Abstract

Targeting proteasome with proteasome inhibitors (PIs) is an approved treatment strategy in multiple myeloma that has also been explored pre-clinically and clinically in other hematological malignancies. The approved PIs target both the constitutive and the immunoproteasome, the latter being present predominantly in cells of lymphoid origin. Therapeutic targeting of the immunoproteasome in cells with sole immunoproteasome activity may be selectively cytotoxic in malignant cells, while sparing the non-lymphoid tissues from the on-target PIs toxicity. Using activity-based probes to assess the proteasome activity profile and correlating it with the cytotoxicity assays, we identified B-cell chronic lymphocytic leukemia (B-CLL) to express predominantly immunoproteasome activity, which is associated with high sensitivity to approved proteasome inhibitors and, more importantly, to the immunoproteasome selective inhibitors LU005i and LU035i, targeting all immunoproteasome active subunits or only the immunoproteasome β5i, respectively. At the same time, LU102, a proteasome β2 inhibitor, sensitized B-CLL or immunoproteasome inhibitor-inherently resistant primary cells of acute myeloid leukemia, B-cell acute lymphoblastic leukemia, multiple myeloma and plasma cell leukemia to low doses of LU035i. The immunoproteasome thus represents a novel therapeutic target, which warrants further testing with clinical stage immunoproteasome inhibitors in monotherapy or in combinations.

Highlights

  • The differentiation of human B-cells from their progenitors to immunoglobulinsecreting cells is completed in a series of clearly recognized, discrete stages

  • Primary samples of patients with B-cell acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic B-cell lymphocytic leukemia (CLL), multiple myeloma (MM) and plasma cell leukemia (PCL) and peripheral blood mononuclear cells (PBMC) from healthy volunteers were obtained at the Clinics for Medical Oncology and Hematology, Cantonal Hospital St

  • We show that B-CLL cells possess increased activity of the immunoproteasome subunits over the constitutive proteasome active subunits, which is associated with their high sensitivity to approved proteasome inhibitors (PIs) bortezomib and carfilzomib or novel immunoproteasome-selective inhibitors LU005i and LU035i

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Summary

Introduction

The differentiation of human B-cells from their progenitors to immunoglobulinsecreting cells is completed in a series of clearly recognized, discrete stages. While B-CLL is the most common chronic type of leukemia in adults, the most common type of acute leukemia in adults is acute myeloid leukemia (AML), a malignancy arising from a myeloid progenitor (National Cancer Institute: https://seer.cancer.gov accessed on 20 January 2022). The treatment of these hematological malignancies has considerably improved in the past years with the recent approval of several novel agents for the treatment of AML, B-ALL, B-CLL and MM, which contributed to expanding the palette of therapeutic options in these diseases [1–4]. As the development of drug resistance is one of the limiting factors affecting long-term efficacy of anti-leukemic or anti-myeloma drugs, the search for therapies with novel mechanisms of action is an ongoing challenge

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