Abstract

Recent studies have shown that high ATP levels exhibit direct cytotoxic effects on several cancer cells types. Among the receptors engaged by ATP, P2×7R is the most consistently expressed by tumors. P2×7R is an ATP-gated ion channel that could drive the opening of a non-selective pore, triggering cell-death signal. We previously demonstrated that acute myeloid leukemia (AML) cells express high level of P2×7R. Here, we show that P2×7R activation with high dose ATP induces AML blast cells apoptosis. Moreover, P2×7R is also expressed on leukemic stem/progenitor cells (LSCs) which are sensitive to ATP-mediated cytotoxicity. Conversely, this cytotoxic effect was not observed on normal hematopoietic stem/progenitor cells (HSCs). Notably, the antileukemic activity of ATP was also observed in presence of bone marrow stromal cells and its addition to the culture medium enhanced cytosine arabinoside cytotoxicity despite stroma-induced chemoresistance. Xenotransplant experiments confirmed ATP antineoplastic activity in vivo.Overall, our results demonstrate that P2×7R stimulation by ATP induced a therapeutic response in AML at the LSC level while the normal stem cell compartment was not affected. These results provide evidence that ATP would be promising for developing innovative therapy for AML.

Highlights

  • Acute myeloid leukemia (AML) is a hematopoietic stem cell disorder characterized by clonal proliferation of myeloid precursors with an inhibition in differentiation, leading to accumulation of immature cells at various stages

  • We demonstrated that leukemic stem cells (LSCs) are sensitive to ATP treatment being induced to apoptosis while the same treatment did not affect normal hematopoietic stem/progenitor cells (HSCs) compartment

  • In order to assess if ATP cell death induction was due to apoptosis, we treated acute myeloid leukemia (AML) cells isolated from 23 AML samples with increasing doses up to 5 mM ATP for 48 h in presence or absence of P2X7R antagonist

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Summary

Introduction

Acute myeloid leukemia (AML) is a hematopoietic stem cell disorder characterized by clonal proliferation of myeloid precursors with an inhibition in differentiation, leading to accumulation of immature cells at various stages. 50% of leukemia patients survive their disease. The percentage of long-term survivors drops down to 5–15% in elderly patients. Disease relapse and toxicity of therapy, especially in elderly patients, represent today the major limiting factors in leukemia treatment. Despite the introduction of novel target therapies in the treatment of cancer, chemotherapy remains as primary option for AML patients. In this scenario, novel therapeutic approaches that aim to reduce toxicity and to improve the efficacy of treatment are expected to greatly improve long-term outcomes in leukemia patients

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