Abstract

Ruxolitinib is a type I JAK inhibitor approved by FDA for targeted therapy of Philadelphia-negative myeloproliferative neoplasms (MPNs), all characterized by mutations activating the JAK2/STAT signaling pathway. Treatment with ruxolitinib improves constitutional symptoms and splenomegaly. However, patients can become resistant to treatment and chronic therapy has only a mild effect on molecular/pathologic remissions. Drugs interaction with plasma proteins, i.e. human serum albumin (HSA), is an important factor affecting the intensity and duration of their pharmacological actions. Here, the ruxolitinib recognition by the fatty acid binding sites (FAs) 1, 6, 7, and 9 of HSA has been investigated from the bioinformatics, biochemical and/or biological viewpoints. Docking simulations indicate that ruxolitinib binds to multiple sites of HSA. Ruxolitinib binds to the FA1 and FA7 sites of HSA with high affinity (Kr = 3.1 μM and 4.6 μM, respectively, at pH 7.3 and 37.0 °C). Moreover, HSA selectively blocks, in a dose dependent manner, the cytotoxic activity of ruxolitinib in JAK2V617F+ cellular models for MPN, in vitro. Furthermore this event is accompanied by changes in the cell cycle, p27Kip1 and cyclin D3 levels, and JAK/STAT signaling. Given the high plasma concentration of HSA, ruxolitinib trapping may be relevant in vivo.

Highlights

  • Philadelphia-negative myeloproliferative neoplasms (MPNs), comprising polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), are hematopoietic stem cell-derived disorders

  • Docking simulations of ruxolitinib binding to human serum albumin (HSA)

  • Docking simulations of ruxolitinib binding to HSA predict that the binding affinity of the drug for the FA1, FA6, FA7, and FA9 sites is similar, values ranging between −7.1 and −8.0 kcal mol−1 (Table 1)

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Summary

Introduction

Philadelphia-negative myeloproliferative neoplasms (MPNs), comprising polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), are hematopoietic stem cell-derived disorders These diseases are characterized by somatic driver mutations mainly occurring in Janus kinase 2 (JAK2), calreticulin (CALR) and thrombopoietin receptor (MPL) genes, all of them playing a role in driving the myeloproliferative phenotype[1]. Constitutive kinase activity, JAK2V617F deregulates myeloid cell proliferation, apoptosis and differentiation and was identified as a major cause of MPNs2–4 These insights led to the development of JAK inhibitors for the treatment of MPN patients and other diseases presenting de-regulated JAK/STAT signaling[5,6,7]. HSA and serum cholesterol levels were used to develop a new cachexia index further enhancing prognostication in MF19

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