ISSN : 2146-3123
E-ISSN : 2146-3131

Cytotoxic Effects of Some Flavonoids and Imatinib on the K562 Chronic Myeloid Leukemia Cell Line: Data Analysis Using the Combination Index Method
Ferdane Danışman Kalındemirtaş1, Hüsniye Birman1, Eda Candöken2, Sema Bilgiş Gazioğlu3, Gülay Melikoğlu4, Serap Kuruca1
1Department of Physiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
2Department of Biochemistry, İstanbul University İstanbul School of Pharmacy, İstanbul, Turkey
3Department of Immunology, İstanbul University Institute of Experimental Medicine, İstanbul, Turkey
4Department of Pharmacognosy, İstanbul University İstanbul School of Pharmacy, İstanbul, Turkey
DOI : 10.4274/balkanmedj.galenos.2018.2017.1244
Pages : 96-105


Background: Flavonoids are natural compounds with antioxidant, anticarcinogenic, and anti-inflammatory effects.
Aims: To determine the cytotoxic effects of flavonoids and drug resistance related to P-gp on K562 human chronic myeloid leukemia cells. We also aimed to evaluate the therapeutic potential of imatinib and flavonoid combinations.
Study Design: Cell culture study.
Methods: In this study, K562 cells were treated with apigenin, luteolin, 5-desmethyl sinensetin and the anticancer drug imatinib mesylate. The effect of flavonoids on K562 cell proliferation was detected using the 3-(4,5-dimethylthiazolyl)2,5‑diphenyl‑tetrazolium bromide assay. Concentrations of apigenin, luteolin, and 5-desmethyl sinensetin ranging from 25 to 200 μM and of imatinib from 5 to 50 μM administered for 72 h were studied. Apoptosis/necrosis and P-gp activity were measured using flow cytometry. The combined effects of different concentrations of flavonoids with imatinib were evaluated according to combination index values calculated using CompuSyn software.
Results: In our study, the IC50 values for apigenin, luteolin, and 5-desmethyl sinensetin were found to be 140 μM, 100 μM, and >200 μM, respectively. Luteolin (100 μM) had the highest cytotoxic activity of these flavonoids. These results were statistically significant (p<0.05). Among the flavonoids studied, the combination of luteolin and imatinib was the most effective and is therefore recommended for its cytotoxic activity in the K562 cell line. After 72 h of incubation at their respective IC50 concentrations, all flavonoids were associated with an apoptosis rate of approximately 50%. P-glycoprotein activity was increased in all groups. Combination treatment may provide better outcomes in terms of cytotoxicity and thus reduce the dosages of imatinib used.
Conclusion: The combination of some flavonoids and imatinib mesylate may increase the cytotoxic effect; However, the antagonistic effect should be considered in combined use on k562 cells.

Keywords : Cell culture, cell cytotoxicity, flavonoids, imatinib mesylate, K562 cells
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