Peiffer Lukas, Poll-Wolbeck Simon Jonas, Flamme Hanna, Gehrke Iris, Hallek Michael, Kreuzer Karl-Anton
Department I of Internal Medicine, University at Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
J Cancer Res Clin Oncol. 2014 Aug;140(8):1283-93. doi: 10.1007/s00432-014-1689-0. Epub 2014 May 4.
The ontogenetic Wnt pathway shows almost no activity in adult tissues. In contrast, chronic lymphocytic leukemia (CLL) cells show constitutionally active Wnt signaling, which is associated with upregulated levels of pathway members such as Wnt3 and lymphoid enhancer-binding factor-1. Functionally, this results in increased resistance to apoptosis. We therefore assumed that targeting members of the pathway could reveal new therapeutic options for the treatment of CLL.
Screening a Wnt compound library with 75 Wnt modulators via ATP assay revealed Trichostatin A as an outstanding substance with strong viability decreasing effects on CLL cells and little effect on healthy peripheral blood mononuclear cells (PBMCs). Further survival analysis was performed via fluorescence-activated cell sorting analysis.
A maximum effect was achieved after 48 h with a wide therapeutic window in contrast to PBMCs (CLL cells: 0.253 µM, PBMCs: 145.22 µM). Trichostatin A induced caspases and acted via a dual mechanism to reveal histone and non-histone targets. Histone targets were displayed in deacetylation inhibition at DNA level, and non-histone targeting was demonstrated by elevated levels of Dickkopf-related protein 1 mRNA. Primary cells of patients with critical mutations such as TP53 or those who had already undergone extensive previous treatment responded well to the treatment. Moreover, the approved histone deacetylase (HDAC) inhibitor suberoylanilidehydroxamic acid (SAHA) was not as effective as Trichostatin A (Trichostatin A: 0.253 µM, SAHA: 7.88 µM). Combining Trichostatin A with established CLL drugs fludarabine or bendamustine showed an additive effect in vitro.
Taken together, Trichostatin A appears to act via a dual anti-HDAC/Wnt mechanism with a high selectivity and efficacy in CLL and therefore warrants further investigation.
个体发育过程中的Wnt信号通路在成体组织中几乎没有活性。相比之下,慢性淋巴细胞白血病(CLL)细胞表现出组成性激活的Wnt信号,这与该信号通路成员如Wnt3和淋巴样增强子结合因子-1的上调水平相关。在功能上,这导致细胞对凋亡的抗性增加。因此,我们推测靶向该信号通路的成员可能会为CLL的治疗揭示新的治疗选择。
通过ATP检测筛选含有75种Wnt调节剂的Wnt化合物库,结果显示曲古抑菌素A是一种出色的物质,对CLL细胞具有很强的活力降低作用,而对健康外周血单个核细胞(PBMC)影响很小。通过荧光激活细胞分选分析进行进一步的生存分析。
与PBMC相比,48小时后达到最大效应,且具有较宽的治疗窗(CLL细胞:0.253 μM,PBMC:145.22 μM)。曲古抑菌素A诱导半胱天冬酶,并通过双重机制作用以揭示组蛋白和非组蛋白靶点。组蛋白靶点表现为在DNA水平抑制去乙酰化,非组蛋白靶向则通过Dickkopf相关蛋白1 mRNA水平升高得以证明。具有关键突变如TP53的患者的原代细胞或那些已经接受过广泛前期治疗的患者的原代细胞对该治疗反应良好。此外,已获批的组蛋白去乙酰化酶(HDAC)抑制剂辛二酰苯胺异羟肟酸(SAHA)不如曲古抑菌素A有效(曲古抑菌素A:0.253 μM,SAHA:7.88 μM)。将曲古抑菌素A与已确立的CLL药物氟达拉滨或苯达莫司汀联合使用在体外显示出相加作用。
综上所述,曲古抑菌素A似乎通过双重抗HDAC/Wnt机制发挥作用,对CLL具有高选择性和疗效,因此值得进一步研究。