surgically removed tumors were used to establish primary cell cultures that were incubated for 96 h with medium supplemented with carnosine at concentrations of 20, 40 and 50 mM. Following incubation, dehydrogenase activity, cellular adenosine triphosphate concentration (ATP), caspase activity, lactate dehydrogenase (LDH) release and the rate of DNA synthesis were determined. After 96 h of carnosine treatment a significant reduction in cellular ATP and dehydrogenase activity was detected already at a concentration of 20 mM carnosine. Carnosine (50 mM) reduced ATP concentration to 42.7 ± 13.5% (n = 6) and dehydrogenase activity to 41.0 ± 19.3% (n = 6) compared to untreated cells. Additional experiments revealed no sign of enhanced apoptosis or necrosis in the presence of carnosine. However, a quantitative bromo-desoxy-uridine-based proliferation assay demonstrated a clear effect of carnosine on DNA synthesis reducing its rate down to 50% (2 cultures) and 10% (4 cultures). Therefore, it can be concluded that carnosine is obviously able to inhibit proliferation of cells derived from glioblastoma. Since it is a naturally occurring substance that appears to be non-toxic to normal tissue and is able to penetrate the blood–brain barrier it may be a candidate for a therapeutic agent that may reduce proliferation of neoplastic cells even in vivo and especially in cases of glioblastoma multiforme.     

Engraftment of Human Glioblastoma Cells in Immunocompetent Rats through Acquired Immunosuppression

Transplantation of glioblastoma patient biopsy spheroids to the brain of T cell-compromised Rowett (nude) rats has been established as a representative animal model for human GBMs, with a tumor take rate close to 100%. In immunocompetent littermates however, primary human GBM tissue is invariably rejected. Here we show that after repeated passaging cycles in nude rats, human GBM spheroids are enabled to grow in the brain of immunocompetent rats. In case of engraftment, xenografts in immunocompetent rats grow progressively and host leukocytes fail to enter the tumor bed, similar to what is seen in nude animals. In contrast, rejection is associated with massive infiltration of the tumor bed by leukocytes, predominantly ED1+ microglia/macrophages, CD4+ T helper cells and CD8+ effector cells, and correlates with elevated serum levels of pro-inflammatory cytokines IL-1β, IL-18 and TNF-α. We observed that in nude rat brains, an adaptation to the host occurs after several in vivo passaging cycles, characterized by striking attenuation of microglial infiltration. Furthermore, tumor-derived chemokines that promote leukocyte migration and their entry into the CNS such as CXCL-10 and CXCL-12 are down-regulated, and the levels of TGF-β2 increase. We propose that through serial in vivo passaging in nude rats, human GBM cells learn to avoid and or/ suppress host immunity. Such adapted GBM cells are in turn able to engraft in immunocompetent rats without signs of an inflammatory response.     

Effects of Combination of Estradiol with Selective Progesterone Receptor Modulators (SPRMs) on Human Breast Cancer Cells In Vitro and In Vivo

Use of estrogen or estrogen / progestin combination was an approved regimen for menopausal hormonal therapy (MHT). However, more recent patient-centered studies revealed an increase in the incidence of breast cancer in women receiving menopausal hormone therapy with estrogen plus progestin rather than estrogen alone. Tissue selective estrogen complex (TSEC) has been proposed to eliminate the progesterone component of MHT with supporting evidences. Based on our previous studies it is evident that SPRMs have a safer profile on endometrium in preventing unopposed estrogenicity. We hypothesized that a combination of estradiol (E2) with selective progesterone receptor modulator (SPRM) to exert a safer profile on endometrium will also reduce mammary gland proliferation and could be used to prevent breast cancer when used in MHT. In order to test our hypothesis, we compared the estradiol alone or in combination with our novel SPRMs, EC312 and EC313. The compounds were effectively controlled E2 mediated cell proliferation and induced apoptosis in T47D breast cancer cells. The observed effects were found comparable that of BZD in vitro. The effects of SPRMs were confirmed by receptor binding studies as well as gene and protein expression studies. Proliferation markers were found downregulated with EC312/313 treatment in vitro and reduced E2 induced mammary gland proliferation, evidenced as reduced ductal branching and terminal end bud growth in vivo. These data supporting our hypothesis that E2+EC312/EC313 blocked the estrogen action may provide basic rationale to further test the clinical efficacy of SPRMs to prevent breast cancer incidence in postmenopausal women undergoing MHT.     

Coibamide A Induces mTOR-Independent Autophagy and Cell Death in Human Glioblastoma Cells

Coibamide A is an N-methyl-stabilized depsipeptide that was isolated from a marine cyanobacterium as part of an International Cooperative Biodiversity Groups (ICBG) program based in Panama. Previous testing of coibamide A in the NCI in vitro 60 cancer cell line panel revealed a potent anti-proliferative response and “COMPARE-negative” profile indicative of a unique mechanism of action. We report that coibamide A is a more potent and efficacious cytotoxin than was previously appreciated, inducing concentration- and time-dependent cytotoxicity (EC₅₀<100 nM) in human U87-MG and SF-295 glioblastoma cells and mouse embryonic fibroblasts (MEFs). This activity was lost upon linearization of the molecule, highlighting the importance of the cyclized structure for both anti-proliferative and cytotoxic responses. We show that coibamide A induces autophagosome accumulation in human glioblastoma cell types and MEFs via an mTOR-independent mechanism; no change was observed in the phosphorylation state of ULK1 (Ser-757), p70 S6K1 (Thr-389), S6 ribosomal protein (Ser-235/236) and 4EBP-1 (Thr-37/46). Coibamide A also induces morphologically and biochemically distinct forms of cell death according to cell type. SF-295 glioblastoma cells showed caspase-3 activation and evidence of apoptotic cell death in a pattern that was also seen in wild-type and autophagy-deficient (ATG5-null) MEFs. In contrast, cell death in U87-MG glioblastoma cells was characterized by extensive cytoplasmic vacuolization and lacked clear apoptotic features. Cell death was attenuated, but still triggered, in Apaf-1-null MEFs lacking a functional mitochondria-mediated apoptotic pathway. From the study of ATG5-null MEFs we conclude that a conventional autophagy response is not required for coibamide A-induced cell death, but likely occurs in dying cells in response to treatment. Coibamide A represents a natural product scaffold with potential for the study of mTOR-independent signaling and cell death mechanisms in apoptotic-resistant cancer cells.     

Lipid Peroxidation Plays an Important Role in Chemotherapeutic Effects of Temozolomide and the Development of Therapy Resistance in Human Glioblastoma

BACKGROUND: Glioblastoma (GBM) is the most malignant primary brain tumor. Relapse occurs regularly, and the clinical behavior seems to be due to a therapy-resistant subpopulation of glioma-initiating cells that belong to the group of cancer stem cells. Aldehyde dehydrogenase (ALDH) has been identified as a marker for this cell population, and we have shown previously that ALDH1A3-positive GBM cells are more resistant against temozolomide (TMZ) treatment. However, it is still unclear how ALDH expression mediates chemoresistance. MATERIALS AND METHODS: ALDH1A3 expression was analyzed in 112 specimens from primary and secondary surgical resections of 56 patients with GBM (WHO grade IV). All patients received combined adjuvant radiochemotherapy. For experimental analysis, CRISPR-Cas9–induced knockout cells from three established GBM cell lines (LN229, U87MG, T98G) and two glioma stem-like cell lines were investigated after TMZ treatment. RESULTS: ALDH1A3 knockout cells were more sensitive to TMZ, and oxidative stress seemed to be the molecular process where ALDH1A3 exerts its role in resistance against TMZ. Oxidative stress led to lipid peroxidation, yielding active aldehydes that were detoxified by ALDH enzymatic activity. During the metabolic process, autophagy was induced leading to downregulation of the enzyme, but ALDH1A3 is upregulated to even higher expression levels after finishing the TMZ therapy in vitro. Recurrent GBMs show significantly higher ALDH1A3 expression than the respective samples from the primary tumor, and patients suffering from GBM with high ALDH1A3 expression showed a shorter median survival time (12 months vs 21 months, P < .05). CONCLUSION: Oxidative stress is an important and clinically relevant component of TMZ-induced therapeutic effects. Cytotoxicity seems to be mediated by aldehydes resulting from lipid peroxidation, and ALDH1A3 is able to reduce the number of toxic aldehydes. Therefore, we present a molecular explanation of the role of ALDH1A3 in therapeutic resistance of human GBM cells.