Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center, Faculty of Medicine, University of Freiburg, Germany.
Department of Molecular Target Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
Haematologica. 2018 Jan;103(1):136-147. doi: 10.3324/haematol.2017.165381. Epub 2017 Nov 9.
Nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) is known to play an important role in the pathogenesis of chronic lymphocytic leukemia (CLL). Several NF-κB inhibitors were shown to successfully induce apoptosis of CLL cells Since the microenvironment is known to be crucial for the survival of CLL cells, herein, we tested whether NF-κB inhibition may still induce apoptosis in these leukemic cells in the presence of protective stromal interaction. We used the specific NF-κB inhibitor dehydroxymethylepoxyquinomicin (DHMEQ). Microenvironmental support was mimicked by co-culturing CLL cells with bone marrow-derived stromal cell lines (HS-5 and M2-10B4). NF-κB inhibition by DHMEQ in CLL cells could be confirmed in both the monoculture and co-culture setting. In line with previous reports, NF-κB inhibition induced apoptosis in the monoculture setting by activating the intrinsic apoptotic pathway resulting in poly (ADP-ribose) polymerase (PARP)-cleavage; however, it was unable to induce apoptosis in leukemic cells co-cultured with stromal cells. Similarly, small interfering ribonucleic acid (siRNA)-mediated downregulation induced apoptosis of CLL cells cultured alone, but not in the presence of supportive stromal cells. B-cell activating factor (BAFF) was identified as a microenvironmental messenger potentially protecting the leukemic cells from NF-κB inhibition-induced apoptosis. Finally, we show improved sensitivity of stroma-supported CLL cells to NF-κB inhibition when combining the NF-κB inhibitor with the SYK inhibitor R406 or the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib, agents known to inhibit the stroma-leukemia crosstalk. We conclude that NF-κB inhibitors are not promising as monotherapies in CLL, but may represent attractive therapeutic partners for ibrutinib and R406.
核因子-κB 轻链增强子的活化 B 细胞(NF-κB)被认为在慢性淋巴细胞白血病(CLL)的发病机制中发挥重要作用。已经证明几种 NF-κB 抑制剂能够成功诱导 CLL 细胞凋亡。由于已知微环境对于 CLL 细胞的存活至关重要,因此,我们在此测试 NF-κB 抑制是否仍然可以在存在保护性基质相互作用的情况下诱导这些白血病细胞凋亡。我们使用了特异性 NF-κB 抑制剂去甲氧基表鬼臼毒素(DHMEQ)。通过将 CLL 细胞与骨髓来源的基质细胞系(HS-5 和 M2-10B4)共培养来模拟微环境支持。在单核培养和共培养环境中均证实了 DHMEQ 对 CLL 细胞 NF-κB 的抑制作用。与先前的报道一致,NF-κB 抑制通过激活内在凋亡途径导致多聚(ADP-核糖)聚合酶(PARP)-切割,在单核培养物中诱导凋亡;然而,它不能诱导与基质细胞共培养的白血病细胞凋亡。同样,小干扰核糖核酸(siRNA)介导的下调诱导单独培养的 CLL 细胞凋亡,但不能在支持基质细胞的存在下诱导凋亡。B 细胞激活因子(BAFF)被鉴定为一种潜在的微环境信使,可保护白血病细胞免受 NF-κB 抑制诱导的凋亡。最后,当将 NF-κB 抑制剂与 SYK 抑制剂 R406 或 Bruton 的酪氨酸激酶(BTK)抑制剂依鲁替尼联合使用时,我们发现支持基质的 CLL 细胞对 NF-κB 抑制的敏感性提高,这些药物已知可抑制基质-白血病串扰。我们得出结论,NF-κB 抑制剂作为 CLL 的单一疗法没有前途,但可能是依鲁替尼和 R406 的有吸引力的治疗伙伴。
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