Mcl-1 is an anti-apoptotic Bcl-2 family member, whose degradation is supposedly
required for induction of apoptosis. However, histone deacetylase inhibitors (HDACi) induce apoptosis primarily through the Bak/Mcl-1/Noxa and Bim pathways without
decreasing Mcl-1. To investigate this discrepancy, we examined the role of Mcl-1 on
HDACi-mediated apoptosis. Inhibition of either Class I or Class II HDAC by selective
HDACi caused an upregulation of Mcl-1 mRNA and protein. Down-regulation of Mcl-1 by three structurally unrelated cyclin dependent kinase inhibitors potentiated
HDACi-mediated apoptosis in primary chronic lymphocytic leukemic (CLL) cells and K562 cells. Sensitivity to HDACi-induced apoptosis was increased ~10-fold by the
cyclin dependent kinase inhibitors. Nanomolar concentrations of HDACi, ~300-fold
lower than required to induce apoptosis alone, sensitized cells to TRAIL, emphasizing
that the mechanism(s) whereby HDACi induce apoptosis is clearly distinct from those by
which they sensitize to TRAIL. Furthermore knockdown of Mcl-1 potentiated HDACi-mediated apoptosis in K562 cells. Thus HDACi-mediated Mcl-1 upregulation plays an important anti-apoptotic regulatory role in limiting the efficacy of HDACi-induced apoptosis, which can be overcome by combination with an agent that down-regulates Mcl-1. Thus a clinical trial in some cancers is warranted using a combination of an HDACi with agents that down-regulate Mcl-1