Response to dexamethasone is glucose-sensitive in multiple myeloma cell lines

Background: Hyperglycemia is among the major side effects of dexamethasone (DEX). Glucose or glucocorticoid (GC) regulates the expression of thioredoxin-interacting protein (TXNIP) that controls the production of reactive oxygen species (ROS) through the modulation of thioredoxin (TRX) activity. Methods: Multiple myeloma (MM) cells were grown in 5 or 20 mM/L glucose with or without 25 mu M DEX. Semiquantitative reverse transcription-PCR (RT-PCR) was used to assess TXNIP RNA expression in response to glucose and DEX. ROS were detected by 5-6-chloromethyl-2',7'-dichlorodihydrofluorescein diacetate (CM-H2DCFDA). TRX activity was assayed by the insulin disulfide-reducing assay. Proliferation was evaluated using CellTiter96 reagent with 490-nm absorbtion and used to calculate the DEX IC50 in 20 mM/L glucose using the Chou's dose effect equation. Results: TXNIP RNA level responded to glucose or DEX with the same order of magnitude ARH77 > NCIH929 > U266B1 in these cells. MC/CAR cells were resistant to the regulation. ROS level increased concurrently with reduced TRX activity. Surprisingly glucose increased TRX activity in MC/CAR cells keeping ROS level low. DEX and glucose were lacking the expected additive effect on TXNIP RNA regulation when used concurrently in sensitive cells. ROS level was significantly lower when DEX was used in conditions of hyperglycemia in ARH77/NCIH9292 cells but not in U266B1 cells. Dex-IC50 increased 10-fold when the dose response effect of DEX was evaluated with glucose in ARH && and MC/Car cells Conclusions: Our study shows for the first time that glucose or DEX regulates important components of ROS production through TXNIP modulation or direct interference with TRX activity in MM cells. We show that glucose modulates the activity of DEX through ROS regualtion in MM cells. A better understanding of these pathways may help in improving the efficacy and reducing the toxicity of DEX, a drug still highly used in the treatment of MM. Our study also set the ground to study the relevance of the metabolic milieu in affecting drug response and toxicity in diabetic versus non-diabetic patients with MM.