Vitamin C increases DNA breaks and suppresses DNA damage-independent activation of ATM by bleomycin

Free Radic Biol Med. 2019 May 20;136:12-21. doi: 10.1016/j.freeradbiomed.2019.03.026. Epub 2019 Mar 26.


Bleomycin is a redox-active drug with anticancer and other clinical applications. It is also frequently used as a tool in fundamental research on cellular responses to DNA double-strand breaks (DSBs). A conversion of bleomycin into its DNA-breaking form requires Fe, one-electron donors and O2. Here, we examined how a major biological antioxidant ascorbate (reduced vitamin C), which is practically absent in standard cell culture, impacts cellular responses to bleomycin. We found that restoration of physiological levels of vitamin C in human cancer cells increased their killing by bleomycin in 2D cultures and 3D tumor spheroids. Higher cytotoxicity of bleomycin occurred in cells with normal and shRNA-depleted p53. Cellular vitamin C enhanced the ability of bleomycin by produce DSBs, which was established by direct measurements of these lesions in three cell lines. Vitamin C-restored cancer cells also showed a higher sensitivity to killing by low-dose bleomycin in combination with inhibitors of DSB repair-activating ATM or DNA-PK kinases. The presence of ascorbate in bleomycin-treated cells suppressed a DSB-independent activation of the ATM-CHK2 axis by blocking superoxide radical. In vitro studies detected a greatly superior ability of ascorbate over other cellular reducers to catalyze DSB formation by bleomycin. Ascorbate was faster than other antioxidants in promoting two steps in activation of bleomycin. Our results demonstrate strong activation effects of vitamin C on bleomycin, shifting its toxicity further toward DNA damage and making it more sensitive to manipulations of DNA repair.

Keywords: ATM; Ascorbate; Bleomycin; DNA double-strand break; Superoxide; Vitamin C.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antibiotics, Antineoplastic / pharmacology*
  • Ascorbic Acid / pharmacology*
  • Ataxia Telangiectasia Mutated Proteins / metabolism
  • Bleomycin / pharmacology*
  • Cell Line, Tumor
  • DNA Breaks, Double-Stranded / drug effects*
  • DNA Damage / drug effects*
  • Enzyme Activation / drug effects
  • Humans


  • Antibiotics, Antineoplastic
  • Bleomycin
  • ATM protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • Ascorbic Acid