XIAP在胰腺癌化疗耐药及治疗中的研究进展

X连锁的凋亡抑制蛋白(X-linked inhibitor of apoptosis protein,XIAP)是凋亡抑制蛋白家族中的一员,具有抗凋亡作用.研究发现XIAP在胰腺癌中呈高表达,并且能诱导胰腺癌细胞及组织对化疗耐药.通过在基因水平及蛋白水平降低XIAP的表达对胰腺癌的治疗具有重要意义.AEG 35156是针对XIAP的反义寡核苷酸分子,能够抑制胰腺癌细胞及组织生长.RNAi能够稳定下调胰腺癌细胞中XIAP水平,从而加强TRAIL诱导的细胞凋亡,并能提高胰腺癌细胞对化疗的敏感性.针对XIAP的小分化合物能够抑制XIAP的功能,释放被XIAP抑制的凋亡起始和效应分子以及XIAP抑制的其他促凋亡蛋白,提高多种肿瘤细胞的凋亡指数及对放化疗的敏感性.XAFl能抑制XIAP的抗凋亡作用.本文就XIAP在胰腺癌化疗耐药及治疗中的研究进展做一综述.     

急性白血病细胞中抗凋亡蛋白bcl－2及其mRNA的表达

采用免疫组织化学与原位杂交方法检测了２５例急性髓系或淋巴系白血病骨髓活检组织及６种白血病细胞株中ｂｃｌ－２蛋白及其ｍＲＮＡ水平。结果２１例白血病标本中存在ｂｃｌ－２蛋白及其ｍＲＮＡ的一致性高表达;５种白血病细胞株（ＣＥＭ、Ｒａｊｉ、ＨＬ－６０、Ｕ９３７及Ｋ５６２）均能表达一定水平的ｂｃｌ－２蛋白及其ｍＲＮＡ（Ｍｏｌｔ－４例外）。提示ｂｃｌ－２基因的功能状态与淋巴造血系统肿瘤密切相关。     

氟苯达唑对人急性髓系白血病HL-60细胞的增殖抑制作用研究

目的:研究氟苯达唑对人急性髓系白血病HL-60细胞增殖的抑制作用,明确氟苯达唑对HL-60细胞周期,凋亡发生的作用机制。方法:噻唑蓝法(MTT)检测氟苯达唑对人急性髓系白血病HL-60细胞的生长抑制作用,流式细胞术检测氟苯达唑对HL-60细胞周期,DNA片段化的影响,免疫印迹法检测Caspase, Raf, Bcl-2家族蛋白表达。结果:氟苯达唑抑制人急性髓系白血病HL-60细胞生长,HL-60细胞G2/M期增加,与阴性对照组相比,在一定的剂量和时间内,差别具有显著统计学意义;DNA片段化上升,0.25,0.5,1μM组与对照组相比差别具有显著统计学意义,促使Cleaved PARP,Cleaved-caspase 3,Cleaved-caspase 9蛋白表达量趋势增加;Bag-1和Bcl-2蛋白表达量降低;b-raf,c-raf磷酸化蛋白表达水平逐渐降低。结论:氟苯达唑通过诱导HL-60细胞阻滞于G2/M期,增加DNA片段化水平,激活Caspase, Raf, Bcl-2家族介导的凋亡相关通路抑制人急性髓系白血病HL-60细胞增殖,诱导人急性髓系白血病HL-60细胞发生凋亡而发挥抗肿瘤作用。     

SHIP1在急性髓细胞白血病患者中的表达及对人白血病细胞凋亡的影响研究

目的:探讨含SH2结构域的肌醇1(SHIP1)在急性髓细胞白血病患者中的表达及对人白血病细胞凋亡的影响。方法:采用Western blot检测收集的急性髓细胞白血病患者骨髓中SHIP1的表达。人白血病细胞U937转染SHIP1过表达载体(pEGFP-SHIP1组)及对照空载体(pEGFP组),同时设置对照组,对照组细胞不转染载体,其他步骤同pEGFP-SHIP1组和pEGFP组。流式细胞仪检测48 h的细胞凋亡情况,Western blot检测48 h细胞中SHIP1、Bcl-2、Bax、Akt、p-Akt的表达。结果:急性髓细胞白血病患者骨髓中SHIP1表达明显低于正常人(P0.05)。pEGFP-SHIP1组细胞中SHIP1、Bax表达和凋亡率均明显高于pEGFP组及对照组(P0.01),Bcl-2、p-Akt表达均明显低于对照组(P0.01)。结论:SHIP1在急性髓细胞白血病患者骨髓中表达下调,其可能通过Akt信号促进人白血病细胞凋亡。     

Nestin蛋白在白血病及其他恶性血液肿瘤中的研究进展

Nestin蛋白为第Ⅵ类中间丝蛋白,最初被认为是神经干细胞标志物,表达于神经干/祖细胞、部分成体组织中的前体细胞及细胞修复阶段,还在多种肿瘤细胞中表达,并和P53、Wnt/β-catenin、AktGSK3β-Rb等肿瘤细胞增殖调控信号通路相关。Nestin蛋白在白血病及其他恶性血液肿瘤中异常表达,并且参与急性淋巴白血病(acute lymphoma leukemia,ALL)细胞抗药性niche的形成,以及急性髓系白血病细胞对骨髓微环境的损伤。目前,临床阶段已在白血病和多发性骨髓瘤患者中检测到nestin蛋白表达,其可以作为区分髓系和淋巴系白血病的标志物。在ALL中,敲除nestin可破坏白血病抗药性niche,这可能作为一种治疗ALL的新方法。     

乳腺恶性血液病的病理类型、临床特点及生存分析

目的:探讨乳腺恶性血液病的病理分型、患者的临床特征及预后。方法:回顾性分析2014年1月至2019年1月空军军医大学西京医院收治的33例乳腺恶性血液病患者的病理分型、临床特征及预后。结果:33例患者中,32例为女性,1例为男性,平均年龄为45.5岁(12-78岁)。经病理确诊29例(29/33,87.9%)为非霍奇金淋巴瘤,其中弥漫大B细胞淋巴瘤(18/29,62.1%)最为常见,其次是NK/T细胞淋巴瘤(3/29,10.3%),B淋巴母细胞白血病/淋巴瘤(2/29,6.8%),而伯基特淋巴瘤、滤泡淋巴瘤、原发皮肤间变大细胞淋巴瘤各1例(1/29,3.4%),其余3例未进一步分型。此外,1例(1/33,3.0%)霍奇金淋巴瘤,3例(3/33,9.1%)急性白血病复发累及乳腺。原发性乳腺恶性血液病为19例(57.6%),继发性为14例(42.4%),病变主要累及右侧乳腺(18例,54.5%),其次为左侧(10例,30.3%),双侧均累及的为少数(5例,15.2%)。19例原发性乳腺恶性血液病均为淋巴瘤,与14例继发性乳腺恶性血液病相比,其血小板计数明显升高(P=0.004),β2-MG显著降低(P=0.049),B症状少(P=0.017),Ann Arbor分期主要为Ⅰ-Ⅱ期(P<0.01),骨髓受累少(P<0.01)等特点。生存分析提示原发性乳腺恶性血液病患者比继发性患者生存期更长(HR=9.846,P=0.002)。恶性血液病累及骨髓可导致生存期显著缩短(HR=6.434,P<0.01)。结论:乳腺恶性血液病患者以中年女性为主,原发性乳腺恶性血液病比继发性发病率高(分别为57.5%和42.5%),最常见的病理类型为弥漫大B细胞淋巴瘤,病变主要累及右侧乳腺。与继发性乳腺恶性血液病相比,原发性乳腺恶性血液病患者具有血小板计数相对更高,β2-MG水平更低,往往不伴B症状,Ann Arbor分期主要为Ⅰ-Ⅱ期,骨髓不受累,且生存期显著延长等特点。此外,恶性血液病累及骨髓提示预后不良。     

干扰PML对人髓系白血病THP-1细胞增殖和凋亡的影响及机制探讨

早幼粒白血病(promyelocytic leukemia,PML)基因与维甲酸受体α(retinoic acid receptorα,RARα)基因形成PML-RARα融合基因是急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)发生的分子基础,而PML在除APL外的其他髓系白血病亚型中的作用研究少见报道。为探讨PML在非APL的髓系白血病恶性表型中的调控作用及潜在机制,该文首先通过q PCR和Western blot检测了5株非APL来源的髓系白血病细胞中PML的表达水平。接着将靶向PML基因的sh RNA慢病毒(sh PML group)感染高表达PML的THP-1细胞;同时,设立未处理对照组(Mock group)和阴性对照组(Scramble group),嘌呤霉素筛选稳定表达sh PML的细胞株。q PCR和Western blot检测sh RNA干扰效率;CCK-8检测细胞体外增殖活性,克隆形成实验检测细胞体外克隆形成能力;流式细胞术检测细胞凋亡率;Western blot检测凋亡相关蛋白质Bcl-2、Bax水平和AKT及下游靶分子Foxo3a磷酸化蛋白质水平的改变。结果显示,5株髓系白血病细胞中PML m RNA和蛋白质水平不同,其中以THP-1细胞中的PML表达水平较高。靶向PML基因的sh RNA慢病毒感染THP-1细胞后,PML m RNA和蛋白质水平均明显下降,提示成功构建稳定表达sh PML的THP-1细胞株。与Mock组和Scramble组相比,sh PML组的细胞增殖能力显著增强(P0.05),细胞凋亡率显著降低(P0.05);同时,抗凋亡蛋白Bcl-2水平升高、促凋亡蛋白Bax水平降低;此外,干扰PML表达可增加p AKT(S473)及下游靶分子p Foxo3a(S253)的蛋白质水平,而总AKT和Foxo3a的蛋白质水平未见明显变化。该研究的结果提示,PML基因可能通过调控AKT/Foxo3a信号通路活性抑制白血病的恶性表型,表明PML在不同白血病型别中发挥着不同的作用。     

急性白血病患者骨髓组织血管新生与Bcl-2蛋白关系的研究

目的：探讨急性白血病患者骨髓组织血管新生与Bcl-2蛋白的关系,为临床治疗白血病提供可靠的理论依据。方法：回顾性分析2007年3月～2011月6月我院收治的42例急性白血病患者和42例增生性贫血和疑为血液系统疾病的患者作为对照组的临床资料。结果：对照组患者骨髓组织中的微血管密度（MVD）、血管内皮生长因子（VEGF）及Bcl-2蛋白的表达水平均显著低于急性白血病患者,两组比较差异有极显著统计学意义（P〈0.01）。急性白血病患者骨髓组织中VEGF、MVD及Bcl-2蛋白之间,彼此两两呈正相关性。结论：Bcl-2蛋白的阳性表达在白血病的抗凋亡与血管新生方面,都发挥着重要的作用,通过对Bcl-2蛋白的研究,为临床治疗白血病提供了一条诊断、治疗白血病的新思路。     

急性胰腺炎大鼠腺泡细胞凋亡及X连锁凋亡抑制蛋白XIP的表达

目的:研究急性胰腺炎(AP)大鼠腺泡细胞凋亡,X连锁凋亡抑制蛋白(XIAP)的表达及其与疾病严重程度的关系。方法:通过胰胆管逆行注射不同浓度的牛黄胆酸钠,制备急性水肿型胰腺炎(AEP)和急性坏死性胰腺炎(ANP)大鼠模型,同时设假手术(SO)组为对照。收集各模型组3,6和12h标本,对胰腺组织进行病理学评分,并测定血清淀粉酶和腹水量;用TUNEL染色检测胰腺腺泡细胞的凋亡,分别RT-PCR和Western Blotting法测定大鼠胰腺组织XIAP mRNA及蛋白的表达。结果:成功建立了大鼠AP模型。同SO组相比,ANP和AEP组胰腺组织在各时间点均有不同程度的病理损害,血清淀粉酶也显著增高(P均<0.01)。且ANP组显著高于AEP组(P均<0.01)。造模成功3h后,各组大鼠胰腺腺泡细胞均出现少量凋亡,但ANP和AEP组凋亡显著多于SO组(P<0.05),ANP和AEP组间没有差别(P>0.05)。同SO组相比,ANP和AEP组在6h和12h时凋亡均增多(P<0.01),且AEP组显著高于ANP组(P<0.01)。造模成功3h后,各模型组XIAP mRNA表达没有差异(P>0.05);6h和12h时AEP组XIAP mRNA表达明显下降,而ANP组明显升高,两组间差异有显著性(P<0.01)。XIAP蛋白表达水平与mRNA表达水平相一致。结论:急性胰腺炎大鼠胰腺组织XIAP表达与腺泡细胞凋亡情况相反,且与疾病严重程度平行。XIAP可能负性调控AP大鼠胰腺腺泡细胞的凋亡。     

XIAP及survivin 在原发性肝细胞癌组织中的表达及其相关性研究

目的：探讨X 连锁凋亡抑制蛋白（XIAP）和survivin 在原发性肝细胞癌中的表达及两者的相关性。方法：选取本院收治的60 例原发性肝细胞癌患者,应用免疫组织化学染色的方法对肝癌组织及癌旁组织中的XIAP及survivin 的表达进行检测。结果：经 比较,肝癌组织中XAIP 及survivin 的阳性率均显著高于癌旁组织,差异有统计学意义。XIAP 和survivin 的表达强度与肿瘤的大 小无关,但随肿瘤的分化程度的降低而升高,且不同分化程度之间差异有统计学意义;XIAP 和survivin 存在正相关关系。结论： XIAP与Survivin 在肿瘤组织中的高表达在促进肿瘤发生、增殖、转移以及耐药,并且能够降低肿瘤的分化程度,增加肝癌的恶性 程度。此外,两者可能存在协同作用,但两者的相关性及作用机制仍需进一步探讨。     

Inhibitors of apoptosis proteins (IAPs) as potential molecular targets for therapy of hematological malignancies

Apoptosis, a programmed cell death, plays a key role in the regulation of tissue homeostasis. However, impairment of its regulation may promote formation and progression of malignancy. An important part of the apoptotic machinery are the inhibitor of apoptosis protein (IAP) family, regulating caspase activity, cell division or cell survival pathways through binding to their baculovirus AIP repeat (BIR) domains and/or by their ubiquitin-ligase RING zinc finger (RZF) activity. The following IAPs have been described so far: NAIP (neuronal apoptosis inhibitory protein; BIRC1), cIAP1 and cIAP2 (cellular inhibitor of apoptosis 1 and 2; BIRC2 and BIRC3, respectively), XIAP (X-chromosome binding IAP; BIRC4), survivin (BIRC5), BRUCE (Apollon; BIRC6), livin (BIRC7) and Ts-IAP (testis-specific IAP; BIRC8). Several studies suggested a potential contribution of IAPs to oncogenesis and resistance to anti-tumor treatment. Increased IAP expression was found in variety of human cancers, including hematological malignancies, such as leukemias and B-cell lymphomas. A correlation between the progression of those diseases and high levels of survivin or XIAP has been reported. Overexpression of XIAP in acute myeloid leukemia or survivin in acute lymphoblastic leukemia and diffuse large B-cell lymphoma have been indicated as an unfavorable prognostic factors. Elevated cellular levels of cIAP1, cIAP2, XIAP and survivin correlated with a progressive course of chronic lymphocytic leukemia. Thus, targeting IAPs with small-molecule inhibitors by their antisense approaches or natural IAP antagonist mimetics, may be an attractive strategy of anti-cancer treatment. Such agents can either directly induce apoptosis of tumor cells or sensitize them to other cytotoxic agents, hence overcoming drug-resistance. This review demonstrates the current knowledge on IAP molecular biology, as well as the mechanisms of action and the development of IAP-targeting agents for treatment of hematological malignancies.     

Nucleolar immunofluorescence in human hematological malignancies.

Rabbit antibodies to the nuclear Tris extract of HeLa cells which have been shown by the indirect immunofluorescence technique to localize in nucleoli of a variety of human malignant tumors but not in a number of nontumor tissues also produced bright fluorescence in nucleoli of tumor cells in several hematological malignancies. The tumors studied included Hodgkins malignant lymphoma, non-Hodgkins malignant lymphoma, acute myeloid and acute myelomonocytic leukemia, chronic lymphatic and chronic myeloid leukemia. In contrast, none of the corresponding normal cell lines in the bone marrow exhibited bright nucleolar fluorescence. In addition, neither the cells of patients with acute infectious mononucleosis nor lymphoid hyperplasia exhibited bright nucleolar fluorescence. These studies suggest that antibodies to HeLa cell nucleolar antigens may be useful in immunodiagnosis of human malignancies.     

Granulocytic sarcoma of the small intestine in a child without leukemia: report of a case with cytologic findings and immunophenotyping pitfalls

BACKGROUND: Granulocytic sarcoma is a rare tumor that is often misdiagnosed as it can be confused with lymphoma. It has unique cytologic features independent of the site of the tumor and can be identified on fine needle aspiration. CASE: A 13-year old girl without a relevant medical history presented with an abdominal mass. Investigation revealed a tumor infiltrate in the small intestine and mesentery. The fine needle aspirate contained myeloid blasts with cytoplasmic granules. Immunohistochemistry on subsequent biopsy confirmed myeloid differentiation. There was no evidence of blood or bone marrow involvement suggestive of acute leukemia. The patient was well after 27 months of follow-up. CONCLUSION: Granulocytic sarcoma should be included in the differential diagnosis of any small intestine infiltrate. Cytomorphology is accurate and efficient for the diagnosis in conjunction with complete immunocytochemistry study.     

Antibody-producing human-human hybridomas. III. Derivation and characterization of two antibodies with specificity for human myeloid cells

Peripheral blood mononuclear cells from a patient with acute myeloid leukemia (AML) and spleen cells from a patient with chronic myeloid leukemia (CML) were fused with HAT-sensitive human B lymphoma cells (RH-L4) in attempts to generate human monoclonal antibodies (Mab) against antigens with high specificity for myeloid leukemia cells. Forty-seven of 246 hybridomas secreted Ig that bound to AML cell surface constituents, as determined by FACS analysis of viable cells that were FITC-stained with the human Mab as the first-step reagent and FITC-conjugated rabbit anti-human Ig as second-step. Two of the 47 human Mab (one from each patient and designated AML-19 and CML-20, respectively) bound to both autologous and allogeneic myeloid leukemia cells. No significant binding was observed to cell surface constituents on human bone marrow cells, granulocytes, lymphocytes, erythrocytes, thymocytes, monocytes, lymphoblastic leukemia cells, fibroblasts, malignant B and T lymphocytic cell lines, and murine bone marrow cells. Both human Mab were IgG and were cytotoxic to myeloid leukemia cells in the presence of complement. About 70% of peripheral blood cell samples from 46 AML patients contained AML-19- and CML-20-positive cells, but the reactivity pattern had no correlation to the morphologic FAB classification of the samples. The promyelocytic HL60 cell line and the K562 cell line reacted with the two antibodies. Dot blot analysis of binding of AML-19 and CML-20 to cellular extracts immobilized on nitrocellulose paper showed that both human Mab in this assay also reacted with normal bone marrow cells. This was supported by microscopic immunofluorescence because both human Mab stained intracytoplasmatic structures in normal bone marrow cells, but both intracytoplasmatic and cell surface components stained in myeloid leukemia cells. Moreover, immunoblotting demonstrated that both human Mab in leukemia cells reacted with two cellular proteins with Mr approximately 14,500 and 18,000, and in normal bone marrow cells with a molecule with Mr approximately 20,000. Immunoprecipitation of cell membrane molecules with both the AML-19 and CML-20 antibody precipitated from leukemic cells only the molecule with Mr approximately 18,000 and no components from normal bone marrow cells. It is concluded that myeloid leukemogenesis may result in generation of cell surface expression of either new or abnormally processed molecules that are immunogenic in the autochthonous host. These molecules may also be useful as markers in diagnosis of myeloid leukemia.     

In vitro culture studies of granulocyte/macrophage and erythroid progenitor cells in lymphoproliferative disorders

Granulocyte/macrophage progenitor cells (CFU-GM) and erythroid progenitor cells (BFU-E) have been assayed in peripheral blood (PB) and/or bone marrow (BM) from 12 patients with acute lymphocytic leukemia (ALL), 16 patients with chronic lymphocytic leukemia (CLL) and 31 patients with various forms of non-Hodgkin lymphoma (NHL) without BM involvement. Progenitor cell growth in PB and BM from the NHL patients did not differ statistically from controls (p greater than 0.1). CFU-GM and BFU-E per ml PB were markedly increased in ALL and CLL patients (p less than 0.001) while CFU-GM and BFU-E per plated BM cells from these patients were severely depressed (p less than 0.001). Lymphoblasts from one ALL patient failed to inhibit CFU-GM and BFU-E-derived colony growth from control PB mononuclear cells. The high levels of circulating progenitor cells in ALL and CLL patients clearly distinguish them from other cytopenic hematological malignancies, in which decreased progenitor cell levels have been demonstrated previously (acute myeloid leukemia, hairy cell leukemia). The cause of this finding and its pathophysiological implication still remains to be established.     

Inhibition of protein kinase CK2 with the clinical-grade small ATP-competitive compound CX-4945 or by RNA interference unveils its role in acute myeloid leukemia cell survival,p53-dependent apoptosis and daunorubicin-induced cytotoxicity

Background

The involvement of protein kinase CK2 in sustaining cancer cell survival could have implications also in the resistance to conventional and unconventional therapies. Moreover, CK2 role in blood tumors is rapidly emerging and this kinase has been recognized as a potential therapeutic target. Phase I clinical trials with the oral small ATP-competitive CK2 inhibitor CX-4945 are currently ongoing in solid tumors and multiple myeloma.

Methods

We have analyzed the expression of CK2 in acute myeloid leukemia and its function in cell growth and in the response to the chemotherapeutic agent daunorubicin We employed acute myeloid leukemia cell lines and primary blasts from patients grouped according to the European LeukemiaNet risk classification. Cell survival, apoptosis and sensitivity to daunorubicin were assessed by different means. p53-dependent CK2-inhibition-induced apoptosis was investigated in p53 wild-type and mutant cells.

Results

CK2α was found highly expressed in the majority of samples across the different acute myeloid leukemia prognostic subgroups as compared to normal CD34⁺ hematopoietic and bone marrow cells. Inhibition of CK2 with CX-4945, K27 or siRNAs caused a p53-dependent acute myeloid leukemia cell apoptosis. CK2 inhibition was associated with a synergistic increase of the cytotoxic effects of daunorubicin. Baseline and daunorubicin-induced STAT3 activation was hampered upon CK2 blockade.

Conclusions

These results suggest that CK2 is over expressed across the different acute myeloid leukemia subsets and acts as an important regulator of acute myeloid leukemia cell survival. CK2 negative regulation of the protein levels of tumor suppressor p53 and activation of the STAT3 anti-apoptotic pathway might antagonize apoptosis and could be involved in acute myeloid leukemia cell resistance to daunorubicin.