Silencing of the DNA damage repair regulator PPP1R15A sensitizes acute myeloid leukemia cells to chemotherapy.

Acute Myeloid Leukemia (AML) is a life-threatening disease whose induction treatment consists of combination chemotherapy with Idarubicin and Cytarabine for fit patients. Treatment failures are frequent, urging the need for novel treatments for this disease. The DNA Damage Response Mechanism (DDR) comprises numerous molecules and pathways intended to arrest the cell cycle until DNA damage is repaired or else drive the cell to apoptosis. AML-derived cell lines after treatment with Idarubicin and Cytarabine were used for studying the expression profile of 84 DDR genes, through PCR arrays. Utilizing de novo AML patient and control samples we studied the expression of PPP1R15A, CDKN1A, GADD45A, GADD45G, and EXO1. Next, we performed PPP1R15A silencing in AML cell lines in two separate experiments using siRNA and CRISPR-cas9, respectively. Our findings highlight that DDR regulators demonstrate increased expression in patients with high cytogenetic risk possibly reflecting increased genotoxic stress. Especially, PPP1R15A is mainly involved in the recovery of the cells from stress and it was the only DDR gene upregulated in AML patients. The PPP1R15A silencing resulted in decreased viability of Idarubicin and Cytarabine-treated cell lines, in contrast to untreated cells. These findings shed light on new strategies to enhance chemotherapy efficacy and demonstrate that PPP1R15A is an important DDR regulator in AML and its downregulation might be a safe and effective way to increase sensitivity to chemotherapy in this disease.

Metformin as an Enhancer for the Treatment of Chemoresistant CD34+ Acute Myeloid Leukemia Cells.

Acute myeloid leukemia is the second most frequent type of leukemia in adults. Due to a high risk of development of chemoresistance to first-line chemotherapy, the survival rate of patients in a 5-year period is below 30%. One of the reasons is that the AML population is heterogeneous, with cell populations partly composed of very primitive CD34+CD38- hematopoietic stem/progenitor cells, which are often resistant to chemotherapy. First-line treatment with cytarabine and idarubicin fails to inhibit the proliferation of CD34+CD38- cells. In this study, we investigated Metformin's effect with or without first-line conventional chemotherapy, or with other drugs like venetoclax and S63845, on primitive and undifferentiated CD34+ AML cells in order to explore the potential of Metformin or S63845 to serve as adjuvant therapy for AML. We found that first-line conventional chemotherapy treatment inhibited the growth of cells and arrested the cells in the S phase of the cell cycle; however, metformin affected the accumulation of cells in the G2/M phase. We observed that CD34+ KG1a cells respond better to lower doses of cytarabine or idarubicin in combination with metformin. Also, we determined that treatment with cytarabine, venetoclax, and S63845 downregulated the strong tendency of CD34+ KG1a cells to form cell aggregates in culture due to the downregulation of leukemic stem cell markers like CD34 and CD44, as well as adhesion markers. Also, we found that idarubicin slightly upregulated myeloid differentiation markers, CD11b and CD14. Treatment with cytarabine, idarubicin, venetoclax, metformin, and S63845 upregulated some cell surface markers like HLA-DR expression, and metformin upregulated CD9, CD31, and CD105 cell surface marker expression. In conclusion, we believe that metformin has the potential to be used as an adjuvant in the treatment of resistant-to-first-line-chemotherapy AML cells. Also, we believe that the results of our study will stimulate further research and the potential use of changes in the expression of cell surface markers in the development of new therapeutic strategies.

Differential in vitro activity of the DNA topoisomerase inhibitor idarubicin against Trypanosoma rangeli and Trypanosoma cruzi

In this study the effect of eight DNA topoisomerase inhibitors on the growth Trypanosoma rangeli epimastigotes in cell culture was investigated. Among the eight compounds tested, idarubicin was the only compound that displayed promising trypanocidal activity with a half-maximal growth inhibition (GI50) value in the sub-micromolar range. Fluorescence-activated cell sorting analysis showed a reduction in DNA content in T. rangeli epimastigotes when treated with idarubicin. In contrast to T. rangeli, against Trypanosoma cruzi epimastigotes idarubicin was much less effective exhibiting a GI50 value in the mid-micromolar range. This result indicates that idarubicin displays differential toxic effects in T. rangeli and T. cruzi. Compared with African trypanosomes, it seems that American trypanosomes are generally less susceptible to DNA topoisomerase inhibitors.

Los oligonucleotidos antisense potencian la apoptosis inducida por la idarubicina en la linea celular K-562 / Antisense oligonucleotides increase the apoptotic effect of idarubicin in K-562 cell line

La línea celular K-562, portadora del rearreglo bcr/abl de tipo b3a2 es resistente a la apoptosis inducida por inhibidores de topoisomerasa II. Se trataron células de dicha línea con complejos de liposomas catiónicos (DMRIE-DOPE y Dcchol-DOPE) y oligonucleótidos antisense (ODNs AS) dirigidos contra el ARNm bcr/abl de tipo b3a2, y non sense (ODNs NS), en una razón 3:1 lípido/ADN, durante 72 horas, luego se incubaron durante 24 horas con idarubicina (IDA), 0.5 mug/ml, para inducir apoptosis. La misma se evaluó por observación morfológica al microscopio de fluorescencia. Las células tratadas con los conjugados DMRIE-DOPE y Dcchol/DOPE con el ODN AS específico mostraron un mayor porcentaje de apoptosis inducida por IDA (X + DS: 14.74 + 2.07 y 20.43 + 4.58, respectivamente) comparadas con los controles no tratados con ODNs (X + DS: 8.08 + 0.82); (p<0.005). Los datos indican que los ODNs-AS dirigidos contra el ARNm bcr-abl de tipo b3a2 vuelven a las células de la línea K-562 sensibles a la IDA a la concentración mencionada.

Importância clínica da resistência a múltiplas drogas nas leucemias agudas / The clinical importance of the resistance to multiple drugs in acute leukemias

Um número significativo de pacientes com leucemia aguda falha em conseguir cura devido ao desenvolvimento de resistência aos quimioterápicos. Uma série de evidências indica que a expressao do gen mdr 1, que codifica para a glicoproteína P (GpP), contribui para a resistência das células leucêmicas aos agentes antineoplásicos. A GpP funciona como uma bomba de efluxo, dependente de ATP, transportando diversas drogas, aparentemente nao-relacionadas, para o exterior da célula. Essa açao pode ser modulada por uma série de drogas denominadas reversoras ou moduladoras da resistência a múltiplas drogas (MDR). No presente trabalho, sao citados alguns métodos para a detecçao do fenótipo MDR, salientando-se que, possivelmente, os resultados mais seguros sao aqueles que utilizam a associaçao de vários métodos. Apesar das divergências quanto ao método mais sensível e específico, a maioria dos autores concorda com o fenótipo MDR, isoladamente, influencia no prognóstico. A coexpressao da GpP com a molécula CD34 confere um pior prognóstico nas leucemias agudas. Os autores demonstram, usando testes de cultura celular com quimioterápicos isoladamente ou associadas a agentes reverssores, que essa linha de pesquisa pode sugerir, no futuro, um tratamento clínico individualizado. Eles enfatizam a necessidade de um estudo integrado dos hematologistas com a pesquisa básica, visando proporcionar uma nova opçao terapêutica aos pacientes refratários ao tratamento convencional.