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  • American Society of Hematology  (11)
  • 1
    Online Resource
    Online Resource
    American Society of Hematology ; 2013
    In:  Blood Vol. 122, No. 21 ( 2013-11-15), p. 4910-4910
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 4910-4910
    Abstract: ER-stress is caused by an imbalance between the amount of unfolded or misfolded protein in the ER lumen and the capacity of the ER machinery to refold these proteins. This stress induces a coordinated cellular response known as unfolded protein response (UPR). The main functions of UPR are to reduce the amount of protein that enters the ER by suppressing the translational rate and to increase the folding capacity of the ER via translational activation of chaperon proteins. Additionally, if proteins cannot be folded correctly in the ER, they are retrotranslocated to the cytoplasm for degradation via the ubiquitin-proteasome pathway for adaptation. However, if these adaptation strategies fail, apoptosis is triggered with the induction of the pro-apoptotic transcription factor CHOP/GADD153 and with the IRE1 involved in signaling via caspase-12. Autophagy is a highly conserved cellular process in eukaryotes. Intracellular proteins and organelles, including ER, are engulfed in a double-membrane vesicle known as an autophagosome, and are delivered to lysosomes for degradation by lysosomal hydrolases. Autophagy has been regarded as a bulk non-selective degradation system for long-lived proteins and organelles, in contrast to the specific degradation of polyubiquitinated short-lived proteins by proteasome. However, evidence indicates a selective degradation pathway of ubiquitinated protein through autophagy via docking proteins such as p62 and the related protein NBR1. Thus, the two major intracellular protein degradation systems are directly linked. We previously reported that macrolide antibiotics including clarithromycin (CAM) block autophagy flux, and that combined treatment with CAM and proteasome inhibitor bortezomib (BZ) enhances ER-stress-mediated apoptosis in myeloma and breast cancer cells, whereas treatment with CAM alone results in almost no cytotoxicity (Moriya S, et al. Int J Oncol. 2013, Komatsu S, et al. Biochem Biophys Res Commun. 2013). HDAC6, a microtubule-associated deacetylase, is a component of the aggresome and has the capacity to bind both polyubiquitinated misfolded proteins and dynein motors. HDAC6 recruits misfolded protein cargo to dynein motors for transport to aggresomes, which is recognized as a cytoprotective response serving to sequester misfolded proteins and facilitate their clearance by autophagy. Therefore, evidence suggests the existence of an elaborate intracellular network system for processing unfolded proteins. In the present study, we further investigated the combined effect of vorinostat (suberoylanilide hydroxamic acid (SAHA)), which has a potent inhibitory effect for HDAC6 (IC50 37 nM), with CAM and BZ in myeloma cell lines. SAHA exhibited some cytotoxicity along with an increased acetylation level of α-tubulin, a substrate of HDAC6. Combined treatment of SAHA, CAM, and BZ potently enhanced the apoptosis-inducing effect compared with treatment using each reagent alone or a combination of two of the three. Concomitant treatment with CAM and BZ for blocking autophagy flux and proteasome activity dramatically enhanced aggresome formation in perinuclear region, whereas this aggresome formation was almost completely eliminated in the presence of SAHA. Expression levels of ER-stress-related genes, including the pro-apoptotic transcription factor CHOP, were maximally induced by the simultaneous combination of three reagents. Like myeloma cell lines, a wild-type murine embryonic fibroblast (MEF) cell line exhibited enhanced cytotoxicity and maximally up-regulated Chop after combined treatment with SAHA, CAM, and BZ; however, a Chop KO MEF cell line almost completely canceled this enhanced effect. The specific HDAC6 inhibitor tubacin also exhibited a pronounced cytocidal effect with a combination of CAM plus BZ. These data suggest that simultaneous targeting of intracellular proteolytic pathways and HDAC6 enhances ER-stress-mediated apoptosis in myeloma cells, and also provide novel insight into “ER-stress loading therapy” for myeloma patients. Disclosures: Miyazawa: Taisho Toyama Phamaceutical Co. Ltd.: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
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  • 2
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 3478-3478
    Abstract: Vitamin K2 (menaquinone-2: VK2) is now known to be a potent inducer for apoptosis in leukemia cells in vitro. HL-60bcl-2 cells, which are derived from a stable transfectant clone of human bcl-2 gene into HL-60 leukemia cell line, show 5-fold greater expression of Bcl-2 protein compared with that in HL-60neo cells, a control clone transfected with vector alone. Although HL-60neo cells are induced apoptosis in response to VK2, HL-60bcl-2 cells are resistant against apoptosis induction but still show cell growth inhibition along with an increase of cytoplasmic vacuoles during exposure to VK2. Electron microscopy revealed autophagosomes and autolysosomes formation in HL-60bcl-2 cells after exposure to VK2. An increase of acid vesicular organelles (AVO) detected by acridine orange staining for lysosomes as well as conversion of LC3B-I into LC3B-II by immunonoblotting and an increased punctuated pattern of cytoplasmic LC3B by fluorescent immunostaining all supported enhanced autophagy induction in response to VK2 in HL-60bcl-2 cells. However, during shorter exposure to VK2, autophagosome formation was rather prominent in HL-60neo cells although nuclear chromatin condensations and nuclear fragments were also observed at the same time. These findings indicated the mixed morphologic features of apoptosis and autophagy. Inhibition of autophagy by either addition of 3-methyladenine, siRNA for Atg7, or Tet-off Atg5 system all resulted in attenuation of VK2-incuded cell death, indicating autophagy-mediated cell death in response to VK2. These data demonstrate that autophagy and apoptosis can be simultaneously induced by VK2. However, autophagy becomes prominent when the cells were protected from rapid apoptotic death by higher expression level of Bcl-2.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
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  • 3
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 4373-4373
    Abstract: Autophagy is a membrane trafficking process that leads to degradation of cytosolic proteins and organelles by lysosomes, and it is conserved throughout evolution. Autophagy is induced above basal levels in response to nutrient deprivation or trophic factor withdrawal, and it sustains metabolism through the targeted catabolism of long-lived proteins. Thus, autophagy acts as a self-limited survival mechanism. However, recent findings have suggested that autophagy is also as a potential contributor to programmed cell death. We previously reported that vitamin K2 (VK2) selectively and potently induces the apoptosis of cultured acute myeloid leukemia cells (AML) and AML cell lines, but has almost no effect on normal hematopoietic cells. In addition, the clinical benefit of using VK2 for patients with AML and myelodysplastic syndrome has been reported. In the present study, we focused on whether autophagy was induced in AML cells by treatment with VK2. HL-60bcl-2 cells with stable transfection of the bcl-2 gene showed 5-fold greater expression of BCL-2 compared with HL-60neo cells, and these cells were resistant to apoptosis induced by VK2, along with the occurrence of monocytic differentiation via G1 arrest. This suggested that VK2 had a differentiation-inducing effect on AML cells that were resistant to apoptosis. However, a cytocidal effect was still detectable in a caspase-independent manner. Treatment of HL-60bcl-2 cells with VK2 resulted in an increase of acid vesicular organelles (AVO) detected by acridine orange staining (for lysosomes). Immunonoblotting with an antibody for microtubule-associated protein-1 light chain-3 (LC3) revealed the conversion of LC3-I into LC3-II a form that migrates more rapidly on SDS-PAGE and participates in the formation of autophagosomes (one of the hallmarks of autophagy). Electron microscopy revealed an increase of autophagosome formation after exposure to VK2. Finally, the induction of caspase-independent cell death by VK2 was suppressed in the presence of 3-methyladenine. These results suggest that autophagic death of HL-60bcl-2 cells was induced by VK2. Furthermore, detailed electron microscopic assessment of HL-60neo cells during exposure to VK2 revealed that autophagosome formation was more prominent compared with that occurring in H-60bcl-2 cells, although nuclear chromatin condensation was also observed at the same time. These findings indicated a mixture of the morphologic features of apoptosis and autophagy. The present results suggest that autophagy and apoptosis can both be induced simultaneously by VK2. However, autophagy only became detectable when cells were protected from rapid apoptotic death.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
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  • 4
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 4185-4185
    Abstract: Autophagy fundamentally refers to a process where cells enclose their own cell organelles with isolated membrane and deliver them to lysosomes for degradation, servicing as a nonspecific degradation mechanism of autologous proteins. Autophagy is induced above basal levels in response to nutrient deprivation or trophic factor withdrawal to sustain metabolism by producing catabolites. In this context, autophagy acts as a cytoprotective mechanism for cells to protect themselves from extracellular stresses. However, in a culture using cells in which autophagy-related genes were suppressed by siRNA and to which an autophagy inhibitor, 3- methyladenine (3-MA), was added, cytotoxic effects of some anticancer agents on cancer cells were diminished. Based on these results, the concept of caspase-independent cell death via autophagy, which is designated as type II programmed cell death (PCD) in contrast to apoptosis as type I PCD, has been receiving increased attention. We here report that treatment of AML cells with low does-Ara-C induces autophagy and enhances its cytocidal effect on AML cells by combined treatment with G-CSF. Treatment of AML cell line U937 cells with 1 to 50 ng/ml of Ara-C induced cell growth inhibition in a dose-dependent manner. Exposure to the higher concentrations of Ara-C (more than 10 ng/ml) induced apoptosis in U937 cells along with formation of apoptotic bodies and caspase-3 activation. However, treatment with the lower concentration of Ara-C (2.5 to 7.5 ng/ml) induced autophagy as assessed by electron microcopy and the punctuated distribution pattern of cytoplasmic microtubule-associated protein 1 light chain 3B (LC3B) by fluorescent immunocytochemistry. Low dose-Ara-C inducing -cell death and -autophagy both were suppressed when the cells were cultured in the presence of 3-MA. This suggests that the autophagic cell death but not the cytoprotective autophagy was induced in response to Ara-C. Combined treatment with G-CSF (lenograstim; 100 ng/ml) plus 2.5 to 7.5 ng/ml of Ara-C, but not plus higher concentrations of Ara-C, resulted in the enhanced cytocidal effect in U937 cells in vitro. These data indicate that combined treatment of Ara-C plus G-CSF has a therapeutic benefit for the AML patients by enhanced cytocidal effect which appears to be mediated via induction of autophagy. In addition, our data appear to explain in part the high response rate of CAG therapy in refractory AML, which consists of low-dose Ara-C in combination with G-CSF and aclarubicin.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
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  • 5
    In: Blood, American Society of Hematology, Vol. 106, No. 11 ( 2005-11-16), p. 2528-2528
    Abstract: Vitamin K2 (VK2) analogs, including menaquinone-4 (MK4) but not vitamin K1, effectively induce apoptosis in acute myeloid leukemia cells (AML). Apoptosis induction by VK2 is specific toward leukemia cells, and almost no effect is observed in normal hematopoietic progenitor cells (Miyazawa K, Leukemia 1999, 2000, 2001). Combined treatment with VK2 plus 1α, 25-dihydroxy-vitamin D3 (D3) dramatically enhanced differentiation of leukemia cells as compared to the cells treated with D3 alone. Concomitant with the induction of differentiation and final maturation by VK2 plus D3, the cells became resistant to various apoptotic stimuli (Funato K, Leukemia, 2002). VK2 has been shown to improve the supportive hematopoietic functions of bone marrow stromal cells (Miyazawa K, Stem Cell Dev. 2004). Since VK2 (MK4, GlakayR) has been used to treat patients with osteoporosis in Japan, its non-toxicity and safety for long-term daily administration have already been well established. Case reports demonstrating the clinical benefits of using VK2 with or without D3 for treating patients with myelodysplastic syndrome (MDS) and AML have been accumulating, i.e. improving cytopenias in refractory anemia (RA) and reduction of blast cells in AML. We performed a multicenter prospective trial to determine the therapeutic benefit of VK2 with or without D3 in MDS. Patients with RA/RCMD with low/ int-1 by IPSS received VK2 (Glakay, 45 mg/day, po) for 16 weeks. The therapeutic response was assessed according to the International Working Group Criteria. Patients who did not respond to VK2 were sequentially re-registered and received a combination of VK2 plus D3 (alfacalcidol, AlfarolR, 0.75 microgram/day, po) for 16 weeks. Patients showing response to VK2 alone or VK2 plus D3 after 16 weeks continued to receive therapy for a total of 12 months. Forty-three patients have been enrolled and 29 patients were evaluable for their response to VK2. Five patients (17.2 %) showed improvement of cytopenia (major HI-E (1), minor HI-E (2), major HI-P (3), and minor HI-P (1)). Twenty out of 24 patients who showed no response to VK2 alone subsequently received VK2 plus D3. Eleven patients were eligible for evaluation and 4 patients (36.4%) showed improvement of cytopenia in response to VK2 plus D3 (major HI-E (3), minor HI-E (1) and major HI-P (1)). Four out of 7 patients (57 %) with anemia showed hematologic response. No adverse events were observed, except for one case of skin rash (Grade I) during VK2 plus D3 therapy. These data suggest that the therapeutic response rate is improved by combined treatment with VK2 plus D3 as compared with that by VK2 monothrapy. Safety and low price also support the therapeutic benefit of VK2 with D3 for improving cytopenia in RA.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2005
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  • 6
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-01), p. 2354-2354
    Abstract: Background AL(acute leukemias) with 11q23 abnormalities involving the MLL (mixed lineage leukemia) gene comprise one category of recurring genetic abnormalities in the WHO classification. However, the prognosis of adult AL with 11q23/MLL between fusion partners are controversial especially in Asia. Methods We analyzed data on 61 Japanese adult patients diagnosed as AL with 11q23/MLL abnormalities, including the translocations t(4;11), t(9;11), t(6;11), t(11;19) between 1990 and 2006. Results Median age of the 61 patients was 48 years (range, 17–79 years). 54 patients were AML (acute myeloid leukemia) and 7 patients were ALL (acute lymphoblastic leukemia).The incidence by fusion partners in AML were as follows; t(9;11) in 29.6%, t(11;19) in 24.0%, t(6;11) in 18.5%. The incidence of patients with t(11;19) was higher than that in Caucasian and t(4;11) was lower than that in childhood. As for the FAB (French-American-British) subtype, 68.5% of the 11q23/MLL patients were M4/M5. Organ involvement was observed commonly (46.2%) in AML with 11q23/MLL patients except for t(11;19) (7.6%).The CR (complete remission) rate of AML with 11q23/MLL was not low (78.7%), but the CR duration was very short (10 months).The DFS (disease free survival) at 1year and the OS (overall survival) at 2 years were 20% and 30% in AML with t(9;11), 10% and 19% in AML with t(11;19), 10% and 30% in AML with t(6;11). In total, the DFS at 1year and the OS at 2 years were 26% and 25% in AML patients, respectively, while 50% and 50% in ALL patients, respectively. The DFS and the OS at 2 years were 44% and 53% in AML patients with 11q23/MLL who were treated with HSCT(hematopoietic stem cell transplantations), while 14% and 21% in those without HSCT respectively. Conclusions Although there were reports that the prognosis of AML with t(9;11) was not bad in Caucasian, the present study showed poor prognosis of AML with 11q23/MLL in Japanese adult patients regardless of the fusion partners. Our study revealed the short CR duration of the AML patients with 11q23/MLL in the face of the high CR rate. AML patients with 11q23/MLL who were treated with HSCT had superior outcomes to those without HSCT (P=.04 for DFS and P=.04 for OS) .This findings suggest that treatment strategies including HSCT should be considered for AML with 11q23/MLL during the first CR.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
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  • 7
    Online Resource
    Online Resource
    American Society of Hematology ; 2010
    In:  Blood Vol. 116, No. 21 ( 2010-11-19), p. 4937-4937
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 4937-4937
    Abstract: Abstract 4937 Autophagy is an intracellular degradation system that delivers cytoplasmic constitutions to the lysosome. Intracellular proteins and organelle are sequestered by the autophagosomes, then delivered to the lysosome and degraded. It has been reported that combining imatinib mesylate (IM) with an autophagy inhibitor such as chloroquine resulted in enhanced elimination of CML clones in vitro and in vivo (Bellodi C et al. J. Clin. Invest. 2009). We here report that IM induces the cytoprotective effect in non-BCR-ABL expressing cells along with autophagosome formation. Treatment with IM resulted in an increased viable cell number of non-BCR-ABL expressing leukemia cell lines by inhibiting spontaneous apoptosis. IM did not show any effects on cell-cycle progression. When HL-60 cells were cultured in the presence of 3–30 μM of IM for 24–96 hr, up to a 1.6-fold increase in the viable cell number was observed in a dose-dependent manner. Furthermore, when HL-60 cells were cultured either under serum depletion or at lower concentrations of FBS, the cytoprotection by IM became more pronounced as compared with the cells cultured with 10% FBS. As well as in BCR-ABL expressing CML cell lines, electron microscopy revealed an increased autophagosomes after IM treatment in non-BCR-ABL expressing cells. Cytoprotection with autophagosome formation by IM was observed in various leukemia and cancer cell lines as well as normal murine embryonic fibroblasts (MEFs). IM attenuated the cytotoxic effect of cytosine arabinoside and bortezomib in leukemia cells. Inhibition of autophagy by knockdown of LC3 gene using shRNA in HL-60 as well as complete knockout of atg5 in the Tet-off atg5-/- MEF system attenuated the cytoprotective effect of IM. This indicates that the effect is at least in part dependent on autophagy. However, the cytoprotection by IM was not medicated through supression of ROS production via “mitophagy” or reduction of ER stress via “ribophagy”. The cytoprotection with autophagy was still detectable in the HL-60 cells after knockdown of c-abl gene and in an ABL deficient-HL-60 cell line. This indicates that the proapoptotic function of ABL kinase is not involved. In addition, this effect was still observed in the presence of cycloheximide, suggesting that the effect is not mediated through translation process. Although the target tyrosine kinase(s) of IM remains unclear, our data provide novel therapeutic possibilities of targeting tyrosine kinase(s) for induction of cytoprotective autophagy. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 8
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 4058-4058
    Abstract: Abstract 4058 Bortezomib (BZ), a first line 26S proteasome inhibitor, has been shown to be effective for the treatment of multiple myeloma (MM). Since IκBα is a substrate of the proteasome, the initial rationale for use of BZ in MM was inhibition of NF-kB activity. However, our data revealed that BZ rather activates NF-κB activity in MM cells as recently reported by others (Hideshima T et al. Blood 2009). BZ showed the more potent cytocidal effect along with caspase activation in MM cell lines as compared with various leukemia and cancer cell lines. BZ also induces autophagy as well as ER stress in various kinds of cell lines. However, autophagy induction in response to BZ requires much longer exposure time as compared with the cells treated with other autophagy inducers such as imatinib mesylate. Several recent reports demonstrated that the selective autophagy of the ubiquitinated proteins via p62/SQSTM1and NBR1 proteins, which can simultaneously bind both ubiquitin and autophagy-specific ubiquitin-like modifier, LC3. Therefore, polyubiquitinated proteins are engulfed into autophagosomes via p62-LC3 binding and subsequently transferred to lysosome and degraded (Kirkin V et al. Mol. Cell. 2009). We therefore speculated that inhibition of autophagy as an alternative protein degradation system may increase the accumulation of misfolded proteins and ER stress. This may result in enhancement of cytocidal effect of BZ. Unexpectedly, inhibition of autophagy by using 3-methyadenine (MA), shRNA-mediated inhibition of LC3 levels or complete knockdown of atg5 using a Tet-off atg5-/- MEF system all attenuated BZ-induced cytotoxic effect. This suggests that induction of autophagy in response to BZ appears to function as leading to cell death but not for cytoprotection. However, combined treatment with BZ plus bafilomycin A1 (BAF), an inhibitor of vacuolar ATPase, showed the synergistic cytotoxicity as compared with the cells treated with either BZ or BAF alone. BAF inhibited autophagy at the late stage and induced ER stress as well as BZ. However, kinetics of CHOP (GADD153) and the chaperon BiP (GRP78) expressions in response to BAF were competently different from those by BZ; BZ induced CHOP/GRP78 within 8 hr while BAF induced these ER stress markers after more than 48 hr exposure. In order to synchronize ER stress, we pre-treated MM cell line, U266 cells with BAF for 48 hr then followed with BZ. The sequential treatment with BAF and BZ showed the further enhanced cytocidal effect as comparing with the simultaneous combination of BAZ plus BZ in U266 cells. Our data suggest that ER stress, but not inhibition of NF-kB, is involved in BZ-induced cytotoxicity in MM cells, and also suggest the tight linkage among autophagy, proteasome, and ER stress. Controlling these relations and kinetics may provide the novel strategy for enhancing the cytotocidal effect for cancer therapy including MM-treatment. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
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  • 9
    In: Blood, American Society of Hematology, Vol. 99, No. 12 ( 2002-06-15), p. 4307-4317
    Abstract: Stromal cell–derived factor 1 (SDF-1/CXCL12) is a multifunctional cytokine. We previously reported that myelopoiesis was enhanced in SDF-1α transgenic mice, probably due in part to SDF-1α enhancement of myeloid progenitor cell (MPC) survival. To understand signaling pathways involved in this activity, we studied the effects on factor-dependent cell line MO7e cells incubated with SDF-1α alone or in combination with other cytokines. SDF-1α induced transient activation of extracellular stress–regulated kinase (ERK1/2), ribosomal S6 kinase (p90RSK) and Akt, molecules implicated in cell survival. Moreover, ERK1/2, p90RSK, and Akt were synergistically activated by SDF-1α in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), Steel factor (SLF), or thrombopoietin (TPO). Similar effects were seen after pretreatment of MO7e cells with SDF-1α followed by stimulation with the other cytokines, suggesting a priming effect of SDF-1α. Nuclear factor-κB (NF-κB) did not appear to be involved in SDF-1α actions, alone or in combination with other cytokines. These intracellular effects were consistent with enhanced myeloid progenitor cell survival by SDF-1α after delayed addition of growth factors. SDF-1α alone supported survival of highly purified human cord blood CD34+++ cells, less purified human cord blood, and MO7e cells; this effect was synergistically enhanced when SDF-1α was combined with low amounts of other survival-promoting cytokines (GM-CSF, SLF, TPO, and FL). SDF-1 may contribute to maintenance of MPCs in bone marrow by enhancing cell survival alone and in combination with other cytokines.
    Type of Medium: Online Resource
    ISSN: 1528-0020 , 0006-4971
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2002
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  • 10
    In: Blood, American Society of Hematology, Vol. 120, No. 21 ( 2012-11-16), p. 4992-4992
    Abstract: Abstract 4992 Macroautophagy (hereafter, “autophagy”) is a highly conserved cellular process of self-degradation in eukaryotes. Intracellular proteins and organelles including the endoplasmic reticulum (ER) are engulfed in a double-membrane vesicle called an autophagosome and are delivered to lysosomes for degradation by lysosomal hydrolases. Autophagy has been regarded as a bulk non-selective degradation system for long-lived proteins and organelles, in contrast to the specific degradation of polyubiquitinated short-lived proteins by proteasome. However, recent reports revealed the selective degradation pathway of ubiquitinated protein through autophagy via docking proteins such as p62 and the related protein NBR1, having both a microtubule-associated protein 1 light chain 3 (LC3)-interacting region and a ubiquitin-associated domain. LC3 is essential for autophagy and is associated with autophagosome membranes after processing. By binding ubiquitin via their C-terminal ubiquitin-associated domains, p62-mediated degradation of ubiquitinated cargo occurs by selective autophagy. Thus the two major intracellular degradation systems are directly linked. We have reported on the inhibition of autophagy using the autophagy inhibitor bafilomycin A1enhanced bortezomib (BZ)-induced apoptosis by burdening ER stress in multiple myeloma (MM) cell lines. It was also reported that clarithromycin (CAM) attenuated or blocked autophagy flux, probably mediated through inhibiting the lysosomal function. We therefore investigated whether simultaneous inhibition of protein degradation systems such as the ubiquitin-proteasome system by BZ and the autophagy-lysosome system by a macrolide antibiotic enhances the loading of ER-stress and ER–stress-mediated CHOP (CADD153) induction, followed by transcriptional activation for proapoptotic genes. BZ potently induces autophagy, ER–stress, and apoptosis in MM cell lines (e. g. U266, IM-9, and RPMI8226). The macrolide antibiotics including CAM, concanamycin A, erythromycin (EM), and azithromycin (AZM) all blocked autophagy flux, as assessed by intracellular accumulation of LC3B-II and p62. Combined treatment of BZ and CAM or AZM enhanced cytotoxicity in MM cell lines, although treatment with either CAM or AZM alone exhibited almost no cytotoxicity. This combination also substantially enhanced aggresome formation, intracellular ubiquitinated proteins, and induced the proapoptotic transcription factor CHOP. Expression levels of the proapoptotic genes transcriptionally regulated by CHOP (e. g. BIM, BAX, DR5, and TRB3) were all enhanced by combined treatment with BZ plus CAM, compared with treatment with each reagent alone. Like the MM cell lines, the CHOP+/+ murine embryonic fibroblast (MEF) cell line exhibited enhanced cytotoxicity and up-regulation of CHOP and its transcriptional targets with a combination of BZ and one of the macrolides. In contrast, CHOP−/− MEF cells exhibited resistance against BZ and almost completely canceled enhanced cytotoxicity with a combination of BZ and a macrolide. These data suggest that ER-stress mediated CHOP induction is involved in pronounced cytotoxicity. Simultaneously targeting two major intracellular protein degradation systems such as the ubiquitin-proteasome system by BZ and the autophagy-lysosome system by a macrolide antibiotic enhances ER-stress-mediated apoptosis in MM cells. This result suggests the therapeutic possibility of using a macrolide antibiotic with a proteasome inhibitor for MM therapy. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2012
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