Reduced cellular uptake of
menaquinone-4 (MK-4), a
vitamin K2 homolog, in human
hepatocellular carcinoma (HCC) limits its usefulness as a safe long-term
antitumor agent for recurrent HCC and produces des-γ-carboxy
prothrombin (DCP). We hypothesized that effective delivery of
menahydroquinone-4 (MKH), the active form of MK-4 for γ-glutamyl carboxylation, into HCC cells is critical for regulating HCC growth, and may enable it to be applied as a safe
antitumor agent. In this study, we verified this hypothesis using
menahydroquinone-4 1,4-bis-N,N-dimethylglycinate hydrochloride (MKH-DMG), a
prodrug of MKH, and demonstrated its effectiveness. Intracellular delivery of MKH and subsequent growth inhibition of PLC/PRF/5 and Hep3B (DCP-positive) and SK-Hep-1 (DCP-negative) cells after MKH-DMG administration were determined and compared with MK-4. The activity of MKH-DMG against
tumor progression in the liver alongside DCP formation was determined in a spleen-liver
metastasis mouse model. MKH-DMG exhibited greater intracellular delivery of MKH in vitro (AUC0-72 hour of MKH) and increased growth-inhibitory activity against both DCP-positive and DCP-negative HCC cell lines. The phenomena of MKH delivery into cells in parallel with simultaneous growth inhibition suggested that MKH is the active form for growth inhibition of HCC cells. Cell-cycle arrest was determined to be involved in the growth inhibition mechanisms of MKH-DMG. Furthermore, MKH-DMG showed significant inhibition of
tumor progression in the liver, and a substantial decrease in plasma DCP levels in the spleen-liver
metastasis mouse model. Our results suggest that MKH-DMG is a promising new candidate
antitumor agent for safe long-term treatment of HCC.