Combination of metformin and cold atmospheric plasma induces glioma cell death to associate with c-Fos

Glioma is the most common type of brain cancer.Chemotherapy combination with surgery and radiotherapy is a standard treatment for patients.Although there are many advances in glioma therapy, the prognosis of glioma patients has not significantly been improved over the past decades.Hence, there is still an urgent need to develop a new therapy to treat glioma.Cell viability was assessed by CellTiter Blue assay; flow cytometry (FCM) was used for detecting cell apoptosis; ROS detection was detected by ROS Assay; H2O2 detection was performed by hydrogen peroxide detection kits; real-time PCR and WB were used to determine gene expression.Using the glioma cell line U251 and U87, we investigated a possible combination inhibitory effect includes metformin and cold atmospheric plasma (CAP).The combination treatment showed a synergistic inhibitory effect on cell viability, significantly inducing cell apoptosis.Furthermore, we also found H2O2 produced by CAP has an important role in the synergistic inhibitory effect, eliminating H2O2 with catalase reversed the synergistic inhibitory effect.In addition, the transcript and protein levels of c-FOS were robustly increased after co-treated with metformin and CAP.Taken together, we propose that pre-treatment of glioma cells with metformin sensitize tumor cells to CAP, which may serve as a potential therapeutic strategy for glioma.