We have investigated the effect of tumor promoting phorbol esters on the antiproliferative actions of several antitumor agents. Pretreatment of HeLa cells with 12-O-tetradecanoylphorbol 13-acetate (TPA) or phorbol 12,13-dibutyrate (PDBu) caused a significant (9-fold) increase in cellular sensitivity to cis-diamminedichloroplatinum(II) (CP). TPA also sensitized HeLa cells to melphalan (2.5-fold) but had no effect on the antiproliferative activity of bleomycin, doxorubicin, vincristine, or mitomycin C. The sensitization of HeLa cells by TPA was concentration-dependent up to 1 nM and paralleled the activation of protein kinase C by TPA measured in vitro. The maximum stimulation of protein kinase C (6-fold) was observed with 10 nM TPA. 4 alpha-Phorbol 12,13-didecanoate neither activated protein kinase C nor sensitized HeLa cells to CP. 4-O-Methyl-TPA, which does not affect cell cycle distribution of HeLa cells, also sensitized these cells to CP by 6-fold and activated protein kinase C by 3-fold. Inhibitors of protein kinase C, such as palmitoylcarnitine and sphingosine, antagonized PDBu-induced sensitization of HeLa cells to CP. The maximum sensitization of HeLa cells to CP required prolonged pretreatment (greater than or equal to 24 h) with phorbol esters but could not be explained by down-regulation of protein kinase C. For example, 4-O-methyl-TPA caused no down-regulation of protein kinase C. Moreover, TPA caused substantial down-regulation of protein kinase C (1% of control) in A-253 cells but failed to sensitize A-253 cells to CP. TPA (100 nM), however, activated protein kinase C in A-253 cells by 5.5-fold. Therefore, activation of protein kinase C by TPA appears to be necessary but not sufficient for cellular sensitization to CP. The sensitization of HeLa cells by TPA was associated with a concentration- and time-dependent increase in cellular platinum content. The protein synthesis inhibitor cycloheximide (10 micrograms/ml) blocked sensitization of HeLa cells to CP as well as the increase in platinum content caused by a 24-h pretreatment with PDBu.
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