Travaglini S, Gurnari C, Antonelli S, Silvestrini G, Noguera N I, Ottone T, Voso M T
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, United States.
Front Cell Dev Biol. 2022 Jul 22;10:930205. doi: 10.3389/fcell.2022.930205. eCollection 2022.
Data derived from high-throughput sequencing technologies have allowed a deeper understanding of the molecular landscape of Acute Myeloid Leukemia (AML), paving the way for the development of novel therapeutic options, with a higher efficacy and a lower toxicity than conventional chemotherapy. In the antileukemia drug development scenario, ascorbic acid, a natural compound also known as Vitamin C, has emerged for its potential anti-proliferative and pro-apoptotic activities on leukemic cells. However, the role of ascorbic acid (vitamin C) in the treatment of AML has been debated for decades. Mechanistic insight into its role in many biological processes and, especially, in epigenetic regulation has provided the rationale for the use of this agent as a novel anti-leukemia therapy in AML. Acting as a co-factor for 2-oxoglutarate-dependent dioxygenases (2-OGDDs), ascorbic acid is involved in the epigenetic regulations through the control of TET (ten-eleven translocation) enzymes, epigenetic master regulators with a critical role in aberrant hematopoiesis and leukemogenesis. In line with this discovery, great interest has been emerging for the clinical testing of this drug targeting leukemia epigenome. Besides its role in epigenetics, ascorbic acid is also a pivotal regulator of many physiological processes in human, particularly in the antioxidant cellular response, being able to scavenge reactive oxygen species (ROS) to prevent DNA damage and other effects involved in cancer transformation. Thus, for this wide spectrum of biological activities, ascorbic acid possesses some pharmacologic properties attractive for anti-leukemia therapy. The present review outlines the evidence and mechanism of ascorbic acid in leukemogenesis and its therapeutic potential in AML. With the growing evidence derived from the literature on situations in which the use of ascorbate may be beneficial and , we will finally discuss how these insights could be included into the rational design of future clinical trials.
来自高通量测序技术的数据使人们对急性髓系白血病(AML)的分子格局有了更深入的了解,为开发新的治疗方案铺平了道路,这些方案比传统化疗具有更高的疗效和更低的毒性。在抗白血病药物开发领域,抗坏血酸,一种也被称为维生素C的天然化合物,因其对白血病细胞潜在的抗增殖和促凋亡活性而受到关注。然而,抗坏血酸(维生素C)在AML治疗中的作用已经争论了几十年。对其在许多生物过程中,特别是在表观遗传调控中的作用的机制性洞察,为将这种药物用作AML的新型抗白血病疗法提供了理论依据。作为2-氧戊二酸依赖性双加氧酶(2-OGDDs)的辅助因子,抗坏血酸通过控制TET(十一-易位)酶参与表观遗传调控,TET酶是表观遗传的主要调节因子,在异常造血和白血病发生中起关键作用。与此发现一致,针对这种靶向白血病表观基因组的药物进行临床试验的兴趣日益浓厚。除了其在表观遗传学中的作用外,抗坏血酸也是人类许多生理过程的关键调节因子,特别是在抗氧化细胞反应中,能够清除活性氧(ROS)以防止DNA损伤和其他与癌症转化有关的影响。因此,由于这种广泛的生物活性,抗坏血酸具有一些对抗白血病治疗有吸引力的药理特性。本综述概述了抗坏血酸在白血病发生中的证据和机制及其在AML中的治疗潜力。随着越来越多来自文献的证据表明使用抗坏血酸盐可能有益,我们最终将讨论如何将这些见解纳入未来临床试验的合理设计中。