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Bercier P, de Thé H. History of Developing Acute Promyelocytic Leukemia Treatment and Role of Promyelocytic Leukemia Bodies. Cancers (Basel) 2024; 16:1351. [PMID: 38611029 PMCID: PMC11011038 DOI: 10.3390/cancers16071351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
The story of acute promyelocytic leukemia (APL) discovery, physiopathology, and treatment is a unique journey, transforming the most aggressive form of leukemia to the most curable. It followed an empirical route fueled by clinical breakthroughs driving major advances in biochemistry and cell biology, including the discovery of PML nuclear bodies (PML NBs) and their central role in APL physiopathology. Beyond APL, PML NBs have emerged as key players in a wide variety of biological functions, including tumor-suppression and SUMO-initiated protein degradation, underscoring their broad importance. The APL story is an example of how clinical observations led to the incremental development of the first targeted leukemia therapy. The understanding of APL pathogenesis and the basis for cure now opens new insights in the treatment of other diseases, especially other acute myeloid leukemias.
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Affiliation(s)
- Pierre Bercier
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, 75231 Paris, France;
- GenCellDis, Inserm U944, CNRS UMR7212, Université Paris Cité, 75010 Paris, France
| | - Hugues de Thé
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, 75231 Paris, France;
- GenCellDis, Inserm U944, CNRS UMR7212, Université Paris Cité, 75010 Paris, France
- Hematology Laboratory, Hôpital St Louis, AP/HP, 75010 Paris, France
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2
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Wang W, Matunis MJ. Paralogue-Specific Roles of SUMO1 and SUMO2/3 in Protein Quality Control and Associated Diseases. Cells 2023; 13:8. [PMID: 38201212 PMCID: PMC10778024 DOI: 10.3390/cells13010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Small ubiquitin-related modifiers (SUMOs) function as post-translational protein modifications and regulate nearly every aspect of cellular function. While a single ubiquitin protein is expressed across eukaryotic organisms, multiple SUMO paralogues with distinct biomolecular properties have been identified in plants and vertebrates. Five SUMO paralogues have been characterized in humans, with SUMO1, SUMO2 and SUMO3 being the best studied. SUMO2 and SUMO3 share 97% protein sequence homology (and are thus referred to as SUMO2/3) but only 47% homology with SUMO1. To date, thousands of putative sumoylation substrates have been identified thanks to advanced proteomic techniques, but the identification of SUMO1- and SUMO2/3-specific modifications and their unique functions in physiology and pathology are not well understood. The SUMO2/3 paralogues play an important role in proteostasis, converging with ubiquitylation to mediate protein degradation. This function is achieved primarily through SUMO-targeted ubiquitin ligases (STUbLs), which preferentially bind and ubiquitylate poly-SUMO2/3 modified proteins. Effects of the SUMO1 paralogue on protein solubility and aggregation independent of STUbLs and proteasomal degradation have also been reported. Consistent with these functions, sumoylation is implicated in multiple human diseases associated with disturbed proteostasis, and a broad range of pathogenic proteins have been identified as SUMO1 and SUMO2/3 substrates. A better understanding of paralogue-specific functions of SUMO1 and SUMO2/3 in cellular protein quality control may therefore provide novel insights into disease pathogenesis and therapeutic innovation. This review summarizes current understandings of the roles of sumoylation in protein quality control and associated diseases, with a focus on the specific effects of SUMO1 and SUMO2/3 paralogues.
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Affiliation(s)
| | - Michael J. Matunis
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
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3
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Parsa L, Motafakkerazad R, Soheyli ST, Haratian A, Kosari-Nasab M, Mahdavi M. Silymarin in combination with ATRA enhances apoptosis induction in human acute promyelocytic NB4 cells. Toxicon 2023; 228:107127. [PMID: 37085055 DOI: 10.1016/j.toxicon.2023.107127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/30/2023] [Accepted: 04/13/2023] [Indexed: 04/23/2023]
Abstract
Although all-trans retinoic acid (ATRA) is an efficient pattern in acute promyelocytic leukemia (APL) therapy, further studies are required due to the extant clinical limitations of ATRA. It has been reported that Silymarin, an anti-cancer herbal substance extracted from milk thistle (Silybum marianum), is able to regulate apoptosis in various types of cancer cells through different mechanisms of action. This study investigated the apoptosis-inducing effect of Silymarin (SM) alone and in combination with ATRA on human acute promyelocytic NB4 cells. Examination using MTT assay indicated that SM treatment leads to growth inhibition in NB4 cells in a dose-dependent manner. The IC50 values of SM and ATRA were calculated 90 μM and 2 μM, respectively. Cell cycle analysis by flow cytometry revealed that a more increase in the sub-G1 phase (a sign of apoptosis) when cells were exposed to SM in combination with ATRA. The incidence of apoptosis was confirmed through Hoechst 33258 staining and Annexin V-FITC analysis. The results showed that Silymarin enhances ATRA-induced apoptosis. The flow cytometric analysis also indicated an enhancement in levels of ROS in the treated cells with both compounds. The real-time PCR illustrated that SM targets apoptosis by down-regulation in Survivin and Bcl-2 while up-regulation in Bax. The findings showed that the combination of the two compounds is more effective in the induction of apoptosis in NB4 cells. Molecular docking studies indicated that Sylibin, as a primary compound of the SM, binds to the BH3 domain of Bcl-2 and the BIR domain of Survivin with various affinities. Based on the findings, it seems that SM used alone and in combination with ATRA may be beneficial for inducing apoptosis in APL cells.
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Affiliation(s)
- Leila Parsa
- Department of Plant Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | | | - Sarvin Taleb Soheyli
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Amin Haratian
- Department of Cell and Molecular Sciences, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Morteza Kosari-Nasab
- Department of Plant Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran; Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mahdavi
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran; Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
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Paul NP, Galván AE, Yoshinaga-Sakurai K, Rosen BP, Yoshinaga M. Arsenic in medicine: past, present and future. Biometals 2023; 36:283-301. [PMID: 35190937 PMCID: PMC8860286 DOI: 10.1007/s10534-022-00371-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/05/2022] [Indexed: 12/17/2022]
Abstract
Arsenicals are one of the oldest treatments for a variety of human disorders. Although infamous for its toxicity, arsenic is paradoxically a therapeutic agent that has been used since ancient times for the treatment of multiple diseases. The use of most arsenic-based drugs was abandoned with the discovery of antibiotics in the 1940s, but a few remained in use such as those for the treatment of trypanosomiasis. In the 1970s, arsenic trioxide, the active ingredient in a traditional Chinese medicine, was shown to produce dramatic remission of acute promyelocytic leukemia similar to the effect of all-trans retinoic acid. Since then, there has been a renewed interest in the clinical use of arsenicals. Here the ancient and modern medicinal uses of inorganic and organic arsenicals are reviewed. Included are antimicrobial, antiviral, antiparasitic and anticancer applications. In the face of increasing antibiotic resistance and the emergence of deadly pathogens such as the severe acute respiratory syndrome coronavirus 2, we propose revisiting arsenicals with proven efficacy to combat emerging pathogens. Current advances in science and technology can be employed to design newer arsenical drugs with high therapeutic index. These novel arsenicals can be used in combination with existing drugs or serve as valuable alternatives in the fight against cancer and emerging pathogens. The discovery of the pentavalent arsenic-containing antibiotic arsinothricin, which is effective against multidrug-resistant pathogens, illustrates the future potential of this new class of organoarsenical antibiotics.
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Affiliation(s)
- Ngozi P Paul
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Adriana E Galván
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Kunie Yoshinaga-Sakurai
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Barry P Rosen
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA.
| | - Masafumi Yoshinaga
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
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5
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Boldig K, Kiamos A, Matthews-Hew T, Omman R, Quan W. Acute Promyelocytic Leukemia Treatment Masking Hepatic Tuberculosis: A Management Dilemma. J Hematol 2023; 12:100-104. [PMID: 37187498 PMCID: PMC10181323 DOI: 10.14740/jh1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023] Open
Abstract
Acute promyelocytic leukemia is a form of acute myeloid leukemia (AML) that is characterized by presence of a promyelocytic leukemia-retinoic acid receptor alpha fusion. In most patients, this fusion is detected on conventional karyotype as the t(15;17)(q24.1;q21.2) translocation, but some patients have cryptic translocations with a normal karyotype. Historically, AML is associated with a poor prognosis. Treatment with all-trans retinoic acid and arsenic trioxide assures long-term survival in the majority of patients. This treatment is generally well-tolerated but may cause hepatotoxicity. This is usually identified by transaminitis but resolves after temporary cessation of treatment. Our patient's hepatotoxicity did not resolve following all-trans retinoic acid and arsenic trioxide cessation which posed a diagnostic dilemma. This prompted exploration of other possible causes of hepatotoxicity. An eventual liver biopsy identified acid-fast bacilli, confirming a diagnosis of hepatic tuberculosis. A broad differential diagnosis is imperative when investigating abnormalities in liver function, especially in chemotherapy patients when treatment cessation may cause cancer progression.
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Affiliation(s)
- Kimberly Boldig
- Department of Internal Medicine, University of Florida College of Medicine: Jacksonville, Jacksonville, FL 32209, USA
- Corresponding Author: Kimberly Boldig, Department of Internal Medicine, University of Florida College of Medicine: Jacksonville, Jacksonville, FL 32209, USA.
| | - Amy Kiamos
- Department of Internal Medicine, University of Florida College of Medicine: Jacksonville, Jacksonville, FL 32209, USA
| | - Trevanne Matthews-Hew
- Department of Hematology and Oncology, Mayo Clinic Jacksonville, Jacksonville, FL 32224, USA
| | - Reeba Omman
- Department of Pathology, University of Florida College of Medicine: Jacksonville, Jacksonville, FL 32209, USA
| | - Walter Quan
- Department of Hematology and Oncology, University of Florida College of Medicine: Jacksonville, Jacksonville, FL 32209, USA
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Korsos V, Miller WH. How retinoic acid and arsenic transformed acute promyelocytic leukemia therapy. J Mol Endocrinol 2022; 69:T69-T83. [PMID: 36112505 DOI: 10.1530/jme-22-0141] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/08/2022]
Abstract
Acute promyelocytic leukemia (APL) is associated with severe coagulopathy leading to rapid morbidity and mortality if left untreated. The definitive diagnosis of APL is made by identifying a balanced reciprocal translocation between chromosomes 15 and 17. This t(15;17) results in a fusion transcript of promyelocytic leukemia (PML) and retinoic acid receptor alpha (RARA) genes and the expression of a functional PML/RARA protein. Detection of a fused PML/RARA genomic DNA sequence using fluorescence in situ hybridization (FISH) or by detection of the PML/RARA fusion transcript via reverse transcriptase polymerase chain reaction (RT-PCR) has revolutionized the diagnosis and monitoring of APL. Once confirmed, APL is cured in over 90% of cases, making it the most curable subtype of acute leukemia today. Patients with low-risk APL are successfully treated using a chemotherapy-free combination of all-trans retinoic acid and arsenic trioxide (ATO). In this review, we explore the work that has gone into the modern-day diagnosis and highly successful treatment of this once devastating leukemia.
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Affiliation(s)
- Victoria Korsos
- Division of Hematology, Jewish General Hospital, Montreal, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Wilson H Miller
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, Jewish General Hospital, Montreal, Canada
- Lady Davis Institute for Medical Research, Montreal, Canada
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Effects of co-administration of arsenic trioxide and Schiff base oxovanadium complex on the induction of apoptosis in acute promyelocytic leukemia cells. Biometals 2021; 34:1067-1080. [PMID: 34255251 DOI: 10.1007/s10534-021-00330-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Acute promyelocytic leukaemia (APL) is commonly treated with arsenic trioxide (As2O3) that has many side effects. Given the increasing trend of studies on beneficial therapeutic properties of synthetic compounds containing vanadium, the present study sought to use Schiff base oxovanadium complex to reduce the needed concentration of arsenic trioxide. The HL-60 cell line, which is a model of APL, was selected and the effects of arsenic trioxide and Schiff base oxovanadium complex were individually and simultaneously evaluated on the cell viability by the MTT assay. Flow cytometry and Real-time RT-PCR were also performed to investigate the rate of apoptosis and the expression of P53 and P21 genes, respectively. The IC50 of arsenic trioxide and Schiff base oxovanadium complex on Hl-60 cells was 8.37 ± 0.36 µM and 34.12 ± 1.52 µg/ml, respectively. At the simultaneous administration of both compounds, the maximum decrease in the cell viability was seen in co-administration of 40 µg/ml of Schiff base oxovanadium complex and 0.001 µM of arsenic trioxide. Real-time RT-PCR indicated that the co-administration of Schiff base oxovanadium complex 40 µg/ml and arsenic trioxide 0.001 µM could increase the expression of P53 and P21 genes by 3.76 ± 0.19 and 6.57 ± 1.29 fold change, respectively to the control sample. The flow cytometry studies also indicated that this co-administration could induce apoptosis up to 67% ± 0.9% significantly higher than the control sample. The use of Schiff base oxovanadium complex could significantly reduce the required dose of arsenic trioxide to induce apoptosis in HL-60 cells.
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Wahiduzzaman M, Ota A, Hosokawa Y. Novel Mechanistic Insights into the Anti-cancer Mode of Arsenic Trioxide. Curr Cancer Drug Targets 2021; 20:115-129. [PMID: 31736446 DOI: 10.2174/1568009619666191021122006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/23/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022]
Abstract
Arsenic, a naturally-occurring toxic element, and a traditionally-used drug, has received a great deal of attention worldwide due to its curative anti-cancer properties in patients with acute promyelocytic leukemia. Among the arsenicals, arsenic trioxide has been most widely used as an anti-cancer drug. Recent advances in cancer therapeutics have led to a paradigm shift away from traditional cytotoxic drugs towards the targeting of proteins closely associated with driving the cancer phenotype. Due to the diverse anti-cancer effects of ATO on different types of malignancies, numerous studies have made efforts to uncover the mechanisms of ATO-induced tumor suppression. From in vitro cellular models to studies in clinical settings, ATO has been extensively studied. The outcomes of these studies have opened doors to establishing improved molecular-targeted therapies for cancer treatment. The efficacy of ATO has been augmented by combination with other drugs. In this review, we discuss recent arsenic-based cancer therapies and summarize the novel underlying molecular mechanisms of the anti-cancer effects of ATO.
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Affiliation(s)
- Md Wahiduzzaman
- Department of Biochemistry, School of Medicine, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Akinobu Ota
- Department of Biochemistry, School of Medicine, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, School of Medicine, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
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Vicari HP, Lima K, Gomes RDC, Fernandes DC, da Silva JCL, Rodrigues Junior MT, Barroso de Oliveira AS, Dos Santos RN, Andricopulo AD, Coelho F, Costa-Lotufo LV, Machado-Neto JA. Synthetic cyclopenta[b]indoles exhibit antineoplastic activity by targeting microtubule dynamics in acute myeloid leukemia cells. Eur J Pharmacol 2021; 894:173853. [PMID: 33422507 DOI: 10.1016/j.ejphar.2021.173853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
Acute promyelocytic leukemia (APL) is associated with PML-RARα oncogene, which is treated using all-trans retinoic acid (ATRA)-based chemotherapy. However, chemoresistance is observed in 20-30% of treated patients and represents a clinical challenge, raising the importance of the development of new therapeutic options. In the present study, the effects of three synthetic cyclopenta[b]indoles on the leukemia phenotype were investigated using NB4 (ATRA-sensitive) and NB4-R2 (ATRA-resistant) cells. Among the tested synthetic cyclopenta[b]indoles, compound 2, which contains a heterocyclic nucleus, was the most active, presenting time-dependent cytotoxic activity in the μM range in APL cells, without cytotoxicity for normal leukocytes, and was selected for further characterization. Compound 2 significantly decreased clonogenicity, increased apoptosis, and caused cell cycle arrest at S and G2/M phases in a drug concentration-dependent manner. Morphological analyses indicated aberrant mitosis and diffuse tubulin staining upon compound 2 exposure, which corroborates cell cycle findings. In the molecular scenario, compound 2 reduced STMN1 expression and activity, and induced PARP1 cleavage and H2AX and CHK2 phosphorylation, and modulated CDKN1A, PMAIP1, GADD45A, and XRCC3 expressions, indicating reduction of cell proliferation, apoptosis, and DNA damage. Moreover, in the in vivo tubulin polymerization assay, NB4 and NB4-R2 cells showed a reduction in the levels of polymerized tubulin upon compound 2 exposure, which indicates tubulin as a target of the drug. Molecular docking supports this hypothesis. Taken together, these data indicated that compound 2 exhibits antileukemic effects through disrupting the microtubule dynamics, identifying a possible novel potential antineoplastic agent for the treatment of ATRA-resistant APL.
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Affiliation(s)
- Hugo Passos Vicari
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-900, Brazil
| | - Keli Lima
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-900, Brazil
| | - Ralph da Costa Gomes
- Department of Organic Chemistry, Chemistry Institute, University of Campinas, Campinas, São Paulo, SP, 13083-970, Brazil
| | - Daniara Cristina Fernandes
- Department of Organic Chemistry, Chemistry Institute, University of Campinas, Campinas, São Paulo, SP, 13083-970, Brazil; Currently at Instituto Federal de Educação Ciência e Tecnologia de São Paulo, Matão, SP, 15991-502, Brazil
| | - Jean Carlos Lipreri da Silva
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-900, Brazil
| | | | | | | | | | - Fernando Coelho
- Department of Organic Chemistry, Chemistry Institute, University of Campinas, Campinas, São Paulo, SP, 13083-970, Brazil
| | - Leticia Veras Costa-Lotufo
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-900, Brazil
| | - João Agostinho Machado-Neto
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-900, Brazil.
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Rinfret Robert C, McManus FP, Lamoliatte F, Thibault P. Interplay of Ubiquitin-Like Modifiers Following Arsenic Trioxide Treatment. J Proteome Res 2020; 19:1999-2010. [PMID: 32223133 DOI: 10.1021/acs.jproteome.9b00807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Arsenic trioxide (ATO) is a therapeutic agent used to treat acute promyelocytic leukemia (APL), a disease caused by a chromosomal translocation of the retinoic acid receptor α (RARα) gene that can occur reciprocally with the promyelocytic leukemia (PML) gene. The mechanisms through which ATO exerts its effects on cells are not fully characterized though they involve the SUMOylation, the ubiquitylation, and the degradation of the PML/RARα oncoprotein through the PML moiety. To better understand the mechanisms that underlie the cytotoxicity induced with increasing ATO levels, we profiled the changes in protein SUMOylation, phosphorylation, and ubiquitylation on HEK293 cells following exposure to low (1 μM) or elevated (10 μM) ATO for 4 h. Our analyses revealed that a low dose of ATO resulted in the differential modification of selected substrates including the SUMOylation (K380, K394, K490, and K497) and ubiquitylation (K337, K401) of PML. These experiments also highlighted a number of unexpected SUMOylated substrates involved in DNA damage response (e.g., PCNA, YY1, and poly[ADP-ribose] polymerase 1 (PARP1)) and messenger RNA (mRNA) splicing (e.g., ACIN1, USP39, and SART1) that were regulated at higher ATO concentrations. Interestingly, additional enzymatic assays revealed that SUMOylation of PARP1 impeded its proteolytic cleavage by caspase-3, suggesting that SUMOylation could have a protective role in delaying cell apoptosis.
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Affiliation(s)
- Clémence Rinfret Robert
- Institute for Research in Immunology and Cancer, Montreal, Québec H3T 1J4, Canada.,Department of Biochemistry, University of Montréal, Montreal, Québec H3T 1J4, Canada
| | - Francis P McManus
- Institute for Research in Immunology and Cancer, Montreal, Québec H3T 1J4, Canada
| | - Frédéric Lamoliatte
- Institute for Research in Immunology and Cancer, Montreal, Québec H3T 1J4, Canada.,Department of Chemistry, University of Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Québec H3T 1J4, Canada
| | - Pierre Thibault
- Institute for Research in Immunology and Cancer, Montreal, Québec H3T 1J4, Canada.,Department of Biochemistry, University of Montréal, Montreal, Québec H3T 1J4, Canada.,Department of Chemistry, University of Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Québec H3T 1J4, Canada
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Chen YT, Ou Yang WT, Juang HH, Chen CL, Chen HW, Tsui KH, Chang YH, Tsai CH, Hsueh C, Liao WC. Proteomic characterization of arsenic and cadmium exposure in bladder cells. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2020; 34 Suppl 1:e8578. [PMID: 31499585 DOI: 10.1002/rcm.8578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 05/22/2023]
Abstract
RATIONALE Accumulating evidence has linked prolonged exposure to heavy metals to cancer occurrence in the urinary system. However, the specific biological mechanisms responsible for the association of heavy metals with the unusually high incidence of upper tract urothelial carcinoma in Taiwan are complex and incompletely understood. METHODS To elucidate the specific biological mechanism and identify molecular indicators of the unusually high association of upper tract urothelial carcinoma with heavy metal exposure, protein expression following the treatment of T24 human bladder carcinoma and RT4 human bladder papilloma cell line models with arsenic (As) and cadmium (Cd) was studied. Proteomic changes in these cell models were integrated with data from a human bladder cancer (BLCA) tissue proteome to identify possible protein indicators of heavy metal exposure. RESULTS After mass spectrometry based proteomic analysis and verification by Western blotting procedures, we identified 66 proteins that were up-regulated and 92 proteins that were down-regulated in RT4 cell extracts after treatment with As or Cd. Some 52 proteins were up-regulated and 136 proteins were down-regulated in T24 cell extracts after treatment with Cd. We further confirmed that down-expression of the PML (promyelocytic leukemia) protein was sustained for at least 75 days after exposure of bladder cells to As. Dysregulation of these cellular proteins by As was associated with three biological pathways. Immunohistochemical analyses of paraffin-embedded BLCA tissue slides confirmed that PML protein expression was decreased in BLCA tumor cells compared with adjacent noncancerous epithelial cells. CONCLUSIONS These data suggest that PML may play an important role in the pathogenesis of BLCA and may be an indicator of heavy metal exposure in bladder cells.
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Affiliation(s)
- Yi-Ting Chen
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Wei-Ting Ou Yang
- Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Anatomy, College of Medicine, Chang Gung University, TaoYuan, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiao-Wei Chen
- Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ying-Hsu Chang
- Division of Urology, Department of Surgery, LinKou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Han Tsai
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chuen Hsueh
- Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Pathology, Chang Gung Memorial Hospital, Linkou, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Wei-Chao Liao
- Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Center for General Education, Chang Gung University, Taoyuan, Taiwan
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12
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Cheng CW, Tse E. Targeting PIN1 as a Therapeutic Approach for Hepatocellular Carcinoma. Front Cell Dev Biol 2020; 7:369. [PMID: 32010690 PMCID: PMC6974617 DOI: 10.3389/fcell.2019.00369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/16/2019] [Indexed: 12/12/2022] Open
Abstract
PIN1 is a peptidyl-prolyl cis/trans isomerase that specifically binds and catalyzes the cis/trans isomerization of the phosphorylated serine or threonine residue preceding a proline (pSer/Thr-Pro) motif of its interacting proteins. Through this phosphorylation-dependent prolyl isomerization, PIN1 is involved in the regulation of various important cellular processes including cell cycle progression, cell proliferation, apoptosis and microRNAs biogenesis; hence its dysregulation contributes to malignant transformation. PIN1 is highly expressed in hepatocellular carcinoma (HCC). By fine-tuning the functions of its interacting proteins such as cyclin D1, x-protein of hepatitis B virus and exportin 5, PIN1 plays an important role in hepatocarcinogenesis. Growing evidence supports that targeting PIN1 is a potential therapeutic approach for HCC by inhibiting cell proliferation, inducing cellular apoptosis, and restoring microRNAs biogenesis. Novel formulation of PIN1 inhibitors that increases in vivo bioavailability of PIN1 inhibitors represents a promising future direction for the therapeutic strategy of HCC treatment. In this review, the mechanisms underlying PIN1 over-expression in HCC are explored. Furthermore, we also discuss the roles of PIN1 in HCC tumorigenesis and metastasis through its interaction with various phosphoproteins. Finally, recent progress in the therapeutic options targeting PIN1 for HCC treatment is examined and summarized.
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Affiliation(s)
- Chi-Wai Cheng
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eric Tse
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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13
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Abstract
Arsenic trioxide (ATO) is among the first-line chemotherapeutic drugs used in oncological practice. It has shown substantial efficacy in treating patients with relapsed or refractory acute promyelocytic leukaemia. The clinical use of ATO is hampered due to cardiotoxicity and hence many patients are precluded from receiving this highly effective treatment. An alternative to this would be to use any drug that can ameliorate the cardiotoxic effects and allow exploiting the full therapeutic potential of ATO, with considerable impact on cancer therapy. Generation of reactive oxygen species is involved in a wide range of human diseases, including cancer, cardiovascular, pulmonary and neurological disorders. Hence, agents with the ability to protect against these reactive species may be therapeutically useful. The present review focuses on the beneficial as well as harmful effects of arsenic and ATO, the mechanisms underlying ATO toxicity and the possible ways that can be adopted to circumvent ATO-induced toxicity.
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14
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15
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Moradzadeh M, Ghorbani A, Erfanian S, Mohaddes ST, Rahimi H, Karimiani EG, Mashkani B, Chiang SC, El-Khamisy SF, Tabarraei A, Sadeghnia HR. Study of the mechanisms of crocetin-induced differentiation and apoptosis in human acute promyelocytic leukemia cells. J Cell Biochem 2019; 120:1943-1957. [PMID: 30203596 DOI: 10.1002/jcb.27489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 07/25/2018] [Indexed: 01/24/2023]
Abstract
Crocetin, the major carotenoid in saffron, exhibits potent anticancer effects. However, the antileukemic effects of crocetin are still unclear, especially in primary acute promyelocytic leukemia (APL) cells. In the current study, the potential antipromyelocytic leukemia activity of crocetin and the underlying molecular mechanisms were investigated. Crocetin (100 µM), like standard anti-APL drugs, all-trans retinoic acid (ATRA, 10 µM) and As2 O 3 (arsenic trioxide, 50 µM), significantly inhibited proliferation and induced apoptosis in primary APL cells, as well as NB4 and HL60 cells. The effect was associated with the decreased expressions of prosurvival genes Akt and BCL2, the multidrug resistance (MDR) proteins, ABCB1 and ABCC1 and the inhibition of tyrosyl-DNA phosphodiesterase 1 (TDP1), while the expressions of proapoptotic genes CASP3, CASP9, and BAX/BCL2 ratio were significantly increased. In contrast, crocetin at relatively low concentration (10 µM), like ATRA (1 µM) and As 2 O 3 (0.5 µM), induced differentiation of leukemic cells toward granulocytic pattern, and increased the number of differentiated cells expressing CD11b and CD14, while the number of the immature cells expressing CD34 or CD33 was decreased. Furthermore, crocetin suppressed the expression of clinical marker promyelocytic leukemia/retinoic acid receptor-α ( PML/RARα) in NB4 and primary APL cells, and reduced the expression of histone deacetylase 1 ( HDAC1) in all leukemic cells. The results suggested that crocetin can be considered as a candidate for future preclinical and clinical trials of complementary APL treatment.
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Affiliation(s)
- Maliheh Moradzadeh
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Department of New Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmad Ghorbani
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saiedeh Erfanian
- Non-Communicable Diseases Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Seyedeh Tahereh Mohaddes
- Internal Medicine Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Rahimi
- Internal Medicine Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Baratali Mashkani
- Department of Medical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shih-Chieh Chiang
- Department of Molecular Biology and Biotechnology, Krebs and Sheffield Institute of Nucleic Acids, University of Sheffield, Sheffield, UK
| | - Sherif F El-Khamisy
- Department of Molecular Biology and Biotechnology, Krebs and Sheffield Institute of Nucleic Acids, University of Sheffield, Sheffield, UK
| | - Alijan Tabarraei
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamid Reza Sadeghnia
- Department of New Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Division of Neurocognitive Sciences, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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16
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FLT3-ITD impedes retinoic acid, but not arsenic, responses in murine acute promyelocytic leukemias. Blood 2019; 133:1495-1506. [PMID: 30674471 DOI: 10.1182/blood-2018-07-866095] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/16/2019] [Indexed: 12/21/2022] Open
Abstract
Acute promyelocytic leukemia (APL) is often associated with activating FLT3 signaling mutations. These are highly related to hyperleukocytosis, a major adverse risk factor with chemotherapy-based regimens. APL is a model for oncogene-targeted therapies: all-trans retinoic acid (ATRA) and arsenic both target and degrade its ProMyelocytic Leukemia/Retinoic Acid Receptor α (PML/RARA) driver. The combined ATRA/arsenic regimen now cures virtually all patients with standard-risk APL. Although FLT3-internal tandem duplication (ITD) was an adverse risk factor for historical ATRA/chemotherapy regimens, the molecular bases for this effect remain unknown. Using mouse APL models, we unexpectedly demonstrate that FLT3-ITD severely blunts ATRA response. Remarkably, although the transcriptional output of initial ATRA response is unaffected, ATRA-induced PML/RARA degradation is blunted, as is PML nuclear body reformation and activation of P53 signaling. Critically, the combination of ATRA and arsenic fully rescues therapeutic response in FLT3-ITD APLs, restoring PML/RARA degradation, PML nuclear body reformation, P53 activation, and APL eradication. Moreover, arsenic targeting of normal PML also contributes to APL response in vivo. These unexpected results explain the less favorable outcome of FLT3-ITD APLs with ATRA-based regimens, and stress the key role of PML nuclear bodies in APL eradication by the ATRA/arsenic combination.
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17
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Pharmacokinetic Properties of Arsenic Species after Intravenous and Intragastrical Administration of Arsenic Trioxide Solution in Cynomolgus Macaques Using HPLC-ICP-MS. Molecules 2019; 24:molecules24020241. [PMID: 30634677 PMCID: PMC6359110 DOI: 10.3390/molecules24020241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/01/2023] Open
Abstract
A rapid and sensitive method was established for arsenic (As) speciation based on high performance liquid chromatography coupled to inductively coupled plasma mass spectrometry (HPLC-ICP-MS). This method was validated for the quantification of four arsenic species, including arsenite (AsIII), arsenate (AsV), monomethylarsonic acid (MMAV) and dimethylarsinic acid (DMAV) in cynomolgus macaque plasma. Separation was achieved in just 3.7 min with an alkyl reverse phase column and highly aqueous mobile phase containing 20 mM citric acid and 5 mM sodium hexanesulfonate (pH = 4.3). The calibration curves were linear over the range of 5⁻500 ng·mL-1 (measured as As), with r > 0.99. The above method was validated for selectivity, precision, accuracy, matrix effect, recovery, carryover effect and stability, and applied in a comparative pharmacokinetic study of arsenic species in cynomolgus macaque samples following intravenous and intragastrical administration of arsenic trioxide solution (0.80 mg·kg-1; 0.61 mg·kg-1 of arsenic); in addition, the absolute oral bioavailability of the active ingredient AsIII of arsenic trioxide in cynomolgus macaque samples was derived as 60.9 ± 16.1%.
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18
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Yen CM, Tsai CW, Chang WS, Yang YC, Hung YW, Lee HT, Shen CC, Sheu ML, Wang JY, Gong CL, Cheng WY, Bau DAT. Novel Combination of Arsenic Trioxide (As 2O 3) Plus Resveratrol in Inducing Programmed Cell Death of Human Neuroblastoma SK-N-SH Cells. Cancer Genomics Proteomics 2018; 15:453-460. [PMID: 30343279 DOI: 10.21873/cgp.20104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 12/23/2022] Open
Abstract
AIM Arsenic trioxide (As2O3), known as pi-shuang and the most toxic compound in traditional Chinese medicine, has been used as an antitumor agent for thousands of years. Resveratrol (3,5,4'-trihydroxy-trans-stilbene) is a natural phenol that has significant anti-bacterial, anti-fungaI and antiaging activities. Our study aimed to examine the combined anticancer effects of As2O3 and resveratrol against human neuroblastoma SK-N-SH cells, and elucidate the underlying intracellular signaling. MATERIALS AND METHODS SK-N-SH cells were treated with an extremely low-dose (2-4 μM) of As2O3 alone or combined with 75 μg/ml resveratrol for further comparisons. Cell viability, apoptotic signaling as well as synergistic cytotoxic effects were estimated using the MTT assay, microscopy observation, flow cytometric analysis for loss of mitochondrial membrane potential (MMP) and reactive oxygen species (ROS), and typical quantitative western blotting analysis. Student's t-test, and one- and two-way analysis of variance (ANOVA) were used for examination of significant differences. RESULTS The combined treatment was more effective than single treatment of As2O3 or resveratrol alone in suppressing cell viability, which correlated with the elevation of ROS levels. The intracellular mechanisms of cytotoxicity of As2O3 plus resveratrol were revealed as ROS accumulation and relative decrease of MMP, leading to activation of caspase-3 and -9, but not of caspase-1, -7 and-8. Combination treatment reduced the expression of B-cell lymphoma 2 (BCL2), BH3 interacting domain death agonist (BID), and BCL-x/L. CONCLUSION Combined treatment at extremely low concentration of two agents from natural products, As2O3 and resveratrol, has high potential as a cocktail of anticancer drugs for neuroblastoma.
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Affiliation(s)
- Chun-Ming Yen
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, R.O.C.,Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Wen-Shin Chang
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Yi-Chin Yang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Yi-Wen Hung
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Hsu-Tung Lee
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chiung-Chyi Shen
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Meei-Ling Sheu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan, R.O.C
| | - Ju-Yu Wang
- Basic Medical Science, Department of Nursing, Hung Kuang University, Taichung, Taiwan, R.O.C
| | - Chi-Li Gong
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.
| | - Wen-Yu Cheng
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C. .,Department of Physical Therapy, Hung Kuang University, Taichung, Taiwan, R.O.C
| | - DA-Tian Bau
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C. .,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, R.O.C
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19
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Yang X, Tan Y, Wang P, Zhang H, Zhao M, Zhao X, Wang K. PML-RARα interferes with erythropoiesis by repressing LMO2 in acute promyelocytic leukaemia. J Cell Mol Med 2018; 22:6275-6284. [PMID: 30320491 PMCID: PMC6237603 DOI: 10.1111/jcmm.13917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 07/06/2018] [Accepted: 08/27/2018] [Indexed: 12/21/2022] Open
Abstract
The PML‐RARα fusion gene, generated by the t(15;17) chromosome translocation, is regarded as the initiating factor of acute promyelocytic leukaemia (APL). In addition to the well‐known effects on blocking myeloid differentiation at the promyelocytic stage, promyelocytic leukaemia‐retinoic acid receptor α (PML‐RARα) has also been reported to interfere with multiple differentiation processes, including erythroid differentiation. However, the detailed molecular mechanism by which PML‐RARα impairs erythropoiesis has not yet been fully addressed. By chromatin immunoprecipitation‐PCR assay, we found that PML‐RARα bound to the distal promoter region of LMO2 (LIM‐only protein 2), a critical erythroid‐specific transcription factor. Luciferase reporter assays and qRT‐PCR results demonstrated that PML‐RARα down‐regulated the expression of the LMO2 distal transcript through transrepressing its promoter activity. Analysis of gene expression profiling data from large cohorts of acute myeloid leukaemia (AML) patients confirmed that LMO2 expressed at a markedly lower level in APL patients in comparison to non‐APL AML patients. Further flow cytometry analysis demonstrated that PML‐RARα inhibited erythropoietin‐induced erythroid differentiation by down‐regulating LMO2 expression. Our findings reveal a previously unidentified mechanism, by which PML‐RARα interferes with erythropoiesis through directly targeting and transrepressing LMO2 expression in the development of APL.
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Affiliation(s)
- Xianwen Yang
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Tan
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Wang
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Zhang
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming Zhao
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xujie Zhao
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kankan Wang
- State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Sino-French Research Center for Life Sciences and Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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20
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Abstract
The field of Traditional Chinese Medicine (TCM) represents a vast and largely untapped resource for modern medicine. Exemplified by the success of the antimalarial artemisinin, the recent years have seen a rapid increase in the understanding and application of TCM-derived herbs and formulations for evidence-based therapy. In this review, we summarise and discuss the developmental history, clinical background and molecular basis of an action for several representative TCM-derived medicines, including artemisinin, arsenic trioxide, berberine and Salvia miltiorrhiza or Danshen. Through this, we highlight important examples of how TCM-derived medicines have already contributed to modern medicine, and discuss potential avenues for further research.
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21
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Park WH, Han BR, Park HK, Kim SZ. Arsenic trioxide induces growth inhibition and death in human pulmonary artery smooth muscle cells accompanied by mitochondrial O2•- increase and GSH depletion. ENVIRONMENTAL TOXICOLOGY 2018; 33:833-840. [PMID: 29708299 DOI: 10.1002/tox.22569] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/01/2018] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Abstract
Arsenic trioxide (ATO; As2 O3 ) induces cell death in various cells via oxidative stress. Expose to chronic arsenic is involved in the development of vascular diseases. However, little is known about the cytotoxic effects of ATO on human normal vascular smooth muscle cells (VSMCs). Thus, in this study, we investigated the effects of ATO on cell growth and death in human pulmonary artery smooth muscle (HPASM) cells in relation to reactive oxygen species (ROS) and glutathione (GSH) levels. ATO treatment decreased the growth of HPASM cells with an IC50 of ∼30-50 μM at 24 h, and ATO induced HPASM cell death via apoptosis or necrosis dependent on the doses of it at this time. Treatment with 50 μM ATO did not increase ROS levels at the early time points, but it significantly increased mitochondrial O2•- levels at 24 h. ATO also induced GSH depletion in HPASM cells. N-acetyl cysteine (NAC; a well-known antioxidant) did not significantly affect apoptotic cell death, ROS levels, or GSH depletion in ATO-treated HPASM cells. However, l-buthionine sulfoximine (BSO; an inhibitor of GSH synthesis) intensified mitochondrial O2•- levels in ATO-treated HPASM cells, and significantly increased cell death and GSH depletion in these cells as well. In summary, we provided the first evidence that ATO inhibited the growth of HPASM cells, and induced apoptotic and/or necrotic cell death in these cells, accompanied by increases in mitochondrial O2•- level and GSH depletion.
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Affiliation(s)
- Woo Hyun Park
- Department of Physiology, Medical School, Research Institute for Endocrine Sciences, Chonbuk National University, 20 Geonji-ro, Deokjin, Jeonju, Jeollabuk, 54907, Republic of Korea
| | - Bo Ran Han
- Department of Physiology, Medical School, Research Institute for Endocrine Sciences, Chonbuk National University, 20 Geonji-ro, Deokjin, Jeonju, Jeollabuk, 54907, Republic of Korea
| | - Hyun Kyung Park
- Department of Physiology, Medical School, Research Institute for Endocrine Sciences, Chonbuk National University, 20 Geonji-ro, Deokjin, Jeonju, Jeollabuk, 54907, Republic of Korea
| | - Sung Zoo Kim
- Department of Physiology, Medical School, Research Institute for Endocrine Sciences, Chonbuk National University, 20 Geonji-ro, Deokjin, Jeonju, Jeollabuk, 54907, Republic of Korea
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22
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Boyer A, Pasquier E, Tomasini P, Ciccolini J, Greillier L, Andre N, Barlesi F, Mascaux C. Drug repurposing in malignant pleural mesothelioma: a breath of fresh air? Eur Respir Rev 2018. [PMID: 29540495 DOI: 10.1183/16000617.0098-2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Drug repurposing is the use of known drugs for new indications. Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. So far, few treatments have been approved in this disease. However, its incidence is expected to increase significantly, particularly in developing countries. Consequently, drug repurposing appears as an attractive strategy for drug development in MPM, since the known pharmacology and safety profile based on previous approvals of repurposed drugs allows for faster time-to-market for patients and lower treatment cost. This is critical in low- and middle-income countries where access to expensive drugs is limited. This review assesses the published preclinical and clinical data about drug repurposing in MPM.In this review, we identified 11 therapeutic classes that could be repositioned in mesothelioma. Most of these treatments have been evaluated in vitro, half have been evaluated in vivo in animal models of MPM and only three (i.e. valproate, thalidomide and zoledronic acid) have been investigated in clinical trials, with limited benefits so far. Efforts could be coordinated to pursue further investigations and test promising drugs identified in preclinical experiments in appropriately designed clinical trials.
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Affiliation(s)
- Arnaud Boyer
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Dept, Marseille, France.,Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
| | - Eddy Pasquier
- Aix Marseille University, Assistance Publique des Hôpitaux de Marseille, Dept of Haematology and Paediatric Oncology, Marseille, France
| | - Pascale Tomasini
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Dept, Marseille, France.,Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
| | - Joseph Ciccolini
- Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
| | - Laurent Greillier
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Dept, Marseille, France.,Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
| | - Nicolas Andre
- Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
| | - Fabrice Barlesi
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Dept, Marseille, France.,Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
| | - Celine Mascaux
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Dept, Marseille, France .,Centre de Recherche en Cancérologie de Marseille (CRCM, Marseille Cancer Research Centre), Inserm UMR1068, CNRS UMR7258 and Aix-Marseille University UM105, Marseille, France
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23
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Voisset E, Moravcsik E, Stratford EW, Jaye A, Palgrave CJ, Hills RK, Salomoni P, Kogan SC, Solomon E, Grimwade D. Pml nuclear body disruption cooperates in APL pathogenesis and impairs DNA damage repair pathways in mice. Blood 2018; 131:636-648. [PMID: 29191918 PMCID: PMC5805489 DOI: 10.1182/blood-2017-07-794784] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/26/2017] [Indexed: 01/20/2023] Open
Abstract
A hallmark of acute promyelocytic leukemia (APL) is altered nuclear architecture, with disruption of promyelocytic leukemia (PML) nuclear bodies (NBs) mediated by the PML-retinoic acid receptor α (RARα) oncoprotein. To address whether this phenomenon plays a role in disease pathogenesis, we generated a knock-in mouse model with NB disruption mediated by 2 point mutations (C62A/C65A) in the Pml RING domain. Although no leukemias developed in PmlC62A/C65A mice, these transgenic mice also expressing RARα linked to a dimerization domain (p50-RARα model) exhibited a doubling in the rate of leukemia, with a reduced latency period. Additionally, we found that response to targeted therapy with all-trans retinoic acid in vivo was dependent on NB integrity. PML-RARα is recognized to be insufficient for development of APL, requiring acquisition of cooperating mutations. We therefore investigated whether NB disruption might be mutagenic. Compared with wild-type cells, primary PmlC62A/C65A cells exhibited increased sister-chromatid exchange and chromosome abnormalities. Moreover, functional assays showed impaired homologous recombination (HR) and nonhomologous end-joining (NHEJ) repair pathways, with defective localization of Brca1 and Rad51 to sites of DNA damage. These data directly demonstrate that Pml NBs are critical for DNA damage responses, and suggest that Pml NB disruption is a central contributor to APL pathogenesis.
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MESH Headings
- Animals
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- DNA Damage/genetics
- DNA End-Joining Repair/genetics
- DNA Repair/genetics
- Intranuclear Inclusion Bodies/genetics
- Intranuclear Inclusion Bodies/metabolism
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/metabolism
- Leukemia, Promyelocytic, Acute/pathology
- Mice
- Mice, Transgenic
- Mutagenesis/genetics
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Promyelocytic Leukemia Protein/genetics
- Promyelocytic Leukemia Protein/physiology
- Signal Transduction/genetics
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Affiliation(s)
- Edwige Voisset
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Eva Moravcsik
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Eva W Stratford
- Department of Tumor Biology, The Norwegian Radium Hospital/Oslo University Hospital, Oslo, Norway
| | - Amie Jaye
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | | | - Robert K Hills
- Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | | | - Scott C Kogan
- Helen Diller Family Comprehensive Cancer Center and
- Department of Laboratory Medicine, University of California, San Francisco, CA
| | - Ellen Solomon
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - David Grimwade
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
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24
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Abstract
The concept of differentiation therapy emerged from the fact that hormones or cytokines may promote differentiation ex vivo, thereby irreversibly changing the phenotype of cancer cells. Its hallmark success has been the treatment of acute promyelocytic leukaemia (APL), a condition that is now highly curable by the combination of retinoic acid (RA) and arsenic. Recently, drugs that trigger differentiation in a variety of primary tumour cells have been identified, suggesting that they are clinically useful. This Opinion article analyses the basis for the clinical successes of RA or arsenic in APL by assessing the respective roles of terminal maturation and loss of self-renewal. By reviewing other successful examples of drug-induced tumour cell differentiation, novel approaches to transform differentiating drugs into more efficient therapies are proposed.
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Affiliation(s)
- Hugues de Thé
- Collège de France, PSL Research University, 75005 Paris; Université Paris Diderot, Sorbonne Paris Cité (INSERM UMR 944, Equipe Labellisée par la Ligue Nationale contre le Cancer; CNRS UMR 7212), Institut Universitaire d'Hématologie, 75010 Paris; and Assistance Publique/Hôpitaux de Paris, Oncologie Moléculaire, Hôpital St Louis, 75010 Paris, France
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25
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de Thé H, Pandolfi PP, Chen Z. Acute Promyelocytic Leukemia: A Paradigm for Oncoprotein-Targeted Cure. Cancer Cell 2017; 32:552-560. [PMID: 29136503 DOI: 10.1016/j.ccell.2017.10.002] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/01/2017] [Accepted: 09/29/2017] [Indexed: 12/14/2022]
Abstract
Recent clinical trials have demonstrated that the immense majority of acute promyelocytic leukemia (APL) patients can be definitively cured by the combination of two targeted therapies: retinoic acid (RA) and arsenic. Mouse models have provided unexpected insights into the mechanisms involved. Restoration of PML nuclear bodies upon RA- and/or arsenic-initiated PML/RARA degradation is essential, while RA-triggered transcriptional activation is dispensable for APL eradication. Mutations of the arsenic-binding site of PML/RARA, but also PML, have been detected in therapy-resistant patients, demonstrating the key role of PML in APL cure. PML nuclear bodies are druggable and could be harnessed in other conditions.
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Affiliation(s)
- Hugues de Thé
- Collège de France, PSL Research University, Chaire d'Oncologie Cellulaire et Moléculaire, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, INSERM UMR 944, CNRS UMR 7212, Hôpital St. Louis, Paris, France.
| | - Pier Paolo Pandolfi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Zhu Chen
- Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025 Shanghai, China
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26
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Zhang YK, Dai C, Yuan CG, Wu HC, Xiao Z, Lei ZN, Yang DH, Le XC, Fu L, Chen ZS. Establishment and characterization of arsenic trioxide resistant KB/ATO cells. Acta Pharm Sin B 2017; 7:564-570. [PMID: 28924550 PMCID: PMC5595296 DOI: 10.1016/j.apsb.2017.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/26/2017] [Accepted: 04/01/2017] [Indexed: 12/14/2022] Open
Abstract
Arsenic trioxide (ATO) is used as a chemotherapeutic agent for the treatment of acute promyelocytic leukemia. However, increasing drug resistance is reducing its efficacy. Therefore, a better understanding of ATO resistance mechanism is required. In this study, we established an ATO-resistant human epidermoid carcinoma cell line, KB/ATO, from its parental KB-3-1 cells. In addition to ATO, KB/ATO cells also exhibited cross-resistance to other anticancer drugs such as cisplatin, antimony potassium tartrate, and 6-mercaptopurine. The arsenic accumulation in KB/ATO cells was significantly lower than that in KB-3-1 cells. Further analysis indicated that neither application of P-glycoprotein inhibitor, breast cancer resistant protein (BCRP) inhibitor, or multidrug resistance protein 1 (MRP1) inhibitor could eliminate ATO resistance. We found that the expression level of ABCB6 was increased in KB/ATO cells. In conclusion, ABCB6 could be an important factor for ATO resistance in KB/ATO cells. The ABCB6 level may serve as a predictive biomarker for the effectiveness of ATO therapy.
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Affiliation(s)
- Yun-Kai Zhang
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
| | - Chunling Dai
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Chun-gang Yuan
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton T6G 2G3, Alberta, Canada
| | - Hsiang-Chun Wu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
| | - Zhijie Xiao
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
| | - Zi-Ning Lei
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
| | - Dong-Hua Yang
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
| | - X. Chris Le
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton T6G 2G3, Alberta, Canada
| | - Liwu Fu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John׳s University, Queens, NY 11439, USA
- Corresponding author. Tel.: +1 718 990 1432; fax: +1 718 990 1877.
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27
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Liang B, Zheng Z, Shi Y, Chen J, Hu X, Qian H, Shen Z, Jiang S, Yu K, Feng J. Maintenance therapy with all-trans retinoic acid and arsenic trioxide improves relapse-free survival in adults with low- to intermediate-risk acute promyelocytic leukemia who have achieved complete remission after consolidation therapy. Onco Targets Ther 2017; 10:2305-2313. [PMID: 28490888 PMCID: PMC5414635 DOI: 10.2147/ott.s135013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Currently, the optimal maintenance therapy for patients with acute promyelocytic leukemia (APL) who have achieved complete remission (CR) after completing consolidation chemotherapy remains controversial. The comparative effectiveness of the all-trans retinoic acid (ATRA) plus arsenic trioxide (As2O3) maintenance strategy with classic ATRA plus chemotherapy has not been evaluated. In this study, we compared the efficacy and toxicity of maintenance therapy with ATRA plus As2O3 and classic ATRA plus chemotherapy in low- to intermediate-risk APL patients reaching the first CR after induction and consolidation therapy. METHODS A retrospective review of 58 adult patients diagnosed with APL was conducted. After receiving consolidation therapy and achieving CR, 30 patients were administered maintenance therapy with an ATRA plus As2O3 regimen (ATRA+As2O3 group), whereas 28 patients were administered 3-monthly cycles of an ATRA plus chemotherapy regimen (ATRA+chemotherapy group). RESULTS Grade 3-4 neutropenia was significantly more frequent in the ATRA+chemotherapy group (N=9, 32.1%) than in the ATRA+As2O3 group (N=0) (P=0.001). At a median follow-up of 49.1 months (range: 9.7-97.4 months) from the completion of consolidation, no relapses were observed in the ATRA+As2O3 group, whereas seven relapses occurred in the ATRA+chemotherapy group. The risk of relapse in the patients administered ATRA+As2O3 maintenance was significantly lower than that in those administered ATRA+chemotherapy maintenance (P=0.004). Based on log-rank analysis, only maintenance therapy with ATRA and As2O3 was associated with a significantly higher relapse-free survival (P=0.0159). CONCLUSION Maintenance therapy with ATRA and As2O3 was beneficial in low- to intermediate-risk APL patients who were effectively treated to achieve CR. Further clinical trials with reliable designs are needed to confirm these observations.
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Affiliation(s)
- Bin Liang
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Zhouyi Zheng
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou.,Division of Hematology-Oncology, Traditional Chinese Medical Hospital of Zhuji, Shaoxing
| | - Yifen Shi
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Jingjing Chen
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Xudong Hu
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Honglan Qian
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Zhijian Shen
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Songfu Jiang
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Kang Yu
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Jianhua Feng
- Division of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou.,Division of Pediatric Hematology-Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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28
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On arsenic trioxide in the clinical treatment of acute promyelocytic leukemia. Leuk Res Rep 2017; 7:29-32. [PMID: 28462082 PMCID: PMC5402621 DOI: 10.1016/j.lrr.2017.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/04/2017] [Indexed: 11/22/2022] Open
Abstract
Arsenic is generally considered hypertoxic. However, it has been used in traditional Chinese medicine since ancient times, to treat serious illnesses. Recently, a single dose of arsenic trioxide (As2O3) has been found especially effective in treating acute promyelocytic leukemia (APL). Generally speaking, As2O3 is a more effective treatment of APL than other, newer medications and has less severe adverse reactions and greater safety.
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29
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Platzbecker U, Avvisati G, Cicconi L, Thiede C, Paoloni F, Vignetti M, Ferrara F, Divona M, Albano F, Efficace F, Fazi P, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Wattad M, Lübbert M, Brandts CH, Hänel M, Röllig C, Schmitz N, Link H, Frairia C, Pogliani EM, Fozza C, D’Arco AM, Di Renzo N, Cortelezzi A, Fabbiano F, Döhner K, Ganser A, Döhner H, Amadori S, Mandelli F, Ehninger G, Schlenk RF, Lo-Coco F. Improved Outcomes With Retinoic Acid and Arsenic Trioxide Compared With Retinoic Acid and Chemotherapy in Non–High-Risk Acute Promyelocytic Leukemia: Final Results of the Randomized Italian-German APL0406 Trial. J Clin Oncol 2017; 35:605-612. [DOI: 10.1200/jco.2016.67.1982] [Citation(s) in RCA: 237] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The initial results of the APL0406 trial showed that the combination of all- trans-retinoic acid (ATRA) and arsenic trioxide (ATO) is at least not inferior to standard ATRA and chemotherapy (CHT) in first-line therapy of low- or intermediate-risk acute promyelocytic leukemia (APL). We herein report the final analysis on the complete series of patients enrolled onto this trial. Patients and Methods The APL0406 study was a prospective, randomized, multicenter, open-label, phase III noninferiority trial. Eligible patients were adults between 18 and 71 years of age with newly diagnosed, low- or intermediate-risk APL (WBC at diagnosis ≤ 10 × 109/L). Overall, 276 patients were randomly assigned to receive ATRA-ATO or ATRA-CHT between October 2007 and January 2013. Results Of 263 patients evaluable for response to induction, 127 (100%) of 127 patients and 132 (97%) of 136 patients achieved complete remission (CR) in the ATRA-ATO and ATRA-CHT arms, respectively ( P = .12). After a median follow-up of 40.6 months, the event-free survival, cumulative incidence of relapse, and overall survival at 50 months for patients in the ATRA-ATO versus ATRA-CHT arms were 97.3% v 80%, 1.9% v 13.9%, and 99.2% v 92.6%, respectively ( P < .001, P = .0013, and P = .0073, respectively). Postinduction events included two relapses and one death in CR in the ATRA-ATO arm and two instances of molecular resistance after third consolidation, 15 relapses, and five deaths in CR in the ATRA-CHT arm. Two patients in the ATRA-CHT arm developed a therapy-related myeloid neoplasm. Conclusion These results show that the advantages of ATRA-ATO over ATRA-CHT increase over time and that there is significantly greater and more sustained antileukemic efficacy of ATO-ATRA compared with ATRA-CHT in low- and intermediate-risk APL.
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Affiliation(s)
- Uwe Platzbecker
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Giuseppe Avvisati
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Laura Cicconi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Christian Thiede
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesca Paoloni
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Marco Vignetti
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Felicetto Ferrara
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Mariadomenica Divona
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesco Albano
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Fabio Efficace
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Paola Fazi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Marco Sborgia
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Eros Di Bona
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Massimo Breccia
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Erika Borlenghi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Roberto Cairoli
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Alessandro Rambaldi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Lorella Melillo
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Giorgio La Nasa
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Walter Fiedler
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Peter Brossart
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Bernd Hertenstein
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Helmut R. Salih
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Mohammed Wattad
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Michael Lübbert
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Christian H. Brandts
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Mathias Hänel
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Christoph Röllig
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Norbert Schmitz
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Hartmut Link
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Chiara Frairia
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Enrico Maria Pogliani
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Claudio Fozza
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Alfonso Maria D’Arco
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Nicola Di Renzo
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Agostino Cortelezzi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesco Fabbiano
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Konstanze Döhner
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Arnold Ganser
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Hartmut Döhner
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Sergio Amadori
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Franco Mandelli
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Gerhard Ehninger
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Richard F. Schlenk
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesco Lo-Coco
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
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Thangapazham RL, Rajeshkumar NV, Sharma A, Warren J, Singh AK, Ives JA, Gaddipati JP, Maheshwari RK, Jonas WB. Effect of Homeopathic Treatment on Gene Expression in Copenhagen Rat Tumor Tissues. Integr Cancer Ther 2016; 5:350-5. [PMID: 17101764 DOI: 10.1177/1534735406294226] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Background: Increasing evidence suggests that the inability to undergo apoptosis is an important factor in the development and progression of prostate cancer. Agents that induce apoptosis may inhibit tumor growth and provide therapeutic benefit. In a recent study, the authors found that certain homeopathic treatments produced anticancer effects in an animal model. In this study, the authors examined the immunomodulating and apoptotic effects of these remedies. Materials and Methods: The authors investigated the effect of a homeopathic treatment regimen containing Conium maculatum, Sabal serrulata, Thuja occidentalis, and a MAT-LyLu Carcinosin nosode on the expression of cytokines and genes that regulate apoptosis. This was assessed in prostate cancer tissues, extracted from animals responsive to these drugs, using ribonuclease protection assay or reverse transcription polymerase chain reaction. Results: There were no significant changes in mRNA levels of the apoptotic genes bax, bcl-2, bcl-x, caspase-1, caspase-2, caspase-3, Fas, FasL, or the cytokines interleukin (IL)–1α, IL-1β, tumor necrosis factor (TNF)–β, IL-3, IL-4, IL-5, IL-6, IL-10, TNF-α, IL-2, and interferon-γ in prostate tumor and lung metastasis after treatment with homeopathic medicines. Conclusions: This study indicates that treatment with the highly diluted homeopathic remedies does not alter the gene expression in primary prostate tumors or in lung metastasis. The therapeutic effect of homeopathic treatments observed in the in vivo experiments cannot be explained by mechanisms based on distinct alterations in gene expression related to apoptosis or cytokines. Future research should explore subtle modulations in the expression of multiple genes in different biological pathways.
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Affiliation(s)
- Rajesh L Thangapazham
- Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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31
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Swallowing a bitter pill–oral arsenic trioxide for acute promyelocytic leukemia. Blood Rev 2016; 30:201-11. [DOI: 10.1016/j.blre.2015.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 11/18/2015] [Accepted: 11/24/2015] [Indexed: 11/23/2022]
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32
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Zheng L, Jiang H, Zhang ZW, Wang KN, Wang QF, Li QL, Jiang T. Arsenic trioxide inhibits viability and induces apoptosis through reactivating the Wnt inhibitor secreted frizzled related protein-1 in prostate cancer cells. Onco Targets Ther 2016; 9:885-94. [PMID: 26966376 PMCID: PMC4770067 DOI: 10.2147/ott.s92129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Growing evidence suggests that arsenic trioxide (As2O3) induces apoptosis and inhibits tumor cell growth in prostate cancer (PCa), although details of the mechanism are still inconclusive. We investigated the antitumor effect of As2O3 in human PCa cell lines LNCaP and PC3 and the underlying mechanisms by focusing on the Wnt signaling pathway. Methods The effect of As2O3 on the viability and apoptosis of PCa cells was investigated by cholecystokinin-8 and flow cytometry. The expression of the related proteins in the Wnt signaling pathway and the downstream target genes of the Wnt signaling pathway was examined by Western blot and quantitative real-time PCR assay. The methylation status of the SFRP1 gene promoter was assessed by bisulfite sequencing. Results As2O3 inhibited the viability of PCa cells and induced apoptosis of PCa cells in a dose-dependent manner. The protein level of phosphoglycogen synthase kinase-3β was upregulated, whereas the protein level of β-catenin and the mRNA levels of c-MYC, MMP-7, and COX-2 were downregulated in a dose-dependent manner in PCa cells treated with As2O3. In addition, As2O3 upregulated the protein and mRNA levels of secreted frizzled related protein-1, and increased the demethylation of the SFRP1 gene promoter. Conclusion Our results suggest that As2O3 may inhibit cell viability and induce apoptosis through reactivating the Wnt inhibitor secreted frizzled related protein-1 in both androgen-dependent and -independent human PCa.
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Affiliation(s)
- Lei Zheng
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Beijing, People's Republic of China; Department of Urology, The Fifth People's Hospital of Dalian, Dalian, Beijing, People's Republic of China
| | - Hui Jiang
- Department of Urology, Third Affiliated Hospital of Beijing University, Beijing, People's Republic of China
| | - Zhi-Wei Zhang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Beijing, People's Republic of China
| | - Ke-Nan Wang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Beijing, People's Republic of China
| | - Qi-Fei Wang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Beijing, People's Republic of China
| | - Quan-Lin Li
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Beijing, People's Republic of China
| | - Tao Jiang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Beijing, People's Republic of China
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Ablain J, Poirot B, Esnault C, Lehmann-Che J, de Thé H. p53 as an Effector or Inhibitor of Therapy Response. Cold Spring Harb Perspect Med 2015; 6:a026260. [PMID: 26637438 DOI: 10.1101/cshperspect.a026260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Although integrity of the p53 signaling pathway in a given tumor was expected to be a critical determinant of response to therapies, most clinical studies failed to link p53 status and treatment outcome. Here, we present two opposite situations: one in which p53 is an essential effector of cure by targeted leukemia therapies and another one in advanced breast cancers in which p53 inactivation is required for the clinical efficacy of dose-dense chemotherapy. If p53 promotes or blocks therapy response, therapies must be tailored on its status in individual tumors.
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Affiliation(s)
- Julien Ablain
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Hôpital St. Louis, 75475 Paris, France INSERM UMR 944, Equipe Labellisée par la Ligue Nationale contre le Cancer, Hôpital St. Louis, 75475 Paris, France CNRS UMR 7212, Hôpital St. Louis, 75475 Paris, France
| | - Brigitte Poirot
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Hôpital St. Louis, 75475 Paris, France INSERM UMR 944, Equipe Labellisée par la Ligue Nationale contre le Cancer, Hôpital St. Louis, 75475 Paris, France CNRS UMR 7212, Hôpital St. Louis, 75475 Paris, France Assistance Publique des Hôpitaux de Paris, Oncologie Moléculaire, Hôpital St. Louis, 75475 Paris, France
| | - Cécile Esnault
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Hôpital St. Louis, 75475 Paris, France INSERM UMR 944, Equipe Labellisée par la Ligue Nationale contre le Cancer, Hôpital St. Louis, 75475 Paris, France CNRS UMR 7212, Hôpital St. Louis, 75475 Paris, France
| | - Jacqueline Lehmann-Che
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Hôpital St. Louis, 75475 Paris, France INSERM UMR 944, Equipe Labellisée par la Ligue Nationale contre le Cancer, Hôpital St. Louis, 75475 Paris, France CNRS UMR 7212, Hôpital St. Louis, 75475 Paris, France Assistance Publique des Hôpitaux de Paris, Oncologie Moléculaire, Hôpital St. Louis, 75475 Paris, France
| | - Hugues de Thé
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Hôpital St. Louis, 75475 Paris, France INSERM UMR 944, Equipe Labellisée par la Ligue Nationale contre le Cancer, Hôpital St. Louis, 75475 Paris, France CNRS UMR 7212, Hôpital St. Louis, 75475 Paris, France Assistance Publique des Hôpitaux de Paris, Oncologie Moléculaire, Hôpital St. Louis, 75475 Paris, France Collège de France, 75005 Paris, France
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Zhan T, Boutros M. Towards a compendium of essential genes - From model organisms to synthetic lethality in cancer cells. Crit Rev Biochem Mol Biol 2015; 51:74-85. [PMID: 26627871 PMCID: PMC4819810 DOI: 10.3109/10409238.2015.1117053] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Essential genes are defined by their requirement to sustain life in cells or whole organisms. The systematic identification of essential gene sets not only allows insights into the fundamental building blocks of life, but may also provide novel therapeutic targets in oncology. The discovery of essential genes has been tightly linked to the development and deployment of various screening technologies. Here, we describe how gene essentiality was addressed in different eukaryotic model organisms, covering a range of organisms from yeast to mouse. We describe how increasing knowledge of evolutionarily divergent genomes facilitate identification of gene essentiality across species. Finally, the impact of gene essentiality and synthetic lethality on cancer research and the clinical translation of screening results are highlighted.
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Affiliation(s)
- Tianzuo Zhan
- a Department of Cell and Molecular Biology , Division of Signaling and Functional Genomics, Medical Faculty Mannheim, German Cancer Research Center (DKFZ), Heidelberg University , Heidelberg , Germany and.,b Department of Medicine II , Medical Faculty Mannheim, University Hospital Mannheim, Heidelberg University , Mannheim , Germany
| | - Michael Boutros
- a Department of Cell and Molecular Biology , Division of Signaling and Functional Genomics, Medical Faculty Mannheim, German Cancer Research Center (DKFZ), Heidelberg University , Heidelberg , Germany and
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Zhang T, Lu H, Li W, Hu R, Chen Z. Identification of Arsenic Direct-Binding Proteins in Acute Promyelocytic Leukaemia Cells. Int J Mol Sci 2015; 16:26871-9. [PMID: 26569224 PMCID: PMC4661853 DOI: 10.3390/ijms161125994] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/23/2015] [Accepted: 10/30/2015] [Indexed: 02/07/2023] Open
Abstract
The identification of arsenic direct-binding proteins is essential for determining the mechanism by which arsenic trioxide achieves its chemotherapeutic effects. At least two cysteines close together in the amino acid sequence are crucial to the binding of arsenic and essential to the identification of arsenic-binding proteins. In the present study, arsenic binding proteins were pulled down with streptavidin and identified using a liquid chromatograph-mass spectrometer (LC-MS/MS). More than 40 arsenic-binding proteins were separated, and redox-related proteins, glutathione S-transferase P1 (GSTP1), heat shock 70 kDa protein 9 (HSPA9) and pyruvate kinase M2 (PKM2), were further studied using binding assays in vitro. Notably, PKM2 has a high affinity for arsenic. In contrast to PKM2, GSTP1and HSPA9 did not combine with arsenic directly in vitro. These observations suggest that arsenic-mediated acute promyelocytic leukaemia (APL) suppressive effects involve PKM2. In summary, we identified several arsenic binding proteins in APL cells and investigated the therapeutic mechanisms of arsenic trioxide for APL. Further investigation into specific signal pathways by which PKM2 mediates APL developments may lead to a better understanding of arsenic effects on APL.
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Affiliation(s)
- Tao Zhang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, 12 Central Urumqi Road, Shanghai 200040, China.
| | - Haojie Lu
- Shanghai Cancer Center and Key Laboratory of Glycoconjugates Research Ministry of Public Health, Fudan University, Shanghai 200032, China.
| | - Weijun Li
- State Key Laboratory of Molecular Biology, Institute of Biochemistry and Cell Biology, University of Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China.
| | - Ronggui Hu
- State Key Laboratory of Molecular Biology, Institute of Biochemistry and Cell Biology, University of Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China.
- Cancer Research Center, SIBS-Xuhui Central Hospital, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China.
| | - Zi Chen
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China.
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36
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Orfali N, O'Donovan TR, Nyhan MJ, Britschgi A, Tschan MP, Cahill MR, Mongan NP, Gudas LJ, McKenna SL. Induction of autophagy is a key component of all-trans-retinoic acid-induced differentiation in leukemia cells and a potential target for pharmacologic modulation. Exp Hematol 2015; 43:781-93.e2. [PMID: 25986473 PMCID: PMC4948855 DOI: 10.1016/j.exphem.2015.04.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 12/16/2022]
Abstract
Acute myeloid leukemia (AML) is characterized by the accumulation of immature blood cell precursors in the bone marrow. Pharmacologically overcoming the differentiation block in this condition is an attractive therapeutic avenue, which has achieved success only in a subtype of AML, acute promyelocytic leukemia (APL). Attempts to emulate this success in other AML subtypes have thus far been unsuccessful. Autophagy is a conserved protein degradation pathway with important roles in mammalian cell differentiation, particularly within the hematopoietic system. In the study described here, we investigated the functional importance of autophagy in APL cell differentiation. We found that autophagy is increased during all-trans-retinoic acid (ATRA)-induced granulocytic differentiation of the APL cell line NB4 and that this is associated with increased expression of LC3II and GATE-16 proteins involved in autophagosome formation. Autophagy inhibition, using either drugs (chloroquine/3-methyladenine) or short-hairpin RNA targeting the essential autophagy gene ATG7, attenuates myeloid differentiation. Importantly, we found that enhancing autophagy promotes ATRA-induced granulocytic differentiation of an ATRA-resistant derivative of the non-APL AML HL60 cell line (HL60-Diff-R). These data support the development of strategies to stimulate autophagy as a novel approach to promote differentiation in AML.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Adenine/analogs & derivatives
- Adenine/pharmacology
- Antineoplastic Agents/pharmacology
- Antirheumatic Agents/pharmacology
- Autophagy/drug effects
- Autophagy-Related Protein 7
- Autophagy-Related Protein 8 Family
- Cell Differentiation/drug effects
- Chloroquine/pharmacology
- Granulocytes/metabolism
- Granulocytes/pathology
- HL-60 Cells
- Humans
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/metabolism
- Leukemia, Promyelocytic, Acute/pathology
- Microfilament Proteins/genetics
- Microfilament Proteins/metabolism
- Microtubule-Associated Proteins/genetics
- Microtubule-Associated Proteins/metabolism
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Tretinoin/pharmacology
- Ubiquitin-Activating Enzymes/antagonists & inhibitors
- Ubiquitin-Activating Enzymes/genetics
- Ubiquitin-Activating Enzymes/metabolism
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Affiliation(s)
- Nina Orfali
- Cork Cancer Research Centre, Leslie C. Quick, Jr., Laboratory, Biosciences Institute, University College Cork, Cork, Ireland; Department of Hematology, Cork University Hospital, Cork, Ireland; Department of Pharmacology, Weill Cornell Medical College, New York, New York, USA
| | - Tracey R O'Donovan
- Cork Cancer Research Centre, Leslie C. Quick, Jr., Laboratory, Biosciences Institute, University College Cork, Cork, Ireland
| | - Michelle J Nyhan
- Cork Cancer Research Centre, Leslie C. Quick, Jr., Laboratory, Biosciences Institute, University College Cork, Cork, Ireland
| | - Adrian Britschgi
- Division of Experimental Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Mario P Tschan
- Division of Experimental Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Mary R Cahill
- Department of Hematology, Cork University Hospital, Cork, Ireland
| | - Nigel P Mongan
- Department of Pharmacology, Weill Cornell Medical College, New York, New York, USA; Faculty of Medicine and Health Science, School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - Lorraine J Gudas
- Department of Pharmacology, Weill Cornell Medical College, New York, New York, USA
| | - Sharon L McKenna
- Cork Cancer Research Centre, Leslie C. Quick, Jr., Laboratory, Biosciences Institute, University College Cork, Cork, Ireland.
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Aznab M, Rezaei M. Induction, consolidation, and maintenance therapies with arsenic as a single agent for acute promyelocytic leukaemia in a 11-year follow-up. Hematol Oncol 2015; 35:113-117. [PMID: 26310595 DOI: 10.1002/hon.2253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/04/2015] [Indexed: 01/04/2023]
Abstract
The aim of this study was to evaluate the effect of arsenic trioxide as a single agent in acute promyelocytic leukaemia cases for induction, consolidation, and maintenance therapy in a long-term, 11-year follow-up. We studied 60 patients with acute promyelocytic leukaemia. Sixty percent of the patients were aged between 12 and 24 years. Arsenic trioxide was infused at a 0.15 mg/kg daily dose until complete remission was achieved. After 2 weeks of rest, arsenic trioxide was infused daily for 28 days as a consolidation therapy. Then, arsenic infusions were given every 3-4 months for 14 days for 2 years, and the patients were followed until relapse or death. The rates of complete remission, disease-free survival, overall survival, and drug toxicity were evaluated. The morphologic complete remission was observed in 55 out of the 60 patients. The most common causes of a remission failure were early mortality because of the APL differentiation syndrome and the lack of response to arsenic treatment. The mean follow-up was 90 months. The primary outcomes for males and females were a mean disease-free survival of 101 and 97 months, respectively, and a mean overall survival of 103 and 101 months, respectively. From the 55 cases with remission, three patients died (late mortality). Of the 60 patients, 85% are still alive. Arsenic trioxide was generally well tolerated. The long-term follow-up of patients with APL, treated with arsenic alone as induction, consolidation, and maintenance therapy, shows high cure rates and excellent outcomes. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Mozaffar Aznab
- Internal Medicine Department, Kermanshah of University of Medical Science, Iran
| | - Mansour Rezaei
- Biostatistics and Epidemiology Department, Kermanshah of University of Medical Science, Iran
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Zhang X, Yang XR, Sun C, Hu B, Sun YF, Huang XW, Wang Z, He YF, Zeng HY, Qiu SJ, Cao Y, Fan J, Zhou J. Promyelocytic leukemia protein induces arsenic trioxide resistance through regulation of aldehyde dehydrogenase 3 family member A1 in hepatocellular carcinoma. Cancer Lett 2015; 366:112-22. [PMID: 26118777 DOI: 10.1016/j.canlet.2015.06.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/16/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
Clinical response of hepatocellular carcinoma (HCC) to arsenic trioxide (ATO) has been poor. Promyelocytic leukemia protein (PML) is central to ATO treatment efficacy of acute promyelocytic leukemia. We examine impacts of PML expression on the effectiveness of ATO treatment in HCC. We show that increased PML expression predicts longer survival and lower cancer recurrence rates after HCC resection. However, high PML expression dampens the anti-tumor effects of ATO in HCC cells. Gene microarray analysis shows that reduced PML expression significantly down-regulates expression of aldehyde dehydrogenase 3 family member A1 (ALDH3A1). ALDH3A1 depression facilitates accumulation of ATO-induced reactive oxygen species. Chromatin immunoprecipitation analysis and promoter activity assays confirm that PML regulates ALDH3A1 expression through binding to the promoter region of ALDH3A1. Clinically, ATO treatment decreases the disease progression rate in advanced HCC patients with negative PML expression. In conclusion, PML confers a favorable prognosis in HCC patients, but it induces ATO resistance through ALDH3A1 up-regulation in HCC cells. ATO is effective for HCC patients with negative PML expression. Combined with an ALDH3A1 inhibitor, ATO may be efficacious in patients with positive PML expression.
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Affiliation(s)
- Xin Zhang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Xin-Rong Yang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Chao Sun
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Bo Hu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Yun-Fan Sun
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Xiao-Wu Huang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China; Institute of Biomedical Sciences, Fudan University, Shanghai 200032, China
| | - Zheng Wang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Yi-Feng He
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Hai-Ying Zeng
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Shuang-Jian Qiu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China
| | - Ya Cao
- Cancer Research Institute, Xiangya School of Medicine, Central South University, Changsha 410078, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Changsha 410078, China
| | - Jia Fan
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China; Institute of Biomedical Sciences, Fudan University, Shanghai 200032, China
| | - Jian Zhou
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China; Institute of Biomedical Sciences, Fudan University, Shanghai 200032, China.
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ANXA1 silencing increases the sensitivity of cancer cells to low-concentration arsenic trioxide treatment by inhibiting ERK MAPK activation. TUMORI JOURNAL 2015; 101:360-7. [PMID: 25983101 DOI: 10.5301/tj.5000315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2015] [Indexed: 12/26/2022]
Abstract
AIMS AND BACKGROUND Arsenic trioxide (ATO), an antitumor agent, is widely used for treating acute promyelocytic leukemia (APL), in which it induces apoptosis. In most solid tumors, ATO disturbs the cell cycle instead of inducing apoptosis. We aimed to determine the exact mechanism underlying the different response of APL to ATO compared with the response of solid tumors. METHODS A proteomics-based screening was used to identify the ATO-associated proteins in the human esophageal squamous cell carcinoma cell line, Eca109. The expression levels of Annexin A1 (ANXA1) in 4 different types of cancer cells were determined by quantitative reverse transcription polymerase chain reaction and Western blotting. Human esophageal squamous cell carcinoma cell line Eca109 and pancreatic carcinoma cell line BxPC3 cells were transfected with siRNAs targeting ANXA1 and scrambled control siRNA. Cell proliferation was evaluated by methyl thiazolyl tetrazolium assay. RESULTS After verification of the mRNA and protein levels in 4 cancer cell lines, ANXA1 and lamin A/B were validated to have increased expression levels after low-concentration ATO treatment. Lower concentrations of ATO, which has no effect on proliferation of cancer cells, induced apoptosis after ANXA1 silencing. Furthermore, overexpression of ANXA1 induced by ATO resulted in activation of extracellular signal-regulated kinase (ERK) mitogen-activated protein kinases (MAPKs), rendering cancer cells resistant to the agent. In addition, PD98059, a specific ERK inhibitor, increased the sensitivity of cancer cells to a lower concentration of ATO treatment. CONCLUSIONS Taken together, these data indicate that overexpression of ANXA1 induced by low-concentration ATO makes cancer cells more resistant to the agent via activated ERK MAPKs. Specific silencing of ANXA1 increased the sensitivity of cancer cells to ATO treatment.
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Testa U, Lo-Coco F. Targeting of leukemia-initiating cells in acute promyelocytic leukemia. Stem Cell Investig 2015; 2:8. [PMID: 27358876 DOI: 10.3978/j.issn.2306-9759.2015.04.03] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/31/2015] [Indexed: 12/26/2022]
Abstract
Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) with peculiar molecular, phenotypic and clinical features and unique therapeutic response to specific treatments. The disease is characterized by a single, pathognomonic molecular event, consisting of the translocation t(15;17) which gives rise to the PML/retinoic acid receptor α (RARα) hybrid protein. The development of this leukemia is mainly related to the fusion oncoprotein PML/RARα, acting as an altered RAR mediating abnormal signalling and repression of myeloid differentiation, with consequent accumulation of undifferentiated promyelocytes. The prognosis of APL has dramatically been improved with the introduction in therapy of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). The main effect of these two drugs is linked to the targeting of either RAR moiety of the PML/RARα molecule and induction of cell differentiation (ATRA) or of the PML moiety of the fusion protein and induction of leukemic cell apoptosis, including leukemic progenitors (mostly induced by ATO). These two drugs exhibited excellent synergism and determine a very high rate of durable remissions in low/intermediate-risk APLs, when administered in the absence of any chemotherapeutic drug. The strong synergism and the marked clinical efficacy of these two agents when administered together seem to be related to their capacity to induce PML/RARα degradation and complete eradication of leukemia stem cells.
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Affiliation(s)
- Ugo Testa
- 1 Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy ; 2 Department of Biomedicine and Prevention, University of Rome "Tor Vergata" and Fondazione Santa Lucia, Rome, Italy
| | - Francesco Lo-Coco
- 1 Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy ; 2 Department of Biomedicine and Prevention, University of Rome "Tor Vergata" and Fondazione Santa Lucia, Rome, Italy
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di Masi A, Leboffe L, De Marinis E, Pagano F, Cicconi L, Rochette-Egly C, Lo-Coco F, Ascenzi P, Nervi C. Retinoic acid receptors: from molecular mechanisms to cancer therapy. Mol Aspects Med 2015; 41:1-115. [PMID: 25543955 DOI: 10.1016/j.mam.2014.12.003] [Citation(s) in RCA: 231] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/15/2014] [Indexed: 02/07/2023]
Abstract
Retinoic acid (RA), the major bioactive metabolite of retinol or vitamin A, induces a spectrum of pleiotropic effects in cell growth and differentiation that are relevant for embryonic development and adult physiology. The RA activity is mediated primarily by members of the retinoic acid receptor (RAR) subfamily, namely RARα, RARβ and RARγ, which belong to the nuclear receptor (NR) superfamily of transcription factors. RARs form heterodimers with members of the retinoid X receptor (RXR) subfamily and act as ligand-regulated transcription factors through binding specific RA response elements (RAREs) located in target genes promoters. RARs also have non-genomic effects and activate kinase signaling pathways, which fine-tune the transcription of the RA target genes. The disruption of RA signaling pathways is thought to underlie the etiology of a number of hematological and non-hematological malignancies, including leukemias, skin cancer, head/neck cancer, lung cancer, breast cancer, ovarian cancer, prostate cancer, renal cell carcinoma, pancreatic cancer, liver cancer, glioblastoma and neuroblastoma. Of note, RA and its derivatives (retinoids) are employed as potential chemotherapeutic or chemopreventive agents because of their differentiation, anti-proliferative, pro-apoptotic, and anti-oxidant effects. In humans, retinoids reverse premalignant epithelial lesions, induce the differentiation of myeloid normal and leukemic cells, and prevent lung, liver, and breast cancer. Here, we provide an overview of the biochemical and molecular mechanisms that regulate the RA and retinoid signaling pathways. Moreover, mechanisms through which deregulation of RA signaling pathways ultimately impact on cancer are examined. Finally, the therapeutic effects of retinoids are reported.
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Affiliation(s)
- Alessandra di Masi
- Department of Science, Roma Tre University, Viale Guglielmo Marconi 446, Roma I-00146, Italy
| | - Loris Leboffe
- Department of Science, Roma Tre University, Viale Guglielmo Marconi 446, Roma I-00146, Italy
| | - Elisabetta De Marinis
- Department of Medical and Surgical Sciences and Biotechnologies, University of Roma "La Sapienza", Corso della Repubblica 79, Latina I-04100
| | - Francesca Pagano
- Department of Medical and Surgical Sciences and Biotechnologies, University of Roma "La Sapienza", Corso della Repubblica 79, Latina I-04100
| | - Laura Cicconi
- Department of Biomedicine and Prevention, University of Roma "Tor Vergata", Via Montpellier 1, Roma I-00133, Italy; Laboratory of Neuro-Oncohematology, Santa Lucia Foundation, Via Ardeatina, 306, Roma I-00142, Italy
| | - Cécile Rochette-Egly
- Department of Functional Genomics and Cancer, IGBMC, CNRS UMR 7104 - Inserm U 964, University of Strasbourg, 1 rue Laurent Fries, BP10142, Illkirch Cedex F-67404, France.
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Roma "Tor Vergata", Via Montpellier 1, Roma I-00133, Italy; Laboratory of Neuro-Oncohematology, Santa Lucia Foundation, Via Ardeatina, 306, Roma I-00142, Italy.
| | - Paolo Ascenzi
- Interdepartmental Laboratory for Electron Microscopy, Roma Tre University, Via della Vasca Navale 79, Roma I-00146, Italy.
| | - Clara Nervi
- Department of Medical and Surgical Sciences and Biotechnologies, University of Roma "La Sapienza", Corso della Repubblica 79, Latina I-04100.
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Abstract
Key Points
PML/RARA loss or detachment from target promoters suffices to differentiate APL cells. PML/RARA degradation by arsenic thus explains arsenic-induced differentiation.
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Ablain J, de Thé H. Retinoic acid signaling in cancer: The parable of acute promyelocytic leukemia. Int J Cancer 2014; 135:2262-72. [PMID: 25130873 DOI: 10.1002/ijc.29081] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 04/04/2014] [Accepted: 05/09/2014] [Indexed: 12/22/2022]
Abstract
Inevitably fatal some 40 years, acute promyelocytic leukemia (APL) can now be cured in more than 95% of cases. This clinical success story is tightly linked to tremendous progress in our understanding of retinoic acid (RA) signaling. The discovery of retinoic acid receptor alpha (RARA) was followed by the cloning of the chromosomal translocations driving APL, all of which involve RARA. Since then, new findings on the biology of nuclear receptors have progressively enlightened the basis for the clinical efficacy of RA in APL. Reciprocally, the disease offered a range of angles to approach the cellular and molecular mechanisms of RA action. This virtuous circle contributed to make APL one of the best-understood cancers from both clinical and biological standpoints. Yet, some important questions remain unanswered including how lessons learnt from RA-triggered APL cure can help design new therapies for other malignancies.
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Affiliation(s)
- Julien Ablain
- Université Paris Diderot, Sorbonne Paris Cité, Hôpital St. Louis, Paris Cedex 10, France; INSERM U 944, Equipe labellisée par la Ligue Nationale contre le Cancer, Institut Universitaire d'Hématologie, Hôpital St. Louis, Paris Cedex 10, France; CNRS UMR 7212, Hôpital St. Louis, Paris Cedex 10, France
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Trottier-Tellier F, Durand M, Kolan C, Wistaff R, Nguyen PV, Laskine M. Recurrent arterial and venous thromboemboli as initial presentation of acute promyelocytic leukemia. J Clin Med Res 2014; 6:388-91. [PMID: 25110545 PMCID: PMC4125336 DOI: 10.14740/jocmr1864w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2014] [Indexed: 11/21/2022] Open
Abstract
We report a case of a 52-year-old Caucasian woman diagnosed with a synchronic arterial and venous thrombosis as an initial presentation of an acute promyelocytic leukemia (APL). After the diagnosis, the patient was treated with all trans-retinoic acid and arsenic chemotherapy concomitant to systemic anticoagulation. This treatment regimen led to a complete remission and absence of relapse of the thrombosis or APL during the follow-up. To our knowledge, this presentation is the second case in the literature. We use this opportunity to emphasize the importance of performing a complete medical evaluation in cases of unusual thromboembolic events.
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Affiliation(s)
| | - Madeleine Durand
- Department of Medicine, Hopital Hotel-Dieu, CRCHUM, Montreal, Canada
| | - Christophe Kolan
- Department of Medicine, Hopital Hotel-Dieu, CHUM, Montreal, Canada
| | - Robert Wistaff
- Department of Medicine, Hopital Hotel-Dieu, CHUM, Montreal, Canada
| | - Paul Van Nguyen
- Department of Medicine, Hopital Hotel-Dieu, CHUM, Montreal, Canada
| | - Mikhael Laskine
- Department of Medicine, Hopital Hotel-Dieu, CRCHUM, Montreal, Canada
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45
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Rice KL, de Thé H. The acute promyelocytic leukaemia success story: curing leukaemia through targeted therapies. J Intern Med 2014; 276:61-70. [PMID: 24635409 DOI: 10.1111/joim.12208] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The recent finding that almost all patients with acute promyelocytic leukaemia (APL) may be cured using a combination of retinoic acid (RA) and arsenic trioxide (As(2)O(3)) (N Engl J Med, 369, 2013 and 111) highlights the progress made in our understanding of APL pathogenesis and therapeutic approaches over the past 25 years. The study of APL has revealed many important lessons related to transcriptional control, nuclear organization, epigenetics and the role of proteolysis in biological control. Even more important has been the clinical demonstration that molecularly targeted therapy can eradicate disease.
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Affiliation(s)
- K L Rice
- Université Paris Diderot, Sorbonne Paris Cité, Hôpital St. Louis, Paris Cedex, France; INSERM UMR 944, Equipe labellisée par la Ligue Nationale contre le Cancer, Institut Universitaire d'Hématologie, Hôpital St. Louis, Paris Cedex, France; CNRS UMR 7212, Hôpital St. Louis, Paris Cedex, France
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Safa M, Mousavizadeh K, Noori S, Pourfathollah A, Zand H. cAMP protects acute promyelocytic leukemia cells from arsenic trioxide-induced caspase-3 activation and apoptosis. Eur J Pharmacol 2014; 736:115-23. [PMID: 24815320 DOI: 10.1016/j.ejphar.2014.04.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/19/2014] [Accepted: 04/23/2014] [Indexed: 11/16/2022]
Abstract
More recently, arsenic trioxide (ATO), was integrated into acute promyelocytic leukemia (APL) treatment, showing high efficacy and tolerability in patients with both ATRA-sensitive and ATRA-resistant APL. ATO could induce apoptosis at relatively high concentrations (0.5 to 2.0 micromol/L) and partial differentiation at low concentrations (0.1 to 0.5 micromol/L) in leukemic promyelocytes. It is known that cAMP agonists enhance low-dose ATO-induced APL cells differentiation. Less well appreciated was the possible interaction between relatively high-doses of ATO and enhanced levels of cAMP in APL cells. Here, we show that elevation of cAMP levels by forskolin inhibited ATO-mediated apoptosis in APL-derived NB4 cells, and this inhibition could be averted by cell permeable cAMP-dependent protein kinase inhibitor (14-22) amide. Inactivating phosphorylation of the proapoptotic protein Bad at Ser118 and phosphorylation of the CREB proto-oncogene at Ser133 were observed upon elevation of cAMP levels in NB4 cells. Phosphorylation of these PKA target proteins is known to promote cell survival in AML cells. The ability of cAMP to endow the APL cells with survival advantage is of particular importance when cAMP agonists may be considered as adjuncts to APL therapy.
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Affiliation(s)
- Majid Safa
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Hematology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Kazem Mousavizadeh
- Oncopathology Research Center, and Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Shekoofeh Noori
- Department of Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arefeh Pourfathollah
- Department of Medical Laboratory Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Zand
- National Institute and Faculty of Nutrition and Food Technology, Department of Molecular Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Testi AM, D’Angiò M, Locatelli F, Pession A, Lo Coco F. Acute Promyelocytic Leukemia (APL): Comparison Between Children and Adults. Mediterr J Hematol Infect Dis 2014; 6:e2014032. [PMID: 24804005 PMCID: PMC4010611 DOI: 10.4084/mjhid.2014.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/10/2014] [Indexed: 01/20/2023] Open
Abstract
The outcome of adults and children with Acute Promyelocytic Leukemia (APL) has dramatically changed since the introduction of all trans retinoic acid (ATRA) therapy. Based on the results of several multicenter trials, the current recommendations for the treatment of patients with APL include ATRA and anthracycline-based chemotherapy for the remission induction and consolidation, and ATRA combined with low-dose chemotherapy for maintenance. This has improved the prognosis of APL by increasing the complete remission (CR) rate, actually > 90%, decreasing the induction deaths and by reducing the relapse rate, leading to cure rates nowadays exceeding 80% considering both adults and children.1-9 More recently the combination of ATRA and arsenic trioxide (ATO) as induction and consolidation therapy has been shown to be at least not inferior and possibly superior to ATRA plus chemotherapy in adult patients with APL conventionally defined as non-high risk (Sanz score).10 Childhood APL has customarily been treated on adult protocols. Data from several trials have shown that the overall outcome in pediatric APL appears similar to that reported for the adult population; however, some clinical and therapeutic aspects differ in the two cohorts which require some important considerations and treatment adjustments.
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Affiliation(s)
- Anna Maria Testi
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Italy
| | - Mariella D’Angiò
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hemato-Oncology, IRCCS Ospedale Bambino Gesù, Roma University of Pavia, Italy
| | - Andrea Pession
- Department of Pediatric Hemato-Oncology, University of Bologna, Italy
| | - Francesco Lo Coco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Laboratory of Neuro-Oncoematology, Santa Lucia Foundation, Rome, Italy
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48
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What is the Standard Regimen for Patients with Acute Promyelocytic Leukemia? Curr Hematol Malig Rep 2014; 9:138-43. [DOI: 10.1007/s11899-014-0206-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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De Braekeleer E, Douet-Guilbert N, De Braekeleer M. RARA fusion genes in acute promyelocytic leukemia: a review. Expert Rev Hematol 2014; 7:347-57. [PMID: 24720386 DOI: 10.1586/17474086.2014.903794] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The t(15;17)(q24;q21), generating a PML-RARA fusion gene, is the hallmark of acute promyelocytic leukemia (APL). At present, eight other genes fusing with RARA have been identified. The resulting fusion proteins retain domains of the RARA protein allowing binding to retinoic acid response elements (RARE) and dimerization with the retinoid X receptor protein (RXRA). They participate in protein-protein interactions, associating with RXRA to form hetero-oligomeric complexes that can bind to RARE. They have a dominant-negative effect on wild-type RARA/RXRA transcriptional activity. Moreover, RARA fusion proteins can homodimerize, conferring the ability to regulate an expanded repertoire of genes normally not affected by RARA. RARA fusion proteins behave as potent transcriptional repressors of retinoic acid signalling, inducing a differentiation blockage at the promyelocyte stage which can be overcome with therapeutic doses of ATRA or arsenic trioxide. However, resistance to these two drugs is a major problem, which necessitates development of new therapies.
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Affiliation(s)
- Etienne De Braekeleer
- Laboratoire d'Histologie, Embryologie et Cytogénétique, Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, France
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Gamell C, Jan Paul P, Haupt Y, Haupt S. PML tumour suppression and beyond: Therapeutic implications. FEBS Lett 2014; 588:2653-62. [DOI: 10.1016/j.febslet.2014.02.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 02/05/2014] [Accepted: 02/05/2014] [Indexed: 01/24/2023]
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