Tabe Yoko
Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine.
Rinsho Ketsueki. 2024;65(9):961-966. doi: 10.11406/rinketsu.65.961.
Mitochondrial metabolic dependencies characteristic of acute myeloid leukemia (AML) have recently been identified, demonstrating that metabolic enzymes regulate AML gene expression and control cell differentiation and stemness. These mitochondrial metabolic adaptations occur independently of underlying genomic abnormalities and contribute to chemotherapy resistance and relapse. Mitochondrial alterations also lead to metabolic vulnerability of AML cells, whose metabolism is characterized by dependence on oxidative phosphorylation, fatty acid oxidation, reactive oxygen species (ROS) production, and mitochondrial dynamics. Currently, mitochondrial properties of AML cells and leukemia stem cells are being investigated, focusing on metabolism, signal transduction, mitochondrial respiration, ROS generation, and mitophagy. In addition, mitochondria-targeted agents have shown promising results in clinical trials. This paper outlines recent findings from preclinical and clinical trials on the utility of agents targeting mitochondria-related molecules and metabolic pathways and their efficacy in combination with existing chemotherapies.
急性髓系白血病(AML)特有的线粒体代谢依赖性最近已被确定,这表明代谢酶调节AML基因表达并控制细胞分化和干性。这些线粒体代谢适应独立于潜在的基因组异常而发生,并导致化疗耐药和复发。线粒体改变还导致AML细胞的代谢脆弱性,其代谢特征是依赖氧化磷酸化、脂肪酸氧化、活性氧(ROS)产生和线粒体动力学。目前,正在研究AML细胞和白血病干细胞的线粒体特性,重点是代谢、信号转导、线粒体呼吸、ROS生成和线粒体自噬。此外,线粒体靶向药物在临床试验中已显示出有前景的结果。本文概述了针对线粒体相关分子和代谢途径的药物的效用及其与现有化疗联合使用的疗效的临床前和临床试验的最新发现。