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Giraudo MF, Jackson Z, Das I, Abiona OM, Wald DN. Chimeric Antigen Receptor (CAR)-T Cell Therapy for Non-Hodgkin's Lymphoma. Pathog Immun 2024; 9:1-17. [PMID: 38550613 PMCID: PMC10972674 DOI: 10.20411/pai.v9i1.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/28/2024] [Indexed: 04/15/2024] Open
Abstract
This review focuses on the use of chimeric antigen receptor (CAR)-T cell therapy to treat non-Hodgkin's lymphoma (NHL), a classification of heterogeneous malignant neoplasms of the lymphoid tissue. Despite various conventional and multidrug chemotherapies, the poor prognosis for NHL patients remains and has prompted the utilization of groundbreaking personalized therapies such as CAR-T cells. CAR-T cells are T cells engineered to express a CAR that enables T cells to specifically lyse tumor cells with extracellular expression of a tumor antigen of choice. A CAR is composed of an extracellular antibody fragment or target protein binding domain that is conjugated to activating intracellular signaling motifs common to T cells. In general, CAR-T cell therapies for NHL are designed to recognize cellular markers ubiquitously expressed on B cells such as CD19+, CD20+, and CD22+. Clinical trials using CAR-T cells such as ZUMA-7 and TRANSFORM demonstrated promising results compared to standard of care and ultimately led to FDA approval for the treatment of relapsed/refractory NHL. Despite the success of CAR-T therapy for NHL, challenges include adverse side effects as well as extrinsic and intrinsic mechanisms of tumor resistance that lead to suboptimal outcomes. Overall, CAR-T cell therapies have improved clinical outcomes in NHL patients and generated optimism around their future applications.
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Affiliation(s)
| | - Zachary Jackson
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - Indrani Das
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | | | - David N. Wald
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
- Department of Pathology, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
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2
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Lee G, Franklin J, Gupta K, Liu R, Zhou L, Ryder C, Sobieraj L, Molitor L, Abiona O, Meyerson H, Das I, Jackson Z, Wald DN. Loss of GSK3β in hematopoietic stem cells results in normal hematopoiesis in mice. Blood Adv 2023; 7:7185-7189. [PMID: 37922427 PMCID: PMC10698258 DOI: 10.1182/bloodadvances.2022008094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/15/2023] [Accepted: 09/04/2023] [Indexed: 11/05/2023] Open
Affiliation(s)
- Grace Lee
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Jude Franklin
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Kalpana Gupta
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Ruifu Liu
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Lan Zhou
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Christopher Ryder
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Lukasz Sobieraj
- Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, IL
| | - Luke Molitor
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Olubukola Abiona
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Howard Meyerson
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Indrani Das
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Zachary Jackson
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - David N. Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH
- Department of Pathology, Louis Stokes Cleveland VA Medical Center, Cleveland, OH
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3
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Wang HY, Gong S, Li GH, Yao YZ, Zheng YS, Lu XH, Wei SH, Qin WW, Liu HB, Wang MC, Xi JY, Chen LM, Zhang M, Zhang XX, Zhang HY, Zhang CS, Wald DN, Zhu HH, Liu L, He PC. An effective and chemotherapy-free strategy of all-trans retinoic acid and arsenic trioxide for acute promyelocytic leukemia in all risk groups (APL15 trial). Blood Cancer J 2022; 12:158. [PMID: 36404343 PMCID: PMC9676182 DOI: 10.1038/s41408-022-00753-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 11/22/2022] Open
Abstract
The combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has been demonstrated to have comparable effectiveness or better to ATRA and chemotherapy (CHT) in non-high-risk acute promyelocytic leukemia (APL). However, the efficacy of ATRA-ATO compared to ATRA-ATO plus CHT in high-risk APL remains unknown. Here we performed a randomized multi-center non-inferiority phase III study to compare the efficacy of ATRA-ATO and ATRA-ATO plus CHT in newly diagnosed all-risk APL to address this question. Patients were assigned to receive ATRA-ATO for induction, consolidation, and maintenance or ATRA-ATO plus CHT for induction followed by three cycles of consolidation therapy, and maintenance therapy with ATRA-ATO. In the non-CHT group, hydroxyurea was used to control leukocytosis. A total of 128 patients were treated. The complete remission rate was 97% in both groups. The 2-year disease-free, event-free survival rates in the non-CHT group and CHT group in all-risk patients were 98% vs 97%, and 95% vs 92%, respectively (P = 0.62 and P = 0.39, respectively). And they were 94% vs 87%, and 85% vs 78% in the high-risk patients (P = 0.52 and P = 0.44, respectively). This study demonstrated that ATRA-ATO had the same efficacy as the ATRA-ATO plus CHT in the treatment of patients with all-risk APL.
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Affiliation(s)
- Huai-Yu Wang
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Sha Gong
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Guo-Hui Li
- grid.233520.50000 0004 1761 4404Department of Hematology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province China
| | - Ya-Zhou Yao
- grid.489934.bDepartment of Hematology, Baoji Central Hospital, Baoji, Shaanxi Province China
| | - Yin-Suo Zheng
- grid.489934.bDepartment of Hematology, Baoji Central Hospital, Baoji, Shaanxi Province China
| | - Xiao-Hong Lu
- grid.452438.c0000 0004 1760 8119Department of Rheumatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Su-Hua Wei
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Wei-Wei Qin
- grid.233520.50000 0004 1761 4404Department of Hematology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province China
| | - Hai-Bo Liu
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Meng-Chang Wang
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Jie-Ying Xi
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Li-Mei Chen
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Mei Zhang
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Xin-Xin Zhang
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - Hui-Yun Zhang
- grid.469564.cDepartment of Oncology, Qinghai Provincial People’s Hospital, Xining, Qinghai Province China
| | - Cheng-Sheng Zhang
- grid.452438.c0000 0004 1760 8119Precision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
| | - David N. Wald
- grid.67105.350000 0001 2164 3847Department of Pathology, Case Western Reserve University, Cleveland, OH USA
| | - Hong-Hu Zhu
- grid.452661.20000 0004 1803 6319Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang China
| | - Li Liu
- grid.233520.50000 0004 1761 4404Department of Hematology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi Province China
| | - Peng-Cheng He
- grid.452438.c0000 0004 1760 8119Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province China
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Jackson Z, Hong C, Schauner R, Dropulic B, Caimi PF, de Lima M, Giraudo MF, Gupta K, Reese JS, Hwang TH, Wald DN. Sequential Single-Cell Transcriptional and Protein Marker Profiling Reveals TIGIT as a Marker of CD19 CAR-T Cell Dysfunction in Patients with Non-Hodgkin Lymphoma. Cancer Discov 2022; 12:1886-1903. [PMID: 35554512 PMCID: PMC9357057 DOI: 10.1158/2159-8290.cd-21-1586] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/02/2022] [Accepted: 05/04/2022] [Indexed: 02/07/2023]
Abstract
Chimeric antigen receptor T-cell (CAR-T cell) therapy directed at CD19 produces durable remissions in the treatment of relapsed/refractory non-Hodgkin lymphoma (NHL). Nonetheless, many patients receiving CD19 CAR-T cells fail to respond for unknown reasons. To reveal changes in 4-1BB-based CD19 CAR-T cells and identify biomarkers of response, we used single-cell RNA sequencing and protein surface marker profiling of patient CAR-T cells pre- and postinfusion into patients with NHL. At the transcriptional and protein levels, we note the evolution of CAR-T cells toward a nonproliferative, highly differentiated, and exhausted state, with an enriched exhaustion profile in CAR-T cells of patients with poor response marked by TIGIT expression. Utilizing in vitro and in vivo studies, we demonstrate that TIGIT blockade alone improves the antitumor function of CAR-T cells. Altogether, we provide evidence of CAR-T cell dysfunction marked by TIGIT expression driving a poor response in patients with NHL. SIGNIFICANCE This is the first study investigating the mechanisms linked to CAR-T patient responses based on the sequential analysis of manufactured and infused CAR-T cells using single-cell RNA and protein expression data. Furthermore, our findings are the first to demonstrate an improvement of CAR-T cell efficacy with TIGIT inhibition alone. This article is highlighted in the In This Issue feature, p. 1825.
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Affiliation(s)
- Zachary Jackson
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Changjin Hong
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, Florida, USA
| | - Robert Schauner
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Paolo F. Caimi
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | | | | | - Kalpana Gupta
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jane S. Reese
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Tae Hyun Hwang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, Florida, USA.,Department of Immunology, Mayo Clinic, Jacksonville, Florida, USA
| | - David N. Wald
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Louis Stokes Cleveland VA Medical Center, Department of Pathology, Cleveland, Ohio, USA
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5
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Otegbeye F, Cooper B, Caimi P, Zamborsky K, Reese-Koc J, Hillian A, Hernandez-Collazo Y, Lee G, Boughan K, Tomlinson B, Gallogly M, Metheny L, Bajor D, Selfridge J, Saltzman J, Lazarus HM, de Lima M, Wald DN. A Phase I study to determine maximum tolerated dose of ex vivo expanded natural killer cells derived from unrelated, HLA-disparate adult donors. Transplant Cell Ther 2022; 28:250.e1-250.e8. [PMID: 35172204 PMCID: PMC9489303 DOI: 10.1016/j.jtct.2022.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/27/2022]
Abstract
The administration of allogeneic natural killer (NK) cells following a lymphodepleting chemotherapy regimen is emerging as a well-tolerated therapeutic approach in the management of various malignancies. Contrary to the expected complications of allogeneic T cell therapy, there remains no evidence of graft-versus-host disease (GVHD) mediated by NK cells in numerous clinical trials. On the contrary, preclinical and clinical studies suggest that NK cells do not induce GVHD and in fact may prevent its development following allogeneic hematopoietic cell transplantation (HCT). In this study, we sought to determine the maximum tolerated dose of non-HLA-matched donor NK cells derived from peripheral blood and ex vivo expanded using a novel feeder cell platform. In a single-center Phase I clinical trial using a 3 × 3 design, 9 subjects each received 2 infusions of NK cells 2 weeks apart following a preparative regimen of cyclophosphamide (60 mg/kg i.v.) and fludarabine (25 mg/m2/day i.v for 5 days). No exogenous cytokines were administered. NK cells were administered at 3 dose levels: 1 × 107/kg, 2.5 × 107/kg, and 5 × 107/kg. Three subjects had myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML), and the other 6 subjects had colorectal carcinoma. Recipients were monitored over a 4-week period for GVHD as well as other adverse events and for persistence of donor NK cells in systemic circulation. Disease assessment was started at 28 days following the first NK cell infusion and continued until postinfusion day 100 or disease progression. In all 9 study subjects, there was no occurrence of GVHD and no dose-limiting toxicities that would warrant cohort expansion at any of the 3 planned cell dose levels. Low-level donor NK cell persistence was observed up to 4 weeks after the first NK cell infusion at all dose levels. The best observed response was a complete response with incomplete platelet recovery in a MDS subject who experienced disease relapse after prior allogeneic HCT. Other responses were stable disease in 1 subject with MDS and 2 subjects with colorectal cancer up to postinfusion day 100. This off-the-shelf, third-party NK cell product can be administered safely without inducing GVHD and exhibits in vivo persistence promoted by preparative lymphodepletion alone. The observed clinical responses could be enhanced by administration of exogenous cytokine support, as well as complementary approaches that promote NK cell function in the tumor microenvironment.
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6
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Stetson LC, Balasubramanian D, Ribeiro SP, Stefan T, Gupta K, Xu X, Fourati S, Roe A, Jackson Z, Schauner R, Sharma A, Tamilselvan B, Li S, de Lima M, Hwang TH, Balderas R, Saunthararajah Y, Maciejewski J, LaFramboise T, Barnholtz-Sloan JS, Sekaly RP, Wald DN. Single cell RNA sequencing of AML initiating cells reveals RNA-based evolution during disease progression. Leukemia 2021; 35:2799-2812. [PMID: 34244611 PMCID: PMC8807029 DOI: 10.1038/s41375-021-01338-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/19/2021] [Accepted: 06/25/2021] [Indexed: 02/06/2023]
Abstract
The prognosis of most patients with AML is poor due to frequent disease relapse. The cause of relapse is thought to be from the persistence of leukemia initiating cells (LIC's) following treatment. Here we assessed RNA based changes in LICs from matched patient diagnosis and relapse samples using single-cell RNA sequencing. Previous studies on AML progression have focused on genetic changes at the DNA mutation level mostly in bulk AML cells and demonstrated the existence of DNA clonal evolution. Here we identified in LICs that the phenomenon of RNA clonal evolution occurs during AML progression. Despite the presence of vast transcriptional heterogeneity at the single cell level, pathway analysis identified common signaling networks involving metabolism, apoptosis and chemokine signaling that evolved during AML progression and become a signature of relapse samples. A subset of this gene signature was validated at the protein level in LICs by flow cytometry from an independent AML cohort and functional studies were performed to demonstrate co-targeting BCL2 and CXCR4 signaling may help overcome therapeutic challenges with AML heterogeneity. It is hoped this work will facilitate a greater understanding of AML relapse leading to improved prognostic biomarkers and therapeutic strategies to target LIC's.
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Affiliation(s)
- L C Stetson
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Tammy Stefan
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Kalpana Gupta
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Xuan Xu
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Slim Fourati
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Anne Roe
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Zachary Jackson
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Robert Schauner
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Ashish Sharma
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | | | - Samuel Li
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Marcos de Lima
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Tae Hyun Hwang
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | | | - Yogen Saunthararajah
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - Jaroslaw Maciejewski
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - Thomas LaFramboise
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Rafick-Pierre Sekaly
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA.
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
- Department of Pathology, University Hospitals Cleveland Medical Center and Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
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7
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Jackson Z, Roe A, Sharma AA, Lopes FBTP, Talla A, Kleinsorge-Block S, Zamborsky K, Schiavone J, Manjappa S, Schauner R, Lee G, Liu R, Caimi PF, Xiong Y, Krueger W, Worden A, Kadan M, Schneider D, Orentas R, Dropulic B, Sekaly RP, de Lima M, Wald DN, Reese JS. Automated Manufacture of Autologous CD19 CAR-T Cells for Treatment of Non-hodgkin Lymphoma. Front Immunol 2020; 11:1941. [PMID: 32849651 PMCID: PMC7427107 DOI: 10.3389/fimmu.2020.01941] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/17/2020] [Indexed: 01/26/2023] Open
Abstract
Chimeric antigen receptor T cells (CAR-T cell) targeting CD19 are effective against several subtypes of CD19-expressing hematologic malignancies. Centralized manufacturing has allowed rapid expansion of this cellular therapy, but it may be associated with treatment delays due to the required logistics. We hypothesized that point of care manufacturing of CAR-T cells on the automated CliniMACS Prodigy® device allows reproducible and fast delivery of cells for the treatment of patients with non-Hodgkin lymphoma. Here we describe cell manufacturing results and characterize the phenotype and effector function of CAR-T cells used in a phase I/II study. We utilized a lentiviral vector delivering a second-generation CD19 CAR construct with 4-1BB costimulatory domain and TNFRSF19 transmembrane domain. Our data highlight the successful generation of CAR-T cells at numbers sufficient for all patients treated, a shortened duration of production from 12 to 8 days followed by fresh infusion into patients, and the detection of CAR-T cells in patient circulation up to 1-year post-infusion.
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MESH Headings
- Animals
- Antigens, CD19/genetics
- Antigens, CD19/immunology
- Antigens, CD19/metabolism
- Automation
- Cell Culture Techniques
- Cell Engineering
- Cells, Cultured
- Clinical Trials, Phase I as Topic
- Clinical Trials, Phase II as Topic
- Cytotoxicity, Immunologic
- Humans
- Immunotherapy, Adoptive
- Lymphoma, Non-Hodgkin/immunology
- Lymphoma, Non-Hodgkin/metabolism
- Lymphoma, Non-Hodgkin/therapy
- Mice, Inbred NOD
- Phenotype
- Point-of-Care Systems
- Receptors, Chimeric Antigen/genetics
- Receptors, Chimeric Antigen/immunology
- Receptors, Chimeric Antigen/metabolism
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- T-Lymphocytes/transplantation
- Transplantation, Autologous
- Treatment Outcome
- Workload
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Zachary Jackson
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Anne Roe
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | | | | | - Aarthi Talla
- The Alan Turing Institute, British Library, London, United Kingdom
| | - Sarah Kleinsorge-Block
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Kayla Zamborsky
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Jennifer Schiavone
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Shivaprasad Manjappa
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Robert Schauner
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Grace Lee
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Ruifu Liu
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Paolo F. Caimi
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Ying Xiong
- Lentigen Technology, Inc., a Miltenyi Biotec Company, Gaithersburg, MD, United States
| | - Winfried Krueger
- Lentigen Technology, Inc., a Miltenyi Biotec Company, Gaithersburg, MD, United States
| | - Andrew Worden
- Lentigen Technology, Inc., a Miltenyi Biotec Company, Gaithersburg, MD, United States
| | - Mike Kadan
- Lentigen Technology, Inc., a Miltenyi Biotec Company, Gaithersburg, MD, United States
| | - Dina Schneider
- Lentigen Technology, Inc., a Miltenyi Biotec Company, Gaithersburg, MD, United States
| | - Rimas Orentas
- Department of Pediatrics, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Boro Dropulic
- Lentigen Technology, Inc., a Miltenyi Biotec Company, Gaithersburg, MD, United States
| | - Rafick-Pierre Sekaly
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Marcos de Lima
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - David N. Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Jane S. Reese
- Stem Cell Transplantation Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
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8
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Shukla S, Roe AJ, Liu R, Veliz FA, Commandeur U, Wald DN, Steinmetz NF. Affinity of plant viral nanoparticle potato virus X (PVX) towards malignant B cells enables cancer drug delivery. Biomater Sci 2020; 8:3935-3943. [PMID: 32662788 DOI: 10.1039/d0bm00683a] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Non-Hodgkin's B cell lymphomas (NHL) include a diverse set of neoplasms that constitute ∼90% of all lymphomas and the largest subset of blood cancers. While chemotherapy is the first line of treatment, the efficacy of contemporary chemotherapies is hampered by dose-limiting toxicities. Partly due to suboptimal dosing, ∼40% of patients exhibit relapsed or refractory disease. Therefore more efficacious drug delivery systems are urgently needed to improve survival of NHL patients. In this study we demonstrate a new drug delivery platform for NHL based on the plant virus Potato virus X (PVX). We observed a binding affinity of PVX towards malignant B cells. In a metastatic mouse model of NHL, we show that systemically administered PVX home to tissues harboring malignant B cells. When loaded with the chemotherapy monomethyl auristatin (MMAE), the PVX nanocarrier enables effective delivery of MMAE to human B lymphoma cells in a NHL mouse model leading to inhibition of lymphoma growth in vivo and improved survival. Thus, PVX nanoparticle is a promising drug delivery platform for B cell malignancies.
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Affiliation(s)
- Sourabh Shukla
- Department of NanoEngineering, University of California San Diego, La Jolla, California 92093, USA.
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9
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Ueda M, Stefan T, Stetson L, Ignatz-Hoover JJ, Tomlinson B, Creger RJ, Cooper B, Lazarus HM, de Lima M, Wald DN, Caimi PF. Phase I Trial of Lithium and Tretinoin for Treatment of Relapsed and Refractory Non-promyelocytic Acute Myeloid Leukemia. Front Oncol 2020; 10:327. [PMID: 32211336 PMCID: PMC7076174 DOI: 10.3389/fonc.2020.00327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/25/2020] [Indexed: 11/13/2022] Open
Abstract
Glycogen synthase kinase-3 (GSK3) inhibitors induce differentiation and growth inhibition of acute myeloid leukemia (AML) cells. Our pre-clinical studies showed GSK3 inhibition leads to sensitization of AML cells to tretinoin-mediated differentiation. We conducted a phase I trial of lithium, a GSK3 inhibitor, plus tretinoin for relapsed, refractory non-promyelocytic AML. Nine patients with median (range) age 65 (42–82) years were enrolled. All subjects had relapsed leukemia after prior therapy, with a median (range) of 3 (1–3) prior therapies. Oral lithium carbonate 300 mg was given 2–3 times daily and adjusted to meet target serum concentration (0.6 to 1.0 mmol/L); tretinoin 22.5 or 45 mg/m2/day (two equally divided doses) was administered orally on days 1–7 and 15–21 of a 28-day cycle. Four patients attained disease stability with no increase in circulating blasts for ≥4 weeks. Median (range) survival was 106 days (60–502). Target serum lithium concentration was achieved in all patients and correlated with GSK3 inhibition in leukemic cells. Immunophenotypic changes associated with myeloid differentiation were observed in five patients. The combination treatment led to a reduction in the CD34+ CD38– AML stem cell population both in vivo and in vitro. The combination of lithium and tretinoin is well-tolerated, induces differentiation of leukemic cells, and may target AML stem cells, but has limited clinical activity in the absence of other antileukemic agents. The results of this clinical trial suggest GSK3 inhibition can result in AML cell differentiation and may be a novel therapeutic strategy in this disease, particularly in combination with other antileukemic agents. Lithium is a weak GSK3 inhibitor and future strategies in AML treatment will probably require more potent agents targeting this pathway or combinations with other antileukemic agents. This trial is registered at ClinicalTrials.gov NCT01820624.
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Affiliation(s)
- Masumi Ueda
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.,Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, United States
| | - Tammy Stefan
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Lindsay Stetson
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - James J Ignatz-Hoover
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Benjamin Tomlinson
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Richard J Creger
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Brenda Cooper
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Hillard M Lazarus
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Marcos de Lima
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Paolo F Caimi
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
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10
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Ojo EO, Sharma AA, Liu R, Moreton S, Checkley-Luttge MA, Gupta K, Lee G, Lee DA, Otegbeye F, Sekaly RP, de Lima M, Wald DN. Membrane bound IL-21 based NK cell feeder cells drive robust expansion and metabolic activation of NK cells. Sci Rep 2019; 9:14916. [PMID: 31624330 PMCID: PMC6797802 DOI: 10.1038/s41598-019-51287-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/27/2019] [Indexed: 02/08/2023] Open
Abstract
NK cell adoptive therapy is a promising cancer therapeutic approach, but there are significant challenges that limiting its feasibility and clinical efficacy. One difficulty is the paucity of clinical grade manufacturing platforms to support the large scale expansion of highly active NK cells. We created an NK cell feeder cell line termed 'NKF' through overexpressing membrane bound IL-21 that is capable of inducing robust and sustained proliferation (>10,000-fold expansion at 5 weeks) of highly cytotoxic NK cells. The expanded NK cells exhibit increased cytotoxic function against a panel of blood cancer and solid tumor cells as compared to IL-2-activated non-expanded NK cells. The NKF-expanded NK cells also demonstrate efficacy in mouse models of human sarcoma and T cell leukemia. Mechanistic studies revealed that membrane-bound IL-21 leads to an activation of a STAT3/c-Myc pathway and increased NK cell metabolism with a shift towards aerobic glycolysis. The NKF feeder cell line is a promising new platform that enables the large scale proliferation of highly active NK cells in support of large scale third party NK cell clinical studies that have been recently intiatied. These results also provide mechanistic insights into how membrane-bound IL-21 regulates NK cell expansion.
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Affiliation(s)
- Evelyn O Ojo
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Ruifu Liu
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stephen Moreton
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Mary-Ann Checkley-Luttge
- Department of Molecular Biology and Microbiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Kalpana Gupta
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Grace Lee
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dean A Lee
- Center for Childhood Cancer and Blood Disorders, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Folashade Otegbeye
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | | | - Marcos de Lima
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA.
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
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11
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Liu Z, Cominelli F, Di Martino L, Liu R, Devireddy N, Devireddy LR, Wald DN. Lipocalin 24p3 Induction in Colitis Adversely Affects Inflammation and Contributes to Mortality. Front Immunol 2019; 10:812. [PMID: 31057545 PMCID: PMC6478753 DOI: 10.3389/fimmu.2019.00812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 03/27/2019] [Indexed: 12/12/2022] Open
Abstract
Recognition of microorganism associated molecular patterns by epithelial cells elicits signaling cascades resulting in the production of host defense proteins. Lipocalin 24p3 is purported to be one such protein. 24p3 binds prokaryotic and eukaryotic siderophores and by sequestering iron laden bacterial siderophores it was believed to restrict bacterial replication. As such mice deficient for 24p3 are susceptible to systemic infections. However, it is not clear whether deficiency of 24p3 on the gut mucosa contributes to inflammation. In line with 24p3's function as a bacteriostat, it would be reasonable to assume that deficiencies in the control of intestinal flora from 24p3 absence play a role in inflammatory intestinal diseases. Surprisingly, we show 24p3 is a contributor of inflammation and 24p3 deficiency protects mice from dextran sodium sulfate (DSS)-induced colitis. 24p3 was found to be a negative regulator of platelet-derived growth factor (PDGF), which helps maintain the integrity of the gut mucosa. Neutralization of PDGF-BB abrogated resistance of 24p3 null mice to DSS confirming the direct link between 24p3 and PDGF-BB. Finally, iron handling in wild-type and 24p3-null mice upon DSS treatment also differed. In summary, differential iron levels and enhanced expression of PDGF-BB in 24p3 null mice confers resistance to DSS.
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Affiliation(s)
- Zhuoming Liu
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Fabio Cominelli
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Luca Di Martino
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Ruifu Liu
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | | | - Lax R Devireddy
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States.,Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
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12
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Hung S, Saiakhova A, Faber ZJ, Bartels CF, Neu D, Bayles I, Ojo E, Hong ES, Pontius WD, Morton AR, Liu R, Kalady MF, Wald DN, Markowitz S, Scacheri PC. Mismatch repair-signature mutations activate gene enhancers across human colorectal cancer epigenomes. eLife 2019; 8:40760. [PMID: 30759065 PMCID: PMC6374075 DOI: 10.7554/elife.40760] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/22/2019] [Indexed: 02/07/2023] Open
Abstract
Commonly-mutated genes have been found for many cancers, but less is known about mutations in cis-regulatory elements. We leverage gains in tumor-specific enhancer activity, coupled with allele-biased mutation detection from H3K27ac ChIP-seq data, to pinpoint potential enhancer-activating mutations in colorectal cancer (CRC). Analysis of a genetically-diverse cohort of CRC specimens revealed that microsatellite instable (MSI) samples have a high indel rate within active enhancers. Enhancers with indels show evidence of positive selection, increased target gene expression, and a subset is highly recurrent. The indels affect short homopolymer tracts of A/T and increase affinity for FOX transcription factors. We further demonstrate that signature mismatch-repair (MMR) mutations activate enhancers using a xenograft tumor metastasis model, where mutations are induced naturally via CRISPR/Cas9 inactivation of MLH1 prior to tumor cell injection. Our results suggest that MMR signature mutations activate enhancers in CRC tumor epigenomes to provide a selective advantage.
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Affiliation(s)
- Stevephen Hung
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Alina Saiakhova
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Zachary J Faber
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Cynthia F Bartels
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Devin Neu
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Ian Bayles
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Evelyn Ojo
- Department of Pathology, Case Western Reserve University, Cleveland, United States
| | - Ellen S Hong
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - W Dean Pontius
- Department of Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, United States
| | - Andrew R Morton
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Ruifu Liu
- Department of Pathology, Case Western Reserve University, Cleveland, United States
| | - Matthew F Kalady
- Department of Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, United States.,Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, United States.,Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, United States
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, United States
| | - Sanford Markowitz
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, United States.,Department of Medicine, Case Western Reserve University, Cleveland, United States
| | - Peter C Scacheri
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, United States
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13
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Ignatz-Hoover JJ, Wang V, Mackowski NM, Roe AJ, Ghansah IK, Ueda M, Lazarus HM, de Lima M, Paietta E, Fernandez H, Cripe L, Tallman M, Wald DN. Aberrant GSK3β nuclear localization promotes AML growth and drug resistance. Blood Adv 2018; 2:2890-2903. [PMID: 30385433 PMCID: PMC6234355 DOI: 10.1182/bloodadvances.2018016006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 08/23/2018] [Indexed: 12/12/2022] Open
Abstract
Acute myeloid leukemia (AML) is a devastating disease with poor patient survival. As targetable mutations in AML are rare, novel oncogenic mechanisms are needed to define new therapeutic targets. We identified AML cells that exhibit an aberrant pool of nuclear glycogen synthase kinase 3β (GSK3β). This nuclear fraction drives AML growth and drug resistance. Nuclear, but not cytoplasmic, GSK3β enhances AML colony formation and AML growth in mouse models. Nuclear GSK3β drives AML partially by promoting nuclear localization of the NF-κB subunit, p65. Finally, nuclear GSK3β localization has clinical significance as it strongly correlates to worse patient survival (n = 86; hazard ratio = 2.2; P < .01) and mediates drug resistance in cell and animal models. Nuclear localization of GSK3β may define a novel oncogenic mechanism in AML and represent a new therapeutic target.
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MESH Headings
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Cell Line, Tumor
- Cell Nucleus/metabolism
- Cell Proliferation/drug effects
- Cell Survival/drug effects
- Drug Resistance, Neoplasm
- Female
- Glycogen Synthase Kinase 3 beta/metabolism
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/pathology
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Myeloid-Lymphoid Leukemia Protein/metabolism
- NF-kappa B/metabolism
- Oncogene Proteins, Fusion/metabolism
- Proportional Hazards Models
- Survival Rate
- Transplantation, Heterologous
- Up-Regulation
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Affiliation(s)
| | - Victoria Wang
- Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) Biostatistics Center, Dana-Farber Cancer Institute, Boston, MA
| | | | - Anne J Roe
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Isaac K Ghansah
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Masumi Ueda
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Hillard M Lazarus
- Department of Hematology and Oncology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH
| | - Marcos de Lima
- Department of Hematology and Oncology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH
| | | | - Hugo Fernandez
- Department of Blood and Marrow Transplant, Moffitt Cancer Center, Tampa, FL
| | - Larry Cripe
- Department of Medicine, Indiana University, Indianapolis, IN
| | - Martin Tallman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH
- Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH
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14
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Otegbeye F, Ojo E, Moreton S, Mackowski N, Lee DA, de Lima M, Wald DN. Correction: Inhibiting TGF-beta signaling preserves the function of highly activated, in vitro expanded natural killer cells in AML and colon cancer models. PLoS One 2018; 13:e0197008. [PMID: 29718995 PMCID: PMC5931648 DOI: 10.1371/journal.pone.0197008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0191358.].
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15
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Otegbeye F, Ojo E, Moreton S, Mackowski N, Lee DA, de Lima M, Wald DN. Inhibiting TGF-beta signaling preserves the function of highly activated, in vitro expanded natural killer cells in AML and colon cancer models. PLoS One 2018; 13:e0191358. [PMID: 29342200 PMCID: PMC5771627 DOI: 10.1371/journal.pone.0191358] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 01/03/2018] [Indexed: 01/08/2023] Open
Abstract
Natural killer cells harnessed from healthy individuals can be expanded ex vivo using various platforms to produce large doses for adoptive transfer into cancer patients. During such expansion, NK cells are increasingly activated and more efficient at killing cancer cells. Adoptive transfer however introduces these activated cells into a highly immunosuppressive tumor microenvironment mediated in part by excessive transforming growth factor beta (TGF-beta) from both cancer cells and their surrounding stroma. This microenvironment ultimately limits the clinical efficacy of NK cell therapy. In this study, we examined the use of a TGF-beta receptor kinase inhibitor, LY2157299, in preserving the cytotoxic function of ex vivo expanded, highly activated NK cells following sustained exposure to pathologic levels of TGF-beta in vitro and in a liver metastases model of colon cancer. Using myeloid leukemia and colon cancer cell lines, we show that the TGF-beta driven impairment of NK cell cytotoxicity is mitigated by LY2157299. We demonstrate this effect using quantitative cytotoxicity assays as well as by showing a preserved activated phenotype with high NKG2D/CD16 expression and enhanced cytokine production. In a mouse liver metastases model of colon cancer, we observed significantly improved eradication of liver metastases in mice treated with adoptive NK cells combined with LY2157299 compared with mice receiving NK cells or TGF beta inhibition alone. We propose that the therapeutic efficacy of adoptive NK cell therapy clinically will be markedly enhanced by complementary approaches targeting TGF-beta signaling in vivo.
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Affiliation(s)
- Folashade Otegbeye
- Department of Medicine, Division of Hematology and Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States of America
- Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Evelyn Ojo
- Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Stephen Moreton
- Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Nathan Mackowski
- Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Dean A. Lee
- Nationwide Children’s Hospital Division of Hematology/Oncology, Columbus, Ohio, United States of America
| | - Marcos de Lima
- Department of Medicine, Division of Hematology and Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States of America
- Case Western Reserve University, Cleveland, Ohio, United States of America
| | - David N. Wald
- Case Western Reserve University, Cleveland, Ohio, United States of America
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States of America
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16
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Ignatz-Hoover JJ, Mackowski N, Wald DN. Abstract 1154: Elevated nuclear GSK3β promotes more aggressive disease in AML. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Acute myeloid leukemia (AML) is a devastating disease with a poor overall 5-yr survival rate and an antiquated and poorly tolerated therapy regimen. Despite an increasing knowledge of the molecular drivers of AML, new therapeutic targets are needed. GSK3β is a key signaling molecule that plays a role in several key oncogenic pathways including the β-catenin and NF-κB pathways, key pathways in AML and other cancers. Upregulation of GSK3β is correlated with poor prognosis in several cancers. We and others have shown GSK3β inhibition promotes AML differentiation as well as death of AML cells while sparing normal cells, suggesting GSK3β plays an important role in AML.
Here we show by western blotting and confocal microscopy that GSK3β is upregulated and more nuclear in AML cells. We utilize flow cytometry to show AML cells express elevated GSK3β compared to normal marrow lineages (Average upregulation = 6 fold). We transform mouse hematopoietic progenitor cells with the MLL-AF9 oncogene and observe GSK3β upregulation as a course of AML leukemogenesis. These data suggest that elevated and nuclear GSK3β is characteristic of AML.
To probe biological effects of GSK3β, we knocked down endogenous GSK3β and utilize a targetted, tetracycline-inducible GSK3β rescue model to show nuclear GSK3β specifically can promote AML growth. Nuclear GSK3β increases colony formation of OCI-AML3 and HL60 cell lines more potently than cytoplasmic (cyto) GSK3β in the same lines (OCI-AML3- Nuclear: 118% Cyto: 93% of control colony growth HL60- Nuclear: 117% Cyto: 100% of control colony growth, Nuclear difference- p<0.01 in both lines). Utilizing a mouse xenograft model and inducing GSK3β via doxycycline water, we show inducing nuclear GSK3β shortens mouse survival compared to uninduced controls, while inducing cytoplasmic GSK3β promotes no change from controls (HL60- Nuclear: Uninduced = 35.4 days mean survival, Induced = 28.75 days mean survival Cyto: Uninduced = 38 days mean survival, Induced = 38.6 days mean survival, Induced nuclear GSK3β difference p<0.01 by log rank test).
At a molecular level, when compared to cells expressing cytoplasmic GSK3β, nuclear GSK3β more potently promotes NF-κB DNA binding and NF-κB mediated transcription as measured by EMSA assay and luciferase assay (Nuclear- 18 fold increase Cyto- 3 fold increase). Nuclear GSK3β more potently promotes activation of the NF-κB subunit p65, as measured by pS536, than cytoplasmic GSK3β. Nuclear GSK3β also promotes nuclear localization of p65. These data suggest that nuclear GSK3β can promote NF-κB activation in AML.
Finally, we utilize imaging cytometry to show GSK3β is upregulated and more nuclear in clinical AML patient samples (N = 80) compared to normal bone marrow controls (N = 5). We also show nuclear localization of GSK3β and p65 correlate linearly in AML patient samples (N = 80 R2 = 0.44721 P<.01). These data suggest elevated nuclear GSK3β is observed in clinical AML and may be related to NF-κB activation.
Citation Format: James J. Ignatz-Hoover, Nathan Mackowski, David N. Wald. Elevated nuclear GSK3β promotes more aggressive disease in AML. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1154.
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17
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Hu S, Ueda M, Stetson L, Ignatz-Hoover J, Moreton S, Chakrabarti A, Xia Z, Karan G, de Lima M, Agrawal MK, Wald DN. A Novel Glycogen Synthase Kinase-3 Inhibitor Optimized for Acute Myeloid Leukemia Differentiation Activity. Mol Cancer Ther 2016; 15:1485-1494. [PMID: 27196775 DOI: 10.1158/1535-7163.mct-15-0566] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 04/06/2016] [Indexed: 11/16/2022]
Abstract
Standard therapies used for the treatment of acute myeloid leukemia (AML) are cytotoxic agents that target rapidly proliferating cells. Unfortunately, this therapeutic approach has limited efficacy and significant toxicity and the majority of AML patients still die of their disease. In contrast to the poor prognosis of most AML patients, most individuals with a rare subtype of AML, acute promyelocytic leukemia, can be cured by differentiation therapy using regimens containing all-trans retinoic acid. GSK3 has been previously identified as a therapeutic target in AML where its inhibition can lead to the differentiation and growth arrest of leukemic cells. Unfortunately, existing GSK3 inhibitors lead to suboptimal differentiation activity making them less useful as clinical AML differentiation agents. Here, we describe the discovery of a novel GSK3 inhibitor, GS87. GS87 was discovered in efforts to optimize GSK3 inhibition for AML differentiation activity. Despite GS87's dramatic ability to induce AML differentiation, kinase profiling reveals its high specificity in targeting GSK3 as compared with other kinases. GS87 demonstrates high efficacy in a mouse AML model system and unlike current AML therapeutics, exhibits little effect on normal bone marrow cells. GS87 induces potent differentiation by more effectively activating GSK3-dependent signaling components including MAPK signaling as compared with other GSK3 inhibitors. GS87 is a novel GSK3 inhibitor with therapeutic potential as a differentiation agent for non-promyelocytic AML. Mol Cancer Ther; 15(7); 1485-94. ©2016 AACR.
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Affiliation(s)
- Sophia Hu
- Department of Pathology Case Western Reserve University
| | | | | | | | | | - Amit Chakrabarti
- University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio; Invenio Therapeutics Inc. Cleveland, Ohio
| | - Zhiqiang Xia
- University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio; Invenio Therapeutics Inc. Cleveland, Ohio
| | - Goutam Karan
- University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio; Invenio Therapeutics Inc. Cleveland, Ohio
| | | | - Mukesh K Agrawal
- University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio; Invenio Therapeutics Inc. Cleveland, Ohio.,MirX Pharmaceuticals Cleveland, Ohio
| | - David N Wald
- Department of Pathology Case Western Reserve University.,University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio; Invenio Therapeutics Inc. Cleveland, Ohio.,University Hospitals Case Medical Center, Cleveland, Ohio
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18
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Gupta K, Stefan T, Ignatz-Hoover J, Moreton S, Parizher G, Saunthararajah Y, Wald DN. GSK-3 Inhibition Sensitizes Acute Myeloid Leukemia Cells to 1,25D-Mediated Differentiation. Cancer Res 2016; 76:2743-53. [PMID: 26964622 DOI: 10.1158/0008-5472.can-15-2290] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 02/16/2016] [Indexed: 11/16/2022]
Abstract
1,25-dihydroxyvitamin D3 (1,25D), the biologically active form of vitamin D, is widely considered a promising therapy for acute myeloid leukemia (AML) based on its ability to drive differentiation of leukemic cells. However, clinical trials have been disappointing in part to dose-limiting hypercalcemia. Here we show how inhibiting glycogen synthase kinase 3 (GSK3) can improve the differentiation response of AML cells to 1,25D-mediated differentiation. GSK3 inhibition in AML cells enhanced the differentiating effects of low concentrations of 1,25D. In addition, GSK3 inhibition augmented the ability of 1,25D to induce irreversible growth inhibition and slow the progression of AML in mouse models. Mechanistic studies revealed that GSK3 inhibition led to the hyperphosphorylation of the vitamin D receptor (VDR), enabling an interaction between VDR and the coactivator, SRC-3 (NCOA3), thereby increasing transcriptional activity. We also found that activation of JNK-mediated pathways in response to GSK3 inhibition contributed to the potentiation of 1,25D-induced differentiation. Taken together, our findings offer a preclinical rationale to explore the repositioning of GSK3 inhibitors to enhance differentiation-based therapy for AML treatment. Cancer Res; 76(9); 2743-53. ©2016 AACR.
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Affiliation(s)
- Kalpana Gupta
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Tammy Stefan
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - James Ignatz-Hoover
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Stephen Moreton
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio. Invenio Therapeutics, Cleveland, Ohio
| | - Gary Parizher
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - David N Wald
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio. Invenio Therapeutics, Cleveland, Ohio. University Hospitals Case Medical Center, Cleveland, Ohio.
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Karan G, Wang H, Chakrabarti A, Karan S, Liu Z, Xia Z, Gundluru M, Moreton S, Saunthararajah Y, Jackson MW, Agarwal MK, Wald DN. Identification of a Small Molecule That Overcomes HdmX-Mediated Suppression of p53. Mol Cancer Ther 2016; 15:574-582. [PMID: 26883273 DOI: 10.1158/1535-7163.mct-15-0467] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 02/02/2016] [Indexed: 11/16/2022]
Abstract
Inactivation of the p53 tumor suppressor by mutation or overexpression of negative regulators occurs frequently in cancer. As p53 plays a key role in regulating proliferation or apoptosis in response to DNA-damaging chemotherapies, strategies aimed at reactivating p53 are increasingly being sought. Strategies to reactivate wild-type p53 include the use of small molecules capable of releasing wild-type p53 from key, cellular negative regulators, such as Hdm2 and HdmX. Derivatives of the Hdm2 antagonist Nutlin-3 are in clinical trials. However, Nutlin-3 specifically disrupts Hdm2-p53, leaving tumors harboring high levels of HdmX resistant to Nutlin-3 treatment. Here, we identify CTX1, a novel small molecule that overcomes HdmX-mediated p53 repression. CTX1 binds directly to HdmX to prevent p53-HdmX complex formation, resulting in the rapid induction of p53 in a DNA damage-independent manner. Treatment of a panel of cancer cells with CTX1 induced apoptosis or suppressed proliferation and, importantly, CTX1 demonstrates promising activity as a single agent in a mouse model of circulating primary human leukemia. CTX1 is a small molecule HdmX inhibitor that demonstrates promise as a cancer therapeutic candidate. Mol Cancer Ther; 15(4); 574-82. ©2016 AACR.
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Affiliation(s)
| | - Huaiyu Wang
- Department of Hematology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | | | | | - Zhigang Liu
- Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH
| | | | | | | | - Yogen Saunthararajah
- Department of Translational Hematology & Oncology Research, Cleveland Clinic Foundation, Cleveland, OH
| | - Mark W Jackson
- Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH
| | - Mukesh K Agarwal
- Invenio Therapeutics, Lexington, KY.,MirX Pharmaceuticals, Cleveland, OH
| | - David N Wald
- Invenio Therapeutics, Lexington, KY.,Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH.,MirX Pharmaceuticals, Cleveland, OH
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20
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Zang S, Liu N, Wang H, Wald DN, Shao N, Zhang J, Ma D, Ji C, Tse W. Wnt signaling is involved in 6-benzylthioinosine-induced AML cell differentiation. BMC Cancer 2014; 14:886. [PMID: 25428027 PMCID: PMC4289047 DOI: 10.1186/1471-2407-14-886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 11/17/2014] [Indexed: 01/02/2023] Open
Abstract
Background We previously demonstrated that 6-benzylthioinosine (6-BT) could induce the differentiation of a subset of acute myeloid leukemia (AML) cell lines and primary AML cells regardless of their cytogenetics. In this study we investigated whether Wnt signaling pathways played roles in 6-BT-induced differentiation of AML cells. Methods We induced differentiation of HL-60 leukemic cells and primary AML cells in vitro using 6-BT. Real-time PCR (qPCR), western blot, and luciferase assays were used to examine the molecules’ expression and biological activity in canonical and noncanonical Wnt signaling pathways. AML cell differentiation was measured by the Nitroblue tetrozolium (NBT) reduction assay. Results 6-BT regulated the expression of both canonical and non-canonical Wnt signaling molecules in HL-60 cells. Both 6-BT and all-trans-retinoic-acid (ATRA) reduced canonical Wnt signaling and activated noncanonical Wnt/Ca2+ signaling in HL-60 cells. Pre-treatment of HL-60 cells with an inhibitor of glycogen synthase kinase-3β (GSK-3β), which activated canonical Wnt signaling, partly abolished the differentiation of HL-60 cells induced by 6-BT. Pre-treatment of HL-60 cells with an inhibitor of protein kinase C (PKC), resulting in inactivation of non-canonical Wnt/Ca2+ signaling, abolished 6-BT-induced differentiation of HL-60 cells. Several molecules in the non-canonical Wnt/Ca2+ pathway were detected in bone marrow samples from AML patients, and the expression of FZD4, FZD5, Wnt5a and RHOU were significantly reduced in newly diagnosed AML samples compared with normal controls. Conclusions Both canonical and non-canonical Wnt signaling were involved in 6-BT-induced differentiation of HL-60 cells, and played opposite roles in this process. Wnt signaling could be involved in the pathogenesis of AML not only by regulating self-renewal of hematopoietic stem cells, but also by playing a role in the differentiation of AML cells. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-886) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | - Chunyan Ji
- Department of Hematology, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong 250012, P,R, China.
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21
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Ignatz-Hoover JJ, Wang H, Moreton SA, Chakrabarti A, Agarwal MK, Sun K, Gupta K, Wald DN. The role of TLR8 signaling in acute myeloid leukemia differentiation. Leukemia 2014; 29:918-926. [PMID: 25283842 PMCID: PMC4387126 DOI: 10.1038/leu.2014.293] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/23/2014] [Accepted: 09/22/2014] [Indexed: 02/02/2023]
Abstract
Acute myeloid leukemia (AML) is an aggressive disease with a poor 5-year survival of 21% that is characterized by a differentiation arrest of immature myeloid cells. For a rare subtype of AML (acute promyeloctyic leukemia, 5-10% of cases) all-trans retinoic acid therapy removes the differentiation block, yielding over a 90% cure rate. However, this treatment is not effective for the other 90-95% of AML patients, suggesting new differentiation strategies are needed. Interestingly, differentiation is induced in normal hematopoietic cells through Toll-like receptor (TLR) stimulation and TLRs are expressed on AML cells. We present evidence that the TLR8 activation promotes AML differentiation and growth inhibition in a TLR8/MyD88/p38 dependent manner. We also show that that TLR7/TLR8 agonist, R848, considerably impairs the growth of human AML cells in immunodeficient mice. Our data suggests TLR8 activation has direct anti-leukemic effects independent of its immunomodulating properties that are currently under investigation for cancer therapy. Taken together, our results suggest that treatment with TLR8 agonists may be a promising new therapeutic strategy for AML.
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Affiliation(s)
| | - Huaiyu Wang
- Department of Pathology, Case Western Reserve University, Cleveland OH.,Department of Hematology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Stephen A Moreton
- Department of Pathology, Case Western Reserve University, Cleveland OH
| | | | | | - Kevin Sun
- Department of Pathology, Case Western Reserve University, Cleveland OH
| | - Kalpana Gupta
- Department of Pathology, Case Western Reserve University, Cleveland OH
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland OH
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22
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Abstract
BACKGROUND Autoimmune thyroid disease (AITD) pathogenesis may result from a loss of immune tolerance to thyroid antigens. Regulatory T cells (Tregs) control immune responses, prevent excessive inflammation, and may be dysfunctional in AITD. We investigated the role of Tregs in Hashimoto's thyroiditis (HT) and Graves' disease (GD), complicated by Down syndrome (DS). Our goal was to identify differences in CD4(+)CD25(high) Treg function or number in patients with GD and HT, compared to healthy controls (HC). METHODS Treg number was assessed by flow cytometric analysis in samples from 20 AITD patients (seven GD, 13 HT), nine HC, and seven individuals with DS, a genetic disorder associated with multiple autoimmune disorders including AITD. Treg function was assessed by the inhibition of proliferation (radioactive thymidine incorporation into DNA) of blood-derived T effector (Teff) cells by Tregs in a coculture. Various methods of stimulation were contrasted. Cytokine levels were determined in conditioned media from the co-cultures. RESULTS No differences were found in the frequency of Tregs as a percentage of CD4(+) cells between AITD and HC. AITD Tregs were less capable of inhibiting the proliferation of Teff cells when compared to HC; however, the impairment was dependent on the type of stimulation used. DS patients without AITD exhibited normal Treg function. We observed few differences in cytokine production between HC and AITD patients. CONCLUSIONS Tregs from AITD patients are partly dysfunctional, possibly explaining their autoimmunity. Future work will elucidate the diagnostic potential and pathophysiology of Tregs in AITD.
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Affiliation(s)
- Abigail B. Glick
- Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Alaina Wodzinski
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - Pingfu Fu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Alan D. Levine
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - David N. Wald
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
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23
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Gupta K, Stefan T, Wald DN. Abstract 3295: Combining GSK3 inhibition and Vitamin D as a differentiation strategy for AML. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-3295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Vitamin D has widely been considered a promising therapy for cancer, particularly Acute Myeloid Leukemia (AML), due to its ability to terminally differentiate leukemic cells. Despite the promise of Vitamin D in preclinical studies, clinical trials have been disappointing likely due to dose limiting hypercalcemia that occurs at relatively low doses. We have identified that the kinase GSK3 is a major regulator of the Vitamin D receptor (VDR) and that targeting GSK3 can sensitize leukemic cells to low concentrations of Vitamin D that may be achievable clinically.
Utilizing cell and animal based models, we found that GSK3 inhibition can significantly enhance the anti-leukemic effects of Vitamin D. By inhibiting GSK3 with both small molecules and shRNA, we found that targeting GSK3 leads to a significant sensitization in AML cells derived from multiple AML subtypes to Vitamin D-mediated differentiation. Differentiation induction can be seen through immunophenotyping for cell surface markers, functional differentiation as measured by NBT reduction, and changes in morphology. For example, treatment of HL-60 cells with low doses of Vitamin D (5nM) or a GSK3 inhibitor SB415286 (10uM) leads to only moderate differentiation (<50%) while the combination of these agents leads to greater than 95% differentiation as measured by the upregulation of the differentiation associated marker, CD11b. In addition to differentiation induction, GSK3 inhibition also significantly enhanced the ability of Vitamin D to cause irreversible growth inhibition as measured by colony assays and slowed the progression of AML in a mouse model system.
Mechanistic studies have revealed significant insights into how GSK3 modulates Vitamin D signaling. GSK3 was found to bind and phosphorylate VDR which negatively regulates VDR activity as measured by luciferase based reporter assays. The mechanism through which GSK3 appears to regulate VDR activity is through impacting its interactions with co-repressors and co-activators. These co-modulators are known to play a predominant role in regulating VDR activity. Utilizing co-immunoprecipitation and mammalian two hybrid assays, we determined that GSK3 inhibition can impair the interaction of VDR with the co-repressor NcoR, and enhance its interaction with the co-activator, SRC-3. Overall, our studies suggest the potential of Vitamin D and GSK3 inhibition as a strategy to improve the efficacy of AML treatment and provide a mechanistic framework to explain the promising activity of this combination regimen.
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Citation Format: Kalpana Gupta, Tammy Stefan, David N. Wald. Combining GSK3 inhibition and Vitamin D as a differentiation strategy for AML. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3295. doi:10.1158/1538-7445.AM2013-3295
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24
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Chakrabarti A, Gupta K, Sharma JP, Yang J, Agarwal A, Glick A, Zhang Y, Agarwal M, Agarwal MK, Wald DN. ATP depletion triggers acute myeloid leukemia differentiation through an ATR/Chk1 protein-dependent and p53 protein-independent pathway. J Biol Chem 2012; 287:23635-43. [PMID: 22621920 DOI: 10.1074/jbc.m111.312801] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Despite advances in oncology drug development, most commonly used cancer therapeutics exhibit serious adverse effects. Often the toxicities of chemotherapeutics are due to the induction of significant DNA damage that is necessary for their ability to kill cancer cells. In some clinical situations, the direct induction of significant cytotoxicity is not a requirement to meet clinical goals. For example, differentiation, growth arrest, and/or senescence is a valuable outcome in some cases. In fact, in the case of acute myeloid leukemia (AML), the use of the differentiation agent all-trans-retinoic acid (ATRA) has revolutionized the therapy for a subset of leukemia patients and led to a dramatic survival improvement. Remarkably, this therapeutic approach is possible even in many elderly patients, who would not be able to tolerate therapy with traditional cytotoxic chemotherapy. Because of the success of ATRA, there is widespread interest in identifying differentiation strategies that may be effective for the 90-95% of AML patients who do not clinically respond to ATRA. Utilizing an AML differentiation agent that is in development, we found that AML differentiation can be induced through ATP depletion and the subsequent activation of DNA damage signaling through an ATR/Chk1-dependent and p53-independent pathway. This study not only reveals mechanisms of AML differentiation but also suggests that further investigation is warranted to investigate the potential clinical use of low dose chemotherapeutics to induce differentiation instead of cytotoxicity. This therapeutic approach may be of particular benefit to patients, such as elderly AML patients, who often cannot tolerate traditional AML chemotherapy.
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Affiliation(s)
- Amitabha Chakrabarti
- Invenio Therapeutics, Case Western Reserve University, Cleveland, Ohio 44106, USA
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25
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Gupta K, Chakrabarti A, Rana S, Ramdeo R, Roth BL, Agarwal ML, Tse W, Agarwal MK, Wald DN. Securinine, a myeloid differentiation agent with therapeutic potential for AML. PLoS One 2011; 6:e21203. [PMID: 21731671 PMCID: PMC3123298 DOI: 10.1371/journal.pone.0021203] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 05/23/2011] [Indexed: 11/24/2022] Open
Abstract
As the defining feature of Acute Myeloid Leukemia (AML) is a maturation arrest, a highly desirable therapeutic strategy is to induce leukemic cell maturation. This therapeutic strategy has the potential of avoiding the significant side effects that occur with the traditional AML therapeutics. We identified a natural compound securinine, as a leukemia differentiation-inducing agent. Securinine is a plant-derived alkaloid that has previously been used clinically as a therapeutic for primarily neurological related diseases. Securinine induces monocytic differentiation of a wide range of myeloid leukemia cell lines as well as primary leukemic patient samples. Securinine's clinical potential for AML can be seen from its ability to induce significant growth arrest in cell lines and patient samples as well as its activity in significantly impairing the growth of AML tumors in nude mice. In addition, securinine can synergize with currently employed agents such as ATRA and decitabine to induce differentiation. This study has revealed securinine induces differentiation through the activation of DNA damage signaling. Securinine is a promising new monocytic differentiation inducing agent for AML that has seen previous clinical use for non-related disorders.
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MESH Headings
- Animals
- Azepines/chemistry
- Azepines/pharmacology
- Azepines/therapeutic use
- Azepines/toxicity
- Cell Differentiation/drug effects
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Cyclin-Dependent Kinase Inhibitor p21/metabolism
- DNA Damage
- HL-60 Cells
- Heterocyclic Compounds, 4 or More Rings/chemistry
- Heterocyclic Compounds, 4 or More Rings/pharmacology
- Heterocyclic Compounds, 4 or More Rings/therapeutic use
- Heterocyclic Compounds, 4 or More Rings/toxicity
- Heterocyclic Compounds, Bridged-Ring
- Humans
- Lactones/chemistry
- Lactones/pharmacology
- Lactones/therapeutic use
- Lactones/toxicity
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Mice
- Mice, Nude
- Monocytes/drug effects
- Monocytes/pathology
- Myeloid Cells/drug effects
- Myeloid Cells/pathology
- Piperidines/chemistry
- Piperidines/pharmacology
- Piperidines/therapeutic use
- Piperidines/toxicity
- Receptors, GABA/metabolism
- Reproducibility of Results
- Signal Transduction/drug effects
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Kalpana Gupta
- Department of Pathology, Case Western Reserve School of Medicine, Cleveland, Ohio, United States of America
| | | | - Sonia Rana
- Invenio Therapeutics, Cleveland, Ohio, United States of America
| | - Ritu Ramdeo
- Department of Pathology, Case Western Reserve School of Medicine, Cleveland, Ohio, United States of America
| | - Bryan L. Roth
- Departments of Pharmacology and Medicinal Chemistry, University of North Carolina Chapel Hill Medical School, Chapel Hill, North Carolina, United States of America
| | - Munna L. Agarwal
- Department of Genetics, Case Western Reserve School of Medicine, Cleveland, Ohio, United States of America
| | - William Tse
- Department of Medicine, West Virginia University, Morgantown, West Virginia, United States of America
| | - Mukesh K. Agarwal
- Invenio Therapeutics, Cleveland, Ohio, United States of America
- * E-mail: (MKA); (DNW)
| | - David N. Wald
- Department of Pathology, Case Western Reserve School of Medicine, Cleveland, Ohio, United States of America
- Invenio Therapeutics, Cleveland, Ohio, United States of America
- University Hospitals Case Medical Center, Cleveland, Ohio, United States of America
- * E-mail: (MKA); (DNW)
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26
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Wang L, Zhang J, Banerjee S, Barnes L, Sajja V, Liu Y, Guo B, Du Y, Agarwal MK, Wald DN, Wang Q, Yang J. Sumoylation of vimentin354 is associated with PIAS3 inhibition of glioma cell migration. Oncotarget 2010; 1:620-627. [PMID: 21317457 PMCID: PMC3248133 DOI: 10.18632/oncotarget.196] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 11/10/2010] [Indexed: 11/25/2022] Open
Abstract
The invasive phenotype of glioblastoma multiforme (GBM) is a hallmark of malignant process, yet the molecular mechanisms that dictate this locally invasive behavior remain poorly understood. Over-expression of PIAS3 effectively changes cell shape and inhibits GBM cell migration. We focused on the molecular target(s) of PIAS3 stimulated sumoylation, which play an important role in the inhibition of GBM cell motility. Here we report, through the immunoprecipitation with SUMO1 antibody, followed by proteomic analysis, the identification of vimentin (vimentin354), a nuclear component in GBM cells, as the main target of sumoylation promoted by PIAS3.
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Affiliation(s)
- Liming Wang
- School of Life Science, Lanzhou University, Lanzhou, P. R. China
- Department of Cancer Biology, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, USA
| | | | - Sipra Banerjee
- Department of Cancer Biology, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, USA
| | - Laura Barnes
- Molecular Genetics, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, USA
| | - Venkateswara Sajja
- Molecular Genetics, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, USA
| | - Yiding Liu
- Department of Chemistry, Cleveland State University, Cleveland, USA
| | - Baochuan Guo
- Department of Chemistry, Cleveland State University, Cleveland, USA
| | - Yuping Du
- School of Life Science, Lanzhou University, Lanzhou, P. R. China
| | | | - David N. Wald
- Department of Pathology, Case Western Reserve University, Cleveland, USA
| | - Qin Wang
- School of Life Science, Lanzhou University, Lanzhou, P. R. China
| | - Jinbo Yang
- School of Life Science, Lanzhou University, Lanzhou, P. R. China
- Molecular Genetics, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, USA
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27
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Thakur VS, Ruhul Amin ARM, Paul RK, Gupta K, Hastak K, Agarwal MK, Jackson MW, Wald DN, Mukhtar H, Agarwal ML. p53-Dependent p21-mediated growth arrest pre-empts and protects HCT116 cells from PUMA-mediated apoptosis induced by EGCG. Cancer Lett 2010; 296:225-32. [PMID: 20444544 DOI: 10.1016/j.canlet.2010.04.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 04/07/2010] [Accepted: 04/08/2010] [Indexed: 11/20/2022]
Abstract
The tumor suppressor protein p53 plays a key role in regulation of negative cellular growth in response to EGCG. To further explore the role of p53 signaling and elucidate the molecular mechanism, we employed colon cancer HCT116 cell line and its derivatives in which a specific transcriptional target of p53 is knocked down by homologous recombination. Cells expressing p53 and p21 accumulate in G1 upon treatment with EGCG. In contrast, same cells lacking p21 traverse through the cell cycle and eventually undergo apoptosis as revealed by TUNEL staining. Treatment with EGCG leads to induction of p53, p21 and PUMA in p21 wild-type, and p53 and PUMA in p21(-/-) cells. Ablation of p53 by RNAi protects p21(-/-) cells, thus indicating a p53-dependent apoptosis by EGCG. Furthermore, analysis of cells lacking PUMA or Bax with or without p21 but with p53 reveals that all the cells expressing p53 and p21 survived after EGCG treatment. More interestingly, cells lacking both PUMA and p21 survived ECGC treatment whereas those lacking p21 and Bax did not. Taken together, our results present a novel concept wherein p21-dependent growth arrest pre-empts and protects cells from otherwise, in its absence, apoptosis which is mediated by activation of pro-apoptotic protein PUMA. Furthermore, we find that p53-dependent activation of PUMA in response to EGCG directly leads to apoptosis with out requiring Bax as is the case in response to agents that induce DNA damage. p21, thus can be used as a molecular switch for therapeutic intervention of colon cancer.
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Affiliation(s)
- Vijay S Thakur
- Department of Genetics, Case Western Reserve University, Cleveland, OH 44106, USA
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28
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Rana S, Gupta K, Gomez J, Matsuyama S, Chakrabarti A, Agarwal ML, Agarwal A, Agarwal MK, Wald DN. Securinine induces p73-dependent apoptosis preferentially in p53-deficient colon cancer cells. FASEB J 2010; 24:2126-34. [PMID: 20133503 DOI: 10.1096/fj.09-148999] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The identification of agents that preferentially kill cancer cells while protecting normal cells offers the potential to overcome toxicities found in many existing chemotherapeutic agents. Because p53 is frequently inactivated in cancer, agents that preferentially kill p53-null cells and protect wild-type p53-expressing cells are highly desirable chemotherapeutic agents. By using pairs of isogenic colon cancer cell lines that differ only in p53 expression (RKO and HCT116), securinine was found to exhibit these properties. Securinine (30 microM) induces apoptosis in 73% of p53-null HCT116 cells (LD(50) 17.5 microM) as opposed to 17.6% of HCT116 parental cells (LD(50) 50 microM) at 72 h after treatment. The mechanism of securinine-mediated death in p53-deficient cells involves the induction of the p53 family member, p73. Interestingly, the proapoptotic protein p73 is down-regulated in colon cancer cells expressing p53. This differential regulation of p73 in a p53-dependent fashion reveals a novel pathway for preferentially targeting cancer cells. In contrast to p53-deficient cells, cells expressing p53 are protected from cell death through the p53-mediated up-regulation of p21. These studies reveal a novel approach to specifically target colon cancer cells lacking p53 as well as identify a novel clinically relevant pathway to selectively induce p73 in p53-null cells.
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Affiliation(s)
- Sonia Rana
- Invenio Therapeutics, Cleveland, Ohio, USA
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29
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Amin ARMR, Thakur VS, Gupta K, Jackson MW, Harada H, Agarwal MK, Shin DM, Wald DN, Agarwal ML. Restoration of p53 functions protects cells from concanavalin A-induced apoptosis. Mol Cancer Ther 2010; 9:471-9. [PMID: 20124456 DOI: 10.1158/1535-7163.mct-09-0732] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A great majority of human cancers encounter disruption of the p53 network. Identification and characterization of molecular components important in both p53-dependent and p53-independent apoptosis might be useful in developing novel therapies. Previously, we reported that concanavalin A (Con A) induced p73-dependent apoptosis of cells lacking functional p53. In the present study, we investigated the mechanism and role of p53 in protection from apoptosis induced by Con A. Treatment with Con A resulted in apoptosis of p53-null ovarian cancer, SKOV3, or Li-Fraumeni syndrome, MDAH041 (041), cells. However, their isogenic pairs, SKP53 and TR9-7, expressing wild-type p53 were much less sensitive and were protected by G(1) arrest. Inhibition of p53 function rendered these cells sensitive to Con A. Con A-induced apoptosis was accompanied by upregulation of forkhead box O1a (FOXO1a) and Bcl-2-interacting mediator (Bim), which were strongly inhibited after p53 expression and rescued after p53 ablation. Moreover, ablation of Bim by short hairpin RNA protected cells from apoptosis. Taken together, our study suggests that Con A induces apoptosis of cells lacking p53 by activating FOXO1a-Bim signaling and that expression of p53 protects these cells by inducing G(1) arrest and by downregulating the expression of both FOXO1a and Bim, identifying a novel cross-talk between FOXO1a and p53 transcription factors.
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Affiliation(s)
- A R M Ruhul Amin
- Department of Genetics, Case Western Reserve University, Cleveland, Ohio 44106, USA
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30
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Wald DN, Vermaat HM, Zang S, Lavik A, Kang Z, Peleg G, Gerson SL, Bunting KD, Agarwal ML, Roth BL, Tse W. Identification of 6-benzylthioinosine as a myeloid leukemia differentiation-inducing compound. Cancer Res 2008; 68:4369-76. [PMID: 18519698 DOI: 10.1158/0008-5472.can-07-6559] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As the pathophysiology of acute myelogenous leukemia (AML) involves a block of myeloid maturation, a desirable therapeutic strategy is to induce leukemic cell maturation to increase the efficacy and to avoid the side effects of traditional chemotherapeutics. Through a compound library screen, 6-benzylthioinosine (6BT) was identified as a promising differentiation-inducing agent. 6BT induces monocytic differentiation of myeloid leukemia cell lines such as HL-60 and OCI-AML3, as well as primary patient samples as evidenced by morphology, immunophenotyping, and nitroblue tetrazolium reduction. Not only can 6BT induce differentiation but a subset of AML cell lines such as MV4-11 and HNT34 instead undergo 6BT-mediated cell death. Despite inducing cell death in some leukemic cells, 6BT exhibits extremely low toxicity on several nonmalignant cells such as fibroblasts, normal bone marrow, and endothelial cells. This toxicity profile may relate to the function of 6BT as an inhibitor of the nucleoside transporter, ent1, which is thought to prevent it from entering many cell types. In contrast, 6BT likely enters at least some leukemic cell lines as shown by its requirement for phosphorylation for its differentiation activity. 6BT is also able to synergize with currently used myeloid differentiation agents such as ATRA and decitabine. Early studies indicate that the mechanism of action of this compound may involve ATP depletion that leads to growth inhibition and subsequent differentiation. Besides in vitro activity, 6BT also shows the ability to impair HL-60 and MV4-11 tumor growth in nude mice. 6BT is a promising new monocytic differentiation agent with apparent leukemic cell-specific activity.
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Affiliation(s)
- David N Wald
- Department of Pathology, Case Western Reserve School of Medicine, Cleveland, Ohio 44106, USA.
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Sandhaus LM, Wald DN, Sauder KJ, Steele EL, Meyerson HJ. Measuring the Clinical Impact of Pathologist Reviews of Blood and Body Fluid Smears. Arch Pathol Lab Med 2007; 131:468-72. [PMID: 17516750 DOI: 10.5858/2007-131-468-mtciop] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2006] [Indexed: 11/06/2022]
Abstract
Abstract
Context.—Despite the widespread practice of pathologist review of blood and body fluid smears, little is known about its impact on improving patient care.
Objective.—To assess the clinical usefulness of pathologist review of blood and body fluid smears.
Design.—Survey study. Pathology residents contacted the ordering physician after pathologist reviews were reported to assess their clinical impact.
Results.—Ninety-six pathologist reviews met criteria for study inclusion, and 64 ordering physicians were successfully contacted during the 2-month study period. Of the 64 cases, 19 reviews (30%) had been seen by the physician within 24 to 48 hours after the report was issued and 33 (51%) had not been seen; in 4 (6%) instances, physicians did not remember whether they had seen the review. Eight reviews (13%) were considered urgent enough to warrant immediate communication by the pathologist. Of the 27 reviews that were seen or directly communicated, 23 (85%) contributed to clinical diagnosis and/or patient management.
Conclusions.—This study demonstrates the contribution of pathologist reviews of blood and body fluids to clinical diagnosis and patient management. The results also highlight the problem of a lack of physician awareness of clinical pathology results.
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Affiliation(s)
- Linda M Sandhaus
- University Hospitals of Cleveland, Department of Pathology, 11100 Euclid Ave, Cleveland, OH 44106, USA.
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