The degree of BCR and NFAT activation predicts clinical outcomes in chronic lymphocytic leukemia

Blood. 2012 Jul 12;120(2):356-65. doi: 10.1182/blood-2011-12-397158. Epub 2012 May 21.

Abstract

B-cell antigen receptor (BCR)-mediated signaling plays a critical role in chronic lymphocytic leukemia (CLL) pathogenesis and gives an in vitro survival advantage to B cells isolated from patients with unfavorable prognostic factors. In this study, we undertook to elucidate the signaling intermediates responsible for this biologic alteration. In responding cells only, in vitro BCR engagement triggers global phosphorylation of Syk, activation of phospholipase Cγ2, and intracellular calcium mobilization, reflecting competency of BCR signaling. The calcium-calcineurin-dependent transcription factor NFAT2 is up-regulated and to some extent constitutively activated in all CLL B cells. In contrast, its DNA-binding capacity is enhanced on IgM stimulation in responding cells only. NFAT inhibition using the VIVIT peptide prevents induction of CD23 target gene and IgM-induced survival, converting responding cells to unresponsive status. At the opposite, ionomycin-induced NFAT activity allows survival of nonresponding cells. These results demonstrate that the functional heterogeneity relies on variability of protein levels establishing BCR-dependent thresholds and NFAT-dependent activation. Finally, status of the BCR-NFAT pathway for each patient reveals its relevance for CLL clinical outcome and points out to BCR-NFAT intermediates as promising functional therapeutic targets.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Calcium Signaling
  • Cell Survival
  • Humans
  • Immunoglobulin M / metabolism
  • Intracellular Signaling Peptides and Proteins / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology*
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism*
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy
  • NFATC Transcription Factors / antagonists & inhibitors
  • NFATC Transcription Factors / genetics
  • NFATC Transcription Factors / metabolism*
  • Oligopeptides / pharmacology
  • Phospholipase C gamma / metabolism
  • Phosphorylation
  • Prognosis
  • Protein-Tyrosine Kinases / metabolism
  • Receptors, Antigen, B-Cell / metabolism*
  • Signal Transduction
  • Syk Kinase
  • Up-Regulation
  • ZAP-70 Protein-Tyrosine Kinase / metabolism

Substances

  • Immunoglobulin M
  • Intracellular Signaling Peptides and Proteins
  • NFATC Transcription Factors
  • NFATC1 protein, human
  • Oligopeptides
  • Receptors, Antigen, B-Cell
  • VIVIT peptide
  • Protein-Tyrosine Kinases
  • SYK protein, human
  • Syk Kinase
  • ZAP-70 Protein-Tyrosine Kinase
  • ZAP70 protein, human
  • Phospholipase C gamma