Drusbosky Leylah, Gars Eric, Trujillo Angelica, McGee Christie, Meacham Amy, Wise Elizabeth, Scott Edward W, Cogle Christopher R
Division of Hematology and Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
Program in Stem Cell Biology and Regenerative Medicine, University of Florida, Gainesville, FL, USA.
Leuk Res. 2015 Sep;39(9):984-9. doi: 10.1016/j.leukres.2015.05.015. Epub 2015 Jul 2.
In acute myeloid leukemia (AML), refractory disease is a major challenge and the leukemia microenvironment may harbor refractory disease. Human AML cell lines KG-1 and HL-60 expressed receptors also found on endothelial cells (ECs) such as VEGFRs, PDGFRs, and cKit. When human AML cells were co-cultured with human umbilical vein endothelial cells (HUVECs) and primary bone marrow endothelial cell (BMECs), the AML cells were more resistant to cytarabine chemotherapy, even in transwell co-culture suggesting angiocrine regulation. Primary BMECs secreted significantly increased levels of VEGF-A and PDGF-AB after exposure to cytarabine. Pazopanib, a receptor tyrosine kinase inhibitor (RTKI) of VEGFRs, PDGFRs, and cKit, removed EC protection of AML cells and enhanced AML cell sensitivity to cytarabine. Xenograft modeling showed significant regression of AML cells and abrogation of BM hypervascularity in RTKI treated cohorts. Together, these results show direct cytotoxicity of RTKIs on AML cells and reversal of EC protection. Combining RTKIs with chemotherapy may serve as promising therapeutic strategy for patients with AML.
在急性髓系白血病(AML)中,难治性疾病是一项重大挑战,白血病微环境可能隐匿着难治性疾病。人AML细胞系KG-1和HL-60表达的受体也存在于内皮细胞(ECs)上,如血管内皮生长因子受体(VEGFRs)、血小板衍生生长因子受体(PDGFRs)和干细胞生长因子受体(cKit)。当人AML细胞与人脐静脉内皮细胞(HUVECs)和原代骨髓内皮细胞(BMECs)共培养时,AML细胞对阿糖胞苷化疗更具抗性,即使在Transwell共培养中也是如此,提示血管旁分泌调节。原代BMECs在暴露于阿糖胞苷后分泌的血管内皮生长因子A(VEGF-A)和血小板衍生生长因子AB(PDGF-AB)水平显著升高。帕唑帕尼是一种VEGFRs、PDGFRs和cKit的受体酪氨酸激酶抑制剂(RTKI),可消除EC对AML细胞的保护作用,并增强AML细胞对阿糖胞苷的敏感性。异种移植模型显示,在接受RTKI治疗的队列中,AML细胞显著消退,骨髓高血管化现象消除。总之,这些结果表明RTKIs对AML细胞具有直接细胞毒性,并可逆转EC保护作用。将RTKIs与化疗联合使用可能是AML患者一种有前景的治疗策略。