Abstract
Hepatocellular carcinoma has high fatality and poor prognosis. For curing hepatocellular carcinoma, the demand for effective therapeutic reagents with low toxicity is urgent. Herein, we investigated plasma-activated medium, an emerging reagent obtained via irradiation of cell-free medium with cold atmospheric plasma. Plasma-activated medium exerts inhibitory effect on many types of tumor cells with little toxicity to non-cancerous cells. In present study, we verified the tumor-specific inhibition of plasma-activated medium on hepatocellular carcinoma cell lines. Under the effect of plasma-activated medium, oxidative stress, mitochondrial dysfunction, and loss of intracellular NAD(+) and ATP were detected inside cells, suggesting an energy depletion. Through investigating the salvage pathway which synthesizes NAD(+) and maintains the respiratory chain in hepatocellular carcinoma, we found that the energy failure was resulted by the blockage of the salvage pathway. Moreover, nicotinamide phosphoribosyltransferase, the rate-limiting enzyme in the salvage pathway, was determined as an important target to be inactivated by the effect of plasma-activated medium. Additionally, the blockage of the salvage pathway activates AMPKα and suppresses mTOR pathway, which reinforces the cell growth inhibition. Overall, our findings demonstrated that the disruption of functions of nicotinamide phosphoribosyltransferase and the salvage pathway contribute to the tumor-specific cytotoxicity of plasma-activated medium.