Abstract

Central nervous system (CNS) involvement remains an important cause of morbidity and mortality in acute leukemia, the mechanisms of leukemic cell infiltration into the CNS have not yet been elucidated. The blood-brain barrier (BBB) makes CNS become a refugee to leukemic cells and serves as a resource of cells that seed extraneural sites. How can the leukemic cells disrupt this barrier and invasive the CNS, even if many of the currently available chemotherapies can not cross the BBB? Tight junction in endothelial cells occupies a central role in the function of the BBB. Except the well known role of degrading extracellular matrix in metastasis of cancer cells, here we show matrix metalloproteinase (MMP)-2 and -9, secreted by leukemic cells, mediate the BBB opening by disrupting tight junction proteins in the CNS leukemia. We demonstrated that leukemic cells impaired tight junction proteins ZO-1, claudin-5 and occludin resulting in increased permeability of the BBB. However, these alterations reduced when MMP-2 and -9 activities were inhibited by RNA interference strategy or by MMP inhibitor GM6001 in an in vitro BBB model. We also found that the disruption of the BBB in company with the down-regulation of ZO-1, claudin-5 and occludin and the up-regulation of MMP-2 and -9 in mouse brain tissues with leukemic cell infiltration by confocal imaging and the assay of in situ gelatin zymography. Besides, GM6001 protected all mice against CNS leukemia. Our findings suggest that the degradation of tight junction proteins ZO-1, claudin-5 and occludin by MMP-2 and -9 secreted by leukemic cells constitutes an important mechanism in the BBB breakdown which contributes to the invasion of leukemic cells to the CNS in acute leukemia.

Highlights

  • The central nervous system (CNS) is one of the most frequent extramedullary locations in acute leukemia (AL)

  • In order to investigate this hypothesis, we examined the relationship of matrix metalloproteinase (MMP)-2 and -9 secreted by leukemic cells with the tight junction (TJ) proteins and the blood-brain barrier (BBB) dysfunction in an in vitro model of BBB and in an animal model of CNS leukemia

  • The quantitative real-time polymerase chain reaction (qRT-PCR) determination of mRNA expressions in SHI-1, HL-60 and U937 cells revealed that the transcriptional level of MMP-2 and -9 in SHI-1 cells were all markedly higher than that in other leukemic cell lines (P,.001) (Fig. 1A)

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Summary

Introduction

The central nervous system (CNS) is one of the most frequent extramedullary locations in acute leukemia (AL). Despite of all kinds of morden therapies (systemic chemotherapy and cranial irradiation) it has become a major obstacle to curing acute leukemia [1,2,3,4,5]. How leukemic cells enter the CNS is poorly understood. The characteristic structure of the blood-brain barrier (BBB) causes the CNS to serve as a resource of cells that seed extraneural sites. Much needs to be learned about how can the leukemic cells disrupt this barrier and invasive the CNS, even if many of the currently available chemotherapies cannot cross the BBB.

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