mTOR,A New Therapeutic Target in Acute Myeloid Leukemia

The mTOR (mammalian target of rapamycin) serine threonine kinase is involved in the regulation of the cell cycle, apoptosis and angiogenesis. mTOR inhibitors (rapamycin, or analogues such as CCI-779, RAD001, AP23573), which have been shown to have a potent anti-neoplastic effect in many solid tumour models, are now being used in clinical trials. Recent data have shown that the mTOR pathway is also aberrantly activated in hematological malignancies including acute myeloid leukemia (AML). This disease still has a bad prognosis and new therapeutic strategies are required. Rapamycin, used at low concentrations, induces the profound inhibition of AML cell clonogenic properties in 60% of cases while sparing their normal counterparts. Moreover, clinical responses have been achieved in poor-risk AML patients. In this review, we discuss the possible mechanisms of mTOR activation, the mechanisms involved in the inhibition of cell proliferation by rapamycin, the possible resistance mechanisms and ways of improving rapamycin efficacy in the context of AML.     

Identification of Two Critically Deleted Regions within Chromosome Segment 7q35-q36 in EVI1 Deregulated Myeloid Leukemia Cell Lines

Chromosomal rearrangements involving the EVI1 proto-oncogene are a recurrent finding in myeloid leukemias and are indicative of a poor prognosis. Rearrangements of the EVI1 locus are often associated with monosomy 7 or cytogenetic detectable deletions of part of 7q. As EVI1 overexpression alone is not sufficient to induce leukemia, loss of a 7q tumour suppressor gene might be a required cooperating event. To test this hypothesis, we performed high-resolution array comparative genomic hybridization analysis of twelve EVI1 overexpressing patients and three EVI1 deregulated cell lines to search for 7q submicroscopic deletions. This analysis lead to the delineation of two critical regions, one of 0.39 Mb on 7q35 containing the CNTNAP2 gene and one of 1.33 Mb on chromosome bands 7q35–q36 comprising nine genes in EVI1 deregulated cell lines. These findings open the way to further studies aimed at identifying the culprit EVI1 implicated tumour suppressor genes on 7q.     

成人急性髓性白血病SOCS-1基因及其甲基化的研究

目的：通过检测成人急性髓性白血病中SOCS．1基因表达水平及其甲基化水平,研究其在白血病发病中的作用。方法：运用甲基化特异性PCR（Methylation specificPCR,MSP）方法,对24例急性髓性白血病患者和4株白血病细胞株（Jurkat、Raji、U937、NALM17）,进行SOCS-1基因甲基化水平的研究;同时运用Real—timePCR法定量分析SOCS—1基因表达水平。以10例健康人为正常对照组。结果：24例成人急性髓性白血病患者中,15例有SOCS-1基因甲基化（62．5％）,而正常对照组无SOCS-1基因甲基化（0％）,二者有显著差异（P〈0．05）;SOCS-1基因甲基化组与无SOCS-1基因甲基化组相比较,其SOCS—1基因相对表达量明显减少（P口0．05）;与患者临床病理特征相结合比较,发现SOCS-1基因的甲基化与患者年龄、性别和病程阶段无相关。4株白血病细胞株中,Jurkat和U937表现有SOCS—1甲基化（50％）,Raji和NALM17无SOCS—1甲基化,前者SOCS-1基因表达量较后者也明显降低（P〈0．05）。结论：SOCS—1基因在成人急性髓性白血病中甲基化水平明显增高,且SOCS-1基因甲基化后表达水平受到抑制,提示SOCS-1基因及其甲基化在急性髓性白血病的发生发展中可能具有一定作用。     

成人急性髓性白血病SOCS-1 基因及其甲基化的研究

目的:通过检测成人急性髓性白血病中SOCS-1基因表达水平及其甲基化水平,研究其在白血病发病中的作用。方法:运用甲基化特异性PCR(Methylation specific PCR,MSP)方法,对24例急性髓性白血病患者和4株白血病细胞株(Jurkat、Raji、U 937、NALM 17),进行SOCS-1基因甲基化水平的研究;同时运用Real-time PCR法定量分析SOCS-1基因表达水平。以10例健康人为正常对照组。结果:24例成人急性髓性白血病患者中,15例有SOCS-1基因甲基化(62.5%),而正常对照组无SOCS-1基因甲基化(0%),二者有显著差异(P<0.05);SOCS-1基因甲基化组与无SOCS-1基因甲基化组相比较,其SOCS-1基因相对表达量明显减少(P﹤0.05);与患者临床病理特征相结合比较,发现SOCS-1基因的甲基化与患者年龄、性别和病程阶段无相关。4株白血病细胞株中,Jurkat和U 937表现有SOCS-1甲基化(50%),Raji和NALM 17无SOCS-1甲基化,前者SOCS-1基因表达量较后者也明显降低(P<0.05)。结论:SOCS-1基因在成人急性髓性白血病中甲基化水平明显增高,且SOCS-1基因甲基化后表达水平受到抑制,提示SOCS-1基因及其甲基化在急性髓性白血病的发生发展中可能具有一定作用。     

Identification of Circulating MicroRNAs as Potential Biomarkers for Detecting Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is the most common acute leukemia in adults. The disease is characterized by various cytogenetic and molecular abnormalities with distinct prognoses and gene expression profiles. Emerging evidence has suggested that circulating microRNAs (miRNAs) could serve as noninvasive biomarkers for cancer detection; however, little is known about circulating miRNA profiles in AML patients. In this study, a genome-wide serum miRNA expression analysis was performed using Solexa sequencing for initial screen, followed by validation with real-time PCR assays. The analysis was conducted on training and verification sets of serum samples from 140 newly diagnosed AML patients and 135 normal adult donors. After a two-phase selection and validation process, 6 miRNAs, miR-10a-5p, miR-93-5p, miR-129-5p, miR-155-5p, miR-181b-5p and miR-320d, were found to have significantly different expression levels in AML compared with control serum samples. Furthermore, unsupervised clustering analysis revealed the remarkable ability of the 6-miRNA profile to differentiate between AML patients and normal controls. The areas under the ROC curve for the selected miRNAs ranged from 0.8129 to 0.9531. More importantly, miR-181b-5p levels in serum were significantly associated with overall survival. These data demonstrated that the expression patterns of circulating miRNAs were systematically altered in AML and miR-181b-5p may serve as a predictor for overall survival in AML patients.     

Identification of the Adapter Molecule MTSS1 as a Potential Oncogene-Specific Tumor Suppressor in Acute Myeloid Leukemia

The adapter protein metastasis suppressor 1 (MTSS1) is implicated as a tumor suppressor or tumor promoter, depending on the type of solid cancer. Here, we identified Mtss1 expression to be increased in AML subsets with favorable outcome, while suppressed in high risk AML patients. High expression of MTSS1 predicted better clinical outcome of patients with normal-karyotype AML. Mechanistically, MTSS1 expression was negatively regulated by FLT3-ITD signaling but enhanced by the AML1-ETO fusion protein. DNMT3B, a negative regulator of MTSS1, showed strong binding to the MTSS1 promoter in PML-RARA positive but not AML1-ETO positive cells, suggesting that AML1-ETO leads to derepression of MTSS1. Pharmacological treatment of AML cell lines carrying the FLT3-ITD mutation with the specific FLT3 inhibitor PKC-412 caused upregulation of MTSS1. Moreover, treatment of acute promyelocytic cells (APL) with all-trans retinoic acid (ATRA) increased MTSS1 mRNA levels. Taken together, our findings suggest that MTSS1 might have a context-dependent function and could act as a tumor suppressor, which is pharmacologically targetable in AML patients.     

组蛋白去乙酰化酶抑制剂在急性髓系白血病中的应用

急性髓系白血病（AML）是造血干/祖细胞恶性克隆性疾病,以骨髓、血液和其他组织中髓系起源的异常原始细胞增殖为特征。“3+7”诱导方案（蒽环类药物联合阿糖胞苷）一直是治疗AML的基石,但仍有部分AML患者无法耐受强化疗或完全缓解后复发,目前AML的总体疗效仍不乐观。因此,寻找新药物以提高AML患者疗效具有重要的临床意义。越来越多的研究证明,表观遗传对AML的发生、发展起重要作用。组蛋白去乙酰化酶抑制剂（HDACi）是表观遗传修饰的分子靶向药物,可抑制组蛋白去乙酰化酶（HDAC）的活性,上调组蛋白赖氨酸的乙酰化水平,目前已应用于AML临床研究中,在联合治疗中显现出良好的耐受性与治疗效果。本综述介绍了HDAC和HDACi的分类依据以及在临床上的应用,阐述了伏立诺他、贝利司他、帕比司他、戊丙酸、恩替诺特、西达本胺等6种HDACi在AML中的临床前研究结果和临床应用研究进展,讨论了HDACi与其他抗癌药物联用在AML中的作用机制,并对HDACi今后的发展提出了建议,期望为临床治疗AML提供参考。     

Nestin基因在髓系白血病的表达及意义

Nestin蛋白是一种神经干细胞标志物,参与组织修复,并且在一些肿瘤细胞中表达。最近研究报道称nestin可能参与肿瘤细胞恶性增殖及细胞侵袭。在急性淋巴细胞白血病(acute lymphoid leukemia,ALL)小鼠模型中,白血病增殖细胞(leukemia-propagating cells,LPCs)可形成一个抗药性niche,其中nestin阳性细胞参与该niche形成。为探索nestin基因在白血病患者的临床表达情况,通过RT-PCR和Western-blot实验方法 ,检测了50位髓系白血病患者的nestin基因的临床表达情况。结果发现,在50位髓系白血病患者(38位AML,12位CML)中,42位患者表达nestin基因mRNA,6位患者表达nestin蛋白,并且nestin基因表达水平和患者血红蛋白、血小板、细胞因子和T淋巴细胞数并不存在相关性,但是高白细胞白血病患者表现出nestin基因mRNA水平高表达。虽然nestin基因和患者完全缓解率(complete remission,CR)并不存在联系,但是nestin基因在髓系白血病异常表达,说明其可能作为一种诊断AML或CML的生物标记物。     

Synthesis and Characterization of Novel 2-Amino-Chromene-Nitriles that Target Bcl-2 in Acute Myeloid Leukemia Cell Lines

The anti-apoptotic protein Bcl-2 is a well-known and attractive therapeutic target for cancer. In the present study the solution-phase T3P-DMSO mediated efficient synthesis of 2-amino-chromene-3-carbonitriles from alcohols, malanonitrile and phenols is reported. These novel 2-amino-chromene-3-carbonitriles showed cytotoxicity in human acute myeloid leukemia (AML) cell lines. Compound 4g was found to be the most bioactive, decreasing growth and increasing apoptosis of AML cells. Moreover, compound 4g (at a concentration of 5 µM) increased the G2/M and sub-G1 (apoptosis) phases of AML cells. The AML cells treated with compound 4g exhibited decreased levels of Bcl-2 and increased levels of caspase-9. In silico molecular interaction analysis showed that compound 4g shared a similar global binding motif with navitoclax (another small molecule that binds Bcl-2), however compound 4g occupies a smaller volume within the P2 hot spot of Bcl-2. The intermolecular π-stacking interaction, direct electrostatic interactions, and docking energy predicted for 4g in complex with Bcl-2 suggest a strong affinity of the complex, rendering 4g as a promising Bcl-2 inhibitor for evaluation as a new anticancer agent.     

Mutation Patterns of 16 Genes in Primary and Secondary Acute Myeloid Leukemia (AML) with Normal Cytogenetics

Acute myeloid leukemia patients with normal cytogenetics (CN-AML) account for almost half of AML cases. We aimed to study the frequency and relationship of a wide range of genes previously reported as mutated in AML (ASXL1, NPM1, FLT3, TET2, IDH1/2, RUNX1, DNMT3A, NRAS, JAK2, WT1, CBL, SF3B1, TP53, KRAS and MPL) in a series of 84 CN-AML cases. The most frequently mutated genes in primary cases were NPM1 (60.8%) and FLT3 (50.0%), and in secondary cases ASXL1 (48.5%) and TET2 (30.3%). We showed that 85% of CN-AML patients have mutations in at least one of ASXL1, NPM1, FLT3, TET2, IDH1/2 and/or RUNX1. Serial samples from 19 MDS/CMML cases that progressed to AML were analyzed for ASXL1/TET2/IDH1/2 mutations; seventeen cases presented mutations of at least one of these genes. However, there was no consistent pattern in mutation acquisition during disease progression. This report concerns the analysis of the largest number of gene mutations in CN-AML studied to date, and provides insight into the mutational profile of CN-AML.     

川芎嗪对急性髓性白血病KG-1a细胞表面标志物的影响

目的:探讨川芎嗪对急性髓性白血病KG-1a细胞表面标志物的影响。方法:通过体外细胞培养技术,利用中药有效成分单体干预细胞生长,运用MTT法及流式细胞术检测了经川芎嗪干预后的KG-1a细胞表面标志物CD34、CD33、CD123与CD7、CD56、CD44表达。结果:川芎嗪干预KG-1a细胞48小时后,细胞表面标志物CD34+CD33+、CD34+CD123+、CD33+CD123+表达率较对照组明显减少(P0.05),但是对于CD34+表达率无明显作用,同时,川芎嗪干预KG-1a细胞48小时后,KG-1a细胞表面标志物CD7、CD56、CD44荧光强度与对照组比较明显降低(P0.05),但是对KG-1a细胞表面标志物CD7、CD56、CD44表达率无明显影响,与对照组比较无统计学意义(P0.05)。结论:川芎嗪逆转白血病耐药作用,除能够降低MDR、P-gp高表达外,能够降低白血病干细胞特异性表面标志物CD34+CD123+、CD34+CD33+、CD33+CD123+、CD7、CD56、CD44表达水平,从白血病干细胞水平逆转多药耐药。     

Integrative Meta-Analysis of Differential Gene Expression in Acute Myeloid Leukemia

Background

Acute myeloid leukemia (AML) is a heterogeneous disease with an overall poor prognosis. Gene expression profiling studies of patients with AML has provided key insights into disease pathogenesis while exposing potential diagnostic and prognostic markers and therapeutic targets. A systematic comparison of the large body of gene expression profiling studies in AML has the potential to test the extensibility of conclusions based on single studies and provide further insights into AML.

Methodology/Principal Findings

In this study, we systematically compared 25 published reports of gene expression profiling in AML. There were a total of 4,918 reported genes of which one third were reported in more than one study. We found that only a minority of reported prognostically-associated genes (9.6%) were replicated in at least one other study. In a combined analysis, we comprehensively identified both gene sets and functional gene categories and pathways that exhibited significant differential regulation in distinct prognostic categories, including many previously unreported associations.

Conclusions/Significance

We developed a novel approach for granular, cross-study analysis of gene-by-gene data and their relationships with established prognostic features and patient outcome. We identified many robust novel prognostic molecular features in AML that were undetected in prior studies, and which provide insights into AML pathogenesis with potential diagnostic, prognostic, and therapeutic implications. Our database and integrative analysis are available online (http://gat.stamlab.org).     

CBFβ-SMMHC Affects Genome-wide Polycomb Repressive Complex 1 Activity in Acute Myeloid Leukemia

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