ganoderic acid a extract induces apoptosis and upregulates autophagy-related genes in nalm-6 cell line: a potential therapeutic agent for acute lymphoblastic leukemia

Background: acute lymphoblastic leukemia (all) is the most common leukemia in children and is associated with a high relapse rate despite current treatments. ganoderic acid a (gaa) is a bioactive compound found in ganoderma lucidum that has shown potential antileukemic properties. objectives: this study aimed to investigate the effect of a gaa extract on autophagy gene expression and apoptosis induction in the nalm-6 cell line. methods: a total of 20 × 103 nalm-6 cells were cultured in triplicate across various conditions: culture condition supplemented with gaa, culture condition supplemented with l-asparaginase, culture condition supplemented with both gaa and l-asparaginase, and culture condition alone without l-asparaginase and gaa. the optimal concentration of gaa treatment was determined using an mtt assay. flow cytometry was used to assess cell death induced by gaa treatment, using fitc-conjugated propidium iodide (pi) and annexin v staining. the expression levels of autophagy-related genes, including map1lc3b, becn1, atg5, atg10, rb1cc1, and ambra1, were measured in the groups using real-time polymerase chain reaction. results: the results of the mtt test indicated that the half maximum inhibitory concentration (ic50) of gaa against leukemic cells was 140 μg/ml after 48 hours of treatment. moreover, flow cytometry analysis demonstrated a 40.5% increase in apoptosis and cell death at a concentration of 140 μg/ml of gaa after 48 hours. furthermore, treatment with gaa resulted in upregulation of the expression of map1lc3b (p = 0.024), becn1 (p = 0.035), atg5 (p = 0.024), atg10 (p = 0.024), rb1cc1 (p = 0.024), and ambra1 (p = 0.024) in nalm-6 cells compared to the control groups. conclusions: these findings suggest that gaa has potential as a therapeutic agent for all. the gaa might have potential therapeutic properties against all.