Silic-Benussi Micol, Sharova Evgenyia, Ciccarese Francesco, Cavallari Ilaria, Raimondi Vittoria, Urso Loredana, Corradin Alberto, Kotler Harel, Scattolin Gloria, Buldini Barbara, Francescato Samuela, Basso Giuseppe, Minuzzo Sonia A, Indraccolo Stefano, D'Agostino Donna M, Ciminale Vincenzo
Veneto Institute of Oncology IOV - IRCCS, Padova, Italy.
Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy.
Redox Biol. 2022 May;51:102268. doi: 10.1016/j.redox.2022.102268. Epub 2022 Feb 24.
mTOR activation is a hallmark of T-cell acute lymphoblastic leukemia (T-ALL) and is associated with resistance to glucocorticoid (GC)-based chemotherapy. We previously showed that altering redox homeostasis primes T-ALL cells to GC-induced apoptosis. Here we investigated the connection between the mTOR pathway and redox homeostasis using pharmacological inhibitors and gene silencing. In vitro studies performed on T-ALL cell lines and CG-resistant patient-derived T-ALL xenograft (PDX) cells showed that the mTOR inhibitor everolimus increased reactive oxygen species (ROS) levels, augmented lipid peroxidation, and activated the ROS-controlled transcription factor NRF2. These effects were accompanied by a decrease in the levels of NADPH and of glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), which is a major source of cytosolic NADPH needed for maintaining the cellular ROS-scavenging capacity. The mTOR inhibitor everolimus induced mitochondrial inner membrane depolarization and dose-dependent apoptosis of T-ALL cells, but did not kill normal T-cells. Importantly, the combination of everolimus and the GC dexamethasone had a synergistic effect on killing T-ALL cells. The effects of mTOR inhibition were blunted by ROS scavengers and phenocopied by siRNA-mediated G6PD silencing. In vivo studies of NOD/SCID mice inoculated with refractory T-ALL PDX demonstrated that everolimus overcame dexamethasone resistance in conditions of high tumor burden that mimicked the clinical setting of acute leukemia. These findings provide insight into the crosstalk between mTOR and ROS homeostasis in T-ALL cells and furnish mechanistic evidence to support the combination of glucocorticoids with mTOR inhibitors as a therapeutic avenue for treating refractory T-ALL.
mTOR激活是T细胞急性淋巴细胞白血病(T-ALL)的一个标志,并且与对基于糖皮质激素(GC)的化疗耐药相关。我们之前表明,改变氧化还原稳态会使T-ALL细胞对GC诱导的凋亡敏感。在此,我们使用药理学抑制剂和基因沉默研究了mTOR通路与氧化还原稳态之间的联系。对T-ALL细胞系和GC耐药的患者来源的T-ALL异种移植(PDX)细胞进行的体外研究表明,mTOR抑制剂依维莫司增加了活性氧(ROS)水平,增强了脂质过氧化,并激活了ROS控制的转录因子NRF2。这些效应伴随着NADPH和葡萄糖-6-磷酸脱氢酶(G-6-PD)水平的降低,G-6-PD是磷酸戊糖途径(PPP)的限速酶,而PPP是维持细胞ROS清除能力所需的胞质NADPH的主要来源。mTOR抑制剂依维莫司诱导线粒体内膜去极化和T-ALL细胞的剂量依赖性凋亡,但不杀死正常T细胞。重要的是,依维莫司和GC地塞米松联合使用对杀死T-ALL细胞具有协同作用。ROS清除剂减弱了mTOR抑制的效应,而siRNA介导的G-6-PD沉默模拟了这些效应。对接种难治性T-ALL PDX的NOD/SCID小鼠进行的体内研究表明,在模拟急性白血病临床情况的高肿瘤负荷条件下,依维莫司克服了地塞米松耐药性。这些发现为深入了解T-ALL细胞中mTOR与ROS稳态之间的相互作用提供了线索,并提供了机制证据来支持将糖皮质激素与mTOR抑制剂联合使用作为治疗难治性T-ALL的治疗途径。