Okada Keigo, Nogami Ayako, Ishida Shinya, Akiyama Hiroki, Chen Cheng, Umezawa Yoshihiro, Miura Osamu
Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Oncotarget. 2017 Dec 4;9(10):8870-8886. doi: 10.18632/oncotarget.22926. eCollection 2018 Feb 6.
FLT3-ITD is the most frequent tyrosine kinase mutation in acute myeloid leukemia (AML) associated with poor prognosis. We previously reported that activation of STAT5 confers resistance to PI3K/Akt inhibitors on the FLT3-ITD-positive AML cell line MV4-11 and 32D cells driven by FLT3-ITD (32D/ITD) but not by FLT3 mutated in the tyrosine kinase domain (32D/TKD). Here, we report the involvement of Pim kinases expressed through STAT5 activation in acquisition of this resistance. The specific pan-Pim kinase inhibitor AZD1208 as well as PIM447 in combination with the PI3K inhibitor GDC-0941 or the Akt inhibitor MK-2206 cooperatively downregulated the mTORC1/4EBP1 pathway, formation of the eIF4E/eIF4G complex, and Mcl-1 expression leading to activation of Bak and Bax to induce caspase-dependent apoptosis synergistically in these cells. These cooperative effects were enhanced or inhibited by knock down of mTOR or expression of its activated mutant, respectively. Overexpression of Mcl-1 conferred the resistance on 32D/ITD cells to combined inhibition of the PI3K/Akt pathway and Pim kinases, while the Mcl-1-specific BH3 mimetic A-1210477 conquered the resistance of MV4-11 cells to GDC-0941. Furthermore, overexpression of Pim-1 in 32D/TKD enhanced the mTORC1/Mcl-1 pathway and partially protected it from the PI3K/Akt inhibitors or the FLT3 inhibitor gilteritinib to confer the resistance to PI3K/Akt inhibitors. Finally, AZD1208 and GDC-0941 cooperatively inhibited the mTORC1/Mcl-1 pathway and reduced viable cell numbers of primary AML cells from some FLT3-ITD positive cases. Thus, Pim kinases may protect the mTORC1/4EBP1/Mcl-1 pathway to confer the resistance to the PI3K/Akt inhibitors on FLT3-ITD cells and represent promising therapeutic targets.
FLT3-ITD是急性髓系白血病(AML)中最常见的酪氨酸激酶突变,与预后不良相关。我们之前报道,STAT5的激活赋予FLT3-ITD阳性AML细胞系MV4-11以及由FLT3-ITD驱动的32D细胞(32D/ITD)对PI3K/Akt抑制剂的抗性,但不赋予酪氨酸激酶结构域发生突变的FLT3(32D/TKD)所驱动的32D细胞这种抗性。在此,我们报道通过STAT5激活表达的Pim激酶参与了这种抗性的获得。特异性泛Pim激酶抑制剂AZD1208以及PIM447与PI3K抑制剂GDC-0941或Akt抑制剂MK-2206联合使用,协同下调mTORC1/4EBP1通路、eIF4E/eIF4G复合物的形成以及Mcl-1表达,导致这些细胞中Bak和Bax激活,从而协同诱导半胱天冬酶依赖性凋亡。这些协同效应分别通过敲低mTOR或表达其激活突变体而增强或受到抑制。Mcl-1的过表达赋予32D/ITD细胞对PI3K/Akt通路和Pim激酶联合抑制的抗性,而Mcl-1特异性BH3模拟物A-1210477克服了MV4-11细胞对GDC-0941的抗性。此外,32D/TKD中Pim-1的过表达增强了mTORC1/Mcl-1通路,并部分保护其免受PI3K/Akt抑制剂或FLT3抑制剂吉列替尼的影响,从而赋予对PI3K/Akt抑制剂的抗性。最后,AZD1208和GDC-0941联合抑制mTORC1/Mcl-1通路,并减少了一些FLT3-ITD阳性病例的原发性AML细胞的存活细胞数量。因此,Pim激酶可能保护mTORC1/4EBP1/Mcl-1通路,赋予FLT3-ITD细胞对PI3K/Akt抑制剂的抗性,并代表有前景的治疗靶点。