Open Access Article
Minh Hien Nguyen
*ab,
Nguyen Thien Han Leab,
Bui Quoc Huy Nguyenc,
Mai Thanh Thi Nguyenbde,
Truong Nhat Van Dobde,
Tho Huu Lebde,
Vu Thanh Nguyenf and
Chia-Hung Yengh
aUniversity of Health Sciences, Vietnam National University Ho Chi Minh City, YA1 Administrative Building, Hai Thuong Lan Ong Street, Dong Hoa Ward, Di An City, Binh Duong Province 75308, Vietnam. E-mail: nmhien@uhsvnu.edu.vn; Tel: (+84) 373 696 894
bVietnam National University Ho Chi Minh City, Quarter 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City 70000, Vietnam
cThe University of Danang – VN-UK Institute for Research and Executive Education, 41 Le Duan Street, Hai Chau 1 Ward, Hai Chau District, Danang City 50000, Vietnam
dFaculty of Chemistry, University of Science, Ho Chi Minh City, Vietnam
eResearch Lab for Drug Discovery and Development, University of Science, Ho Chi Minh City, Vietnam
fDivision of Aquacultural Biotechnology, Biotechnology Center of Ho Chi Minh City, 2374, Highway 1, Quarter 2, Trung My Tay Ward, District 12, Ho Chi Minh City 70000, Vietnam
gGraduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung City 80708, Taiwan
hNational Natural Product Libraries and High-Throughput Screening Core Facility, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung City 80708, Taiwan
First published on 21st January 2025
Cancer is a leading global health concern, with over 20 million new cases and 9.7 million deaths reported in 2022. Chemotherapy remains a widely used treatment, but drug resistance, which affects up to 90% of treatment outcomes, significantly hampers its effectiveness. The transcription factor Nrf2, which is crucial for cellular defense against oxidative stress, plays a dual role in cancer treatment. Although Nrf2 activation can suppress early carcinogenesis, its overexpression in cancer cells contributes to drug resistance, resulting in poor patient outcomes. Thus, inhibiting Nrf2 has emerged as a promising strategy for overcoming cancer drug resistance. Natural compounds such as luteolin and brusatol have shown potential in inhibiting Nrf2, although with limitations. This study isolates and characterizes seven triterpenoids from the n-hexane sub-fraction of Helicteres hirsuta, a plant traditionally used for medicinal purposes, to evaluate their ability to modulate Nrf2 activity in Huh7 cancer and HaCaT normal cells. Additionally, molecular docking and dynamic simulations were utilized to assess the binding potential of these compounds to the PI3Kα receptor, which regulates downstream signaling pathways, thereby suppressing Nrf2 activity in cancer cells. Our findings provide insights into new strategies seeking triterpenoids as promising structures to reverse chemoresistance by regulating Nrf2. The results also reveal the potential of 3β-O-trans-caffeoylbetulinic acid from H. hirsuta leaves as the unprecedented compound inhibiting Nrf2 activity, with an IC50 of 74.5 μg mL−1 in Huh7 cancer cells.
Cancer drug resistance is a condition in which cancer cells develop the ability to resist the effects of chemotherapy drugs. This results in drug treatment partially or completely losing its expected effectiveness.5 Ineffective drug treatment resulting from drug resistance is the cause of up to 90% of treatment failures and deaths.6 Drug resistance can arise through different mechanisms, which can be classified into intrinsic and acquired resistance, depending on the time of occurrence.7 In general, the goal of overcoming drug resistance in cancer cells is to optimize the sensitivity of the treatment method.
Nuclear factor erythroid-2 p45-related factor 2 (Nrf2) is a transcription factor that regulates the cellular defense against toxic agents and oxidative stress by expressing genes involved in oxidative stress response and detoxification.8 Nrf2 maintains cellular redox homeostasis and exerts anti-inflammatory and anti-cancer activities, thereby supporting cell survival. Some evidence suggests that Nrf2 activation can suppress carcinogenesis, especially at early stages.9 However, Nrf2 expression can be considered a double-edged sword for cancer patients. Indeed, overexpression of Nrf2 in cancer cells is closely related to the development of drug resistance in cancer cells.10 Nrf2 protects cells against toxic agents, which are currently understood as chemotherapy drugs, enhancing their resistance to chemotherapeutic agents.11 Clinically, overexpression of Nrf2 is consistently observed with poor prognosis in cancer patients.12 Therefore, direct or indirect inhibition of Nrf2 expression may increase the sensitivity of cancer cells to chemotherapy drugs and reverse drug resistance.13 The inhibition of Nrf2 expression is now considered a promising target for strategies to combat cancer drug resistance. The dual functions of Nrf2 pose a complex challenge when considering Nrf2 inhibition as a therapeutic strategy. However, this approach carries potential risks, such as increased vulnerability of normal cells to oxidative stress and toxic agents, potentially leading to adverse effects.14,15 Thus, a thorough risk-benefit strategies should prioritize selective inhibition of Nrf2 in cancer cells, while preserving Nrf2 activity and sparing normal tissues to minimize collateral toxicity.
Luteolin is a flavone that has been reported to be a potent inhibitor of Nrf2 activity. Luteolin reduced the effective inhibitory concentration of Nrf2 mRNA by 34% when co-administered with actinomycin D for 30 min, and by 43% after 1.5 h in A549 human lung carcinoma cells.16 In vivo studies in mice showed that single treatment with increasing doses of luteolin, and co-treatment with luteolin and cisplatin significantly reduced tumor sizes compared to solely treating with cisplatin.17 Brusatol was also shown to enhance the therapeutic effect of gemcitabine by inhibiting cell growth and inducing apoptosis in human pancreatic cancer cells compared to others through inhibition of the Nrf2 pathway when combined with 1 μM brusatol and 20 μM gemcitabine for 48 h of treatment.18 However, the Nrf2 inhibition by brusatol was reported to be nonspecific, and it also reduced the viability of healthy human colon cells.19 Other natural compounds, such as ochratoxin A and trigonelline in coffee beans, were also reported to block the nuclear accumulation of Nrf2 in leukemic cells.20,21 Malabaricone A, a plant-derived antioxidant, effectively inhibited Nrf2 transcriptional activity as reflected by a decrease in HO-1 protein levels, and led to ROS accumulation and subsequent cell apoptosis.22 Overall, the number of compounds demonstrated to selectively inhibit Nrf2 in cancer cells without affecting healthy cells is currently very limited, and concentrated in the flavonoid group.
Nrf2 inhibitors exhibit regulatory effects through a variety of complex pathways, both upstream and downstream mechanisms, and influence the expression and activity of Nrf2.23 For instance, the phosphoinositide 3-kinase (PI3K) pathway has been identified as one of the modulators of Nrf2.24 Thus, inhibiting the PI3K/AKT pathway can effectively restore cancer cells' sensitivity to chemotherapy, thereby overcoming drug resistance.25 This approach targets a key survival pathway that is often hyperactivated in tumors, leading to overexpression of the Nrf2 activity. However, the exact mechanisms regulating Nrf2 expression and activity remain unclear and complicated.26 The use of in silico approaches for predicting the Nrf2 inhibitory signalling pathway offers a valuable tool for reassessing the potential of Nrf2 inhibition, specifically through the PI3K regulatory receptor.
Helicteres hirsuta, a plant traditionally used for various medicinal purposes in Southeast Asia, has been reported to possess anti-inflammatory and antioxidant activities.27 Previous phytochemical studies have identified various compounds from this plant, including flavonoids, terpenoids, and phenolics.28 However, the potential of H. hirsuta and its constituents in targeting Nrf2 and overcoming drug resistance in cancer remains largely unexplored. Based on our previous in vitro screening results, the n-hexane subfraction of H. hirsuta leaves demonstrated a significant decrease in Nrf2 activity on cancer cells and no cytotoxicity on HaCaT normal cells.28 Furthermore, in an in vivo study using a zebrafish model, the n-hexane subfraction from H. hirsuta leaves showed antioxidant activity by protecting wild-type larvae against oxidative stress, while significantly reducing both Nrf2 expression and the expression of its target genes on an overexpressed Nrf2 zebrafish model.29 These findings underscore the potential of this subfraction as a selective Nrf2 modulator with minimal adverse events to normal tissues. Therefore, our study aims to isolate and elucidate the structure of triterpenoids from the n-hexane sub-fraction of H. hirsuta. We then evaluated their ability to regulate Nrf2 activity on Huh7 cancer cells and HaCaT normal cells. Compounds demonstrating Nrf2 inhibition in Huh7 cancer cells, while simultaneously activating Nrf2 in HaCaT normal cells, were identified as promising candidates for further investigation. Furthermore, we employed docking methods and dynamic simulations to evaluate the binding ability of these triterpenoids to the Nrf2 activity-regulating receptor PI3Kα.
A part of the n-hexane sub-fraction (AxH; 4.1 g) was fractionated by normal-phase silica gel column chromatography (NP-CC) using a gradient of n-hexane–acetone (0%, 5%, 10%, 20%, and 50% acetone), yielding six major fractions: AxH1 (626.3 mg), AxH2 (425.0 mg), AxH3 (335.0 mg), AxH4 (1.2 g), AxH5 (771.6 mg), and AxH6 (327.4 mg). Fraction AxH2 underwent further separation via NP-CC with a gradient of n-hexane–isopropanol (100
:
0, 97
:
3, 95
:
5, 90
:
10, 85
:
15, 80
:
20, and 70
:
30), producing two subfractions: AxH2.1 and AxH2.2. Subfraction AxH2.1 (64.7 mg) was recrystallized in MeOH, affording 1 (5.0 mg). Subfraction AxH2.2 (290.2 mg) was subjected to NP-CC using an n-hexane–EtOAc gradient (0–80% EtOAc), followed by preparative normal-phase thin-layer chromatography (NP-PTLC) with n-hexane–isopropanol (95
:
5), which led to the isolation of 7 (5.2 mg). Fraction AxH4 (1.2 g) underwent further separation by NP-CC using a gradient of CHCl3–MeOH (100
:
0, 97
:
3, 95
:
5, 90
:
10, 85
:
15, and 70
:
30), resulting in six subfractions: AxH4.1 − AxH4.6. Subfraction AxH4.2 (166.9 mg) was further purified by NP-CC using an n-hexane–CH2Cl2 gradient (0–100% CH2Cl2), yielding 2 (5.3 mg). Subfraction AxH4.6 (224.8 mg) was divided by NP-CC utilizing a gradient of CH2Cl2–acetone (0–30% acetone), followed by RP-PTLC using H2O–ACN–MeOH system (50
:
40
:
10), resulting in the isolation of 6 (5.3 mg). Subfraction AxH4.4 (325.4 mg) was processed via RP-CC with H2O–acetone gradient (10–100% acetone), yielding 4 (4.1 mg) and 5 (3.7 mg). Fraction AxH5 (771.6 mg) was subjected to RP-CC using a gradient of H2O–MeOH (10–100% MeOH), resulting in three subfractions: AxH5.1 − AxH5.3. Subfraction AxH5.2 (324.7 mg) was further fractionated by RP-CC using an H2O–ACN gradient (80
:
20, 50
:
50, and 30
:
70), followed by NP-PTLC with n-hexane–CH2Cl2–isopropanol (50
:
45
:
5), yielding 3 (2.0 mg).
| Compound | Relative Nrf2 activity in HaCaT cell (%) | Relative Nrf2 activity in Huh7 cell (%) | HaCaT cell viability (%) | Huh7 cell viability (%) |
|---|---|---|---|---|
| a Betulinic acid (1), lupeol (2), 3β-O-trans-caffeoylbetulinic acid (3), oleanolic acid (4), maslinic acid (5), ursolic acid (6), and β-sitosterol (7). DMSO*: negative control. tBHQ** (tert-butylhydroquinone 10 μM): positive control for HaCaT. Luteolin*** (50 μM): positive control for Huh7. | ||||
| DMSO* | 100 | 100 | 100 | 100 |
| tBHQ** | 1144.7 ± 135.2 | — | 101.0 ± 0.4 | — |
| Luteolin*** | — | 7.6 ± 0.1 | — | 88.1 ± 1.8 |
| 1 | 375.6 ± 6.2 | 53.6 ± 2.3 | 104.8 ± 0.6 | 116.4 ± 2.9 |
| 2 | 123.0 ± 12.5 | 115.5 ± 1.6 | 99.2 ± 0.3 | 109.9 ± 0.4 |
| 3 | 305.2 ± 10.7 | 15.6 ± 1.1 | 88.8 ± 2.1 | 72.9 ± 1.7 |
| 4 | 130.9 ± 15.3 | 87.8 ± 6.7 | 101.1 ± 1.0 | 120.7 ± 0.6 |
| 5 | 14.3 ± 1.5 | 8.8 ± 1.2 | 49.5 ± 1.8 | 31.2 ± 0.6 |
| 6 | 17.5 ± 1.8 | 7.6 ± 0.5 | 36.6 ± 2.0 | 36.7 ± 0.7 |
| 7 | 441.4 ± 213.7 | 34.8 ± 2.1 | 110.4 ± 1.2 | 175.4 ± 4.6 |
These preliminary results underscore the potential application of H. hirsuta triterpenoids as promising compounds selectively inhibiting Nrf2 in Huh7 cancer cells. Compounds 5 and 6, while not selective, were able to reduce Nrf2 activity by over 80% in both cell types, showing further potential for anti-cancer strategies targeting Nrf2.
| Compounds | Docking score (kcal mol−1) | Residue | |
|---|---|---|---|
| Sites 1&2 | 3β-O-trans-caffeoylbetulinic acid (3) | −9.8 | H-bond: Pro168 (2.5 Å), Asn170 (2.7 Å), Val166 (2.9 Å) |
| Alkyl: Arg575 (3.7 Å), Arg662 (3.7 Å), Val851 (4.2 Å) | |||
| π-sigma: Ala758 (3.8 Å) | |||
| Betulinic acid (1) | −8.2 | H-bond: Glu259 (2.3 Å), Lys924 (2.7 Å) | |
| β-Sitosterol (7) | −8.0 | H-bond: Arg852 (2.0 Å) | |
| Unfavorable donor–donor: Arg852 (2.1 Å) | |||
| Site 3 | 3β-O-trans-caffeoylbetulinic acid (3) | −8.9 | H-bond: Glu707 (2.4 Å) |
| π-sigma: Thr86 (3.8 Å) | |||
| Betulinic acid (1) | −8.8 | H-bond: Arg88 (2.8 Å), Asp746 (2.9 Å) | |
| π-sigma: Phe119 (3.6 Å) | |||
| Unfavorable donor–donor: Asn703 (2.2 Å) | |||
| β-Sitosterol (7) | −7.6 | Alkyl: Arg87 (4 Å), Arg115 (3.9 Å), Phe119 (4.2 Å) | |
| Site 4 | 3β-O-trans-caffeoylbetulinic acid (3) | −9.6 | H-bond: Ser464 (3.0 Å), Thr679 (2.2 Å), Ser681 (2.5 Å), Gln682 (2.0 Å) |
| Betulinic acid (1) | −8.2 | H-bond: Asn428 (1.9 Å) | |
| Alkyl: Val437 (5.7 Å) | |||
| Unfavorable donor–donor: Lys132 (2.2 Å) | |||
| β-Sitosterol (7) | −7.8 | H-bond: Gln682 (2.2 Å), Ser681 (2.7 Å) | |
| Alkyl: Pro466 (4.9 Å) | |||
| Site 5 | 3β-O-trans-caffeoylbetulinic acid (3) | −10.7 | H-bond: Glu365 (2.9 Å), Asn605 (4.2 Å), Glu348-chain B (2.0 Å and 2.2 Å) |
| π-anion: Asp1018 (4.2 Å) | |||
| Betulinic acid (1) | −10.1 | H-bond: Ile453 (2.5 Å), Arg574-chainB (1.5 Å) | |
| β-Sitosterol (7) | −9.1 | H-bond: Arg574-chainB (2.3 Å) | |
| Alkyl: His419 (4.8 Å); Ile571-chainB (4.1 Å) |
![]() | ||
| Fig. 3 2D and 3D molecular interaction between 3β-O-trans-caffeoylbetulinic acid (3) and five active sites on PI3Kα: (A) site 1 and 2, (B) site 3, (C) site 4, and (D) site 5. | ||
Based on the results of the in vitro study, PI3Kα and the complex of PI3Kα with compounds 1, 3, and 7 were subjected to MD simulation in 100 ns. The root mean square deviation (RMSD) analysis indicated that the PI3Kα-ligand complexes exhibited greater stability compared to free PI3Kα (Fig. 4A). For the entire MD simulation, the free PI3Kα and its complexes displayed fluctuations within the 3–4.1 Å range. Notably, the PI3Kα-3 complex reached a stable state during MD simulation and exhibited RMSD values below 2.5 Å, much less than that of the free PI3Kα and other complexes, indicating their significantly enhanced stability. The radii of gyration (Rg) were consistent with the RMSD values when they maintained the lowest stable values within 3.45–3.50 nm throughout the simulation time, as shown in Fig. 4B. To determine the effect of fluctuations on protein residues, the root mean square fluctuations (RMSF) were calculated for chain A and chain B of PI3Kα, as demonstrated by Fig. 4C and D, respectively. The peaks observed in the RMSF curves of chain A (p110α) around residues 500–560 and 1000 are consistent with the residues mentioned in Table 2 and Fig. 3D (binding site 5). From residues 500–530 and around residue 600 on chain B (p85α), there were also RMSF peaks that corresponded well with the surrounding residues in binding site 5. The peaks observed in the RMSF curves of chain A, 200–300 residues, were closely aligned with the residues identified in Fig. 3A, corresponding to binding sites 1 and 2. In particular, the residues that formed hydrogen bonds contributed to peaks in RMSF. When in combination with compounds, the PI3Kα backbone atoms showed a distinguished decrease in the fluctuation of residues; specifically, around the region covering the amino acids mentioned. Further analysis of the hydrogen bond interactions revealed that compound 3 formed the greatest number of hydrogen bonds with PI3Kα (up to 6), demonstrating higher binding affinity compared to other compounds. In contrast, compound 1 established only a single hydrogen bond, leading to lower stability within the complex (Fig. 4E). Furthermore, solvent accessible surface area (SASA) analysis was carried out to evaluate the surface area of all systems that are available to water molecules (Fig. 4F). It is noted that the SASA values follow a similar trend demonstrated by Rg values, with compound 3 almost having the lowest SASA values. Regions with a decrease in the SASA value of the complexes indicate a relative contraction of their structure, suggesting a more compact conformation compared to free PI3Kα. These results align with the in vitro findings, where compound 3 exhibited great Nrf2 inhibitory activity on Huh7 cells, followed by compounds 1 and 7. These findings also support the hypothesis that PI3Kα is a regulator of the Nrf2 signaling pathway, suggesting that inhibiting the PI3Kα activity may contribute to the suppression of the Nrf2 activity in cancer cells.
P values exceeding 5, other parameters, including molecular weight and the number of hydrogen bond donors and acceptors, complied with the established criteria. Meanwhile, 3β-O-trans-caffeoylbetulinic acid violated Lipinski's Rule of Five as the molecular weights exceeded 500 g mol−1 and the log
P values were higher than 5. All three compounds were predicted to have poor solubility in water, poor gastrointestinal absorption, and negative log
Kp values, indicating limited skin permeability. The ADME predictions also revealed that none of the compounds are expected to bind to P-glycoprotein, potentially reducing the likelihood of drug efflux.
| Parameter | Betulinic acid | 3β-O-trans-caffeoylbetulinic acid | β-Sitosterol |
|---|---|---|---|
| a Probability that a compound may have >10% bioavailability on rat model. | |||
| Molecular weight | 456.70 | 618.84 | 414.71 |
| Num. H-bond acceptors | 3 | 6 | 1 |
| Num. H-bond donors | 2 | 3 | 1 |
| Num. Rotatable bonds | 2 | 6 | 6 |
| Molar refractivity | 136.91 | 180.31 | 133.23 |
| TPSA (Å2) | 57.53 | 104.06 | 20.23 |
Lipophilicity (log Po/w) |
5.82 | 5.87 | 6.73 |
Water solubility (log S) |
−7.71 | −9.77 | −7.90 |
| GI absorption | Low | Low | Low |
| BBB permeant | No | No | No |
| P-gp substrate | No | No | No |
| CYP1A2 inhibitor | No | No | No |
| CYP2C19 inhibitor | No | No | No |
| CYP2C9 inhibitor | Yes | No | No |
| CYP2D6 inhibitor | No | No | No |
| CYP3A4 inhibitor | No | Yes | No |
Skin permeation (log Kp cm s−1) |
−3.26 | −2.87 | −2.20 |
| Lipinski violation | 1 Violation | 2 Violations | 1 Violation |
| Bioavailability scorea | 0.85 | 0.56 | 0.55 |
The oral toxicity predictions from ProTox 3.0 revealed varying safety profiles among the compounds. 3β-O-trans-caffeoylbetulinic acid is predicted to be non-toxic, with a LD50 of 9600 mg kg−1, an accuracy level of 69.26%, and a confidence level of 72.94%. Betulinic acid has an LD50 of 2610 mg kg−1 and an accuracy level of 69.26%. β-Sitosterol exhibited higher toxicity, with an LD50 of 890 mg kg−1 and an accuracy level of 70.97%, similar to other compounds in databases up to 89.38%. The pharmacophore models also indicated that none of the compounds interact with toxicity targets, including adenosine receptor A2a, β-2 adrenergic receptor, or androgen receptor, avoiding the neurotoxic potentials of these compounds. These findings underscore the toxicity levels of the compounds, emphasizing the need for careful safety assessment in future studies.
Based on the results from both in vitro and in silico screening the relative Nrf2 activity, compound 3 was selected to determine the concentration that inhibits 50% of Nrf2 activity in Huh7 cells. The result indicated that the IC50 of compound 3 was 74.2 μg mL−1 or 119 nM (Fig. 5). This result reveals that the triterpenoid derived from H. hirsuta, 3β-O-trans-caffeoylbetulinic acid, is a compound with promising inhibition of Nrf2 activity in cancer cells without affecting healthy cells.
![]() | ||
| Fig. 5 Concentration response of 3β-O-trans-caffeoylbetulinic acid toward Nrf2 activity on the Huh7 cell line. | ||
Footnote |
| † Electronic supplementary information (ESI) available. See DOI: https://doi.org/10.1039/d4ra07646j |
| This journal is © The Royal Society of Chemistry 2025 |