Department of Hematological Malignancies Translational Science, Gehr Family Center for Leukemia Research, Hematologic Malignancies and Stem Cell Transplantation Institute, Beckman Research Institute, City of Hope Medical Center, Duarte, CA.
College of Pharmacy, Western University of Health Sciences, Pomona CA.
Blood. 2019 Aug 8;134(6):548-560. doi: 10.1182/blood.2019001282. Epub 2019 Jun 19.
The presence of FMS-like receptor tyrosine kinase-3 internal tandem duplication (FLT3-ITD) mutations in patients with acute myeloid leukemia (AML) is associated with poor clinical outcome. FLT3 tyrosine kinase inhibitors (TKIs), although effective in kinase ablation, do not eliminate primitive FLT3-ITD leukemia cells, which are potential sources of relapse. Thus, understanding the mechanisms underlying FLT3-ITD AML cell persistence is essential to devise future AML therapies. Here, we show that expression of protein arginine methyltransferase 1 (PRMT1), the primary type I arginine methyltransferase, is increased significantly in AML cells relative to normal hematopoietic cells. Genome-wide analysis, coimmunoprecipitation assay, and -knockout mouse studies indicate that PRMT1 preferentially cooperates with FLT3-ITD, contributing to AML maintenance. Genetic or pharmacological inhibition of PRMT1 markedly blocked FLT3-ITD AML cell maintenance. Mechanistically, PRMT1 catalyzed FLT3-ITD protein methylation at arginine 972/973, and PRMT1 promoted leukemia cell growth in an FLT3 methylation-dependent manner. Moreover, the effects of FLT3-ITD methylation in AML cells were partially due to cross talk with FLT3-ITD phosphorylation at tyrosine 969. Importantly, FLT3 methylation persisted in FLT3-ITD AML cells following kinase inhibition, indicating that methylation occurs independently of kinase activity. Finally, in patient-derived xenograft and murine AML models, combined administration of AC220 with a type I PRMT inhibitor (MS023) enhanced elimination of FLT3-ITD AML cells relative to AC220 treatment alone. Our study demonstrates that PRMT1-mediated FLT3 methylation promotes AML maintenance and suggests that combining PRMT1 inhibition with FLT3 TKI treatment could be a promising approach to eliminate FLT3-ITD AML cells.
FLT3 内部串联重复(FLT3-ITD)突变患者的存在与急性髓系白血病(AML)的不良临床结果相关。FLT3 酪氨酸激酶抑制剂(TKI)虽然在激酶消融方面有效,但不能消除原始的 FLT3-ITD 白血病细胞,这些细胞是复发的潜在来源。因此,了解导致 FLT3-ITD AML 细胞持续存在的机制对于设计未来的 AML 治疗方法至关重要。在这里,我们表明,与正常造血细胞相比,蛋白质精氨酸甲基转移酶 1(PRMT1)的表达在 AML 细胞中显著增加。全基因组分析、共免疫沉淀测定和 PRMT1 基因敲除小鼠研究表明,PRMT1 优先与 FLT3-ITD 合作,有助于 AML 的维持。PRMT1 的遗传或药理学抑制显著阻断了 FLT3-ITD AML 细胞的维持。从机制上讲,PRMT1 催化 FLT3-ITD 蛋白精氨酸 972/973 的甲基化,PRMT1 以 FLT3 甲基化依赖性的方式促进白血病细胞生长。此外,AML 细胞中 FLT3 甲基化的作用部分归因于与酪氨酸 969 处的 FLT3-ITD 磷酸化的交叉对话。重要的是,在激酶抑制后,FLT3-ITD AML 细胞中的 FLT3 甲基化仍然存在,表明甲基化独立于激酶活性发生。最后,在患者来源的异种移植和小鼠 AML 模型中,与单独使用 AC220 相比,联合使用 AC220 和 I 型 PRMT 抑制剂(MS023)增强了对 FLT3-ITD AML 细胞的消除。我们的研究表明,PRMT1 介导的 FLT3 甲基化促进 AML 的维持,并表明联合使用 PRMT1 抑制和 FLT3 TKI 治疗可能是消除 FLT3-ITD AML 细胞的一种有前途的方法。