Tetrandrine, a
bisbenzylisoquinoline alkaloid isolated from the roots of Stephania tetrandra is a
traditional Chinese medicine and exerts anticancer capacity in various types of
cancers. Previous studies have shown that
tetrandrine induces apoptosis in
bladder cancer cells via activation of the
caspase cascade. However, the underlying mechanism has not yet been reported. Autophagy is a cellular process involved in the degradation of broken
proteins and aging organelles to maintain homeostasis. Recent studies indicate that autophagy is implicated in
cancer therapy. Thus, we focused on the correlation between autophagy and apoptosis upon
tetrandrine treatment in human
bladder cancer cells. Firstly, our results observed a marked increase in autophagic double-membrane vacuoles and fluorescent puncta of red fluorescence
protein-green fluorescence protein-LC3 (GRP-RFP-LC3) upon
tetrandrine treatment, as evidenced by transmission electron microscopy and confocal fluorescence microscopy. Secondly, the expression of LC3-II was increased in
tetrandrine-treated T24 and 5637 cells in a time- and concentration-dependent manner. Subsequently, downregulation of p62 and LC3 turnover assay further confirmed that
tetrandrine induced autophagic flux in
bladder cancer T24 and 5637 cells. Thirdly, the
protein levels of phosphorylated-
AMP-activated protein kinase (AMPK) and phosphorylated-acetyl-coenzyme A carboxylase (ACC) were upregulated in the
tetrandrine-treated cells, while the
mammalian target of rapamycin (mTOR)-related
proteins were downregulated. Moreover,
AICAR, a common AMPK activator, further increased the expression the LC3-II, while AMPK inhibitor compound C partially reversed the LC3-II
protein levels in
bladder cancer T24 cells. Finally,
AICAR significantly reinforced the growth inhibition and apoptosis induction of
tetrandrine in T24 and 5637 cells, while compound C had an opposite effect, suggesting that AMPK-mediated autophagy enhanced the cytotoxic and pro-apoptosis effect of
tetrandrine in human
bladder cancer cells. Taken together, the present study showed that
tetrandrine induced autophagy in human
bladder cancer cells by regulating the AMPK/mTOR signaling pathway, which contributed to the apoptosis induction by
tetrandrine, indicating that
tetrandrine may be a potential anticancer candidate for the treatment of
bladder cancer, and autophagy may be a possible mechanism for
cancer therapy.