Mussai Francis, Egan Sharon, Higginbotham-Jones Joseph, Perry Tracey, Beggs Andrew, Odintsova Elena, Loke Justin, Pratt Guy, U Kin Pong, Lo Anthony, Ng Margaret, Kearns Pamela, Cheng Paul, De Santo Carmela
School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom;
School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom;
Blood. 2015 Apr 9;125(15):2386-96. doi: 10.1182/blood-2014-09-600643. Epub 2015 Feb 20.
Acute myeloid leukemia (AML) is one of the most common acute leukemias in adults and children, yet significant numbers of patients relapse and die of disease. In this study, we identify the dependence of AML blasts on arginine for proliferation. We show that AML blasts constitutively express the arginine transporters CAT-1 and CAT-2B, and that the majority of newly diagnosed patients' blasts have deficiencies in the arginine-recycling pathway enzymes argininosuccinate synthase and ornithine transcarbamylase, making them arginine auxotrophic. BCT-100, a pegylated human recombinant arginase, leads to a rapid depletion in extracellular and intracellular arginine concentrations, resulting in arrest of AML blast proliferation and a reduction in AML engraftment in vivo. BCT-100 as a single agent causes significant death of AML blasts from adults and children, and acts synergistically in combination with cytarabine. Using RNA sequencing, 20 further candidate genes which correlated with resistance have been identified. Thus, AML blasts are dependent on arginine for survival and proliferation, as well as depletion of arginine with BCT-100 of clinical value in the treatment of AML.
急性髓系白血病(AML)是成人和儿童中最常见的急性白血病之一,但仍有大量患者复发并死于该疾病。在本研究中,我们确定了AML原始细胞增殖对精氨酸的依赖性。我们发现AML原始细胞组成性表达精氨酸转运体CAT-1和CAT-2B,并且大多数新诊断患者的原始细胞在精氨酸循环途径酶精氨琥珀酸合酶和鸟氨酸转氨甲酰酶方面存在缺陷,使其成为精氨酸营养缺陷型。聚乙二醇化人重组精氨酸酶BCT-100可导致细胞外和细胞内精氨酸浓度迅速降低,从而导致AML原始细胞增殖停滞并减少AML在体内的植入。BCT-100作为单一药物可导致成人和儿童AML原始细胞大量死亡,并与阿糖胞苷联合使用时具有协同作用。通过RNA测序,已鉴定出另外20个与耐药相关的候选基因。因此,AML原始细胞的存活和增殖依赖于精氨酸,并且用BCT-100消耗精氨酸在AML治疗中具有临床价值。