Sun Xiaofan, Li Yue, Du Juan, Liu Fangshu, Wu Caiping, Xiao Weihao, Yu Guopan, Chen Xiaowei, Gale Robert Peter, Zeng Hui
Department of Hematology, The First Affiliated Hospital, Jinan University, Guangzhou, 510630, China.
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Nat Commun. 2025 Feb 4;16(1):1358. doi: 10.1038/s41467-025-56520-7.
Sphingolipid, ceramide for example, plays an essential role in regulating cancer cell death. Defects in the generation and metabolism of ceramide in cancer cells contribute to tumor cell survival and resistance to chemotherapy. Ceramide Transfer Protein (CERT) determines the ratio of ceramide and sphingomyelin in cells. Targeting CERT sensitizes solid cancer cells to chemotherapy. However, whether targeting CERT to induce ceramide accumulation thereby improving AML therapy efficiency remains elusive. Here, we show that knocking down CERT inhibits the growth and promotes the apoptosis of AML cells carrying FLT3-ITD mutation. Combining CERT inhibitor with FLT3 inhibitor exhibits synergistic effects on FLT3-ITD mutated acute myeloid leukemia (AML) cells. Additionally, co-treatment of HPA-12 and Crenolanib is effective in FLT3-ITD and FLT3-TKD AML patients. The synergistic effects are found to be mediated by the endoplasmic reticulum stress-GRP78/ATF6/CHOP axis and mitophagy. Our data provide an effective strategy to enhance the efficacy of FLT3 inhibitors in AML.
鞘脂,例如神经酰胺,在调节癌细胞死亡中起重要作用。癌细胞中神经酰胺的生成和代谢缺陷有助于肿瘤细胞存活和对化疗产生抗性。神经酰胺转运蛋白(CERT)决定细胞中神经酰胺和鞘磷脂的比例。靶向CERT可使实体癌细胞对化疗敏感。然而,靶向CERT以诱导神经酰胺积累从而提高急性髓系白血病(AML)治疗效率是否可行仍不清楚。在此,我们表明敲低CERT可抑制携带FLT3-ITD突变的AML细胞的生长并促进其凋亡。将CERT抑制剂与FLT3抑制剂联合使用对FLT3-ITD突变的急性髓系白血病(AML)细胞具有协同作用。此外,HPA-12和克伦洛尼联合治疗对FLT3-ITD和FLT3-TKD AML患者有效。发现协同作用是由内质网应激-GRP78/ATF6/CHOP轴和线粒体自噬介导的。我们的数据提供了一种提高FLT3抑制剂在AML中疗效的有效策略。