Longo G S, Gorlick R, Tong W P, Ercikan E, Bertino J R
Department of Molecular Pharmacology and Therapeutics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Blood. 1997 Aug 1;90(3):1241-5.
Previous work showed that acute myelocytic leukemia blasts accumulate less long chain polyglutamates of methotrexate (MTX) than acute lymphocytic leukemia blasts when incubated with this radiolabeled antifolate. This difference likely explains the increased sensitivity of lymphoid leukemias to short-term exposure of MTX as compared with myeloid leukemias. In this study, we examined the basis for differences between long chain MTX polyglutamate accumulation between different leukemia cell types using both leukemia cell lines and blasts freshly isolated from blood of leukemic patients. The major difference found between leukemia cells that accumulate long chain polyglutamates and those that do not were differences in Km values for the enzyme folylpolyglutamate synthetase. Km values did not change with partial purification of this enzyme, indicating that interfering substances in crude lysates were not responsible for this difference. We postulate that there may be differences in the properties of this enzyme related to tissue specific expression. In contrast to MTX, both Tomudex (Zeneca Pharmaceuticals, Wilmington, DE) and 1843U89, potent inhibitors of thymidylate synthetase, have low Kms for folylpolyglutamate synthetase, and polyglutamate forms of these inhibitors are accumulated to the same degree in both myeloid and lymphoid acute leukemia cells, paralleling the equivalent cytotoxicity found between myeloid and lymphoid leukemia cell lines. Based on these results, we believe a clinical trial of Tomudex in patients with acute myeloid leukemia is warranted.
先前的研究表明,与急性淋巴细胞白血病原始细胞相比,急性髓细胞白血病原始细胞在与这种放射性标记的抗叶酸剂孵育时,甲氨蝶呤(MTX)的长链聚谷氨酸积累较少。这种差异可能解释了与髓系白血病相比,淋巴系白血病对短期暴露于MTX的敏感性增加。在本研究中,我们使用白血病细胞系和从白血病患者血液中新鲜分离的原始细胞,研究了不同白血病细胞类型之间长链MTX聚谷氨酸积累差异的基础。在积累长链聚谷氨酸的白血病细胞和不积累的白血病细胞之间发现的主要差异在于叶酸聚谷氨酸合成酶的Km值不同。该酶部分纯化后Km值未发生变化,表明粗裂解物中的干扰物质并非造成这种差异的原因。我们推测,这种酶的性质可能存在与组织特异性表达相关的差异。与MTX不同,胸苷酸合成酶的强效抑制剂Tomudex(阿斯利康制药公司,特拉华州威尔明顿)和1843U89对叶酸聚谷氨酸合成酶的Km值较低,并且这些抑制剂的聚谷氨酸形式在髓系和淋巴系急性白血病细胞中的积累程度相同,这与髓系和淋巴系白血病细胞系之间等效的细胞毒性情况相似。基于这些结果,我们认为有必要对Tomudex在急性髓细胞白血病患者中进行临床试验。