Xu Guilin, Wang Feng, Chen Ming, Gao Wenhui, Liu Ying, Zhu Jiayan, Wang Churan, Jiang Huimin, Li Yunxuan, Zhang Peitao, Yuan Jian, Zhang Tingting, Zhao Chenxi, Wang Lining, Wang Ling, Jiang Jieling, Cao Wenbin, Zhang Zhuan, Fu Haigen, Dong Ting, Hu Jiong, Li Ke
Shanghai Institute of Hematology, Blood and Marrow Transplantation Center, Collaborative Innovation Center of Hematology, Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
State Key Laboratory of Bioactive Substance and Function of Natural Medicines, NHC Key Laboratory of Biotechnology of Antibiotics, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.
Leukemia. 2025 Sep 2. doi: 10.1038/s41375-025-02749-6.
Tyrosine kinase inhibitors (TKIs) only partially inhibit the growth of Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia (Ph B-ALL) cells, and often lead to rapid relapse. Therefore, it is essential to elucidate the mechanisms of resistance and develop novel treatment strategies. Histone deacetylases (HDACs) are often dysregulated in hematological malignancies, and many HDAC inhibitors have shown potent antitumor activities. In this study, we found that HDAC8 was highly expressed in Ph B-ALL patient samples upon TKI treatment. HDAC8 inhibition significantly increased TKI-mediated elimination of leukemia cells and decreased their ability to initiate leukemia. Using two mouse models, we demonstrated that TKIs in combination with targeting HDAC8 effectively inhibited leukemia progression and reduced the frequencies of stem cells. Mechanistically, HDAC8 deacetylated hypoxia inducible factor-1α (HIF-1α) at lysine 19/21, leading to a reduction in PHD2-mediated hydroxylation and subsequent pVHL-mediated ubiquitination, which slowed the degradation of HIF-1α. HIF-1α inhibition induced apoptosis and decreased the initiating capacity of leukemia cells. Importantly, in a Ph B-ALL patient-derived xenograft model, targeting HDAC8 or HIF-1α in combination with TKIs significantly inhibited leukemia progression. In conclusion, our study revealed that targeting HDAC8/HIF-1α in combination with TKIs could be a promising strategy for treating Ph B-ALL.
酪氨酸激酶抑制剂(TKIs)只能部分抑制费城染色体阳性B细胞急性淋巴细胞白血病(Ph B-ALL)细胞的生长,并且常常导致快速复发。因此,阐明耐药机制并开发新的治疗策略至关重要。组蛋白去乙酰化酶(HDACs)在血液系统恶性肿瘤中常常失调,许多HDAC抑制剂已显示出强大的抗肿瘤活性。在本研究中,我们发现HDAC8在接受TKI治疗的Ph B-ALL患者样本中高表达。抑制HDAC8可显著增加TKI介导的白血病细胞清除,并降低其引发白血病的能力。使用两种小鼠模型,我们证明TKIs与靶向HDAC8联合使用可有效抑制白血病进展并降低干细胞频率。机制上,HDAC8使缺氧诱导因子-1α(HIF-1α)的赖氨酸19/21去乙酰化,导致PHD2介导的羟基化减少以及随后pVHL介导的泛素化减少,从而减缓了HIF-1α的降解。抑制HIF-1α可诱导细胞凋亡并降低白血病细胞的起始能力。重要的是,在一个源自Ph B-ALL患者的异种移植模型中,靶向HDAC8或HIF-1α与TKIs联合使用可显著抑制白血病进展。总之,我们的研究表明,靶向HDAC8/HIF-1α与TKIs联合使用可能是治疗Ph B-ALL的一种有前景的策略。
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