# Licoflavone A Suppresses Gastric Cancer Growth and Metastasis by Blocking the VEGFR-2 Signaling Pathway

Authors: Gong Hongxia; Jin Xiaojie; Leng Guangxian; Zhang Min; Niu Shiwei; Cao Wangjie; Zhang Han; Zeng Yuanding; Li Chenghao; Li Yaling; Su Yun; Liu Yongqi
Journal: Journal of Oncology
 (2022)

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## Abstract

Objectives. Licoflavone A (LA) is a natural flavonoid compound derived from the root of Glycyrrhiza. This study investigated the antitumor effect and underlying molecular mechanisms of LA against gastric cancer (GC) in vitro and in vivo. Materials and Methods. A CCK8 assay was used to measure the antiproliferative activity of LA in human GC SGC-7901, MKN-45, MGC-803 cells, and human GES-1 cells. Target prediction and protein-protein interaction (PPI) analysis were used to identify the potential molecular targets of LA. The binding pattern of LA to VEGFR-2 was analyzed by molecular docking and molecular dynamic (MD). The affinity of LA for VEGFR-2 was determined by microscale thermophoresis (MST). The protein tyrosine kinase activity of VEGFR-2 in the presence of LA was determined by an enzyme activity test. The effect of LA on the proliferation of VEGF-stimulated MKN-45 cells was measured with CCK8 assays, clone formation assays, and 3D microsphere models. Hoechst 33342 staining, FCM, MMP, and WB assays were used to investigate the ability of LA to block cell cycle and promote apoptosis of VEGF-stimulated MKN-45 cells. Transwell matrix assays were used to measure migration and invasion, and WB assays were used to measure EMT. Results. LA inhibited the proliferation of SGC-7901, MKN-45, and MGC-803 cells and VEGF-stimulated MKN-45 cells. VEGFR-2 was identified as the target of LA. LA could also block cell cycle, induce apoptosis, and inhibit migration, invasion, and EMT of VEGF-stimulated MKN-45 cells. Functional analyses further revealed that the cytotoxic effect of LA on VEGF-stimulated MKN-45 cells potentially involved the PI3K/AKT and MEK/ERK signaling pathways. Conclusions. This study demonstrates that LA has anti-GC potency in vitro and in vivo. LA affects the proliferation, cycle, apoptosis, migration, invasion, and EMT by targeting VEGFR-2 and blocks the PI3K/AKT and MEK/ERK signaling pathways in VEGF-stimulated MKN-45 cells.


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## Body

## 1. Introduction

The incidence and mortality of gastric cancer (GC) occupy the fifth and fourth place of malignant tumors, respectively [1]. As patients with GC are often asymptomatic, they are typically diagnosed late in the progression of the disease, too late for surgery. Although chemotherapy is the main treatment for advanced GC, its therapeutic effectiveness is limited and its toxicity is severe [2]. Therefore, it is important to develop a class of new, effective, and safe drugs. Natural compounds are excellent candidate drugs, as they offer antioxidant, antiallergenic, anti-inflammatory, antimicrobial, and antitumor activities and are readily available with low toxicity and low molecular weights [3].Licorice, the root ofGlycyrrhiza glabra (Figure 1(a)), has anti-inflammatory, antioxidative, antiallergenic, antitumor, and antimicrobial properties [4]. Licoflavone A (LA) (Figure 1(b)), which is derived from the Glycyrrhiza root, is a natural flavonoid compound [5]. A previous study has shown that LA has a protective effect on carbon-tetrachloride and acetaminophen-induced HepG2 cell injury [6]. LA can also inhibit protein tyrosine phosphatase-1B (PTP1B) [7], which may influence tumorigenesis [8]. It is unclear whether LA has antitumor effects. However, protein-protein interaction (PPI) networks are useful for drug target discovery and drug discovery in silico lever [9] and can provide support for exploring the mechanism of LA.Figure 1
Licoflavone A (LA) suppressed GC cell proliferation in vitro. (a) The root of Glycyrrhiza glabra. (b) The chemical structure of LA. (c, d, e, and f) Human SGC-7901, MKN-45, MGC-803, and GES-1 cells were treated with LA (0, 6.25, 12.5, 25, 50, and 100μM) for 24, 48, and 72 h, respectively (n=5). Cell viability was measured by CCK8 assay. Cell viability is represented in percentage relative absorbance compared to the controls. Values are given as the mean±standarderrorofthemean (SEM) of three independent experiments. ∗p<0.05 vs. control and ∗∗p<0.01 vs. control.
(a)(b)(c)(d)(e)(f)Vascular endothelial growth factor (VEGF) is one of the most important active regulatory factors in angiogenesis. VEGF has six isoforms including VEGFA, VEGFB, VEGFC, VEGFD, VEGFE, and placental growth factor (PGF). VEGFA, commonly referred to VEGF, binds to the vascular endothelial growth factor receptor-1/2/3 (VEGFR-1/2/3) and promotes the formation of new blood vessels and lymphatics. The VEGF/VEGFR-2 signaling pathway is a key pathway involved in angiogenesis [10]. VEGF binding to VEGFR-2 results in homo- or heterodimerization of VEGFR-2. Subsequent phosphorylation of the kinase domain with activation of downstream RAF-1/MAPK/ERK kinases and the PI3K/AKT/mTOR signaling pathways ultimately enhances vascular permeability, angiogenesis, tumor proliferation, and migration [11, 12]. In addition, VEGF can directly promote tumor growth by prosurvival effects [13, 14]. A series of VEGFR-2 inhibitors have been approved for clinical GC treatment by the US Food and Drug Administration (FDA) [15–18]. However, their use is restricted because of decreased efficacy caused by drug resistance, resulting in toxicity and severe adverse effects [19]. Natural products provide a readily accessible source for the development of new antitumor drugs.Our results indicate that LA affects VEGF-mediated cell proliferation, apoptosis, migration, invasion, and epithelial interstitial transformation (EMT) by targeting VEGFR-2 via the inactivation of the PI3K/AKT and MEK/ERK signaling pathways, providing new evidence and support for further research and development.


## 2. Materials and Methods

### 2.1. Chemicals and Reagents

LA (purity>98%) was purchased from Shanghai Yuanye (Shanghai, China). Roswell Park Memorial Institute (RPMI) medium modified (1640) was obtained from Hyclone (Utah, USA). Cell Counting Kit-8 (CCK8) and ECL chemiluminescence kits were purchased from YEASEN (Shanghai, China). Hoechst 33342 was purchased from Biosharp (Guangzhou, China). Penicillin-streptomycin and the mitochondrial membrane potential (MMP) assay kit (JC-10) were purchased from Solarbio (Beijing, China). The annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) double staining assay kit was purchased from Meilunbio (Dalian, China). BCA assay kit was purchased from Sangon (Shanghai, China). Human recombinant VEGFR-2 protein and VEGF were purchased from PeproTech (Rocky Hill, NJ). Monolith NTTM (L001) - Protein Labeling Kit (NanoTemper Technologies, Germany). An ADP-Glo™ kinase assay kit was purchased from Promega Corporation (Madison, USA). Matrigel (BD Biosciences, USA) TRIzol® reagent, Reverse Transcription System kit, and QuantiTect Probe RT-PCR were purchased from Qiagen (Holland).The primary antibodies to cyclin D1, c-Myc, E-cadherin, N-cadherin, Bcl-2, Bax, Cyt c, cleaved-caspase 3, PI3K, p-PI3K (Y607), AKT, p-AKT (Ser473), ERK1/2, p-ERK1/2 (Y204), GAPDH, and horseradish peroxidase- (HRP-) labeled goat anti-rabbit immunoglobulin G (IgG) (H+L) were purchased from ImmunoWay (Plano, TX). The primary antibodies to VEGFR-2 and p-VEGFR-2 (Tyr1175) were purchased from GeneTex (Alton Parkway, Irvine, CA). The primary antibodies to MMP2 and MMP9 were purchased from Bosterbio (California, USA). The primary antibody to caspase 9 was purchased from Servicebio (Tianjin, China). The primary antibodies to MEK1/2 and p-MEK1(Ser218/222) were purchased from Beyotime (Shanghai, China).


### 2.2. Cell Culture and Treatment

The MKN-45 cell line was purchased from FuHeng Biology (Shanghai, China). SGC-7901, MGC-803, and GES-1 cell lines were purchased from Zhong Qiao Xin Zhou Biotechnology Co., Ltd. (Shanghai, China). SGC-7901, MKN-45, MGC-803, and GES-1 cell lines were cultured in 10% FBS RPMI 1640 complete medium supplemented with 1% penicillin-streptomycin (100 U/mL penicillin and 100μg/mL streptomycin). The cells were incubated at 37°C in a humidified atmosphere of 5% CO2 and 95% air in an incubator. The cells were subcultured every 2–4 days to maintain logarithmic growth. SGC-7901, MKN-45, MGC-803, and GES-1 cells were treated with LA (0, 6.25, 12.5, 25, 50, and 100 μM) and IC50 was calculated.


### 2.3. Cell Proliferation Assay

Cell viability was examined by CCK8. SGC-7901, MKN-45, MGC-803, and GES-1 cells were seeded into 96-well plates and treated with LA (0, 6.25, 12.5, 25, 50, and 100μM) for 24, 48, and 72 h, respectively. 10 μL of CCK8 reagents was added to each well at 24, 48, and 72 h. After incubation for 1.5-2.0 h at 37°C in the incubator, the absorbance was read at 450 nm. The same method was used to detect the proliferation of VEGF-stimulated MKN-45 cells treated with LA (0, 25, 50, and 100 μM) for 72 h. Cell viability was quantified as follows: cellsurvival%=Absexperimentalgroup−Absblankgroup/Abscontrolgroup−Absblankgroup×100%. The 50% concentration for inhibition (IC50) was calculated.


### 2.4. Target Analysis of the Anti-GC Effect of LA and Network Construction

The simplified molecular structure of LA was entered into line entry specification (SMILES) code, which was obtained from PubChem. Based on SMILES, target genes of LA were identified through Similarity Ensemble Approach (SEA) (http://sea.bkslab.org/). The SEA relates proteins based on the set-wise chemical similarity among their ligands [20]. The GC-related targets were searched using the keywords “gastric cancer” in the GeneCards (https://www.genecards.org/) [21], TTD (http://db.idrblab.net/ttd/) [22], and DrugBank database (https://www.drugbank.ca/) [23]. Common targets of GC and LA were obtained based Venn analysis by Funrich 3.1.3 software. PPI networks were constructed with the STRING platform (http://string-db.org). In this analysis, the common targets of GC and LA were imported into the STRING database. “Homo sapiens” was selected as the organism and the confidence score was set 0.7. Cytoscape 3.7.2 was used to perform network visualization and analysis [24].


### 2.5. Molecular Docking

The Schrödinger 2020-4 software was used for molecular docking. The 3D structure of LA was downloaded from TCMSP (https://tcmspw.com/tcmspsearch.php, molecule ID: MOL004851). The crystal structure of VEGFR-2 (PDB ID: 4AGD) was downloaded from RCSB Protein Data Bank (https://www.rcsb.org/) [25]. The “Protein Preparation Wizard” module was used for preparing protein receptors. The “LigPrep” module was used for optimizing the ligand in Schrödinger 2020-4. The receptor grid files were derived from the “Receptor Grid Generation Panel.” The docking site of the protein was the same as the binding site of the original ligand (sunitinib) in its crystal structure. The ligand was docked with its corresponding receptor VEGFR-2 using a standard precision (SP) scoring model. The protein receptors were docked with ligand using the “Glide Docking” module in Schrödinger 2020-4 software.


### 2.6. Molecular Dynamic (MD) Simulation Analysis

The binding of the ligand-protein complex in the simulated physiological solvent system was evaluated through molecular dynamic simulation using the Desmond module (Schrodinger suite). The molecular system was solvated with crystallographic water (TIP3P) molecules under orthorhombic periodic boundary conditions and a 10 Å buffer region. The system charges were neutralized by adding Na+ and Cl−. OPLS 2005 force field was used for energy calculation. An ensemble (NPT) of the Nose-Hoover thermostat and barostat was applied to maintain the constant temperature (300 K) and pressure (1 bar) of the systems, respectively. The complex of dynamic structural simulation for the best complex was carried out with an NPT ensemble for 50 ns and the trajectory was set at an interval of 10 ps.


### 2.7. Microscale Thermophoresis (MST) Assay

The affinity of LA for protein was determined by MST Reagent and Monolith NT.115. The human recombinant VEGFR-2 protein was desalted into MST buffer (10 mM HEPES, pH 7.5, 150 mM NaCl) before the experiment, and the protein concentration was adjusted to 10μM. Fluorescent dye NT-647-NHS (NanoTemper Technologies, Germany) was added and the sample incubated for 30 min at 4°C in the dark. 10 μL of fluorescent-labeled protein (approximately 0.1 μM) and 10 μL of unlabeled ligand LA were mixed. Samples at 16 concentrations were loaded into premium capillaries and measured by 20% light-emitting diode power and medium MST power used at 25°C. The dissociation constant (Kd) was used to evaluate the affinity of a compound to the target, and the smaller the value, the stronger the affinity. MO Affinity Analysis 2.2.3 software was used for data analysis.


### 2.8. In Vitro VEGFR-2 Tyrosine Kinase Assay

An ADP-Glo™ kinase assay kit [26] (Promega Corporation, catalog no. V9101) was used for the assay as per manufacturer’s protocol. Briefly, 20 μL of kinase assay buffer was added into 384-well plates. Next, 30 μM was used as the maximum concentration of LA, and 8 concentration gradients were set. Finally, the fluorescent signals were positively related to the amount of ATP present and negatively associated to kinase activity. IC50 values were defined as the drug concentration that resulted in 50% inhibition of enzyme activity. The inhibition at each concentration was the average of duplicate determinations.


### 2.9. Colony Formation Assay

MKN-45 cells were seeded into 60 mm diameter plates at a density of 1000 cells/well. The cells were cultured with 20 ng/mL VEGF and different concentrations of LA (0, 25, 50, and 100μM). The medium was renewed every 3 days. After 14 days of culture, the colonies were fixed and dyed with crystal violet (Beyotime) for 30 min. The colony images were recorded using a digital camera.


### 2.10. 3D Microsphere Model

The 3D microsphere model was used to evaluate the ability of cell proliferation and cell adhesion. MKN-45 cells were seeded in a 96 well U-bottom 3D cell culture plate (1×103 cells/well, PE, USA). When the microspheres became visible to the naked eye, the cells were treated with corresponding concentrations of VEGF and LA and recorded at 0, 24, 48, 72, and 96 h with an inverted microscope, respectively (IX83, Olympus, Tokyo, Japan).


### 2.11. Flow Cytometry Analysis of Cell Cycle and Apoptosis

Cell cycle and apoptotic analysis were performed according to the manufacturer’s instructions. MKN-45 cells were seeded at a density of1×105 cells/well in a 6-well plate for 24 h. The cells were treated with the indicated concentrations of VEGF and LA for 72 h. The collected MKN-45 cells were stained with the propidium iodide (PI) solution (BD, Biosciences, USA) for 15 min. The cell cycle phase distribution was measured by flow cytometry with a BD FACS Array (BD). The collected cells were stained with Annexin V-FITC/PI at room temperature (RT) for 30 min in the dark. FCM analysis was performed after staining with BD FACSCalibur 663044 (Dickinson, USA) and analyzed with ModFit software (Topsham, USA). The annexin V+/PI− and annexin V+/PI+ cell populations were considered indicators of apoptotic cells.


### 2.12. Transwell Migration/Invasion Assay

Transwell chambers were used to perform a cell migration assay. Treated MKN-45 cells were resuspended at a density of5×104 cells/well (200 μL) and seeded in the upper chambers (24-well migration chambers, 8.0 μm pore membrane, Corning, New York, USA) in serum-free medium. Complete medium was placed in the lower chamber. After incubation for 48 h, the nonmigrated cells in the upper chamber were removed using cotton swabs. The migrated cells on the undersurface of the chambers were fixed and stained with crystal violet. Five images of different fields were observed using a microscope, and migrated cells were measured with ImageJ software. The same transwell inserts (8 μm pores) for 24-well plates were precoated with 100 μL/insert of 0.5 mg/mL Matrigel (BD Biosciences) for 1 h at 37°C and used to assess cell invasiveness in the invasion assay.


### 2.13. Hoechst 33342 Staining

LA-treated VEGF-stimulated MKN-45 cells were fixed with 4% paraformaldehyde for 10 min at RT, rinsed with PBS, and incubated with 100μL Hoechst 33342 for 10 min at 37°C. Stained cells were visualized and photographed using confocal scanning laser microscopes (IX81, Olympus, Tokyo, Japan).


### 2.14. Measurement of Mitochondrial Membrane Potential (MMP)

A JC-10 kit was used to measure the mitochondrial membrane potential (MMP). Carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was used as a positive control. LA-treated VEGF-stimulated MKN-45 cells were stained with JC-10 working fluid and CCCP at 37°C in the 5% CO2 incubator for 20 min. Monomer form and depolarized J-aggregate form were marked by green and red fluorescence staining, respectively, and then observed under the confocal microscope.


### 2.15. Quantitative Real-Time PCR (qRT-PCR)

Total RNA was extracted from cultured MKN-45 cells using TRIzol® reagent and reverse transcribed into cDNA using the Qiagen cDNA synthesis kit. In addition, QuantiTect Probe RT-PCR was performed to quantify the RNA expression level. The reaction conditions were as follows: 94°C for 5 min and 100 cycles of 94°C for 10 s, 55°C for 35 s, and 72°C for 20 s. All the primers were synthesized by Sangon (Shanghai, China). The primers used included the following:GeneForward primers (5′-3′)Reverse primers (3′-5′)PI3KCTT GGT AAT CGG AGG ATA GGGAG TGC TTC AAC CTG CTT AGAKTCAC GCT ACT TCC TCC TCA AGA ATGCAT CTC CTC CTC CTC CTG CTT CMEKATC AAC GAC CTG GAG AAC TTGGGC TCT TCA GCA CCA CAT CERKTCC AAC CTG CTG CTC AACGCT GGT CAA GAT AAT GCT TCCGAPDHCAG GAG GCA TTG CTG ATG ATGAA GGC TGG GGC TCA TTT


### 2.16. Western Blot (WB) Analysis

Total protein was extracted from cells using a protein lysis buffer. The protein concentrations were measured using the BCA assay kit. Equal amounts of protein samples were separated using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The separated proteins were adsorbed onto a polyvinylidene difluoride (PVDF) (Millipore, Bedford, MA, USA). After blocking, the membranes were incubated at 4 °C with anti-GAPDH, anti-VEGFR-2 (1 : 1000), anti-p-VEGFR-2 (Tyr1175) (1 : 1000), anti-cyclin D1 (1 : 1000), anti-c-Myc (1 : 1000), anti-E-cadherin (1 : 1000), anti-N-cadherin (1 : 1000), anti-MMP2 (1 : 1000), anti-MMP9 (1 : 1000), anti-Cyt c (1 : 1000), anti-caspase 9 (1 : 1000), anti-cleaved-caspase 3 (1 : 1000), anti-Bcl-2 (1 : 1000), anti-Bax (1 : 1000), anti-PI3K (1 : 1000), anti-p-PI3K (Y607) (1 : 1000), anti-AKT (1 : 1000), anti-p-AKT (Ser473) (1 : 1000), anti-MEK1/2 (1 : 1000), anti-p-MEK1 (Ser218/222) (1 : 1000), anti-ERK1/2 (1 : 1000) anti-p-ERK1/2 (Y204) (1 : 1000), and anti-goat or anti-rabbit secondary antibodies. Immunoblots were visualized by enhanced chemiluminescence. ImageJ software was used to quantify the band signal of each target protein and normalized according to respective GAPDH levels.


### 2.17. Human MKN-45 Xenograft Model

4-6-week-old male BALB/c-nude mice (weighing18±2 g) were purchased from SPF (Beijing, China) and fed a standard animal diet and water. They were group-housed in specific pathogen-free condition with a 12/12 h light/dark cycle at a temperature of 25±1°C and relative humidity of 55±5% throughout the experiment. The animal studies were approved by the Institutional Animal Ethics Committee of the Gansu University of Chinese Medicine. Nude mice were acclimated for 7 days before the study. The xenograft model in mice was established through subcutaneous injection of human MKN-45 cells, suspended in PBS at a density of 5×107/mL, and inoculated into the right legs of mice. Mice-bearing tumors (50-100 mm2) were selected and divided into two groups. The mice in the LA group were orally administrated daily with LA at 50 mg/kg body weight. The mice in the control group were administrated with vehicle solution. All treatments started on the same day. The body weight and tumor weight, width, and length were measured with calipers every three days. The tumor volume was calculated using the following formula: V=width2×length/2. The mice were killed by cervical dislocation after 14 days of treatment and tumors were measured and weighed.


### 2.18. Statistical Analysis

SPSS 22.0 statistical software was used for statistical analysis. The GraphPad Prism 8.0 software was used for plotting data. The experimental data are expressed asmeanvalues±standarderrorofthemean (SEM), with the mean error of the triplicate experiments. All experimental results are presented as mean of triplicate samples. One-way ANOVA and multiple independent samples from a nonparametric test were performed to evaluate statistical significance. Statistical significance is considered to be p<0.05 and p<0.01.


## 2.1. Chemicals and Reagents

LA (purity>98%) was purchased from Shanghai Yuanye (Shanghai, China). Roswell Park Memorial Institute (RPMI) medium modified (1640) was obtained from Hyclone (Utah, USA). Cell Counting Kit-8 (CCK8) and ECL chemiluminescence kits were purchased from YEASEN (Shanghai, China). Hoechst 33342 was purchased from Biosharp (Guangzhou, China). Penicillin-streptomycin and the mitochondrial membrane potential (MMP) assay kit (JC-10) were purchased from Solarbio (Beijing, China). The annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) double staining assay kit was purchased from Meilunbio (Dalian, China). BCA assay kit was purchased from Sangon (Shanghai, China). Human recombinant VEGFR-2 protein and VEGF were purchased from PeproTech (Rocky Hill, NJ). Monolith NTTM (L001) - Protein Labeling Kit (NanoTemper Technologies, Germany). An ADP-Glo™ kinase assay kit was purchased from Promega Corporation (Madison, USA). Matrigel (BD Biosciences, USA) TRIzol® reagent, Reverse Transcription System kit, and QuantiTect Probe RT-PCR were purchased from Qiagen (Holland).The primary antibodies to cyclin D1, c-Myc, E-cadherin, N-cadherin, Bcl-2, Bax, Cyt c, cleaved-caspase 3, PI3K, p-PI3K (Y607), AKT, p-AKT (Ser473), ERK1/2, p-ERK1/2 (Y204), GAPDH, and horseradish peroxidase- (HRP-) labeled goat anti-rabbit immunoglobulin G (IgG) (H+L) were purchased from ImmunoWay (Plano, TX). The primary antibodies to VEGFR-2 and p-VEGFR-2 (Tyr1175) were purchased from GeneTex (Alton Parkway, Irvine, CA). The primary antibodies to MMP2 and MMP9 were purchased from Bosterbio (California, USA). The primary antibody to caspase 9 was purchased from Servicebio (Tianjin, China). The primary antibodies to MEK1/2 and p-MEK1(Ser218/222) were purchased from Beyotime (Shanghai, China).


## 2.2. Cell Culture and Treatment

The MKN-45 cell line was purchased from FuHeng Biology (Shanghai, China). SGC-7901, MGC-803, and GES-1 cell lines were purchased from Zhong Qiao Xin Zhou Biotechnology Co., Ltd. (Shanghai, China). SGC-7901, MKN-45, MGC-803, and GES-1 cell lines were cultured in 10% FBS RPMI 1640 complete medium supplemented with 1% penicillin-streptomycin (100 U/mL penicillin and 100μg/mL streptomycin). The cells were incubated at 37°C in a humidified atmosphere of 5% CO2 and 95% air in an incubator. The cells were subcultured every 2–4 days to maintain logarithmic growth. SGC-7901, MKN-45, MGC-803, and GES-1 cells were treated with LA (0, 6.25, 12.5, 25, 50, and 100 μM) and IC50 was calculated.


## 2.3. Cell Proliferation Assay

Cell viability was examined by CCK8. SGC-7901, MKN-45, MGC-803, and GES-1 cells were seeded into 96-well plates and treated with LA (0, 6.25, 12.5, 25, 50, and 100μM) for 24, 48, and 72 h, respectively. 10 μL of CCK8 reagents was added to each well at 24, 48, and 72 h. After incubation for 1.5-2.0 h at 37°C in the incubator, the absorbance was read at 450 nm. The same method was used to detect the proliferation of VEGF-stimulated MKN-45 cells treated with LA (0, 25, 50, and 100 μM) for 72 h. Cell viability was quantified as follows: cellsurvival%=Absexperimentalgroup−Absblankgroup/Abscontrolgroup−Absblankgroup×100%. The 50% concentration for inhibition (IC50) was calculated.


## 2.4. Target Analysis of the Anti-GC Effect of LA and Network Construction

The simplified molecular structure of LA was entered into line entry specification (SMILES) code, which was obtained from PubChem. Based on SMILES, target genes of LA were identified through Similarity Ensemble Approach (SEA) (http://sea.bkslab.org/). The SEA relates proteins based on the set-wise chemical similarity among their ligands [20]. The GC-related targets were searched using the keywords “gastric cancer” in the GeneCards (https://www.genecards.org/) [21], TTD (http://db.idrblab.net/ttd/) [22], and DrugBank database (https://www.drugbank.ca/) [23]. Common targets of GC and LA were obtained based Venn analysis by Funrich 3.1.3 software. PPI networks were constructed with the STRING platform (http://string-db.org). In this analysis, the common targets of GC and LA were imported into the STRING database. “Homo sapiens” was selected as the organism and the confidence score was set 0.7. Cytoscape 3.7.2 was used to perform network visualization and analysis [24].


## 2.5. Molecular Docking

The Schrödinger 2020-4 software was used for molecular docking. The 3D structure of LA was downloaded from TCMSP (https://tcmspw.com/tcmspsearch.php, molecule ID: MOL004851). The crystal structure of VEGFR-2 (PDB ID: 4AGD) was downloaded from RCSB Protein Data Bank (https://www.rcsb.org/) [25]. The “Protein Preparation Wizard” module was used for preparing protein receptors. The “LigPrep” module was used for optimizing the ligand in Schrödinger 2020-4. The receptor grid files were derived from the “Receptor Grid Generation Panel.” The docking site of the protein was the same as the binding site of the original ligand (sunitinib) in its crystal structure. The ligand was docked with its corresponding receptor VEGFR-2 using a standard precision (SP) scoring model. The protein receptors were docked with ligand using the “Glide Docking” module in Schrödinger 2020-4 software.


## 2.6. Molecular Dynamic (MD) Simulation Analysis

The binding of the ligand-protein complex in the simulated physiological solvent system was evaluated through molecular dynamic simulation using the Desmond module (Schrodinger suite). The molecular system was solvated with crystallographic water (TIP3P) molecules under orthorhombic periodic boundary conditions and a 10 Å buffer region. The system charges were neutralized by adding Na+ and Cl−. OPLS 2005 force field was used for energy calculation. An ensemble (NPT) of the Nose-Hoover thermostat and barostat was applied to maintain the constant temperature (300 K) and pressure (1 bar) of the systems, respectively. The complex of dynamic structural simulation for the best complex was carried out with an NPT ensemble for 50 ns and the trajectory was set at an interval of 10 ps.


## 2.7. Microscale Thermophoresis (MST) Assay

The affinity of LA for protein was determined by MST Reagent and Monolith NT.115. The human recombinant VEGFR-2 protein was desalted into MST buffer (10 mM HEPES, pH 7.5, 150 mM NaCl) before the experiment, and the protein concentration was adjusted to 10μM. Fluorescent dye NT-647-NHS (NanoTemper Technologies, Germany) was added and the sample incubated for 30 min at 4°C in the dark. 10 μL of fluorescent-labeled protein (approximately 0.1 μM) and 10 μL of unlabeled ligand LA were mixed. Samples at 16 concentrations were loaded into premium capillaries and measured by 20% light-emitting diode power and medium MST power used at 25°C. The dissociation constant (Kd) was used to evaluate the affinity of a compound to the target, and the smaller the value, the stronger the affinity. MO Affinity Analysis 2.2.3 software was used for data analysis.


## 2.8. In Vitro VEGFR-2 Tyrosine Kinase Assay

An ADP-Glo™ kinase assay kit [26] (Promega Corporation, catalog no. V9101) was used for the assay as per manufacturer’s protocol. Briefly, 20 μL of kinase assay buffer was added into 384-well plates. Next, 30 μM was used as the maximum concentration of LA, and 8 concentration gradients were set. Finally, the fluorescent signals were positively related to the amount of ATP present and negatively associated to kinase activity. IC50 values were defined as the drug concentration that resulted in 50% inhibition of enzyme activity. The inhibition at each concentration was the average of duplicate determinations.


## 2.9. Colony Formation Assay

MKN-45 cells were seeded into 60 mm diameter plates at a density of 1000 cells/well. The cells were cultured with 20 ng/mL VEGF and different concentrations of LA (0, 25, 50, and 100μM). The medium was renewed every 3 days. After 14 days of culture, the colonies were fixed and dyed with crystal violet (Beyotime) for 30 min. The colony images were recorded using a digital camera.


## 2.10. 3D Microsphere Model

The 3D microsphere model was used to evaluate the ability of cell proliferation and cell adhesion. MKN-45 cells were seeded in a 96 well U-bottom 3D cell culture plate (1×103 cells/well, PE, USA). When the microspheres became visible to the naked eye, the cells were treated with corresponding concentrations of VEGF and LA and recorded at 0, 24, 48, 72, and 96 h with an inverted microscope, respectively (IX83, Olympus, Tokyo, Japan).


## 2.11. Flow Cytometry Analysis of Cell Cycle and Apoptosis

Cell cycle and apoptotic analysis were performed according to the manufacturer’s instructions. MKN-45 cells were seeded at a density of1×105 cells/well in a 6-well plate for 24 h. The cells were treated with the indicated concentrations of VEGF and LA for 72 h. The collected MKN-45 cells were stained with the propidium iodide (PI) solution (BD, Biosciences, USA) for 15 min. The cell cycle phase distribution was measured by flow cytometry with a BD FACS Array (BD). The collected cells were stained with Annexin V-FITC/PI at room temperature (RT) for 30 min in the dark. FCM analysis was performed after staining with BD FACSCalibur 663044 (Dickinson, USA) and analyzed with ModFit software (Topsham, USA). The annexin V+/PI− and annexin V+/PI+ cell populations were considered indicators of apoptotic cells.


## 2.12. Transwell Migration/Invasion Assay

Transwell chambers were used to perform a cell migration assay. Treated MKN-45 cells were resuspended at a density of5×104 cells/well (200 μL) and seeded in the upper chambers (24-well migration chambers, 8.0 μm pore membrane, Corning, New York, USA) in serum-free medium. Complete medium was placed in the lower chamber. After incubation for 48 h, the nonmigrated cells in the upper chamber were removed using cotton swabs. The migrated cells on the undersurface of the chambers were fixed and stained with crystal violet. Five images of different fields were observed using a microscope, and migrated cells were measured with ImageJ software. The same transwell inserts (8 μm pores) for 24-well plates were precoated with 100 μL/insert of 0.5 mg/mL Matrigel (BD Biosciences) for 1 h at 37°C and used to assess cell invasiveness in the invasion assay.


## 2.13. Hoechst 33342 Staining

LA-treated VEGF-stimulated MKN-45 cells were fixed with 4% paraformaldehyde for 10 min at RT, rinsed with PBS, and incubated with 100μL Hoechst 33342 for 10 min at 37°C. Stained cells were visualized and photographed using confocal scanning laser microscopes (IX81, Olympus, Tokyo, Japan).


## 2.14. Measurement of Mitochondrial Membrane Potential (MMP)

A JC-10 kit was used to measure the mitochondrial membrane potential (MMP). Carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was used as a positive control. LA-treated VEGF-stimulated MKN-45 cells were stained with JC-10 working fluid and CCCP at 37°C in the 5% CO2 incubator for 20 min. Monomer form and depolarized J-aggregate form were marked by green and red fluorescence staining, respectively, and then observed under the confocal microscope.


## 2.15. Quantitative Real-Time PCR (qRT-PCR)

Total RNA was extracted from cultured MKN-45 cells using TRIzol® reagent and reverse transcribed into cDNA using the Qiagen cDNA synthesis kit. In addition, QuantiTect Probe RT-PCR was performed to quantify the RNA expression level. The reaction conditions were as follows: 94°C for 5 min and 100 cycles of 94°C for 10 s, 55°C for 35 s, and 72°C for 20 s. All the primers were synthesized by Sangon (Shanghai, China). The primers used included the following:GeneForward primers (5′-3′)Reverse primers (3′-5′)PI3KCTT GGT AAT CGG AGG ATA GGGAG TGC TTC AAC CTG CTT AGAKTCAC GCT ACT TCC TCC TCA AGA ATGCAT CTC CTC CTC CTC CTG CTT CMEKATC AAC GAC CTG GAG AAC TTGGGC TCT TCA GCA CCA CAT CERKTCC AAC CTG CTG CTC AACGCT GGT CAA GAT AAT GCT TCCGAPDHCAG GAG GCA TTG CTG ATG ATGAA GGC TGG GGC TCA TTT


## 2.16. Western Blot (WB) Analysis

Total protein was extracted from cells using a protein lysis buffer. The protein concentrations were measured using the BCA assay kit. Equal amounts of protein samples were separated using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The separated proteins were adsorbed onto a polyvinylidene difluoride (PVDF) (Millipore, Bedford, MA, USA). After blocking, the membranes were incubated at 4 °C with anti-GAPDH, anti-VEGFR-2 (1 : 1000), anti-p-VEGFR-2 (Tyr1175) (1 : 1000), anti-cyclin D1 (1 : 1000), anti-c-Myc (1 : 1000), anti-E-cadherin (1 : 1000), anti-N-cadherin (1 : 1000), anti-MMP2 (1 : 1000), anti-MMP9 (1 : 1000), anti-Cyt c (1 : 1000), anti-caspase 9 (1 : 1000), anti-cleaved-caspase 3 (1 : 1000), anti-Bcl-2 (1 : 1000), anti-Bax (1 : 1000), anti-PI3K (1 : 1000), anti-p-PI3K (Y607) (1 : 1000), anti-AKT (1 : 1000), anti-p-AKT (Ser473) (1 : 1000), anti-MEK1/2 (1 : 1000), anti-p-MEK1 (Ser218/222) (1 : 1000), anti-ERK1/2 (1 : 1000) anti-p-ERK1/2 (Y204) (1 : 1000), and anti-goat or anti-rabbit secondary antibodies. Immunoblots were visualized by enhanced chemiluminescence. ImageJ software was used to quantify the band signal of each target protein and normalized according to respective GAPDH levels.


## 2.17. Human MKN-45 Xenograft Model

4-6-week-old male BALB/c-nude mice (weighing18±2 g) were purchased from SPF (Beijing, China) and fed a standard animal diet and water. They were group-housed in specific pathogen-free condition with a 12/12 h light/dark cycle at a temperature of 25±1°C and relative humidity of 55±5% throughout the experiment. The animal studies were approved by the Institutional Animal Ethics Committee of the Gansu University of Chinese Medicine. Nude mice were acclimated for 7 days before the study. The xenograft model in mice was established through subcutaneous injection of human MKN-45 cells, suspended in PBS at a density of 5×107/mL, and inoculated into the right legs of mice. Mice-bearing tumors (50-100 mm2) were selected and divided into two groups. The mice in the LA group were orally administrated daily with LA at 50 mg/kg body weight. The mice in the control group were administrated with vehicle solution. All treatments started on the same day. The body weight and tumor weight, width, and length were measured with calipers every three days. The tumor volume was calculated using the following formula: V=width2×length/2. The mice were killed by cervical dislocation after 14 days of treatment and tumors were measured and weighed.


## 2.18. Statistical Analysis

SPSS 22.0 statistical software was used for statistical analysis. The GraphPad Prism 8.0 software was used for plotting data. The experimental data are expressed asmeanvalues±standarderrorofthemean (SEM), with the mean error of the triplicate experiments. All experimental results are presented as mean of triplicate samples. One-way ANOVA and multiple independent samples from a nonparametric test were performed to evaluate statistical significance. Statistical significance is considered to be p<0.05 and p<0.01.


## 3. Results

### 3.1. Licoflavone A (LA) Suppresses GC Cell Proliferation

The viability of human GC SGC-7901, MKN-45, MGC-803 cells, and normal GES-1 cells was decreased by LA in a dose-dependent and time-dependent manner (p<0.01) (Figures 1(c), 1(d), 1(e), and 1(f)). Furthermore, IC50 analysis showed that the inhibitory ability of LA on GES-1 cells was weaker than that observed for SGC-7901, MKN-45, and MGC-803 cells (Table 1). Cytotoxicity was greater when the cells were treated for 72 h compared with 24 h and 48 h. Therefore, 72 h was used to treat GC with LA. These results indicate that LA has an excellent antitumor effect by inhibiting the proliferation of GC cells.Table 1
The IC50 of LA for SGC-7901, MKN-45, MGC-803, and GES-1 cells.
Cell lineIC50 (μM)24 h48 h72 hSGC-790178.0840.8323.74MKN-4543.2623.6712.19MGC-803124.5075.7547.19GES-1180.30130.30110.00


### 3.2. Protein-Protein Interaction (PPI) Analysis and Validation of LA Targets in Vitro

A total of 78 LA-related targets were obtained after searching the SEA database, and a total of 12224 GC-related targets were acquired by searching the GeneCards, the TTD, and the DrugBank databases. In addition, 52 common targets were entered into the STRING database to set up the PPI network, which included 34 nodes and 36 interaction edges (Supplement table1 and Supplement table 2). VEGFA (6), estrogen receptor alpha gene (ESR1) (6), aromatase (CYP19A1) (5), telomerase reverse transcriptase (TERT) (4), and cAMP response element binding protein-1 (CREB1) (4) are the potential key targets of LA (Figure 2(a)).Figure 2
Protein-protein interaction (PPI) analysis and validation of LA targets. (a) The bubble size represents the number of genes enriched in this pathway, the bubble color difference represents the level of gene enrichment, and the circle size represents the number of targets in the pathway. The redder the color, the smaller thep value. (b) A 2D diagram of the interaction between LA and VEGFR-2 (PBD: 4AGD). Dashed lines indicate hydrogen bonds, and eyelashes indicate hydrophobicity. (c) A 3D diagram of the interaction between LA and VEGFR-2 (PBD: 4AGD). The LA structure is shown in green. The amino acids associated with the A-chain binding pocket of 4AGD are indicated in purple. The amino acids associated with the B-chain binding pocket of 4AGD are indicated in indigo. Yellow dashed lines indicate the length of the hydrogen bonds. (d) Stability analysis of modeled proteins using the Desmond module (Schrodinger suite) for VEGFR-2 and LA protein interactions. (e) Histogram and percentage of interaction in molecular dynamics simulation of VEGFR-2-LA. (f) Simulation interaction diagram showing interactions of LA with crucial amino acids of the VEGFR-2 protein. (g) Results of microscale thermophoresis for LA vs. VEGFR-2. (h) Enzyme inhibitory activity of VEGFR-2.
(a)(b)(c)(d)(e)(f)(g)(h)Molecular docking analysis showed that the interactive amino acids were CYS919, LEU1035, YAL916, ASN923, and LYS868, and hydrogen bonding was the main interacting force (Figures2(b) and 2(c)). After docking with the target protein VEGFR-2, the score of LA was -10.229. The molecular docking result means that LA binds to some key sites of VEGFR-2 and reduces its phosphorylation level, thus decreasing the activity of the VEGFR signaling pathway. A 50 ns molecular dynamic simulation was performed to understand the binding of LA in the active pocket of VEGFR-2 (Figure 2(c)). The fluctuation values of root-mean-square deviation (RMSD) of each system were all stable, and the simulated system reached the equilibrium state (Figure 2(d)). Detailed interactions of LA with VEGFR-2 are shown in Figure 2(e) and Figure 2(f). In the 50 ns simulation, LA and VEGFR-2 mainly formed hydrophobic interactions, hydrogen bonding, and water bridge. LEU1035 and VAL916 formed a stable interaction with LA mainly by hydrophobic interaction. CYS919 and LYS868 amino acids in the VEGFR-2 protein interacted with LA by hydrophobic. LA was stably bound to ASN923 by a water bridge.The MST assay showed that theKd value was fitted by all 16 concentration gradients. The binding affinity value for LA and VEGFR-2 was 142.38 nM (Figure 2(g)). Finally, the result of the VEGFR-2 kinase activity test showed that LA effectively inhibited VEGFR-2 kinase activity with an IC50 of about 14.36 μM (Figure 2(h)). These results indicate that LA has a strong potential for targeting VEGFR-2 and is a potent inhibitor of VEGFR-2 kinase.


### 3.3. LA Arrested Proliferation of VEGF-Stimulated MKN-45 Cells

WB assays show that the expression of VEGFR-2 protein in SGC-7901, MKN-45, and MGC-803 cells is higher than that in GES-1 (p<0.01). MKN-45 cells were selected for further investigation since the expression of VEGFR-2 protein in MKN-45 cells shows the highest level (Figures 3(a) and 3(b)). So MKN-45 cells were used for further mechanistic validation of cell lines. LA decreased the level of p-VEGFR-2 protein in VEGF-stimulated MKN-45 cells in a dose-dependent manner (Figures 3(c) and 3(d)). Additionally, to confirm that LA affected proliferation, colony formation, and 3D tumor microsphere formation of MKN-45 cells by blocking the binding of VEGF and VEGFR-2, MKN-45 cells were stimulated with 20 ng/mL VEGF and then treated with 0, 25, 50, and 100 μM LA for 72 h. The results demonstrate that LA inhibits proliferation and that 20 ng/mL VEGF promotes proliferation. In contrast, LA dose-dependently inhibited proliferation of VEGF-stimulated MKN-45 cells, with statistical significance compared to the VEGF0ng/mL+LA0μM group and the VEGF20ng/mL+LA0μM group (p<0.01) (Figure 3(e)). The results of colony formation show that LA also significantly inhibited colony formation of VEGF-stimulated MKN-45 cells (Figure 3(f)). The results of the 3D tumor microsphere formation assay indicate that the VEGF0ng/mL+LA0μM group and the VEGF20ng/mL+LA0μM group had good ability to form 3D tumor microspheres. LA inhibited the formation of 3D tumor microspheres, and the higher the concentration of LA, the lesser the ability for 3D tumor microsphere formation (Figure 3(g)).Figure 3
LA arrests the proliferation of VEGF-stimulated MKN-45 cells. (a) The expression of VEGFR-2 protein in SGC-7901, MKN-45, MGC-803, and GES-1 cells. (b) Relative VEGFR-2 expression levels were quantified in SGC-7901, MKN-45, MGC-803, and GES-1 cells. GSE-1 is the reference. (c) The p-VEGFR-2 expression level of LA-treated VEGF-stimulated MKN-45 cell. (d) Relative p-VEGFR-2 protein expression levels were quantified by normalization to GAPDH values as the mean of three independent experiments. (e) The proliferation of VEGF-stimulated MKN-45 cells was measured by the CCK8 assay. (f) LA inhibited the colony formation of VEGF-stimulated MKN-45 cells. (g) 3D microsphere was observed at 0, 24, 48, 72, and 96 h, respectively.Bar=200 μm. Values are given as the mean±standarderrorofthemean (SEM) experiments. n=3. ∗p<0.05 vs. control and ∗∗p<0.01 vs. control. #p<0.05 vs. VEGF20ng/mL+LA0μM and ##p<0.01 vs. VEGF20ng/mL+LA0μM.
(a)(b)(c)(d)(e)(f)(g)


### 3.4. LA Arrested Cells at the G1 Phase and Induced Apoptosis in VEGF-Stimulated MKN-45 Cells

To further explore the mechanism of VEGF-stimulated suppression of proliferation in MKN-45 cells, cell cycle distributions of VEGF-stimulated MKN-45 cells were determined by flow cytometry after LA treatment. The results show that LA blocked the G1 to S cell cycle transition in a concentration-dependent manner (Figures4(a) and 4(b)) (p<0.05 or p<0.01). Furthermore, LA concentration dependently downregulated the expression of Cyclin D1 and c-Myc, which are G1 phase proteins (Figure 4(g)).Figure 4
LA arrested cells at G1 phase and induced apoptosis of VEGF-stimulated MKN-45 cells. (a) Flow cytometry assay of cell cycle distribution. (b) The quantitation of cell cycle distribution. The data are presented asmean±SD (n=3). (c) The Hoechst 33342-stained nuclei were imaged under laser confocal microscopy. Bar=50 μm. Representative photographs of the morphological changes observed. The red arrow indicates apoptotic bodies and the white arrows indicate shrunken and deformed nuclei of apoptotic cells. (d) Apoptosis of LA-treated VEGF-stimulated MKN-45 cells was determined by flow cytometric analysis. (e) The quantitation of cell cycle distribution. The data are presented as mean±SD (n=3). (f) A JC-10 kit was used to measure the mitochondrial membrane potential of VEGF-stimulated MKN-45 cells by laser confocal microscopy. CCCP staining results were used as the positive control. JC-10 is the monomer with green fluorescence, while JC-10 is the polymer with red fluorescence. Bar=100 μm. (g) Cyclin D1, c-Myc, Bcl-2, Bax, Cyt C, caspase 9, and cleaved-caspase 3 protein expression levels were detected by western blot.
(a)(b)(c)(d)(e)(f)(g)Apoptosis is thought to be one of the critical antiproliferative mechanisms of anticancer drugs, so we examined the effect of LA on apoptosis in VEGF-stimulated MKN-45 cells. Firstly, morphological characteristics were observed after Hoechst 33342 staining. Apoptotic features like the formation of apoptotic bodies and the condensation and fragmentation of nuclei indicated that LA enhanced VEGF-stimulated MKN-45 cell apoptosis (Figure4(c)). Furthermore, at 25 μM LA, typical apoptotic bodies were observed, and the nuclear shrinkage and deformation were positively correlative with concentration. Secondly, the percentage of apoptotic rates was markedly increased in LA-treated VEGF-stimulated MKN-45 cells in a dose-dependent manner (p <0.01) (Figures 4(d) and 4(e)). The JC-10 kit was used to detect the MMP of VEGF-stimulated MKN-45 cells by confocal microscopy. As shown in Figure 5(f), the MMP of VEGF-stimulated MKN-45 cells increased, and the red fluorescence was enhanced compared with the control group. While LA promoted cell apoptosis, MMP decreased in a concentration-dependent manner, and the expression of green fluorescence in the cells increased with the increase in drug concentration. These results indicate that LA significantly induced apoptosis in VEGF-stimulated MKN-45 cells by downregulating the mitochondrial signal transduction pathway (Figure 4(f)). Finally, LA upregulated the ratio of Bax/Bcl-2 protein and activated downstream cell apoptosis effectors, including Cyt C protein, caspase 9 protein, and final effector cleaved-caspase 3 protein (p<0.01) (Figure 4(g)). These results indicate that the intrinsic pathway of apoptosis makes an essential contribution to the proliferative repression induced by LA.Figure 5
LA suppressed the migration and invasion capacities of VEGF-stimulated MKN-45 cells. VEGF-stimulated MKN-45 cells were treated with LA for 72 h. (a) Transwell assays without or with Matrigel were carried out to evaluate the migration and invasion capacity. (b) The numbers of migrated and invaded cells were quantified. Scarbar=100 μm. The data are presented as mean±SD (n=3). ∗p<0.05 vs. VEGF0ng/mL+LA0μM and ∗∗p<0.01 vs. VEGF0ng/mL+LA0μM. #p<0.05 vs. VEGF20ng/mL+LA0μM and ##p<0.01 vs. VEGF20ng/mL+LA0μM. (c) Western blot analysis of EMT-regulated proteins MMP2, MMP9, E-cadherin, and N-cadherin.
(a)(b)(c)


### 3.5. LA Suppressed the Migration, Invasion, and EMT Capacities of VEGF-Stimulated MKN-45 Cells

To further evaluate the role of LA on the metastatic potency of VEGF-stimulated MKN-45 cells, transwell assays were carried out. The experiment showed that after 24 h, the numbers of migrated cells and invaded cells were significantly reduced compared to that of the control (Figures5(a) and 5(b)). LA effectively suppressed the migration and invasion of VEGF-stimulated MKN-45 cells.Considering that the epithelial-mesenchymal transition (EMT) is closely related to in situ invasion and distant metastasis of tumor cells, we next investigated the expression of EMT-related proteins. WB assays confirmed that the protein levels of MMP2, MMP9, and N-cadherin were decreased, whereas the level of E-cadherin was increased in LA-treated cells (Figure5(c)). Overall, these results indicated that LA inhibited metastasis by repressing the EMT process in VEGF-stimulated MKN-45 cells.


### 3.6. LA Blocked the PI3K/AKT and MEK/ERK Signaling Pathways in VEGF-Stimulated MKN-45 Cells

We measured the expression levels of PI3K/AKT and MEK/ERK signaling pathway-related proteins PI3K, AKT, MEK, and ERK and its phosphorylated active forms p-PI3K (Y607), p-AKT (Y607), p-MEK(Ser218/222), and p-ERK(Y204) in VEGF-stimulated MKN-45 cells by WB analysis. The results indicate that the protein levels of PI3K, AKT, p-PI3K (Y607), p-AKT (Y607), p-MEK (Ser218/222), and p-ERK(Y204) were significantly decreased in a concentration-dependent manner (Figure6(a)). We also measured the relative expression levels of PI3K mRNA, AKT mRNA, MEK mRNA, and ERK mRNA by RT-PCR. The results show that the relative expression levels of PI3K mRNA and AKT mRNA decreased in a concentration-dependent manner (p<0.05 or p<0.01) (Figure 6(b)). On the other hand, there was no statistical difference in the relative expression levels of MEK mRNA and ERK mRNA among the groups (p>0.05) (Figure 6(c)). These results suggest that the effects of LA may be related to the downregulation of PI3K/AKT and MEK/ERK signaling pathways.Figure 6
LA suppressed GC growth and metastasis in VEGF-stimulated MKN-45 cells through PI3K/AKT and MEK/ERK signaling pathway activation. (a) Western blot analysis of PI3K, p-PI3K, AKT, p-AKT, MEK, p-MEK, ERK, and p-ERK in LA-treated VEGF-stimulated MKN-45 cells. (b and c) RT-PCR analysis of PI3K, AKT, MEK, and ERK mRNA relative expression in LA-treated VEGF-stimulated MKN-45 cells. The data are presented asmean±SD (n=3). ∗p<0.05 vs. VEGF0ng/mL+LA0μM and ∗∗p<0.01 vs. VEGF0ng/mL+LA0μM. #p<0.05 vs. VEGF20ng/mL+LA0μM, ##p<0.01 vs. VEGF20ng/mL+LA0μM.
(a)(b)(c)


### 3.7. LA Inhibited the Growth of MKN-45 Cells In Vivo

MKN-45 cells were injected into BALB/c nude mice by subcutaneous injection to establish a tumor-bearing mouse model. The tumor volume and body weight of tumor-bearing mice were measured every three days during the 14 days of intragastric administration. After administration for 14 days, the body weight of tumor-bearing mice had no obvious changes, but tumor volume and tumor weight were significantly reduced in LA-treated mice (Figures7(a)–7(d)). This suggests that LA treatment is effective in preventing tumor growth.Figure 7
LA inhibited the growth of GC cells in vivo. (a) Images of the xenograft tumors of the control and LA treatment group. (b and c) Tumor volume and tumor weight were measured. (d) Body weights of mice were recorded every 3 days after indicated treatment. The data are presented asmean±SD (n=5). ∗p<0.05 vs. control. ∗∗p<0.01 vs. control. The data are presented as mean±SD (n=5).
(a)(b)(c)(d)


## 3.1. Licoflavone A (LA) Suppresses GC Cell Proliferation

The viability of human GC SGC-7901, MKN-45, MGC-803 cells, and normal GES-1 cells was decreased by LA in a dose-dependent and time-dependent manner (p<0.01) (Figures 1(c), 1(d), 1(e), and 1(f)). Furthermore, IC50 analysis showed that the inhibitory ability of LA on GES-1 cells was weaker than that observed for SGC-7901, MKN-45, and MGC-803 cells (Table 1). Cytotoxicity was greater when the cells were treated for 72 h compared with 24 h and 48 h. Therefore, 72 h was used to treat GC with LA. These results indicate that LA has an excellent antitumor effect by inhibiting the proliferation of GC cells.Table 1
The IC50 of LA for SGC-7901, MKN-45, MGC-803, and GES-1 cells.
Cell lineIC50 (μM)24 h48 h72 hSGC-790178.0840.8323.74MKN-4543.2623.6712.19MGC-803124.5075.7547.19GES-1180.30130.30110.00


## 3.2. Protein-Protein Interaction (PPI) Analysis and Validation of LA Targets in Vitro

A total of 78 LA-related targets were obtained after searching the SEA database, and a total of 12224 GC-related targets were acquired by searching the GeneCards, the TTD, and the DrugBank databases. In addition, 52 common targets were entered into the STRING database to set up the PPI network, which included 34 nodes and 36 interaction edges (Supplement table1 and Supplement table 2). VEGFA (6), estrogen receptor alpha gene (ESR1) (6), aromatase (CYP19A1) (5), telomerase reverse transcriptase (TERT) (4), and cAMP response element binding protein-1 (CREB1) (4) are the potential key targets of LA (Figure 2(a)).Figure 2
Protein-protein interaction (PPI) analysis and validation of LA targets. (a) The bubble size represents the number of genes enriched in this pathway, the bubble color difference represents the level of gene enrichment, and the circle size represents the number of targets in the pathway. The redder the color, the smaller thep value. (b) A 2D diagram of the interaction between LA and VEGFR-2 (PBD: 4AGD). Dashed lines indicate hydrogen bonds, and eyelashes indicate hydrophobicity. (c) A 3D diagram of the interaction between LA and VEGFR-2 (PBD: 4AGD). The LA structure is shown in green. The amino acids associated with the A-chain binding pocket of 4AGD are indicated in purple. The amino acids associated with the B-chain binding pocket of 4AGD are indicated in indigo. Yellow dashed lines indicate the length of the hydrogen bonds. (d) Stability analysis of modeled proteins using the Desmond module (Schrodinger suite) for VEGFR-2 and LA protein interactions. (e) Histogram and percentage of interaction in molecular dynamics simulation of VEGFR-2-LA. (f) Simulation interaction diagram showing interactions of LA with crucial amino acids of the VEGFR-2 protein. (g) Results of microscale thermophoresis for LA vs. VEGFR-2. (h) Enzyme inhibitory activity of VEGFR-2.
(a)(b)(c)(d)(e)(f)(g)(h)Molecular docking analysis showed that the interactive amino acids were CYS919, LEU1035, YAL916, ASN923, and LYS868, and hydrogen bonding was the main interacting force (Figures2(b) and 2(c)). After docking with the target protein VEGFR-2, the score of LA was -10.229. The molecular docking result means that LA binds to some key sites of VEGFR-2 and reduces its phosphorylation level, thus decreasing the activity of the VEGFR signaling pathway. A 50 ns molecular dynamic simulation was performed to understand the binding of LA in the active pocket of VEGFR-2 (Figure 2(c)). The fluctuation values of root-mean-square deviation (RMSD) of each system were all stable, and the simulated system reached the equilibrium state (Figure 2(d)). Detailed interactions of LA with VEGFR-2 are shown in Figure 2(e) and Figure 2(f). In the 50 ns simulation, LA and VEGFR-2 mainly formed hydrophobic interactions, hydrogen bonding, and water bridge. LEU1035 and VAL916 formed a stable interaction with LA mainly by hydrophobic interaction. CYS919 and LYS868 amino acids in the VEGFR-2 protein interacted with LA by hydrophobic. LA was stably bound to ASN923 by a water bridge.The MST assay showed that theKd value was fitted by all 16 concentration gradients. The binding affinity value for LA and VEGFR-2 was 142.38 nM (Figure 2(g)). Finally, the result of the VEGFR-2 kinase activity test showed that LA effectively inhibited VEGFR-2 kinase activity with an IC50 of about 14.36 μM (Figure 2(h)). These results indicate that LA has a strong potential for targeting VEGFR-2 and is a potent inhibitor of VEGFR-2 kinase.


## 3.3. LA Arrested Proliferation of VEGF-Stimulated MKN-45 Cells

WB assays show that the expression of VEGFR-2 protein in SGC-7901, MKN-45, and MGC-803 cells is higher than that in GES-1 (p<0.01). MKN-45 cells were selected for further investigation since the expression of VEGFR-2 protein in MKN-45 cells shows the highest level (Figures 3(a) and 3(b)). So MKN-45 cells were used for further mechanistic validation of cell lines. LA decreased the level of p-VEGFR-2 protein in VEGF-stimulated MKN-45 cells in a dose-dependent manner (Figures 3(c) and 3(d)). Additionally, to confirm that LA affected proliferation, colony formation, and 3D tumor microsphere formation of MKN-45 cells by blocking the binding of VEGF and VEGFR-2, MKN-45 cells were stimulated with 20 ng/mL VEGF and then treated with 0, 25, 50, and 100 μM LA for 72 h. The results demonstrate that LA inhibits proliferation and that 20 ng/mL VEGF promotes proliferation. In contrast, LA dose-dependently inhibited proliferation of VEGF-stimulated MKN-45 cells, with statistical significance compared to the VEGF0ng/mL+LA0μM group and the VEGF20ng/mL+LA0μM group (p<0.01) (Figure 3(e)). The results of colony formation show that LA also significantly inhibited colony formation of VEGF-stimulated MKN-45 cells (Figure 3(f)). The results of the 3D tumor microsphere formation assay indicate that the VEGF0ng/mL+LA0μM group and the VEGF20ng/mL+LA0μM group had good ability to form 3D tumor microspheres. LA inhibited the formation of 3D tumor microspheres, and the higher the concentration of LA, the lesser the ability for 3D tumor microsphere formation (Figure 3(g)).Figure 3
LA arrests the proliferation of VEGF-stimulated MKN-45 cells. (a) The expression of VEGFR-2 protein in SGC-7901, MKN-45, MGC-803, and GES-1 cells. (b) Relative VEGFR-2 expression levels were quantified in SGC-7901, MKN-45, MGC-803, and GES-1 cells. GSE-1 is the reference. (c) The p-VEGFR-2 expression level of LA-treated VEGF-stimulated MKN-45 cell. (d) Relative p-VEGFR-2 protein expression levels were quantified by normalization to GAPDH values as the mean of three independent experiments. (e) The proliferation of VEGF-stimulated MKN-45 cells was measured by the CCK8 assay. (f) LA inhibited the colony formation of VEGF-stimulated MKN-45 cells. (g) 3D microsphere was observed at 0, 24, 48, 72, and 96 h, respectively.Bar=200 μm. Values are given as the mean±standarderrorofthemean (SEM) experiments. n=3. ∗p<0.05 vs. control and ∗∗p<0.01 vs. control. #p<0.05 vs. VEGF20ng/mL+LA0μM and ##p<0.01 vs. VEGF20ng/mL+LA0μM.
(a)(b)(c)(d)(e)(f)(g)


## 3.4. LA Arrested Cells at the G1 Phase and Induced Apoptosis in VEGF-Stimulated MKN-45 Cells

To further explore the mechanism of VEGF-stimulated suppression of proliferation in MKN-45 cells, cell cycle distributions of VEGF-stimulated MKN-45 cells were determined by flow cytometry after LA treatment. The results show that LA blocked the G1 to S cell cycle transition in a concentration-dependent manner (Figures4(a) and 4(b)) (p<0.05 or p<0.01). Furthermore, LA concentration dependently downregulated the expression of Cyclin D1 and c-Myc, which are G1 phase proteins (Figure 4(g)).Figure 4
LA arrested cells at G1 phase and induced apoptosis of VEGF-stimulated MKN-45 cells. (a) Flow cytometry assay of cell cycle distribution. (b) The quantitation of cell cycle distribution. The data are presented asmean±SD (n=3). (c) The Hoechst 33342-stained nuclei were imaged under laser confocal microscopy. Bar=50 μm. Representative photographs of the morphological changes observed. The red arrow indicates apoptotic bodies and the white arrows indicate shrunken and deformed nuclei of apoptotic cells. (d) Apoptosis of LA-treated VEGF-stimulated MKN-45 cells was determined by flow cytometric analysis. (e) The quantitation of cell cycle distribution. The data are presented as mean±SD (n=3). (f) A JC-10 kit was used to measure the mitochondrial membrane potential of VEGF-stimulated MKN-45 cells by laser confocal microscopy. CCCP staining results were used as the positive control. JC-10 is the monomer with green fluorescence, while JC-10 is the polymer with red fluorescence. Bar=100 μm. (g) Cyclin D1, c-Myc, Bcl-2, Bax, Cyt C, caspase 9, and cleaved-caspase 3 protein expression levels were detected by western blot.
(a)(b)(c)(d)(e)(f)(g)Apoptosis is thought to be one of the critical antiproliferative mechanisms of anticancer drugs, so we examined the effect of LA on apoptosis in VEGF-stimulated MKN-45 cells. Firstly, morphological characteristics were observed after Hoechst 33342 staining. Apoptotic features like the formation of apoptotic bodies and the condensation and fragmentation of nuclei indicated that LA enhanced VEGF-stimulated MKN-45 cell apoptosis (Figure4(c)). Furthermore, at 25 μM LA, typical apoptotic bodies were observed, and the nuclear shrinkage and deformation were positively correlative with concentration. Secondly, the percentage of apoptotic rates was markedly increased in LA-treated VEGF-stimulated MKN-45 cells in a dose-dependent manner (p <0.01) (Figures 4(d) and 4(e)). The JC-10 kit was used to detect the MMP of VEGF-stimulated MKN-45 cells by confocal microscopy. As shown in Figure 5(f), the MMP of VEGF-stimulated MKN-45 cells increased, and the red fluorescence was enhanced compared with the control group. While LA promoted cell apoptosis, MMP decreased in a concentration-dependent manner, and the expression of green fluorescence in the cells increased with the increase in drug concentration. These results indicate that LA significantly induced apoptosis in VEGF-stimulated MKN-45 cells by downregulating the mitochondrial signal transduction pathway (Figure 4(f)). Finally, LA upregulated the ratio of Bax/Bcl-2 protein and activated downstream cell apoptosis effectors, including Cyt C protein, caspase 9 protein, and final effector cleaved-caspase 3 protein (p<0.01) (Figure 4(g)). These results indicate that the intrinsic pathway of apoptosis makes an essential contribution to the proliferative repression induced by LA.Figure 5
LA suppressed the migration and invasion capacities of VEGF-stimulated MKN-45 cells. VEGF-stimulated MKN-45 cells were treated with LA for 72 h. (a) Transwell assays without or with Matrigel were carried out to evaluate the migration and invasion capacity. (b) The numbers of migrated and invaded cells were quantified. Scarbar=100 μm. The data are presented as mean±SD (n=3). ∗p<0.05 vs. VEGF0ng/mL+LA0μM and ∗∗p<0.01 vs. VEGF0ng/mL+LA0μM. #p<0.05 vs. VEGF20ng/mL+LA0μM and ##p<0.01 vs. VEGF20ng/mL+LA0μM. (c) Western blot analysis of EMT-regulated proteins MMP2, MMP9, E-cadherin, and N-cadherin.
(a)(b)(c)


## 3.5. LA Suppressed the Migration, Invasion, and EMT Capacities of VEGF-Stimulated MKN-45 Cells

To further evaluate the role of LA on the metastatic potency of VEGF-stimulated MKN-45 cells, transwell assays were carried out. The experiment showed that after 24 h, the numbers of migrated cells and invaded cells were significantly reduced compared to that of the control (Figures5(a) and 5(b)). LA effectively suppressed the migration and invasion of VEGF-stimulated MKN-45 cells.Considering that the epithelial-mesenchymal transition (EMT) is closely related to in situ invasion and distant metastasis of tumor cells, we next investigated the expression of EMT-related proteins. WB assays confirmed that the protein levels of MMP2, MMP9, and N-cadherin were decreased, whereas the level of E-cadherin was increased in LA-treated cells (Figure5(c)). Overall, these results indicated that LA inhibited metastasis by repressing the EMT process in VEGF-stimulated MKN-45 cells.


## 3.6. LA Blocked the PI3K/AKT and MEK/ERK Signaling Pathways in VEGF-Stimulated MKN-45 Cells

We measured the expression levels of PI3K/AKT and MEK/ERK signaling pathway-related proteins PI3K, AKT, MEK, and ERK and its phosphorylated active forms p-PI3K (Y607), p-AKT (Y607), p-MEK(Ser218/222), and p-ERK(Y204) in VEGF-stimulated MKN-45 cells by WB analysis. The results indicate that the protein levels of PI3K, AKT, p-PI3K (Y607), p-AKT (Y607), p-MEK (Ser218/222), and p-ERK(Y204) were significantly decreased in a concentration-dependent manner (Figure6(a)). We also measured the relative expression levels of PI3K mRNA, AKT mRNA, MEK mRNA, and ERK mRNA by RT-PCR. The results show that the relative expression levels of PI3K mRNA and AKT mRNA decreased in a concentration-dependent manner (p<0.05 or p<0.01) (Figure 6(b)). On the other hand, there was no statistical difference in the relative expression levels of MEK mRNA and ERK mRNA among the groups (p>0.05) (Figure 6(c)). These results suggest that the effects of LA may be related to the downregulation of PI3K/AKT and MEK/ERK signaling pathways.Figure 6
LA suppressed GC growth and metastasis in VEGF-stimulated MKN-45 cells through PI3K/AKT and MEK/ERK signaling pathway activation. (a) Western blot analysis of PI3K, p-PI3K, AKT, p-AKT, MEK, p-MEK, ERK, and p-ERK in LA-treated VEGF-stimulated MKN-45 cells. (b and c) RT-PCR analysis of PI3K, AKT, MEK, and ERK mRNA relative expression in LA-treated VEGF-stimulated MKN-45 cells. The data are presented asmean±SD (n=3). ∗p<0.05 vs. VEGF0ng/mL+LA0μM and ∗∗p<0.01 vs. VEGF0ng/mL+LA0μM. #p<0.05 vs. VEGF20ng/mL+LA0μM, ##p<0.01 vs. VEGF20ng/mL+LA0μM.
(a)(b)(c)


## 3.7. LA Inhibited the Growth of MKN-45 Cells In Vivo

MKN-45 cells were injected into BALB/c nude mice by subcutaneous injection to establish a tumor-bearing mouse model. The tumor volume and body weight of tumor-bearing mice were measured every three days during the 14 days of intragastric administration. After administration for 14 days, the body weight of tumor-bearing mice had no obvious changes, but tumor volume and tumor weight were significantly reduced in LA-treated mice (Figures7(a)–7(d)). This suggests that LA treatment is effective in preventing tumor growth.Figure 7
LA inhibited the growth of GC cells in vivo. (a) Images of the xenograft tumors of the control and LA treatment group. (b and c) Tumor volume and tumor weight were measured. (d) Body weights of mice were recorded every 3 days after indicated treatment. The data are presented asmean±SD (n=5). ∗p<0.05 vs. control. ∗∗p<0.01 vs. control. The data are presented as mean±SD (n=5).
(a)(b)(c)(d)


## 4. Discussion

Antitumor intervention with natural products is a promising approach that provides an effective antitumor strategy. Various active components in licorice have antitumor effects, such as licochalcone A [27], isoliquiritigenin [28], formononetin [29], and isorhamnetin [30]. LA is a small flavonoid molecule found in licorice. However, the antitumor effect of LA has not been reported. In the present study, LA significantly interrupts the proliferation of multiple GC cell lines in a time-dependent and dose-dependent manner, including SGC-7901, MKN-45, and MGC-803 cells. LA also significantly inhibited the growth of GC xenograft tumors. This study is the first to report antitumor effects of LA on GC MKN-45 cells in vitro and in vivo.The PPI network analysis results showed that VEGF might be the most likely target of LA for its antitumor effects. VEGF is a crucial regulator of physiological angiogenesis during embryonic development [31], bone growth [32], and reproductive function [33]. VEGF is also associated with tumor-related pathologic vessels [34] and intraocular neovascularization [35]. Although VEGF is now used as an antitumor target in various of tumors, anti-VEGF treatment causes enhancement of tumor metastasis [36] and inhibits the immune response [37]. Its receptor, VEGFR-2, has become the focus of antiangiogenesis efforts in recent years. VEGF is known to stimulate VEGF receptors to activate its kinase activity [38]. Eventually, cell proliferation, migration, survival, vascular permeability, and invasion into the surrounding tissue are observed in related cells with high expression of VEGFR-2. The high expression of VEGFR-2 is also closely associated with a poor prognosis of GC patients [39]. At present, the development of VEGFR-2 inhibitors has become an important field in antitumor research. VEGFR-2 inhibitors are recommended for clinical anti-GC treatment by the 2021 NCCN guidelines [40]. Therefore, we measured the binding ability of LA to VEGFR-2. Molecular docking technology allows the prediction of the interaction and binding ability of ligands and target proteins at the atomic level based on computer simulation technology, which can help in the discovery of new drugs as well as optimize drug design [41]. Binding ability is evaluated according to the binding score of ligands and target proteins. MD is performed to monitor the protein–ligand complex stability and compatibility [42]. MST is a technology that analyzes the interaction between molecules based on the principle of thermo-swimming [43]. The thermo-swimming instrument was used to achieve the quantitative affinity determination between molecules [44]. Because of its sensitivity and its speed, it is widely used in disease diagnosis, medical evaluation, drug development, signaling pathway research, and other fields. Tyrosine kinases play an essential role in tumorigenesis and development and are targets of antitumor therapy. At present, the mechanism of action of small-molecule inhibitors targeting tyrosine kinase activity is mostly by blocking the activation of receptor tyrosine kinases [45]. VEGFR-2 is an essential member of the tyrosine kinase family. Therefore, in vitro detection of the inhibitory activity of LA against VEGFR-2 may also reflect the ability of LA to target VEGFR-2. Our results with molecular docking, MD, MST, and in vitro tyrosine kinase assay show that LA binds firmly to target VEGFR-2, suggesting that LA may be a promising inhibitor of VEGFR-2.Tumor growth, abnormal proliferation, antiapoptosis, migration, invasion, and EMT are closely related to the occurrence, development, and poor prognosis of cancer [45]. VEGF binds to VEGFR to promote its phosphorylation, activating downstream signaling pathways, enhancing cell proliferation, migration, and invasion. In this study, the VEGFR-2 overexpression cell line MKN-45 was stimulated with VEGF in vitro, and different concentrations of LA were used to determine if LA could block or attenuate the proliferative effect of VEGE. LA significantly inhibited cell proliferation, clone formation, and 3D tumor microsphere formation with VEGF-stimulated MKN-45 cells in a concentration-dependent manner in vitro. We also found that LA suppressed the growth of VEGF-stimulated MKN-45 cells by inducing G1 phase cell cycle arrest and apoptosis and migration, as well as the invasion and EMT ability of VEGF-stimulated MKN-45 cells. These results indicate that LA is a promising antitumor drug and the effect may be mediated by negatively modulating VEGF/VEGFR-2 signaling pathway. Taken together, our results suggested that LA could inhibit the proliferative effect of VEGF-stimulated MKN-45 cells and maybe a VEGFR-2 inhibitor. More research is needed to further reveal the mechanisms of its anti-GC effect.Mechanistically, we found that LA attenuated VEGF/VEGFR-2 signaling pathways, leading to downstream PI3K-Akt and MEK/ERK axis inhibition. PI3K/AKT and MEK/ERK signaling pathways regulate a broad range of cellular processes, including survival, proliferation, growth, apoptosis, angiogenesis, metabolism, and metastasis. Considerable evidence indicates that the PI3K/AKT and MEK/ERK pathways are the major signaling molecules that mediate downstream signals of VEGF/VEGFR-2 [46–48]. Notably, apatinib affects VEGF-mediated cell proliferation, migration, and invasion via blocking VEGFR-2/RAF/MEK/ERK and PI3K/AKT pathways in cholangiocarcinoma cells [49]. Similarly, concanavalin A can induce autophagy by blocking PI3K/Akt/mTOR and MEK/ERK pathways in HeLa cells [50]. The PI3K/AKT and MEK/ERK pathways are also key pathways of many antitumor drugs. Our research reveals that exogenous VEGF elevated the protein levels of the major downstream targets, PI3K, AKT, p-PI3K, p-AKT, MEK, and ERK1/2, but did not affect the protein levels of total MEK and ERK1/2. LA could reverse this effect of VEGF in a dose-dependent manner. LA also affected the relative expression levels of PI3K mRNA and AKT mRNA, but MEK mRNA and ERK mRNA expression levels were not affected by LA. Our findings reveal that LA inhibits the activation of the VEGFR-2 signaling pathway to act through a dual mechanism, by competitive-binding to VEGFR-2 and suppressing the transcription of PI3K and AKT and the phosphorylation of MEK and ERK. LA affects activation of PI3K/AKT and MEK/ERK signaling pathways further supporting the possibility that LA plays an antitumor role by targeting VEGFR-2.


## 5. Conclusions

In conclusion, our results reveal for the first time that LA could suppresses GC growth and metastasis in vitro and in vivo. Furthermore, LA inhibits VEGFR-2 phosphorylation by inhibiting the binding of VEGF and VEGFR-2 and affects the activation of downstream the P13K/AKT and MEK/ERK signaling pathways. In addition, LA can inhibit the proliferation, block the G1 phase, induce apoptosis, and inhibit the migration, invasion, and EMT of VEGF-stimulated MKN-45 cells (Figure8). Taken together, this is the first report on the ability of LA to target and inhibit the tyrosine kinase activity of VEGFR-2, thereby facilitating GC targeted therapy.Figure 8
The schematic representation of the proposed model. LA inhibits activation of VEGFR2, blocking downstream PI3K/AKT and MEK/ERK signaling pathways, which represses GC cell proliferation and metastasis, and induces cycle arrest as well as apoptosis.



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*Source: 5497991-2022-04-25.xml*