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磷酸肌醇 3-激酶 δ 抑制剂 CAL-101 抑制慢性淋巴细胞白血病中 B 细胞受体信号和趋化因子网络。

The phosphoinositide 3'-kinase delta inhibitor, CAL-101, inhibits B-cell receptor signaling and chemokine networks in chronic lymphocytic leukemia.

机构信息

Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.

出版信息

Blood. 2011 Sep 29;118(13):3603-12. doi: 10.1182/blood-2011-05-352492. Epub 2011 Jul 29.

Abstract

In lymphocytes, the phosphoinositide 3'-kinase (PI3K) isoform p110δ (PI3Kδ) transmits signals from surface receptors, including the B-cell receptor (BCR). CAL-101, a selective inhibitor of PI3Kδ, displays clinical activity in CLL, causing rapid lymph node shrinkage and a transient lymphocytosis. Inhibition of pro-survival pathways, the presumed mechanism of CAL-101, does not explain this characteristic pattern of activity. Therefore, we tested CAL-101 in assays that model CLL-microenvironment interactions in vitro. We found that CAL-101 inhibits CLL cell chemotaxis toward CXCL12 and CXCL13 and migration beneath stromal cells (pseudoemperipolesis). CAL-101 also down-regulates secretion of chemokines in stromal cocultures and after BCR triggering. CAL-101 reduces survival signals derived from the BCR or from nurse-like cells, and inhibits BCR- and chemokine-receptor-induced AKT and MAP kinase (ERK) activation. In stromal cocultures, CAL-101 sensitizes CLL cells toward bendamustine, fludarabine, and dexamethasone. These results are corroborated by clinical data showing marked reductions in circulating CCL3, CCL4, and CXCL13 levels, and a surge in lymphocytosis during CAL-101 treatment. Thus, CAL-101 displays a dual mechanism of action, directly decreasing cell survival while reducing interactions that retain CLL cells in protective tissue microenvironments. These data provide an explanation for the clinical activity of CAL-101, and a roadmap for future therapeutic development.

摘要

在淋巴细胞中,磷酸肌醇 3-激酶(PI3K)同工型 p110δ(PI3Kδ)从表面受体传递信号,包括 B 细胞受体(BCR)。CAL-101 是 PI3Kδ 的选择性抑制剂,在 CLL 中显示出临床活性,导致淋巴结迅速缩小和短暂的淋巴细胞增多。抑制生存途径,即 CAL-101 的推测机制,不能解释这种特征性的活性模式。因此,我们在体外模拟 CLL-微环境相互作用的测定中测试了 CAL-101。我们发现 CAL-101 抑制 CLL 细胞向 CXCL12 和 CXCL13 的趋化性和向基质细胞(假性游走)下的迁移。CAL-101 还下调基质共培养物和 BCR 触发后的趋化因子分泌。CAL-101 减少来自 BCR 或类滋养细胞的存活信号,并抑制 BCR 和趋化因子受体诱导的 AKT 和 MAP 激酶(ERK)激活。在基质共培养物中,CAL-101 使 CLL 细胞对苯达莫司汀、氟达拉滨和地塞米松敏感。这些结果得到临床数据的证实,表明循环 CCL3、CCL4 和 CXCL13 水平显著降低,并且在 CAL-101 治疗期间淋巴细胞增多。因此,CAL-101 具有双重作用机制,直接降低细胞存活,同时减少将 CLL 细胞保留在保护性组织微环境中的相互作用。这些数据为 CAL-101 的临床活性提供了解释,并为未来的治疗发展提供了路线图。

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