Akt inhibitors induce apoptosis in chronic lymphocytic leukemia cells

Background: The phosphatidylinositol-3-kinase/Akt pathway has been described to be critical in the survival of chronic lymphocytic leukemia cells. In this study we analyzed the effect of two selective chemical inhibitors of Akt (Akti-1/2 and A-443654) on the survival of chronic lymphocytic leukemia cells. Design and Methods: Using cytometry we studied the cytotoxic effects of Akt inhibitors on peripheral B and T lymphocytes from patients with chronic lymphocytic leukemia and from healthy donors. We studied the changes induced by Akti-1/2 and A-443654 at the mRNA level by performing reverse transcriptase multiplex ligation-dependent probe amplification. We also studied the changes induced by both Akt inhibitors in some BCL-2 protein family members on chronic lymphocytic leukemia cells by western blotting. Moreover, we analyzed the cytotoxic effect of Akt inhibitors in patients' cells with deleted/mutated TP53. Results: Both inhibitors induced apoptosis in chronic lymphocytic leukemia cells in a dose-dependent manner. Moreover, B cells from patients with chronic lymphocytic leukemia were more sensitive to Akt inhibitors than T cells from leukemic patients, and B or T cells from healthy donors. Survival factors for chronic lymphocytic leukemia cells, such as interleukin-4 and stromal cell-derived factor-1 alpha, were not able to block the apoptosis induced by either Akt inhibitor. Akti-1/2 did not induce any change in the mRNA expression profile of genes involved in apoptosis, while A-443654 induced some changes, including an increase in NOXA and PUMA mRNA levels, suggesting the existence of additional targets for A-443654. Both inhibitors induced an increase in PUMA and NOXA protein levels, and a decrease in MCL-1 protein level. Moreover, Akti-1/2 and A-443654 induced apoptosis irrespective of TP53 status. Conclusions: These results demonstrate that Akt inhibitors induce apoptosis of chronic lymphocytic leukemia cells and might be a new therapeutic option for the treatment of chronic lymphocytic leukemia

The potential anticancer agent PK11195 induces apoptosis irrespective of p53 and ATM status in chronic lymphocytic leukemia cells

Background and Objectives The potential anticancer agent 1-(2-chlorophenyl-N-methylpropyl)-3-isoquinolinecarboxamide (PK11195), a translocator protein (18KDa) (TSPO) ligand, facilitates the induction of cell death by a variety of cytotoxic and chemotherapeutic agents. Primary chronic lymphocytic leukemia (CLL) cells overexpress TSPO. The aim of this study was to examine the effects of PK11195 on CLL cells. Design and Methods Using cytometric analysis, we studied the cytotoxic effects of PK11195 on peripheral B and T lymphocytes from patients with CLL and from healthy donors. Western blot and cytometric analyses were used to study the mitochondrial effects of PK11195 on CLL cells. Moreover, we analyzed the cytotoxic effect of PK11195 in patients' cells with mutated p53 or ATM. Results PK11195 induces apoptosis and had additive effects with chemotherapeutic drugs in primary CLL cells. Other TSPO ligands such as RO 5-4864 and FGIN-1-27 also induce apoptosis in CLL cells. PK11195 induces mitochondrial depolarization and cytochrome c release upstream of caspase activation, and dithiocyana-tostilbene-2,2-disulfonic acid (DIDS), a voltage-dependent anion channel (VDAC) inhibitor, inhibits PK11195-induced apoptosis, demonstrating a direct involvement of mitochondria. CLL cells and normal B cells are more sensitive than T cells to PK11195-induced apoptosis. Interestingly, PK11195 induced apoptosis in CLL cells irrespective of their p53 or ATM status. Interpretation and Conclusions These results suggest that PK11195 alone or in combination with chemotherapeutic drugs might be a new therapeutic option for the treatment of CLL

Synergistic anti-tumor activity of acadesine (AICAR) in combination with the anti-CD20monoclonal antibody rituximab in in vivo and in vitro models of mantle cell lymphoma

Mantle cell lymphoma (MCL) is considered one of the most challenging lymphoma, with limited responses to current therapies. Acadesine, a nucleoside analogue has shown antitumoral effects in different preclinical cancer models as well as in a recent phase I/II clinical trial conducted in patients with chronic lymphocytic leukemia. Here we observed that acadesine exerted a selective antitumoral activity in the majority of MCL cell lines and primary MCL samples, independently of adverse cytogenetic factors. Moreover, acadesine was highly synergistic, both in vitro and in vivo, with the anti-CD20 monoclonal antibody rituximab, commonly used in combination therapy for MCL. Gene expression profiling analysis in harvested tumors suggested that acadesine modulates immune response, actin cytoskeleton organization and metal binding, pointing out a substantial impact on metabolic processes by the nucleoside analog. Rituximab also induced changes on metal binding and immune responses.The combination of both drugs enhanced the gene signature corresponding to each single agent, showing an enrichment of genes involved in inflammation, metabolic stress, apoptosis and proliferation. These effects could be important as aberrant apoptotic and proinflammatory pathways play a significant role in the pathogenesis of MCL. In summary, our results suggest that acadesine exerts a cytotoxic effect in MCL in combination with rituximab, by decreasing the proliferative and survival signatures of the disease, thus supporting the clinical examination of this strategy in MCL patients

Regulació de la xarxa PKC/PI3K/Akt: Possible diana terapèutica per la leucèmia limfocítica crònica de cèl·lules B

[cat] Les cèl·lules de leucèmia limfocítica crònica (LLC) en sang perifèrica presenten una resistència anòmala a la inducció d'apoptosi, i reben senyals del microentorn cel·lular que afavoreixen la seva supervivència. En un gran percentatge de malalts no s'aconsegueix controlar la malaltia amb les teràpies convencionals, i en molts altres apareixen recaigudes i resistències al tractament, sobretot degudes a alteracions en la via de p53. A més, la majoria de tractaments no són selectius per les cèl·lules tumorals, provocant problemes d'immunosupressió. Per tant, és necessari identificar nous agents amb toxicitat selectiva per les cèl·lules B malignes, que utilitzin mecanismes d'acció diferents als coneguts i que sobrepassin la via de p53. En aquesta tesi doctoral ens vam plantejar estudiar una de les vies de supervivència més alterades en càncer, i que ja havia demostrat que jugava un paper en la supervivència de les cèl·lules de LLC. Així, l'objectiu d'aquesta tesi ha estat caracteritzar la xarxa de PKC/PI3K/Akt, i els efectes de la seva inhibició en les cèl·lules de LLC. En primer lloc, hem comprovat que existeixen dues vies de senyalització convergents en les cèl·lules de LLC. La primera, dependent de PI3K, present de manera basal en les cèl·lules de LLC i activada per factors de supervivència com la IL-4 i el SDF-1alfa; i una segona, dependent de PKC, també present de manera basal en les cèl·lules de LLC i activada per PMA. En aquesta via, PKCbeta juga un paper important en la fosforilació i activació d'Akt. Hem comprovat com la inhibició de la via, amb inhibidors generals de PKC (Bis I), de PI3K, generals (LY294002 i wortmanina) o selectius de les isoformes de classe I, o d'Akt (Akti-1/2 i A-443654), indueix apoptosi en les cèl·lules de LLC. Aquesta inducció de mort cel·lular es dóna inclús en presència de senyals de supervivència (IL-4, SDF-1alfa, PMA) i en pacients amb delecions 17p o mutacions en p53. Això confirma que aquesta via juga un paper clau en la supervivència de les cèl·lules leucèmiques de LLC. A més, les cèl·lules B de LLC són més sensibles a la inhibició d'aquesta via que les cèl·lules T normals, i en alguns casos, inclús que les cèl·lules B normals (com en el cas del tractament amb Akt1-1/2). Aquesta "addició oncogènica" de les cèl·lules tumorals a la via de PI3K/Akt, ja s'ha descrit en altres càncers, on s'ha demostrat que les teràpies contra PI3K/Akt indueixen més mort cel·lular en les cèl·lules amb més activitat de la via, com són les cèl·lules tumorals. Així, una vegada més, comprovem que la via d'Akt és d'especial importància per aquestes cèl·lules leucèmiques, i que la seva inhibició és d'especial interès per aconseguir noves teràpies més selectives, que evitin els efectes secundaris immunosupressors. En conjunt, els resultats obtinguts en aquesta tesi doctoral aporten nous coneixements sobre les vies de supervivència i d'inducció d'apoptosi de les cèl·lules de LLC, i demostren que la inhibició de la via PKC/PI3K/Akt és una prometedora via d'intervenció terapèutica pel tractament de la LLC.[eng] CLL cells from peripheral blood receive signals from the microenvironment that supports their survival and present an anomalous resistance to the induction of apoptosis. One of the survival pathways that have been described to contribute to CLL cells survival is PKC/PI3K/Akt pathway. A high number of patients are resistant to the current therapies, and most of the treatments are not selective for tumoral cells. Thus, new compounds with a different mechanism of action are needed. The main goal of this thesis has been to characterize the PKC/PI3K/Akt pathway, and the effects of its inhibition in CLL cells. First, we proved that CLL cells have two convergent signal transduction pathways to phosphorylate and activate Akt. The first pathway is PI3K-dependent and corresponds to the classical PI3K-Akt pathway described in most models. The second pathway depends on PKCβ, is independent of PI3K, and contributes to the basal-constitutive Akt activity present in B-CLL cells. By using general and specific PKC, PI3K and Akt inhibitors we confirmed that the inhibition of this pathway induces apoptosis in CLL cells. This apoptosis is observed even in the presence of survival pathways and in patients with alterations in p53. We found that B cells from CLL samples were more sensitive to the inhibition of this pathway than T cells from CLL samples, and B or T cells from healthy donors. Most of the current drugs induce apoptosis equally in both B and T cells, leading to immunosuppression. Thus, the differential effect of these inhibitors in B and T lymphocytes is of interest. In conclusion, the results presented in this thesis contribute to increase the knowledge on the survival pathways and the regulation of apoptosis in CLL cells, and suggest that inhibition of PKC/PI3K/Akt might be a new therapeutic option for CLL therapy