Abstract

Chronic lymphocytic leukemia (CLL) is still an incurable disease despite aggressive chemotherapies including the B-cell receptor (BCR) targeted-inhibitors. Therefore, we assessed the expression status of key signal mediators of the BCR pathway in CLL cells. Indeed, we detected aberrantly elevated levels of CD79a, B-cell adaptor for PI3K (BCAP) and phospholipase C (PLC)γ2, key mediators of BCR signal, in CLL cells. As HSP90 is also overexpressed in CLL cells, we hypothesized that HSP90 could potentiate the BCR signal via stabilization of multiple key components of the BCR-signalosome. We found that HSP90 formed a multi-molecular complex with CD79a, BCAP, PLCγ2, LYN, SYK, Bruton tyrosine kinase (BTK) and AKT and that, pharmacologic inhibition or partial depletion of HSP90 reduced the expression of these signal mediators in CLL cells. In addition, our findings also demonstrated that HSP90 could stabilize the tyrosine phosphatase, PTPN22 which positively regulates AKT phosphorylation, and the constitutively active fibroblast growth factor receptor 3 (FGFR3) in CLL cells. Finally, HSP90 inhibition induced apoptosis in CLL cells in a dose-dependent manner likely via downregulation of anti-apoptotic proteins MCL-1 and XIAP, but not BCL2, reported to be overexpressed in CLL cells. In total, our findings suggest that HSP90-inhibition may sensitize the leukemic B-cells to BCR-targeted agents, particularly those become resistant to these therapies.

Highlights

  • Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the Western hemisphere [1]

  • It is noteworthy that the expression of the CD79b subunit of B-cell receptor (BCR) is reported to be down-regulated in CLL cells [27], suggesting that transmission of constitutive level of BCR signal may depend on the expression status of CD79a

  • We have demonstrated that Heat shock protein 90 (HSP90) is overexpressed in CLL cells that controls key signal mediators of the BCR pathway including CD79a, B-cell adaptor for PI3K (BCAP), PLCγ2, LYN, spleen tyrosine kinase (SYK), Bruton tyrosine kinase (BTK) and AKT

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Summary

Introduction

CLL is the most common form of adult leukemia in the Western hemisphere [1] It is characterized by the accumulation of CD19+/CD5+/CD23+ mature, monoclonal B-cells in the blood, bone marrow and lymphoid tissues. While the use of BCR-targeted oral agents ibrutinib (BTK-inhibitor) and idelalisib (PI3Kδinhibitor) has been shown to be effective in relapsed/ refractory CLL patients, the responses are limited to partial remissions [4]. Significant toxicities have been reported for the regimen of idelalisib/rituximab with excess infectious deaths [7] and increased risk of immune based hepatic toxicity for CLL patients treated in an upfront setting while, with venetoclax, the risk of tumor lysis syndrome continues even with the use of a slow dose escalation. We have investigated if overexpression of critical signaling components of the BCR pathway potentiates BCR signal in CLL cells

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