M.
Lasalvia
ab,
G.
Perna
*ab,
P.
Pisciotta
cd,
F. P.
Cammarata
d,
L.
Manti
ef and
V.
Capozzi
ab
aDipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy. E-mail: giuseppe.perna@unifg.it
bIstituto Nazionale di Fisica Nucleare – Sezione di Bari, 70126 Bari, Italy
cIstituto Nazionale di Fisica Nucleare, Laboratori Nazionali del Sud, INFN-LNS, Catania, Italy
dInstitute of Molecular Bioimaging and Physiology, National Research Council, 90015 Cefalù, Pa, Italy
eDipartimento di Fisica, Università di Napoli “Federico II”, 80126 Napoli, Italy
fIstituto Nazionale di Fisica Nucleare – Sezione di Napoli, 80126 Napoli, Italy
First published on 24th January 2019
Among different radiotherapy techniques, proton irradiation is an established and effective method for treatment of several types of cancer, because less healthy tissue is exposed with respect to conventional radiotherapy by photons/electrons. Recently, proton therapy has been proposed for the treatment of breast cancer. In vitro studies of proton irradiated normal human breast cells can provide information about cellular radioresponse, particularly as far as healthy tissue is concerned. In this paper, a study of the effects at different time points, following proton irradiation at different doses, of human normal MCF10A breast cells is performed by Raman spectroscopy. The aim of this investigation is to detect the unwanted effects of proton treatment and to investigate the possibility of monitoring them and of making an assessment of the cellular sensitivity by means of such a technique. The obtained results seem to indicate a rather significant sensitivity of MCF10A cells to proton irradiation. In fact, even at doses as low as 0.5 Gy, biological effects are clearly detectable in Raman spectra. In particular, ratiometric analysis of the Raman spectra measured from the nucleoplasm compartment showed that DNA/RNA damage increases with time, suggesting that most cells are unable to repair DNA/RNA broken bonds. The results obtained by the Raman spectroscopy analysis exhibit a similar trend with regard to dose to those obtained by commonly used radiobiological assays (i.e. MTT, clonogenic assay, senescence, apoptosis and necrosis). The results of this study strongly suggest the possibility that the Raman technique can be used to identify molecular markers predicting radiation response.
The motivations for using radiotherapy for cancer treatment are that ionizing radiation can cause lethal damage to cells both directly, causing the breakage of DNA bonds, and indirectly, by forming highly reactive radicals in the intracellular material that can chemically break bonds within the DNA macromolecule, causing a cell to lose its proliferative ability.5 The most deleterious types of lesion are DNA single- and double-strand breaks, i.e. the breakage of bonds in one or both DNA helices, respectively.6 Such damage is experienced both by malignant cells and cells in the exposed healthy tissue. With a sublethally damaged normal tissue increase, the probability of developing secondary malignant neoplasms might significantly increase.7 From a clinical point of view, this corresponds to unexpected side effects on normal tissue at the entrance position of the beam. Among the aims of a cancer treatment, achieving the right balance between the highest rate of local tumor cure and the lowest normal tissue complication probability is arguably a fundamental one.
Cells respond to radiation-induced DNA damage within a few hours by activating a complex set of biochemical signals aiming to restore DNA integrity.8 In current radiotherapy treatments, the total dose scheduled for the patient, typically about 50 Gy, depending on the tumor type, is fractioned in ∼2 Gy daily doses delivered over several weeks.9 The rationale for fractionation between two consecutive tumour tissue exposures is to allow the recovery of irradiated healthy cells so that they can repair sub-lethal damage minimizing the risk of early and late normal-tissue reactions.
Normal-tissue toxicity can vary in its severity and is patient-dependent.10 Effectiveness of proton-therapy could be improved if molecular markers predicting radiation response are identified and known before the start of treatment: in fact, the response of such markers could be used to tailor the radiation treatment as a good compromise between tumor control and normal tissue complications.
Proton irradiation of tumour tissue has been established as an effective tool for the radiotherapy treatment of ocular melanoma, brain and lung tumours.11 Recently, it has been suggested that proton therapy can be extended to the treatment of breast cancer.12,13 In order to propose proton therapy for the treatment of breast cancer, the response of healthy cells to the proton beam should be evaluated, especially at low doses, considering that the healthy tissues located at the entrance position of the SOBP are unavoidably irradiated. In vitro measurements of cell lines modelling human healthy breast tissue are a preliminary step to address this issue. In particular, the MCF10A human mammary epithelial cell line is a widely used in vitro model for studying normal breast cell functions.14
Based on these premises, the aim of our work is twofold. The first one is to evaluate, by means of biological assays (as viability, premature senescence, apoptosis and necrosis assays), the MCF10A cells’ response at different time points after irradiation. This will provide information on whether cellular physiological mechanisms are able to restore the balance among the cellular components existing in unexposed cells, particularly at low proton doses, and the time they need to eventually restore such a balance. This is important for the preservation of healthy breast tissue during proton-therapy treatments, in order to eventually review the time needed for the healthy cells to repair. Of course, the possibility of recovery also depends on cellular sensitivity to radiation. The second aim of this work is to investigate the capability of Raman spectroscopy (RS) to provide information about cellular sensitivity at low doses (on the order of 1 Gy) of proton radiation, in order to propose such a non-invasive and reagent-free technique as a complementary method to detect cell sensitivity, without neither affecting the cell sample with non-physiological chemicals nor waiting for a long time as is necessary for conventional radiobiological assays for measurement of cell survival and DNA damage (clonogenic assay, senescence induction, chromosome aberration analysis, micronuclei assay, etc.). RS is a vibrational technique based on the spectral analysis of a laser beam focused onto a sample: such a monochromatic beam induces molecular vibrations in the investigated sample, resulting in inelastically scattered photons whose frequencies and intensities are characteristic of the functional groups inside the molecules of the sample. Thus, RS is able to provide a molecular fingerprint of the analysed sample. In addition, RS is able to yield information at the single-cell level, unlike the abovementioned biological assays: therefore, it can be a complementary technique with respect to molecular biology assays traditionally employed in clinical radiobiology to detect the cellular response to radiotherapy.
In fact, numerous papers have been published in the last few years about the biological effects of cell lines exposed to ionizing radiation. Most of them concern tumour cell lines exposed to X- and γ-ray radiation15,16 as well as proton radiation.16–19 The irradiated cells have been frequently analyzed by means of conventional radiobiological assays for the measurement of cell survival and DNA damage (clonogenic assay, viability assays, immunofluorescence, flow cytometry analysis, etc.).16–18,20 Some authors have also used the RS technique to investigate the effects of the cells’ exposure under X- and γ-ray radiation both at high doses as for tumour cell lines21–24 and at low doses as for non-tumorigenic cell lines.25 In contrast, very few studies reported the RS analysis of proton irradiated cells, although such a technique has been proposed by Devpura et al.26 for application in radiation therapy response assessment.
In this study, we observed a significant presence of proton-induced cytogenetic effects in MCF10A cells, even at the lowest investigated dose (0.5 Gy), in terms of (i) cell death, assessed by MTT viability, clonogenic, apoptosis and necrosis assays, (ii) induction of premature cellular senescence and (iii) induction of DNA damage, estimated by the RS technique. In a recent study,27 we showed that the RS technique applied to single MCF10A cells, fixed immediately after proton-irradiation at low doses, can detect radiation-induced changes in the relative content of the functional groups characteristic of cellular components. In this work, we extend this method to the same cell type, but fixing cells at different time points after irradiation, in order to investigate either the capability of cellular mechanisms to repair the proton-induced damage or to propose the RS technique as an effective tool for the detection of cellular radiosensitivity. We observed that the radiation-induced changes to the DNA/RNA content increased after 24 and 48 h from irradiation, so that the exposed MCF10A cells were not able to recover the original proportions about the different components inside the cell nucleus. A quite anomalous behavior observed in the Raman spectra of cells fixed 72 h after irradiation can be explained by considering the breaking of chemical bonds in other cellular components (such as proteins) different from DNA/RNA. Since the above changes characterize also the spectra of cells exposed to a low dose of 0.5 Gy, we conclude that RS analysis performed at the single-cell level may serve as a useful tool to detect proton radiation cellular sensitivity.
The plates containing the MCF10A exposed cells for RS measurements were incubated and three coverslips for each dose were fixed at 24, 48 and 72 h time points after the end of the exposure process, by means of 3.7% PFA in PBS solution.
Ratiometric analysis of several characteristic Raman peaks was performed by considering, for each of the about 30 normalized single spectra (corresponding to a specific fixation time and exposure dose), the intensity of these characteristic peaks, in order to calculate the intensity ratios between a couple of them. Therefore, a set of about 30 values for specific intensity ratios was obtained for each fixation time and dose. Then, for each set the mean value and standard error related to each specific intensity ratio were calculated.
Data compared in ratiometric analysis were expressed as mean ± standard error. The statistical difference between the exposed groups and control group was assessed by the Holm–Sidak method. P values <0.05 were considered to be statistically significant. All statistical analyses were performed by SigmaPlot software (version 12.5, Systat Software).
As the normalized MTT absorbance is proportional to the percentage of living cells, the data in Fig. 1b can be considered as a viability assay based on the inactivation of mitochondrial functions. In particular, Fig. 1b suggests that the viability of the exposed MCF10A cells at the three different investigated time points is characterized by a dose-dependent behavior. However, for cells measured 24 h after irradiation, the decreasing rate as a function of proton dose seems to be slower than for those measured 48 and 72 h after exposure. Overall, the surviving fraction after 2 Gy irradiation, known as the SF2 value, is less than 0.50.
The results obtained from the clonogenic assay performed two weeks after proton irradiation are shown in Fig. 1c. Survival data (points) are well fitted (continuous line) to a linear-quadratic model: S = exp(−αD − βD2), where S is the surviving fraction, D is the proton dose, and α and β are linear and quadratic coefficients describing the variation in cell survival at low and high dose, respectively.25 The value of the cell surviving fraction after 2 Gy irradiation, as obtained from the fitting procedure, corresponds to 0.48, in good agreement with that obtained by means of the MTT assay and also with previously published data about the MCF10A cell line subjected to proton irradiation.32 Therefore, the MCF10A cells can be considered as a radiosensitive cell line.16,22
These results confirm the risk to the health tissue as a result of the exposure to the clinical proton beam, not only at higher doses (e.g. 2 and 4 Gy), but also at doses as low as those to which the tissue is unintentionally exposed during the treatment (0.5 Gy).
The results of the Annexin V and PI staining assay on radiation-induced apoptosis and necrosis indicate a strong dose-dependence of such cellular events. Typical fluorescence images are shown in Fig. 2 for MCF10A cells exposed to different proton doses and fixed 24 h after exposure. Similar images were obtained for cells fixed 48 and 72 h after irradiation (ESI Fig. 1 and 2†). In particular, neither apoptotic nor necrotic cells are visible for unexposed (D = 0 Gy) MCF10A cells. In contrast, the heterogeneous cell population including apoptotic (green stained) and necrotic (red stained) cells, as well as living (non-stained) cells are present after 0.5 Gy exposure. Moreover, most of the cells exposed to 2 and 4 Gy of proton radiation appear to be in the necrotic state, regardless of the time point at which the staining was performed.
The induction of cellular death by means of apoptosis and necrosis processes is not the only damage caused by proton irradiation. In fact, the exposed cells are also subjected to premature senescence, as can be deduced from Fig. 3, where the percentage of β-galactosidase positive cells is reported at different time points and for different proton doses. In particular, the percentage of senescent cells among the unexposed samples slightly increases with time (1.39% after 24 h, 2.97% after 48 h and 5.01% after 72 h), as expected for cultured cells, because cellular senescence increases with aging.33 In contrast, the proton irradiation causes a strong time- and dose-dependent increase of cellular senescence, particularly after 48 and 72 h from the end of the exposure process. Instead, 24 h after exposure the proportion of senescent cells among irradiated cells is significantly larger than that of unexposed cells, but the results are almost dose-independent. Such results were to be expected, because ionising radiation is known to induce premature senescence at high and low doses.34 Moreover, the optical microscopy images show a fair number of detached death cells after 24 h for 2 Gy and 4 Gy exposure: it explains the decreasing percentage at higher doses after 24 h (Fig. 3a).
Overall, fluorescence images highlight that proton radiation causes physiological modifications in most cells, including the induction of premature senescence and apoptosis and necrosis events, not only at high doses (2 and 4 Gy) but also at the lowest investigated one (0.5 Gy). Such events involve a modification of the morphology and distribution of biochemical components inside cells (cell shrinkage, nuclear condensation, DNA fragmentation, etc.). Therefore, they can be investigated by Raman microspectroscopy, which allows the biochemical analysis at the single cell level.
The most intense bands visible in the Raman spectra in Fig. 4 are due to the contribution of the amide I (∼1662 cm−1), CH2 deformation (∼1452 cm−1), amide III (∼1260 cm−1) and phenylalanine ring breathing vibrations (1003 cm−1) of proteins. Other protein-related bands include aromatic ring vibrations associated with phenylalanine, tryptophan and tyrosine (e.g. 1032, 1128, 1180, 1207, 1340, and 1615 cm−1). The contribution of DNA and RNA components is mostly related to the peaks at 784 cm−1 (O–P–O stretching mode of the phosphodiester bond of the phosphate group), 1096 cm−1 (PO2− phosphodioxy bond of the phosphate group) and 1583 cm−1 (ring breathing vibrational modes characteristic of adenine and guanine).37 In contrast, lipid-related peaks scarcely contribute to the Raman spectra in Fig. 4, where they are mainly overlapped with the protein ones, as occurs at 1065, 1128, 1300 and 1440 cm−1.
Normalized and averaged Raman spectra measured from the nucleolus and nucleoplasm compartments of MCF10A cells exposed to different proton doses and fixed 24 h after irradiation are shown in Fig. 5a and b, respectively. For each average spectrum, the 95% confidence intervals are similar to those reported in Fig. 4 (data not shown). Among the many spectral features characterizing the spectra in Fig. 5, we investigated the dose dependent behavior of (i) the peaks at 784 and 1096 cm−1 as a pointer of radiation-induced modification of the phosphate groups in DNA and RNA, (ii) the peak at 1583 cm−1 as an index of the radiation-induced changes to DNA and RNA bases, (iii) the peak at 1003 cm−1 as related to the protein component modification induced by radiation and (iv) the peak at 1452 cm−1 as a marker of protein and lipid component changes following radiation exposure. This choice is due to the fact that such spectral features correspond to well-resolved peaks related to single cellular components. At first glance, it seems that the intensity of DNA and RNA related peaks (at 784, 1096 and 1583 cm−1) in Fig. 5 decreases with increasing exposure dose, particularly for the nucleoplasm spectra. However, it is worth remarking that, because of the normalization procedure, the relative intensity of specific Raman peaks, related to different vibrational bonds, should be considered as a proper marker of relative radiation-induced damage to the respective cellular components.
Overall, such results indicate that 24 h after irradiation a stronger damaging effect of irradiation involves the nucleic acid components with respect to the protein and lipid ones. Such damage mainly consists of the breaking of the O–P–O and PO2− bonds of the phosphate groups: in fact, the intensity ratios I784/I1003 and I1096/I1003 decrease by about 15% for the MCF10A cells exposed to a 0.5 Gy proton beam with respect to unexposed cells, both for nucleolus and nucleoplasm sampling. A minor damaging action involves the modification of chemical linkages inside single bases, because the intensity ratio I1583/I1452 decreases by about 4% and 8% in 0.5 Gy exposed cells with respect to the unexposed ones for nucleolus and nucleoplasm compartments, respectively. Similar results, consisting of decreasing Raman peak intensities from specific nucleic acids, were recently found also by S. Rangan et al. for CHO cultured cells undergoing chemically and physically inducted apoptosis and necrosis processes.38 In this work, the Raman signal of exposed cells is sampled from a heterogeneous population, comprising apoptotic, necrotic and living cells. Synytsya et al.39 also observed by means of RS a significant intensity decrease of the peaks related to the phosphodiester bond (at 784 cm−1) and DNA bases ring modes (at 1574 cm−1) in proton irradiated calf thymus DNA. Such results were observed only at high doses of radiation (50 Gy), whereas no significant intensity decrease of the spectral features after 0.5 Gy proton irradiation was reported. In addition, Lipiec et al. detected the intensity change and spectral shift of O–P–O stretching bands in the FTIR spectra of adenocarcinoma PC-3 cells irradiated by different doses of protons and fixed 24 h after exposure:19 they attributed such spectral modifications to DNA repair processes.
The cells sense DNA damage and begin to repair it through the formation of foci around the site of damage within 1 h of irradiation.39 Therefore, 24 h after irradiation, the repair of DNA and RNA simple lesions is supposed to be completed, whereas more complicated residual lesions can be present.40 In particular, the decreasing trend of DNA and RNA peak intensities as a function of the dose suggests that the repair process did not occur completely. Therefore, by considering also the results shown in Fig. 1–3, a strong sensitivity of MCF10A cells to proton radiation, even at the lowest investigated dose (0.5 Gy), can be deduced.
Raman measurements were also performed for the nucleolus and nucleoplasm compartments of MCF10A single cells exposed to different proton doses and fixed 48 h after irradiation (Fig. 3 of the ESI† shows the average normalized spectra). The above intensity ratios were estimated for each single spectrum and the obtained mean values vs. doses are shown in Fig. 7 for the Raman spectra collected from the nucleolus (Fig. 7a) and the nucleoplasm (Fig. 7b) region. The observed trend of such intensity ratios, similar to that reported in Fig. 6, suggests that the repair of DNA damage did not even occur 48 h after irradiation. Also for this time point multiple comparisons of exposed groups versus the control group revealed a statistically significant difference (p < 0.05), except for the comparison of the I1583/I1452 ratio at 4 Gy for spectra related to the nucleolus region. Moreover, it can be stated that 48 h after irradiation the amount of unrepaired damage to nucleic acid components increases with respect to what is reported after 24 h irradiation, particularly for the nucleoplasm region. In particular, I784/I1003 and I1096/I1003 decreased by about 42% and 20% for the MCF10A cells exposed to a 0.5 Gy proton beam with respect to unexposed cells. In contrast, such ratios for the nucleolus region are almost unchanged (they decreased by about 15% and 9%, respectively) if compared to the results obtained after 24 h irradiation. Instead, the intensity ratio I1583/I1452 decreased by about 10% and 13% in the 0.5 Gy exposed cells with respect to the unexposed ones for the nucleolus and nucleoplasm compartments, respectively.
Therefore, RS data suggest that proton radiation action mainly caused the breaking of chemical bonds inside phosphate groups and that such damage increases with time, i.e. physiological cellular mechanisms are unable to recover and repair the radiation induced chemical changes. These results are in agreement with those reported by Lipiec et al. about nuclei isolated from glioblastoma cells exposed to protons at 1 Gy and 10 Gy and were measured by means of the FTIR technique 48 h after exposure.41 In particular, they observed a decrease of the peak intensity due to the phosphodiester bond and an increase of the amide II protein peak in the exposed cells with respect to the unexposed ones. Such spectral changes were attributed to the DNA repair process, which involves a stopping of cells in the G1 phase and an increase of the amount of proteins.41 Probably, in our case an effective DNA repair process is inactive because of the larger radiation sensitivity of MCF10A cells with respect to the glioblastoma cells.
A contradictory behavior appears in the Raman spectra and the corresponding intensity ratios of MCF10A cells were fixed 72 h after irradiation. In particular, the mean values of the intensity ratio obtained from the Raman spectra of the cells (average normalized spectra shown in Fig. 4 of the ESI†) are shown in Fig. 8a and b for the spectra measured on the nucleolus and nucleoplasm compartment, respectively. In fact, there is neither a statistically significant difference for the I784/I1003, I1096/I1003 and I1583/I1452 intensity ratios of the exposed groups versus the control group, nor an evident decreasing trend of such ratios with increasing exposure dose, particularly for the nucleolus region. This behavior is in disagreement with the results obtained by Meade et al. about the Raman spectra of HaCaT cells γ-ray irradiated at different doses and measured 96 h after exposure.25 Indeed, an intensity decrease of DNA and RNA related peaks was observed in the Raman spectra of exposed cells with respect to those of the control ones.25
In our opinion, such apparently anomalous behavior, characterized by an almost constant value of intensity ratios independent of the irradiation dose, cannot be explained by a repairing mechanism of DNA/RNA due to the cell response to the irradiation damage. In fact, both MTT and Annexin-V measurements suggest that at 72 h cell necrosis occurred, similar to that at 24 h and 48 h time points. In contrast, by remarking that the investigated intensity ratios concern the intensity of a nucleic acid-related Raman peak with respect to that of a protein one, this could be explained by considering that the damage elicited by proton radiation to DNA alters or stops the normal evolution of the biochemical content, specifically the synthesis of the protein component, in MCF10A cells. In fact, we reckon that most cells evolving towards an apoptotic or necrotic stage, but still living after 72 h irradiation, originate from parent cells that have not repaired the DNA bonds broken by a proton beam and, consequently, these are cells where the protein synthesis mechanism is strongly altered. Such unrepaired cells are also present in the samples fixed 24 and 48 h after irradiation, but the number of daughter cells is probably lower in the latter samples with respect to those fixed after 72 h, so that the direct DNA/RNA damage is predominant with respect to the indirect protein synthesis damage. Therefore, the intensity decrease of DNA and RNA peaks observed in HaCaT cells 96 h after photon irradiation25 could be related to the increased radioresistance of HaCaT cells compared to MCF10A and to a larger relative biological effectiveness (RBE) of proton radiation with respect to photon radiation.
Although previous studies by Matthews et al.21–23 have reported the use of RS to detect, at different time points, tumour cells’ response to clinical and high doses of ionizing radiation, it is very hard to compare such data with those reported by us, because of the marked differences about the investigated cell lines (tumour vs. normal line), ionizing radiation quality (photon vs. proton) and measured cell volume (several μm vs. less than 1 μm laser spot). However, Matthews et al. have demonstrated the ability of RS to identify radiation-induced cellular response by means of spectral changes occurring in the Raman signals of exposed cells with respect to the unexposed ones. On the other hand, they reported that the spectral changes are specific for a cell line and very subtle for the most radioresistant cell lines. Therefore, our results corroborate the utility and effectiveness of RS at the single cell level to identify the sensitivity of the investigated normal breast cellular model to proton beam exposure at low doses, as those unavoidably occurring during proton therapy treatments. A comparison with the proposed viability, apoptosis and necrosis assays reveals that RS is able to provide sensitivity information within a few hours after exposure.
Raman spectra from both nucleolus and nucleoplasm compartments have been investigated by RS since the sampled spot size is less than the single cell area. A comparison of the results obtained by means of biological assays and Raman spectra indicates that the spectral response from the nucleoplasm region is somewhat more sensitive to the cytogenetic damage with respect to that from the nucleolus compartment. In particular, the intensity ratio of several Raman peaks, as I784/I1003, I1096/I1003 and I1583/I1452 discussed above, are sensitive to the DNA/RNA injury caused by the exposure to the proton beam, even at the lowest investigated dose: so, they could be considered as spectral markers of cytogenetic damage. A limitation about the use of RS for the detection of cellular sensitivity to proton radiation has emerged for measurements carried out 72 h after irradiation. Indeed, the corresponding results are not able to effectively discriminate the cytogenetic damage occurred. In contrast, the obtained results suggest that proper indications could be provided by RS analysis performed 24 h or 48 h after irradiation.
In conclusion, our investigation confirms the utility of RS for radiobiological studies, supporting the possibility of using such a technique as a complimentary method for non-invasive monitoring of radiation sensitivity in clinical practice.
Footnote |
† Electronic supplementary information (ESI) available. See DOI: 10.1039/c8an02155d |
This journal is © The Royal Society of Chemistry 2019 |