McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
J Clin Invest. 2023 Dec 15;133(24):e173116. doi: 10.1172/JCI173116.
We previously demonstrated that a subset of acute myeloid leukemia (AML) patients with concurrent RAS pathway and TP53 mutations have an extremely poor prognosis and that most of these TP53 mutations are missense mutations. Here, we report that, in contrast to the mixed AML and T cell malignancy that developed in NrasG12D/+ p53-/- (NP-/-) mice, NrasG12D/+ p53R172H/+ (NPmut) mice rapidly developed inflammation-associated AML. Under the inflammatory conditions, NPmut hematopoietic stem and progenitor cells (HSPCs) displayed imbalanced myelopoiesis and lymphopoiesis and mostly normal cell proliferation despite MEK/ERK hyperactivation. RNA-Seq analysis revealed that oncogenic NRAS signaling and mutant p53 synergized to establish an NPmut-AML transcriptome distinct from that of NP-/- cells. The NPmut-AML transcriptome showed GATA2 downregulation and elevated the expression of inflammatory genes, including those linked to NF-κB signaling. NF-κB was also upregulated in human NRAS TP53 AML. Exogenous expression of GATA2 in human NPmut KY821 AML cells downregulated inflammatory gene expression. Mouse and human NPmut AML cells were sensitive to MEK and NF-κB inhibition in vitro. The proteasome inhibitor bortezomib stabilized the NF-κB-inhibitory protein IκBα, reduced inflammatory gene expression, and potentiated the survival benefit of a MEK inhibitor in NPmut mice. Our study demonstrates that a p53 structural mutant synergized with oncogenic NRAS to promote AML through mechanisms distinct from p53 loss.
我们之前的研究表明,一部分同时存在 RAS 通路和 TP53 突变的急性髓系白血病(AML)患者预后极差,而且这些 TP53 突变大多数为错义突变。在这里,我们报告称,与在 NrasG12D/+ p53-/-(NP-/-)小鼠中发展的混合 AML 和 T 细胞恶性肿瘤不同,NrasG12D/+ p53R172H/+(NPmut)小鼠迅速发展为炎症相关的 AML。在炎症条件下,NPmut 造血干细胞和祖细胞(HSPCs)表现出失衡的髓系和淋系造血,尽管 MEK/ERK 过度激活,但细胞增殖大多正常。RNA-Seq 分析显示,致癌性 NRAS 信号和突变型 p53 协同作用,建立了与 NP-/-细胞不同的 NPmut-AML 转录组。NPmut-AML 转录组显示 GATA2 下调,并上调了炎症基因的表达,包括与 NF-κB 信号相关的基因。人类 NRAS TP53 AML 中 NF-κB 也被上调。在人类 NPmut KY821 AML 细胞中外源性表达 GATA2 下调了炎症基因的表达。在体外,鼠和人 NPmut AML 细胞对 MEK 和 NF-κB 抑制敏感。蛋白酶体抑制剂硼替佐米稳定了 NF-κB 抑制蛋白 IκBα,降低了炎症基因的表达,并增强了 MEK 抑制剂在 NPmut 小鼠中的生存获益。我们的研究表明,一种 p53 结构突变体与致癌性 NRAS 协同作用,通过不同于 p53 缺失的机制促进 AML 的发生。