Lymphoid Leukemia Cells Research Articles

Causal pathways in lymphoid leukemia: the gut microbiota, immune cells, and serum metabolites.

We employed Mendelian randomization (MR) to investigate the causal relationship between the gut microbiota and lymphoid leukemia, further exploring the causal relationships among immune cells, lymphoid leukemia, and potential metabolic mediators. We utilized data from the largest genome-wide association studies to date, encompassing 418 species of gut microbiota, 713 types of immune cells, and 1,400 serum metabolites as exposures. Summary statistics for lymphoid leukemia, acute lymphocytic leukemia (ALL), and chronic lymphocytic leukemia (CLL) were obtained from the FinnGen database. We performed bidirectional Mendelian analyses to explore the causal relationships among the gut microbiota, immune cells, serum metabolites, and lymphoid leukemia. Additionally, we conducted a two-step mediation analysis to identify potential intermediary metabolites between immune cells and lymphoid leukemia. Several gut microbiota were found to have causal relationships with lymphoid leukemia, ALL, and CLL, particularly within the Firmicutes and Bacteroidetes phyla. In the two-step MR analysis, various steroid hormone metabolites (such as DHEAS, pregnenolone sulfateprogestogen derivatives, and androstenediol-related compounds) were identified as potential intermediary metabolites between lymphoid leukemia and immune cells. In ALL, the causal relationship between 1-palmitoyl-2-docosahexaenoyl-GPE (16:0/22:6) and ALL was mediated by CD62L-plasmacytoid DC%DC (mediated proportion=-2.84%, P=0.020). In CLL, the causal relationship between N6,n6,n6-trimethyllysine and CLL was mediated by HLA DR+ CD8br AC (mediated proportion=4.07%, P=0.021). This MR study provides evidence supporting specific causal relationships between the gut microbiota and lymphoid leukemia, as well as between certain immune cells and lymphoid leukemia with potential intermediary metabolites.

Pharmacological degradation of ATR induces antiproliferative DNA replication stress in leukemic cells.

Mammalian cells replicate ~ 3 × 109 base pairs per cell cycle. One of the key molecules that slows down the cell cycle and prevents excessive DNA damage upon DNA replication stress is the checkpoint kinase ataxia-telangiectasia-and-RAD3-related (ATR). Proteolysis-targeting-chimeras (PROTACs) are an innovative pharmacological invention to molecularly dissect, biologically understand, and therapeutically assess catalytic and non-catalytic functions of enzymes. This work defines the first-in-class ATR PROTAC, Abd110/Ramotac-1. It is derived from the ATR inhibitor VE-821 and recruits the E3 ubiquitin-ligase component cereblon to ATR. Abd110 eliminates ATR rapidly in human leukemic cells. This mechanism provokes DNA replication catastrophe and augments anti-leukemic effects of the clinically used ribonucleotide reductase-2 inhibitor hydroxyurea. Moreover, Abd110 is more effective than VE-821 against human primary leukemic cells but spares normal primary immune cells. CRISPR-Cas9 screens show that ATR is a dependency factor in 116 myeloid and lymphoid leukemia cells. Treatment of wild-type but not of cereblon knockout cells with Abd110 stalls their proliferation which verifies that ATR elimination is the primary mechanism of Abd110. Altogether, our findings demonstrate specific anti-leukemic effects of an ATR PROTAC.

CTLA-4 Blockade of Natural Killer Cells Increases Cytotoxicity against Acute Lymphoid Leukaemia Cells Neda.

There is interest in using cytotoxic T lymphocyte antigen-4 (CTLA-4) immunotherapy to treat blood cancers. Unfortunately, patients with acute lymphoblastic leukaemia (ALL) frequently exhibit resistance to treatment and natural killer (NK) cell exhaustion. This study aims to increase the cytotoxic potency of natural killer cells by using CTLA-4 to block the Nalm-6 leukaemia cell line. In this experimental study, NK cells were purified from the peripheral blood mononuclear cells (PBMCs) of 10 healthy people and assessed by flow cytometry for purity and viability. The purified cells were activated overnight at 37°C and 5% CO2 with interleukin-15 (IL-15, 10 ng/ml) followed by evaluation of expressions of CTLA-4, activating and inhibitory receptors, and the release of interferon gamma (IFN-γ) and granzyme B (GZM B). CTLA-4 expression on NK cells from recurrent ALL patients was also evaluated. Finally, the cytotoxic activity of NK cells was assessed after the CTLA-4 blockade. The purity of the isolated cells was 96.58 ± 2.57%. Isolated NK cells activated with IL-15 resulted in significantly higher CTLA-4 expression (8.75%, P<0.05). Similarly, CTLA-4 expression on the surface of NK cells from patients with ALL was higher (7.46%) compared to healthy individuals (1.46%, P<0.05). IL-15 reduced NKG2A expression (P<0.01), and increased expressions of NKP30 (P<0.05) and NKP46 (P<0.01). The activated NK cells released more IFN-γ (P<0.5) and GZM B (P<0.01) compared to unactivated NK cells. Blockade of CTLA-4 enhanced the NK cell killing potential against Nalm-6 cells (56.3%, P<0.05); however, IFN-γ and GZM B levels were not statistically different between the blocked and non-blocked groups. Our findings suggest that CTLA-4 blockage of Nalm-6 cells causes an increase in antitumour activity of NK cells against these cells. Our study also provides evidence for the potential of cancer immunotherapy treatment using blocking anti-CTLA-4 mAbs.

A Novel Interaction between RUNX1 and the Splicing Factor PTBP1 Is Enriched in Leukemia Cells

RUNX1 and CBFβ form a critical hematopoietic transcription factor complex. RUNX1 is important not only for normal blood development, but also in leukemia. In the context of Inversion 16 acute myeloid leukemia (AML), RUNX1 is required for the activity of CBFβ-SMMHC (CM), the fusion oncoprotein generated by a chromosomal rearrangement and driver of this subtype of AML. The respective roles RUNX1 and CBFβ play in transcriptional regulation are well characterized but the role of other interacting partners is less well understood. To identify novel RUNX1 binding partners, we immunoprecipitated the transcription factor in mouse leukemia cells expressing CBFβ-SMMHC (CM+) and analyzed precipitated proteins by mass spectrometry. One of the proteins identified was the splicing factor Polypyrimidine Tract Binding Protein 1 (PTBP1). PTBP1 is an RNA binding protein that regulates alternative splicing of mRNAs. PTBP1 is required for normal hematopoiesis, including roles in stem cell maintenance, erythroid differentiation, and B-cell selection. However, a role for PTBP1 in leukemia has yet to be described. We confirmed the association of PTBP1 with RUNX1 via immunoprecipitation/western blot in mouse CM+ leukemia cells and the human Inv(16) cell line, ME-1. Next, we asked if this interaction is unique to inv(16) AML. We found that antibodies against RUNX1, but not isotype control antibodies, immunoprecipitated PTBP1 in a variety of myeloid (Molm-13, MV411, Kasumi-1) and lymphoid (Jurkat, MOLT-4, REH, SEM) human leukemia cell lines, indicating that this interaction occurs in multiple leukemia subtypes. To identify the region of RUNX1 required for the interaction with PTBP1, we used two deletion mutants found in patients with RUNX1-Familial Platelet Disorder ( RUNX1-FPD), RUNX1-R232 and RUNX1-Y287. We observed strong binding of PTBP1 with full length RUNX1, but not with either truncation mutant indicating that the RUNX1 C-terminus is required for interaction with PTBP1. To determine location of this novel interaction, we used proximity ligation assay (PLA). We found that the RUNX1:PTBP1 association occurred exclusively in the nucleus in both mouse and human leukemia cells. Next, we asked if this association is observed in healthy hematopoietic cells. By PLA, we found that the RUNX1:PTBP1 interaction is significantly increased in mouse leukemic cells compared to wild type lineage depleted (lin-) mouse bone marrow cells. To determine if the decrease of PLA signal in healthy bone marrow cells was due to spatial separation of PTBP1 and RUNX1, we performed immunofluorescence staining. We observed diffuse nuclear staining of both proteins in the majority of both healthy and leukemic cells. These results indicate that the interaction between RUNX1 and PTBP1 is significantly increased in leukemia cells, despite both proteins being expressed in similar patterns in both healthy and leukemic cells. During our experiments, we noticed large variations in PTBP1 expression levels in different mouse CM+ leukemia samples. To test whether PTBP1 levels correlate with a difference in leukemia stem cell activity, we performed colony assays using equal numbers of leukemia cells from samples with differing PTBP1 expression. We found that samples expressing high levels of PTBP1 resulted in a statistically significant increase in colony number. In addition, the colonies that formed from PTBP1 high samples were notably larger than those formed from PTBP1 low cells, implying a relationship between PTBP1 and leukemia stem cell self-renewal and proliferation. To determine if human AML samples show the same variability in PTBP1 levels, we performed western blot analysis using a panel of nine de novo and relapsed AML samples. Like our findings in mouse leukemia, human samples showed high variability in PTBP1 levels. We are currently addressing whether increased PTBP1 directly promotes leukemia progression. Collectively, our results demonstrate that PTBP1, a splicing regulator, is a novel RUNX1 interacting partner whose association with RUNX1 is significantly increased in leukemia cells. In addition, our data imply a potential role in leukemia stem cell proliferation, self-renewal and a role for PTBP1 in the splicing of RUNX1 target genes, perhaps generating leukemia specific splicing variants. This work has the potential to identify a new component of the RUNX1 transcriptional complex important for leukemogenesis.

The Topoisomerase-I Inhibitor Gimatecan Exhibits Potent and Selective Activities Against B-Cell Precursor Acute Lymphoblastic Leukemia with a Favorable Cardiotoxicity Profile

Topoisomerase-II inhibitors such as daunorubicin have long been the standard chemotherapeutic agents for managing acute leukemias. Yet, severe complications could be resulted from their myelosuppressive and cardiotoxic nature. Here, we report preclinical evidence showing the exceptional activities of gimatecan, an orally available topoisomerase-I inhibitor currently being investigated in Phase II trials for solid cancers, on hematologic malignancies. Activity screening on leukemia cell lines revealed a substantially higher potency of gimatecan than frontline chemotherapeutics against B-cell precursor acute lymphoblastic leukemia (BCP-ALL) driven by on-target depletion of topoisomerase-I. Gimatecan had a median IC50 of 0.9 nM against BCP-ALL with profound selectivity over acute myeloid leukemia (AML, 3.6-fold, P&amp;lt; 0.01) or hematopoietic stem/progenitor cells (HSPCs, 75-fold, P&amp;lt; 0.001). In contrast, the four standard chemotherapeutics (cytarabine, daunorubicin, dexamethasone and vincristine) exhibited much higher median IC50s against BCP-ALL (18-2,201 nM). Following single-agent gimatecan treatment, complete dissolution of medullary and extramedullary leukemia (CNS and testis) by &amp;gt;95% inhibition concomitant with markedly extended survival (1.2 to 3.3-fold, P&amp;lt; 0.01) were demonstrated in animals grafted with cytogenetically distinct lymphoid leukemia cell lines (Reh, ETV6-RUNX1+; 697, TCF3-PBX1+; RS4;11, KMT2A-AFF1+; HAL-01, TCF3-HLF+) and in patient-derived xenografts from three cases of highly resistant BCP-ALL failing salvage chemotherapy or upfront immunotherapies. Splenocytes isolated from NSG mice relapsed from gimatecan treatment demonstrated recurrent drug sensitivity ex vivo comparing with vehicle controls and that gimatecan reinduction offered additional survival benefits in the xenograft model ( P&amp;lt; 0.05). The therapeutic efficacy was also observed at varied initial tumor load, together suggesting its potential for reinduction and flexibility on the administration schedule. In NSG mice reconstituted with cord blood HSPCs, gimatecan displayed a mild but transient suppression on normal hematopoiesis without bias on lineage output (63% reduction at 6 weeks, P=0.002; not statistically significant at 14 weeks). Importantly, gimatecan did not affect the viability of human iPSC-derived cardiomyocytes (hiPSC-CM) even at the highest tested dose (1,000 nM) as opposed to daunorubicin (IC50: 130 nM). Concordantly, no noticeable signs of DNA damage (by γ-H2AX staining) or apoptotic events (by enumeration of condensed nuclei) on hiPSC-CMs were observed after gimatecan exposure at doses at or above its Cmax (~130 nM). The gross structure of heart tissues harvested from gimatecan-treated mice was also intact without signs of cardiotoxicity at the dose effective to suppress leukemia (0.2 mg/kg). When compared with malignant B-lymphoblasts, there was a declined expression of topoisomerase-I in HSPCs (0.63-fold, P=0.025) and cardiomyocytes (0.24-fold, P&amp;lt;0.001), potentially explaining its selectivity against BCP-ALL. Mechanistically, gimatecan induced time- and dose-dependent cell death via intrinsic apoptosis coupled with G2/M cell cycle arrest. RNA-seq analysis of gimatecan-treated BCP-ALL cells showed activation of the tumor suppressive p53 pathway and suppression of the MYC pathway. Phosphorylation of p53 and appearance of DNA damage markers, including CHK1/2, PARP and H2AX, were robustly detected upon gimatecan treatment. In short, gimatecan possesses remarkable anti-leukemia activities and tolerable toxicity profiles compared to counterpart topoisomerase-II inhibitor. This study, therefore, puts forward a new agent for BCP-ALL and points towards randomized clinical trials to realize its potential on acute leukemias.

CRISPR/Cas9-Mediated Induction of Relapse-Specific NT5C2 and PRPS1 Mutations Confers Thiopurine Resistance as a Relapsed Lymphoid Leukemia Model.

6-Mercaptopurine (6-MP) is a key component in maintenance therapy for childhood acute lymphoblastic leukemia (ALL). Recent next-generation sequencing analysis of childhood ALL clarified the emergence of the relapse-specific mutations of the NT5C2 and PRPS1 genes, which are involved in thiopurine metabolism. In this scenario, minor clones of leukemia cells could acquire the 6-MP-resistant phenotype as a result of the NT5C2 or PRPS1 mutation during chemotherapy (including 6-MP treatment) and confer disease relapse after selective expansion. Thus, to establish new therapeutic modalities overcoming 6-MP resistance in relapsed ALL, human leukemia models with NT5C2 and PRPS1 mutations in the intrinsic genes are urgently required. Here, mimicking the initiation process of the above clinical course, we sought to induce two relapse-specific hotspot mutations (R39Q mutation of the NT5C2 gene and S103N mutation of the PRPS1 gene) into a human lymphoid leukemia cell line by homologous recombination (HR) using the CRISPR/Cas9 system. After 6-MP selection of the cells transfected with Cas9 combined with single-guide RNA and donor DNA templates specific for either of those two mutations, we obtained the sublines with the intended NT5C2-R39Q and PRPS1-S103N mutation as a result of HR. Moreover, diverse in-frame small insertion/deletions were also confirmed in the 6-MP-resistant sublines at the target sites of the NT5C2 and PRPS1 genes as a result of nonhomologous end joining. These sublines are useful for molecular pharmacological evaluation of the NT5C2 and PRPS1 gene mutations in the 6-MP sensitivity and development of therapy overcoming the thiopurine resistance of leukemia cells. SIGNIFICANCE STATEMENT: Mimicking the initiation process of relapse-specific mutations of the NT5C2 and PRPS1 genes in childhood acute lymphoblastic leukemia treated with 6-mercaptopurine (6-MP), this study sought to introduce NT5C2-R39Q and PRPS1-S103N mutations into a human lymphoid leukemia cell line by homologous recombination using the CRISPR/Cas9 system. In the resultant 6-MP-resistant sublines, the intended mutations and diverse in-frame small insertions/deletions were confirmed, indicating that the obtained sublines are useful for molecular pharmacological evaluation of the NT5C2 and PRPS1 gene mutations.

P19 a Parthenin Analog Induces Cell Lineage Dependent Apoptotic and Immunomodulatory Signaling in Acute Lymphoid Leukemia Cells.

Leukemia is a type of cancer that affects the blood and bone marrow. Acute lymphoid leukaemia, also known as ALL, is regarded as one of the deadliest forms of cancer. Due to the rapid increase in various cancer cases and the development of resistance in cancer cells, it is necessary to identify novel lead molecules with more potent anticancer properties. There is a growing interest in using herbal products/analogs as multi-component agents (as anticancer agents and immunomodulators) for cancer treatment. In the present investigation, an attempt has been made to explore the anticancer and immunomodulatory activity of P19, an analog of parthenin in ALL. P19 was reported to exhibit anticancer efficacy by triggering apoptotic signaling events in human leukaemia HL-60 cells by significant NO production. In contrast to this finding, ROS and NO were not required for P19-mediated apoptosis in Raji cells. The mechanism of action of P19 was observed to be cancer cell lineage dependent. P19 demonstrated very effective anticancer properties against ALL (IC50 3µM). Molecular investigations revealed that P19 induced mitochondrion mediated apoptosis by Bax localization to mitochondria and enhanced cytosolic calcium in the cytoplasm. Further activation of the caspase 3, caspase 8 and PARP cleavage suggested the involvement of the caspase-mediated apoptosis. Anti-proliferative activity revealed the telomerase inhibition and cell cycle arrest in G0/G1 phase after P19 treatment. Immunomodulatory effects of the P19 revealed the enhanced INFɣ and NO production in Jurkat and THP cells. Owing to its antiproliferative and immunomodulatory potential against leukemia cells P19 can further be explored as effective therapeutics against leukemia.

The Marine Product Elatol Is a Novel Inhibitor of Mitochondrial Translation Triggering the Integrated Stress Response and Apoptosis in Leukemia and Lymphoma Cells

Background: Leukemia stem cells (LSCs) show unique, targetable dependence on activity of mitochondrial ribosomes (mitoribosomes). In addition, aggressive B-cell lymphomas may have gene expression signatures of increased dependence on oxidative phosphorylation (OXPHOS) and show sensitivity to mitoribosome inhibitors such as the FDA approved antibiotic tigecycline. Discovery and optimization of new mitoribosome inhibitors, however, is relatively unexplored in drug development for hematologic malignancies despite demonstrated therapeutic potential. Here, we assess the marine natural product elatol as a novel mitochondrial translation inhibitor. Methods and Results: We have previously reported that elatol, the major compound from the red alga Laurencia microcladia, is effective against several non-Hodgkin lymphomas and primary chronic lymphoid leukemia (CLL) cells. In vitro studies showed elatol inhibits eIF4A1 helicase activity, suppressing cytoplasmic cap-dependent translation initiation. Further assessments using 35S-methionine incorporation in newly synthesized polypeptides in HEK293T cells with or without single-digit micromolar concentrations of elatol for short time periods revealed strong attenuation of mitochondrial protein synthesis with no effect on mitochondrial transcription. Based on previously published work highlighting the effectiveness of tigecycline in leukemia and our data supporting elatol cytotoxicity in hematologic malignancies, we assessed elatol cytotoxicity and mitochondrial translation inhibition in several leukemia and lymphoma cell lines in comparison to tigecycline. All but one line decreased viability by 50% or more (compared to vehicle control) after elatol incubation with EC50 values near 1 μM. This potency was 10-40x higher than for tigecycline in side-by-side comparisons across several lines when compared at 72h. The compound cooperated to activate a heightened integrated stress response (ISR) through DELE1 cleavage by the mitochondrial stress-activated protease OMA1. This in turn suppressed glycolytic capacity, resulting in adenosine triphosphate (ATP) depletion and subsequent cell death. We found elatol does not affect integrity of small and large mitoribosome subunits through sedimentation property analysis using sucrose gradients. Although the specific target on the mitochondrial translation apparatus remains elusive, we found that its mechanism of action differs from that of chloramphenicol, which inhibits translation elongation. Conclusions: We have performed proof-of-concept studies using HEK293T and HeLa cell lines, isolated mitochondria from HEK293T, and leukemia and lymphoma cell lines to reveal that elatol is a potent inhibitor of mitochondrial protein synthesis at concentrations that do not affect cytoplasmic protein synthesis and that this mechanism differs from chloramphenicol. Elatol triggers the OMA1-DELE1-ATF4 mitochondrial stress pathway and apoptosis of leukemia and lymphoma cells. Tigecycline's compelling preclinical data in combination with kinase inhibitors informed design of a pending clinical trial (NCT02883036). Elatol's greatly improved potency provides a potential starting point for further optimization of this paradigm.

Targeting PIP4K2 Lipid Kinases through Thz-P1-2 Reveals Vulnerabilities Related to Mitochondrial Homeostasis and Autophagy in Acute Leukemia

Mitochondrial metabolism plays an important role in the therapeutic response of acute myeloid leukemia (AML) cell subsets and affects treatment outcome. Of not, leukemia stem cells (LSC) were shown to have increased sensitivity to disruptions of the oxidative phosphorylation process. These vulnerabilities may be specifically targeted with the BCL2 inhibitor venetoclax, which suppresses the tricarboxylic acid cycle by inhibiting amino acid metabolism. Additionally, autophagy and lysosomal biosynthesis have emerged as potential targets to improve the therapeutic response to these diseases. Genetic models of phosphatidylinositol-5-phosphate 4-kinase type 2 proteins (PIP4K2s) inhibition demonstrated the relevance of these enzymes in mitochondrial homeostasis and autophagic flux. High PIP4K2A and PIP4K2C transcript levels were associated with adverse cytogenetic risk and poor clinical outcomes in AML. Taking together, these data suggest that PIP4K2s inhibitors may have antileukemic effects and may synergize with venetoclax. Here, we uncover the cellular and molecular effects of THZ-P1-2, a pan-inhibitor of PIP4K2s, in acute leukemia cells and tested aforementioned hypothesis. Using a panel of 21 commonly used human myeloid and lymphoid leukemic cell lines, THZ-P1-2 caused a dose-dependent decrease in viability in these leukemia cells. Our results indicated cytostatic effects associated with a reduction of cells in S and G2/M phases when THZ-P1-2 was administrated at low concentrations (1.6 or 3.2 µM). Conversely, when THZ-P1-2 was administrated at high concentrations (6.4 µM), we observed cytotoxic effects linked with an increased accumulation of cells in the subG1 (all p < 0.05). The presence of DNA damage after exposure to THZ-P1-2 in leukemia cells was confirmed by the comet assay (all p < 0.05). An increase in apoptosis was detected in all cellular models upon the treatment with THZ-P1-2 in leukemia cells (all p < 0.05). Notably, acidic vesicular organelles levels were substantially elevated upon THZ-P1-2 exposure, particularly at concentrations that induced lower levels of apoptosis. At the molecular level, THZ-P1-2 induced the expression of apoptosis markers (PARP1 cleavage) and DNA damage (γH2AX) at levels compatible with those observed in previous cellular assays. Furthermore, LC3BII and SQSTM1/p62 levels were increased, which indicates a failure to complete the autophagic flow. In addition, exposure to THZ-P1-2 reduced basal and maximal cellular respiration capacity as well as glycolytic flux. The combined treatment showed synergistic effects, reducing the IC50 of venetoclax and strongly increasing the induction of apoptosis in leukemia cells [apoptosis rates (mean, SD); vehicle: 3.8, 0.7%, 6.4 µM venetoclax: 33.3, 4.8%, 6.4 µM THZ-P1-2: 18.5, 2.8%, 12.5 µM THZ-P1-2: 64.3, 4.3%, 6.4 µM venetoclax plus 6.4 µM THZ-P1-2: 78.3, 1.2%, 6.4 µM venetoclax plus 12.5 µM THZ-P1-2: 97.4, 0.3%, all p < 0.05]. Similar to what was observed in the cell line model, THZ-P1-2 reduced the viability of primary leukemic cells (AML, n = 45; ALL, n = 20) in a dose-dependent manner, which was correlated with a more metabolically active phenotype (oxygen consumption and extracellular acidification) of the leukemic blasts. Proteome analysis was performed on samples from patients considered sensitive and resistant to THZ-P1-2, which presented distinct protein signatures. A gene enrichment analysis identified multiple processes and signaling pathways associated with mitochondrial metabolism, cell cycle stage, leukemic cell-of-origin, and TP53 pathway (all FDR q-value < 0.05). Minimal effects of THZ-P1-2 observed in healthy CD34+ cells suggested a favorable therapeutic window. Our study provides insight into pharmacological inhibition of PIP4Ks targeting mitochondrial homeostasis and autophagy shedding light on a new class of drugs for acute leukemias. Supported by FAPESP, CNPq and CAPES.

The effect of apigenin and chemotherapy combination treatments on apoptosis-related genes and proteins in acute leukaemia cell lines

Apigenin is a dietary polyphenol found abundantly in fruit and vegetables, which sensitizes leukaemia cells to topoisomerase inhibitor agents (e.g., etoposide), and alkylating agents (e.g., cyclophosphamide), reducing ATP levels and inducing apoptosis; whilst being protective to control haematopoietic stem cells. This study analysed the expression profiles of intrinsic and extrinsic apoptosis-related genes and proteins to help elucidate the mechanisms of action of apigenin when used in combination with etoposide or cyclophosphamide in lymphoid and myeloid leukaemia cell lines (Jurkat and THP-1). Expression of apoptosis-related genes were measured using a TaqMan® Human Apoptosis Array and the StepOne Plus RT-qPCR System, whilst apoptosis-related proteins were determined using a protein profiler™-human apoptosis array and the LI-COR OdysseyR Infrared Imaging System. Apigenin when combined with etoposide or cyclophosphamide-induced apoptosis via the mitochondrial pathway, increasing the expression of pro-apoptotic cytochrome c, SMAC/DIABLO, and HTRA2/OMI, which promoted caspase-9 and -3 activation. Targeting anti-apoptotic and/or pro-apoptotic members of the apoptotic pathways is a promising strategy to induce cancer cell death and improve sensitivity to chemotherapy agents. Here the apoptotic pathways induced by apigenin in combination with etoposide or cyclophosphamide were identified within human leukaemia cell lines, such applications could provide combination therapies for the treatment of leukaemia.

Introduction of the T315I gatekeeper mutation of BCR/ABL1 into a Philadelphia chromosome-positive lymphoid leukemia cell line using the CRISPR/Cas9 system.

Imatinib and second-generation tyrosine kinase inhibitors (TKIs) have dramatically improved the prognosis of Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). However, overcoming TKI resistance due to the T315I gatekeeper mutation of BCR/ABL1 is crucial for further improving the prognosis. The clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system is appropriate for establishing a human model of Ph+ ALL with the T315I mutation, because it can induce specific mutations via homologous recombination (HR) repair in cells with intact endogenous HR pathway. Here we used CRISPR/Cas9 to introduce the T315I mutation into the Ph+ lymphoid leukemia cell line KOPN55bi, which appeared to have an active HR pathway based on its resistance to a poly (ADP-Ribose) polymerase-1 inhibitor. Single-guide RNA targeting at codon 315 and single-strand oligodeoxynucleotide containing ACT to ATT nucleotide transition at codon 315 were electroporated with recombinant Cas9 protein. Dasatinib-resistant sublines were obtained after one-month selection with the therapeutic concentration of dasatinib, leading to T315I mutation acquisition through HR. T315I-acquired sublines were highly resistant to imatinib and second-generation TKIs but moderately sensitive to the therapeutic concentration of ponatinib. This authentic human model is helpful for developing new therapeutic strategies overcoming TKI resistance in Ph+ ALL due to T315I mutation.

Synthesis, in vitro and structural aspects of cap substituted Suberoylanilide hydroxamic acid analogs as potential inducers of apoptosis in Glioblastoma cancer cells via HDAC /microRNA regulation

Glioblastoma multiforme (GBM) is a heterogeneous, aggressive brain cancer characterized by chemo-resistance and cancer stemness. Histone deacetylases (HDACs) are a group of enzymes that regulate chromatin epigenetics which were in turn found to be controlled by microRNAs (miRs). The drug employed in chemotherapy for the treatment of GBM is Temozolomide (TMZ). Unfortunately, many GBM patients exhibit chemo-resistance to this drug. Here we have synthesized various Suberoyl anilide hydroxamic acid (SAHA) analogs with many substitutions at the cap site majority of which not yet studied. These SAHA analogs have exhibited profound cytotoxicity at 2 μM, and 4 μM concentrations in GBM cancer cell line U87MG, and 1 μM, and 2 μM concentrations in breast cancer cell line MCF-7. Surprisingly, these analogs have exhibited cytotoxic effects in chronic lymphoid leukemia cells (Raji) at 64 μM, and 128 μM concentrations due to mutated p53. Among all the synthesized analogs 3-Chloro-SAHA, 3-Chloro-4-fluoro SAHA have exhibited effective cytotoxicity in all cancer cells. These potent analogs inhibited HDAC-8 enzyme activity by 2-folds in U87MG, and MCF-7 cell lines and 7-folds decrease in HDAC-8 activity was observed in Raji cell line. These analogs decreased the expression of HDAC-2, HDAC-3 genes and enhanced the expression of p53 tumor suppressor. Interestingly, these compounds decreased the expression of Rictor, the main component of the mTORC2 complex involved cancer cell metabolism. Furthermore, these molecules have decreased oncogenic microRNA expression such as miR-21 and enhanced the expression of tumor suppressor microRNAs such as miR-143. The HDAC binding ability of these molecules was highly significant and have exhibited the ability to cross blood-brain barrier (BBB), and followed the Lipinski rule of five. Thus, these molecules need to be taken up further to clinics for better therapy against GBM either singly or combination therapy.

Investigation of Anticancer Effects of Apigenin on MOLT-3 Human Leukaemia Cell Line

Leukaemia is an aggressive blood malignancies characterized by abnormal accumulation and proliferation of WBCs. Among children younger than 15 years, leukaemia consider the most common type of cancer which accounting 30% of all diagnosed malignancies. The Saudi Cancer Registry (SCR) reported that leukaemia ranked as the 5th type of cancer among both male and female. Because of the undesirable side-effects of the chemotherapy commonly used for leukaemia treatment such as high toxicity and development of secondary cancer, the search for novel and new promising treatment with fewer side-effects and higher therapeutic efficiency is still a priority goal. Using bioactive compounds from natural sources was an effective treatment for a variety of blood cancer. Thus, the aim of this study was to use the bioactive compound Apigenin to treat human lymphoid leukaemia cell line MOLT-3 with three different doses (25, 50, 100 µM) for 24 h. The results of this study showed that cellular proliferation was significantly reduced with 25, 50 and 100 µM Apigenin. In addition, significant increase in apoptotic induction was demonstrated when assessed with Annexin V-FITC/ PI and Caspase-3 substrate based on flow cytometry. Cell cycle arrest was significantly reported at S phase within MOLT-3 cells in a dose response manner. Thus, the finding of this study suggested that Apigenin is a potent and efficient anticancer compound through its activity of blocked cell proliferation, apoptotic induction and cell cycle arrest. However, further studies are required to investigate if the dietary intake of Apigenin might interfere with chemotherapeutic treatment of leukaemia.

PaDef (Persea americana var. drymifolia), a Plant Antimicrobial Peptide, Triggers Apoptosis, and Induces Global Epigenetic Modifications on Histone 3 in an Acute Lymphoid Leukemia Cell Line.

In recent years, it has been recognized that epigenetic alterations play an important role in the development and maintenance of cancer, including leukemias. Furthermore, it is known that these alterations are involved in the emergence of resistance to conventional chemotherapeutics. Consequently, molecules with an anticancer activity whose activity is ruled by epigenetic modifications are attractive to search for new therapies against cancer. The plant antimicrobial peptides have been widely evaluated as molecules with anticancer activity; however, the analysis of the epigenetic regulation induced by these molecules associated with this activity is scarce and still is an unexplored field. In this work, we show that the PaDef defensin, a plant antimicrobial peptide from Mexican avocado fruit (Persea americana var. drymifolia) is cytotoxic for Jurkat cell line from acute lymphoid leukemia cells, through an apoptotic process. PaDef inhibited cell viability in a concentration-dependent manner, with an IC50 = 47.3 μM. Treatment of Jurkat cells with PaDef (IC50) induced cell death by apoptosis dependent on caspases 8 and 9; besides, it was related to an increase in the production of reactive oxygen species and the loss of mitochondrial membrane potential. Interestingly, the inhibition of caspase activation by inhibitors of caspases 8 and 9 does not revert the reduction in viability, suggesting that other mechanisms, in addition to caspase activity, could be participating in the PaDef cytotoxic effect. Also, the modifications in the histone 3 tails induced by PaDef in Jurkat cells were evaluated, specifically acetylation and methylation. PaDef increased global histone 3 acetylation and lysine 9 specific marks (2-fold and up to 4-fold, respectively). These effects correlated with the reduction of the Histone Deacetylase activity (HDAC, ∼50%). Based on methylation marks, PaDef treatment increased lysine 9 di- and tri-methylation tags (2-fold in both cases). The epigenetic modulation induced by PaDef on Jurkat cells could be related to the chromatin compaction-decompaction promoting gene expression or repression; however, further studies are necessary to correlate these marks with the transcription of specific genes. Therefore, the study of new molecules that may have anticancer activity through epigenetic modulation is interesting.

Scorpion Venom Antimicrobial Peptides Induce Caspase-1 Dependant Pyroptotic Cell Death.

Within the last decade, several peptides have been identified according to their ability to inhibit the growth of microbial pathogens. These antimicrobial peptides (AMPs) are a part of the innate immune system of all living organisms. Many studies on their effects on prokaryotic microorganisms have been reported; some of these peptides have cytotoxic properties although the molecular mechanisms underlying their activity on eukaryotic cells remain poorly understood. Smp24 and Smp43 are novel cationic AMPs which were identified from the venom of the Egyptian scorpion Scorpio maurus palmatus. Smp24 and Smp43 showed potent activity against both Gram-positive and Gram-negative bacteria as well as fungi. Here we describe cytotoxicity of these peptides towards two acute leukaemia cell lines (myeloid (KG1-a) and lymphoid (CCRF-CEM) leukaemia cell lines) and three non-tumour cell lines CD34+ (hematopoietic stem progenitor from cord blood), HRECs (human renal epithelial cells) and HaCaT (human skin keratinocytes). Smp24 and Smp43 (4–256 µg/ml) decreased the viability of all cell lines, although HaCaT cells were markedly less sensitive. With the exception HaCaT cells, the caspase-1 gene was uniquely up-regulated in all cell lines studied. However, all cell lines showed an increase in downstream interleukin-1β (IL-1β) expression. Transmission electron microscope studies revealed the formation of cell membrane blebs and the appearance of autolysosomes and lipid droplets in all cell lines; KG1-a leukemia cells also showed the unique appearance of glycogen deposits. Our results reveal a novel mechanism of action for scorpion venom AMPs, activating a cascade of events leading to cell death through a programmed pyroptotic mechanism.

Suppressing crucial oncogenes of leukemia initiator cells by major royal jelly protein 2 for mediating apoptosis in myeloid and lymphoid leukemia cells.

Relapse of leukemia and drug resistance are still the major obstacles to therapy due to leukemia-initiating stem/progenitor cells (LICs); thus, targeting them using safe compounds is crucial. Here, we evaluated the anti-leukemic effect of royal jelly (RJ) components, which had a higher safe concentration (EC100 values) than the chemotherapeutic drug doxorubicin (DOX). The RJ-protein fraction 50 (PF50, precipitated at 40-50% ammonium sulfate saturation) and its constituents, major RJ protein (MRJP) 2 and its isoform X1, exhibited the highest growth inhibitory effect against myeloid NFS-60 and lymphoid Jurkat cell lines. MRJP2 has a nanosize, which may be the reason for its higher anti-leukemic activity than its isoform. These RJ proteins, particularly MRJP2, suppressed LIC-associated oncogenes (GATA2 and Evi-1) and eliminated CD34+ LICs, in contrast to the low anti-LIC efficacy of DOX. MRJP2 demonstrated higher apoptotic activity than its isoform by upregulating p53 and p21-mediated cell cycle arrest. This study also reported the potent inhibitory effect of RJ-proteins on matrix metallopeptidase 10 (metastatic marker) and histone deacetylase 8 (mediates LIC survival) activities. Thus, MRJP2 can be considered a promising novel therapeutic agent for both myeloid and lymphoid leukemia.

3068 – CBX7 INHIBITORS BLOCK CELL PROLIFERATION AND INDUCE DIFFERENTIATION OF ACUTE MYELOID AND LYMPHOBLASTIC LEUKEMIA CELLS

Background Hematopoietic stem cells have the capacity to self-renew as well as to differentiate and thus ensure blood production throughout life. The balance between self-renewal and differentiation is well controlled to avoid hyper-proliferative conditions like leukemia. Chromobox 7 (CBX7) plays an important role in regulating this balance. CBX7 can recognize H3K27me3 which will induce Polycomb Repressive Complex 1 (PRC1)-dependent gene repression, including genes required for differentiation and cell cycle arrest. In this study, we tested existing and newly synthesized CBX7 inhibitors to investigate whether they block proliferation and induce differentiation of human myeloid and lymphoid leukemic cell lines and primary cells. Results Pharmacological inhibition of CBX7 led to reduction of H2Aub levels, loss of CBX7 binding to differentiation and cell cycle arrest target genes, reduced viability and proliferation, and terminal differentiation of leukemic cells. Beyond canonical binding to H3K27me3, we recently showed that CBX7 can recognize the histone H3K9 methyltransferases SETDB1 and EHMT, suggesting that CBX7 regulates the balance between proliferation and differentiation by canonical and non-canonical interactions. Indeed, CBX7 inhibitors reduced H3K9me2/3 levels in leukemic cells and prevented the binding of CBX7 to SETDB1 and EHMT. SETDB1 or EHMT inhibitors alone phenocopied the effect of the CBX7 inhibitors, as they reduced viability and induced differentiation. Interestingly, SETDB1 or EHMT inhibitors synergized with CBX7 inhibitors in leukemic cells. Conclusion This study demonstrates that inhibition of CBX7 alone, or in combination with inhibiting SETDB1 or EHMT, blocks proliferation and induces differentiation of leukemic cells. Therefore, pharmacological targeting of CBX7 may constitute a novel therapeutic approach in leukemia. Hematopoietic stem cells have the capacity to self-renew as well as to differentiate and thus ensure blood production throughout life. The balance between self-renewal and differentiation is well controlled to avoid hyper-proliferative conditions like leukemia. Chromobox 7 (CBX7) plays an important role in regulating this balance. CBX7 can recognize H3K27me3 which will induce Polycomb Repressive Complex 1 (PRC1)-dependent gene repression, including genes required for differentiation and cell cycle arrest. In this study, we tested existing and newly synthesized CBX7 inhibitors to investigate whether they block proliferation and induce differentiation of human myeloid and lymphoid leukemic cell lines and primary cells. Pharmacological inhibition of CBX7 led to reduction of H2Aub levels, loss of CBX7 binding to differentiation and cell cycle arrest target genes, reduced viability and proliferation, and terminal differentiation of leukemic cells. Beyond canonical binding to H3K27me3, we recently showed that CBX7 can recognize the histone H3K9 methyltransferases SETDB1 and EHMT, suggesting that CBX7 regulates the balance between proliferation and differentiation by canonical and non-canonical interactions. Indeed, CBX7 inhibitors reduced H3K9me2/3 levels in leukemic cells and prevented the binding of CBX7 to SETDB1 and EHMT. SETDB1 or EHMT inhibitors alone phenocopied the effect of the CBX7 inhibitors, as they reduced viability and induced differentiation. Interestingly, SETDB1 or EHMT inhibitors synergized with CBX7 inhibitors in leukemic cells. This study demonstrates that inhibition of CBX7 alone, or in combination with inhibiting SETDB1 or EHMT, blocks proliferation and induces differentiation of leukemic cells. Therefore, pharmacological targeting of CBX7 may constitute a novel therapeutic approach in leukemia.

Redefining Hyperviscosity in Acute Leukemia: Implications for Red Cell Transfusions

Hyperleukocytosis, most commonly defined as a white blood cell (WBC) count greater than 100,000/μL, is an emergency in acute leukemia, possibly resulting in life-threatening microvascular obstruction, or leukostasis, leading to neurologic (CNS hemorrhage, thrombosis) or pulmonary (respiratory distress, hypoxia) complications. The underlying mechanisms remain poorly understood and are canonically attributed to blood hyperviscosity secondary to high WBC count and abnormal biophysical properties of leukemia cells themselves (leukemia immunophenotype, increased cell size, adhesion, and stiffness). Leukapheresis is a commonly-used therapy for rapid cytoreduction in symptomatic patients, but the procedure carries risk and existing guidelines are supported by scant evidence. Interestingly, despite hematocrit(Hct)/hemoglobin(Hgb) levels being major drivers of blood viscosity due to the high prevalence of circulating red cells (RBCs), how Hct/Hgb mediates hyperviscosity in acute leukemia is unknown. This is clinically important as Hct/Hgb often decrease as leukemic cell counts rise, and acute leukemia patients with anemia are often transfused. While sickle cell disease guidelines advise using a target post transfusion Hct of 30% to minimize iatrogenic hyperviscosity and its morbid complications, no guidelines have been established for acute leukemia. As such, can RBC transfusion actually increase leukostasis risk in acute leukemia?To explore this question requires new biophysical tools as the complexity of blood viscosity increases substantially at the microvascular level as the physical properties of the cells themselves become the major determinants of resistance to blood flow. To that end, we developed “microvasculature-on-a-chip” devices that recapitulate microvascular biophysical and hemodynamic conditions to investigate how the differing presentations of acute leukemia and transfusion support affect the effective blood viscosity at the microvascular level to cause “in vitro leukostasis.”A multiple-vessel “multiplex” microfluidic device that operates at the appropriate size scale and mimics the microvascular geometry was designed to enable assessing accurate biophysical measurements of blood hyperviscosity. The devices were microfabricated using standard polydimethylsiloxane-based photolithography (Figure 1). Acute B-cell lymphoblastic (B-ALL, 697), acute T-cell lymphoblastic (T-ALL, Jurkat) and acute myelocytic (AML, HL60) leukemia cell lines were maintained via standard cell culture conditions. Patient samples were obtained through our institution's IRB. RBCs from healthy donors were isolated and mixed with leukemia cells to achieve target Hct/Hgb and WBC levels. Various physiologic leukemia “mixtures” were then perfused under physiologic microcirculatory flow conditions through the microvascular device and microchannels occlusion was tracked via videomicroscopy (Figure 2).Using a standard least squares multivariable linear regression with first and second order effects, microchannel size, Hct/Hgb, WBC count and leukemia cell type all showed statically significant effect on in vitro leukostasis, or microchannel occlusion over time, (all p values < 0.03) (Figure 3). Overall, severe anemia appears to be protective against in vitro leukostasis and there appears to be Hct/Hgb thresholds above which in vitro leukostasis becomes more prevalent, though this is different for B-ALL versus T-ALL. This is in contrast to AML, where severe anemia does not appear to offer protection against in vitro leukostasis as occlusion was appreciated at all Hct/Hgb levels.These data suggest when determining risk for leukostasis, WBC count and leukemia immunophenotype should not be the sole determinants. Here we show Hct/Hgb levels affect microvascular blood viscosity and risk for microvascular occlusion. These results may impact decisions regarding RBC transfusions and possibly initiation of leukapheresis in asymptomatic patients. Having a model to assess risk associated with RBC transfusions and informing clinicians when a patient might become at risk for leukostasis can have a significant impact on their clinical outcome, morbidity and mortality. Ongoing studies incorporating patient lymphoid and myeloid leukemia cells are needed to support this cell line data. [Display omitted] DisclosuresKemp: Parthenon Therapeutics: Membership on an entity's Board of Directors or advisory committees. Lam: Sanguina, Inc.: Current holder of individual stocks in a privately-held company.

Pseurotin D Induces Apoptosis through Targeting Redox Sensitive Pathways in Human Lymphoid Leukemia Cells.

Chronic lymphocytic leukemia (CLL) is the most prevalent lymphoid malignancy in many geographical regions of the world. Pseurotin D, a secondary metabolite of fungi, represents a group of bioactive natural products with a newly ascribed range of interesting biological activities. The purpose of this study was to bring new insights into the mechanism behind the effects of pseurotin D on MEC-1 cells as a representative CLL cell line, with a particular focus on selected signaling pathways important in the proliferation of cells and targeting mitochondrial metabolism. Our results showed that pseurotin D was able to significantly inhibit the proliferation of MEC-1 cells and arrested them in the G2/M cell cycle phase. In addition, pseurotin D was able to induce apoptosis. We found that all of these effects were associated with a change in mitochondrial membrane potential and the production of mitochondrial reactive oxygen species (ROS). We showed for the first time that pseurotin D suppresses MEC-1 cell proliferation and induces apoptotic cell death via induction of the collapse of the mitochondria respiratory chain and the ROS-related caspase pathway. Our results show the pseurotins family as promising compounds which could serve as a basis for the development of new compounds in the treatment of lymphoma.

Modeling IKZF1 lesions in B-ALL reveals distinct chemosensitivity patterns and potential therapeutic vulnerabilities

AbstractIKAROS family zinc finger 1 (IKZF1) alterations represent a diverse group of genetic lesions that are associated with an increased risk of relapse in B-cell acute lymphoblastic leukemia. Due to the heterogeneity of concomitant lesions, it remains unclear how IKZF1 abnormalities directly affect cell function and therapy resistance, and whether their consideration as a prognostic indicator is valuable in improving outcome. CRISPR/Cas9 strategies were used to engineer multiple panels of isogeneic lymphoid leukemia cell lines with a spectrum of IKZF1 lesions to measure changes in chemosensitivity, gene expression, cell cycle, and in vivo engraftment that can be linked to loss of IKAROS protein. IKZF1 knockout and heterozygous null cells displayed relative resistance to a number of common therapies for B-cell acute lymphoblastic leukemia, including dexamethasone, asparaginase, and daunorubicin. Transcription profiling revealed a stem/myeloid cell–like phenotype and JAK/STAT upregulation after IKAROS loss. A CRISPR homology-directed repair strategy was also used to knock-in the dominant-negative IK6 isoform into the endogenous locus, and a similar drug resistance profile, with the exception of retained dexamethasone sensitivity, was observed. Interestingly, IKZF1 knockout and IK6 knock-in cells both have significantly increased sensitivity to cytarabine, likely owing to marked downregulation of SAMHD1 after IKZF1 knockout. Both types of IKZF1 lesions decreased the survival time of xenograft mice, with higher numbers of circulating blasts and increased organ infiltration. Given these findings, exact specification of IKZF1 status in patients may be a beneficial addition to risk stratification and could inform therapy.