Arsenic trioxide (ATO) and MEK1 inhibition synergize to induce apoptosis in acute promyelocytic leukemia cells

Leukemia. 2005 Feb;19(2):234-44. doi: 10.1038/sj.leu.2403585.

Abstract

Recent studies suggest that components of the prosurvival signal transduction pathways involving the Ras-mitogen-activated protein kinase (MAPK) can confer an aggressive, apoptosis-resistant phenotype to leukemia cells. In this study, we report that acute promyelocytic leukemia (APL) cells exploit the Ras-MAPK activation pathway to phosphorylate at Ser112 and to inactivate the proapoptotic protein Bad, delaying arsenic trioxide (ATO)-induced apoptosis. Both in APL cell line NB4 and in APL primary blasts, the inhibition of extracellular signal-regulated kinases 1/2 (ERK1/2) and Bad phosphorylation by MEK1 inhibitors enhanced apoptosis in ATO-treated cells. We isolated an arsenic-resistant NB4 subline (NB4-As(R)), which showed stronger ERK1/2 activity (2.7-fold increase) and Bad phosphorylation (2.4-fold increase) compared to parental NB4 cells in response to ATO treatment. Upon ATO exposure, both NB4 and NB4-As(R) cell lines doubled protein levels of the death antagonist Bcl-xL, but the amount of free Bcl-xL that did not heterodimerize with Bad was 1.8-fold greater in NB4-As(R) than in the parental line. MEK1 inhibitors dephosphorylated Bad and inhibited the ATO-induced increase of Bcl-xL, overcoming ATO resistance in NB4-As(R). These results may provide a rationale to develop combined or sequential MEK1 inhibitors plus ATO therapy in this clinical setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / toxicity*
  • Apoptosis / drug effects
  • Arsenic Trioxide
  • Arsenicals
  • Cell Line, Tumor
  • Drug Resistance, Neoplasm
  • Enzyme Inhibitors / pharmacology
  • Flavonoids / pharmacology
  • Growth Inhibitors / toxicity
  • Humans
  • Kinetics
  • Leukemia, Promyelocytic, Acute
  • MAP Kinase Kinase 1 / antagonists & inhibitors*
  • Membrane Potentials / drug effects
  • Mitochondria / drug effects
  • Mitochondria / pathology
  • Mitochondria / physiology
  • Oxides / toxicity*
  • RNA, Small Interfering / genetics
  • Transfection

Substances

  • Antineoplastic Agents
  • Arsenicals
  • Enzyme Inhibitors
  • Flavonoids
  • Growth Inhibitors
  • Oxides
  • RNA, Small Interfering
  • MAP Kinase Kinase 1
  • MAP2K1 protein, human
  • Arsenic Trioxide
  • 2-(2-amino-3-methoxyphenyl)-4H-1-benzopyran-4-one