Cholinergic Machinery as Relevant Target in Acute Lymphoblastic T Leukemia

Variation of nicotinic subtype α7 and muscarinic subtype M3 acetylcholine receptor expression in three main types of leukemia

Cholinergic receptors, such as α7-nicotinic acetylcholine receptor (α7-nAChR) and M3-muscarinic acetylcholine receptor (M3-mAChR), have been demonstrated to serve a significant role in the proliferation, differentiation and apoptosis of leukemic cells. However, the expression of these receptors in samples from patients with leukemia remains unclear. The present study aimed to determine the expression of M3-mAChR and α7-nAChR in the bone marrow or peripheral blood of 51 patients with leukemia, including acute myeloid leukemia (AML; n=33), acute lymphoblastic leukemia (ALL; n=13), and chronic myeloid leukemia (CML; n=5). Peripheral blood mononuclear cells (PBMCs) were also isolated from healthy subjects (n=5) for comparison. Western blot analysis was performed to determine the protein expression profiles, and a pattern of decreased α7-nAChR levels in patients with leukemia was observed. Among the leukemia types, the lowest expression of α7-nAChR and M3-mAChR were identified in patients with T-cell ALL/lymphoma (T-ALL). CML exhibited the highest level of M3-mAChR, which was significantly different from APL and AML-M4, yet not from healthy subjects (P<0.05). Therefore, different expression profiles of α7-nACR and M3-mAChR were detected amongst the leukemia types. Collectively, the present study supports the potential role of cholinergic signaling in mediating leukemogenesis. However, further studies in larger cohorts are required to validate these findings.

Heart-Rate Variability-More than Heart Beats?

Heart-rate variability (HRV) is frequently introduced as mirroring imbalances within the autonomous nerve system. Many investigations are based on the paradigm that increased sympathetic tone is associated with decreased parasympathetic tone and vice versa. But HRV is probably more than an indicator for probable disturbances in the autonomous system. Some perturbations trigger not reciprocal, but parallel changes of vagal and sympathetic nerve activity. HRV has also been considered as a surrogate parameter of the complex interaction between brain and cardiovascular system. Systems biology is an inter-disciplinary field of study focusing on complex interactions within biological systems like the cardiovascular system, with the help of computational models and time series analysis, beyond others. Time series are considered surrogates of the particular system, reflecting robustness or fragility. Increased variability is usually seen as associated with a good health condition, whereas lowered variability might signify pathological changes. This might explain why lower HRV parameters were related to decreased life expectancy in several studies. Newer integrating theories have been proposed. According to them, HRV reflects as much the state of the heart as the state of the brain. The polyvagal theory suggests that the physiological state dictates the range of behavior and psychological experience. Stressful events perpetuate the rhythms of autonomic states, and subsequently, behaviors. Reduced variability will according to this theory not only be a surrogate but represent a fundamental homeostasis mechanism in a pathological state. The neurovisceral integration model proposes that cardiac vagal tone, described in HRV beyond others as HF-index, can mirror the functional balance of the neural networks implicated in emotion-cognition interactions. Both recent models represent a more holistic approach to understanding the significance of HRV.

Acetylcholine released from T cells regulates intracellular Ca2+, IL-2 secretion and T cell proliferation through nicotinic acetylcholine receptor

AIMS

T lymphocytes synthesize acetylcholine (ACh) and express muscarinic and nicotinic ACh receptors (mAChR and nAChR, respectively) responsible for increases in the intracellular Ca²⁺ concentration ([Ca²⁺]_i). Our aim in the present study was to assess whether autocrine ACh released from T lymphocytes regulates their physiological functions.

MAIN METHODS

MOLT-3 human leukemic cell line and murine splenocytes were loaded with fura-2 to monitor [Ca²⁺]_i changes in the absence or presence of several AChR antagonists, including mecamylamine, methyllycaconitine and scopolamine. Real-time PCR and ELISA were performed to measure interleukin-2 (IL-2) mRNA and protein levels.

KEY FINDINGS

T lymphocytes constitutively produce sufficient amounts of ACh to elicit autocrine changes in [Ca²⁺]_i. These autocrine ACh-evoked [Ca²⁺]_i transients were mediated by nAChRs and then influx of extracellular Ca²⁺. Mecamylamine, a nAChR inhibitor, suppressed not only these [Ca²⁺]_i transients, but also IL-2 release and T cell proliferation.

SIGNIFICANCE

Here, we confirmed that T lymphocytes utilize ACh as a tool to interact with each other and that autocrine ACh-activated nAChRs are involved in cytokine release and cell proliferation. These findings suggest the possibility that nAChR agonists and antagonists and smoking are able to modulate immune function, which in turn suggests the therapeutic potential of immune activation or suppression using nAChR agonists or antagonists.