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Dartora VFC, Passos JS, Costa-Lotufo LV, Lopes LB, Panitch A. Thermosensitive Polymeric Nanoparticles for Drug Co-Encapsulation and Breast Cancer Treatment. Pharmaceutics 2024; 16:231. [PMID: 38399285 PMCID: PMC10892816 DOI: 10.3390/pharmaceutics16020231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Despite advances in breast cancer treatment, there remains a need for local management of noninvasive, low-grade ductal carcinoma in situ (DCIS). These focal lesions are well suited for local intraductal treatment. Intraductal administration supported target site drug retention, improved efficacy, and reduced systemic exposure. Here, we used a poly(N-isopropyl acrylamide, pNIPAM) nanoparticle delivery system loaded with cytotoxic piplartine and an MAPKAP Kinase 2 inhibitor (YARA) for this purpose. For tumor environment targeting, a collagen-binding peptide SILY (RRANAALKAGELYKSILYGSG-hydrazide) was attached to pNIPAM nanoparticles, and the nanoparticle diameter, zeta potential, drug loading, and release were assessed. The system was evaluated for cytotoxicity in a 2D cell culture and 3D spheroids. In vivo efficacy was evaluated using a chemical carcinogenesis model in female Sprague-Dawley rats. Nanoparticle delivery significantly reduced the IC50 of piplartine (4.9 times) compared to the drug in solution. The combination of piplartine and YARA in nanoparticles further reduced the piplartine IC50 (~15 times). Treatment with these nanoparticles decreased the in vivo tumor incidence (5.2 times). Notably, the concentration of piplartine in mammary glands treated with nanoparticles (35.3 ± 22.4 μg/mL) was substantially higher than in plasma (0.7 ± 0.05 μg/mL), demonstrating targeted drug retention. These results indicate that our nanocarrier system effectively reduced tumor development with low systemic exposure.
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Affiliation(s)
- Vanessa Franco Carvalho Dartora
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo 05508-900, Brazil; (V.F.C.D.); (J.S.P.); (L.V.C.-L.); (L.B.L.)
- Department of Biomedical Engineering, College of Engineering, University of California Davis, Davis, CA 95616, USA
| | - Julia S. Passos
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo 05508-900, Brazil; (V.F.C.D.); (J.S.P.); (L.V.C.-L.); (L.B.L.)
| | - Leticia V. Costa-Lotufo
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo 05508-900, Brazil; (V.F.C.D.); (J.S.P.); (L.V.C.-L.); (L.B.L.)
| | - Luciana B. Lopes
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo 05508-900, Brazil; (V.F.C.D.); (J.S.P.); (L.V.C.-L.); (L.B.L.)
| | - Alyssa Panitch
- Department of Biomedical Engineering, College of Engineering, University of California Davis, Davis, CA 95616, USA
- Wallace H. Coulter Department of Biomedical Engineering, College of Engineering, Georgia Institute of Technology, School of Medicine, Emory University, Atlanta, GA 30322, USA
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Alimbetov D, Umbayev B, Tsoy A, Begimbetova D, Davis T, Kipling D, Askarova S. Small molecule targeting of the p38/Mk2 stress signaling pathways to improve cancer treatment. BMC Cancer 2023; 23:895. [PMID: 37740222 PMCID: PMC10517462 DOI: 10.1186/s12885-023-11319-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/18/2023] [Indexed: 09/24/2023] Open
Abstract
PURPOSE Although a long-term goal of cancer therapy always has been the development of agents that selectively destroy cancer cells, more recent trends have been to seek secondary agents that sensitize cancer cells to existing treatment regimens. In this regard, the present study explored the possibility of using small molecule inhibitors of p38MAPK/MK2 stress signaling pathways as potential agents to enhance the sensitivity of cancer cells with abrogated G1 checkpoint to the DNA damaging agent etoposide by specifically targeting the DNA damage-induced G2 cell cycle checkpoint. METHODS We have applied CCK8 and FACS-based viability assays and cell cycle analysis to investigate the effect of small molecules SB203580 and MK2.III on the sensitivity of small cell lung cancer cells (SCLC) that lack the G1 checkpoint to the DNA damaging agent Etoposide when used in combination. We have also assessed the effectiveness of combination chemotherapy on tumor xenograft suppression with etoposide and MK2.III in immunosuppressed mice. In addition, additional CCK8 cell viability analysis of the MDA-MB-231 breast cancer cell line, and SW620, and SW480 colorectal cancer cell lines was performed. RESULTS Results suggest that etoposide produces a profound effect on the cell cycle profile of cells in a manner that is consistent with the degree of cell viability that is seen using the viable cell assay. Results of the co-treatment experiments revealed that the p38/MK2 kinase inhibitors SB203580 and MK2.III both enhanced the DNA-damaging effects of etoposide on NCI-H69 cell viability in vitro. Results revealed that in vivo MK2.III was able to act as a chemosensitizer when used in combination with etoposide making NCI-H69 lung cancer cells sensitive to chemotherapeutic drug by 45% compared to single usage of the drug. We also report that MK2.III sensitizes metastatic cell lines SW-620 and MDA-MB-231 to etoposide but does not increase the sensitivity of non-metastasizing SW-480 colorectal cells to DNA damaging agent in vitro. CONCLUSION Findings reported in this study provide evidence that specific inhibitors of MK2 may indeed improve overall cancer therapy; however, their effectiveness depends on cell types.
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Affiliation(s)
- D Alimbetov
- Creehey Children's Cancer Research Institute, UT Health at San Antonio, San Antonio, USA.
| | - B Umbayev
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - A Tsoy
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - D Begimbetova
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - T Davis
- Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, UK
| | - D Kipling
- Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, UK
| | - Sh Askarova
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan.
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Zhang J, Bellani MA, Huang J, James RC, Pokharel D, Gichimu J, Gali H, Stewart G, Seidman MM. Replication of the Mammalian Genome by Replisomes Specific for Euchromatin and Heterochromatin. Front Cell Dev Biol 2021; 9:729265. [PMID: 34532320 PMCID: PMC8438199 DOI: 10.3389/fcell.2021.729265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/10/2021] [Indexed: 11/26/2022] Open
Abstract
Replisomes follow a schedule in which replication of DNA in euchromatin is early in S phase while sequences in heterochromatin replicate late. Impediments to DNA replication, referred to as replication stress, can stall replication forks triggering activation of the ATR kinase and downstream pathways. While there is substantial literature on the local consequences of replisome stalling-double strand breaks, reversed forks, or genomic rearrangements-there is limited understanding of the determinants of replisome stalling vs. continued progression. Although many proteins are recruited to stalled replisomes, current models assume a single species of "stressed" replisome, independent of genomic location. Here we describe our approach to visualizing replication fork encounters with the potent block imposed by a DNA interstrand crosslink (ICL) and our discovery of an unexpected pathway of replication restart (traverse) past an intact ICL. Additionally, we found two biochemically distinct replisomes distinguished by activity in different stages of S phase and chromatin environment. Each contains different proteins that contribute to ICL traverse.
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Affiliation(s)
- Jing Zhang
- Department of Neurosurgery, Institute for Advanced Study, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Marina A. Bellani
- Laboratory of Molecular Biology and Immunology, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Jing Huang
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Biology, Institute of Chemical Biology and Nanomedicine, Hunan University, Changsha, China
| | - Ryan C. James
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, NY, United States
| | - Durga Pokharel
- Horizon Discovery Group plc, Lafayette, CO, United States
| | - Julia Gichimu
- Laboratory of Molecular Biology and Immunology, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Himabindu Gali
- Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Grant Stewart
- College of Medical and Dental Sciences, Institute of Cancer and Genomic Science, University of Birmingham, Birmingham, United Kingdom
| | - Michael M. Seidman
- Laboratory of Molecular Biology and Immunology, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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Traub B, Roth A, Kornmann M, Knippschild U, Bischof J. Stress-activated kinases as therapeutic targets in pancreatic cancer. World J Gastroenterol 2021; 27:4963-4984. [PMID: 34497429 PMCID: PMC8384741 DOI: 10.3748/wjg.v27.i30.4963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/17/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer is a dismal disease with high incidence and poor survival rates. With the aim to improve overall survival of pancreatic cancer patients, new therapeutic approaches are urgently needed. Protein kinases are key regulatory players in basically all stages of development, maintaining physiologic functions but also being involved in pathogenic processes. c-Jun N-terminal kinases (JNK) and p38 kinases, representatives of the mitogen-activated protein kinases, as well as the casein kinase 1 (CK1) family of protein kinases are important mediators of adequate response to cellular stress following inflammatory and metabolic stressors, DNA damage, and others. In their physiologic roles, they are responsible for the regulation of cell cycle progression, cell proliferation and differentiation, and apoptosis. Dysregulation of the underlying pathways consequently has been identified in various cancer types, including pancreatic cancer. Pharmacological targeting of those pathways has been the field of interest for several years. While success in earlier studies was limited due to lacking specificity and off-target effects, more recent improvements in small molecule inhibitor design against stress-activated protein kinases and their use in combination therapies have shown promising in vitro results. Consequently, targeting of JNK, p38, and CK1 protein kinase family members may actually be of particular interest in the field of precision medicine in patients with highly deregulated kinase pathways related to these kinases. However, further studies are warranted, especially involving in vivo investigation and clinical trials, in order to advance inhibition of stress-activated kinases to the field of translational medicine.
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Affiliation(s)
- Benno Traub
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm 89081, Germany
| | - Aileen Roth
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm 89081, Germany
| | - Marko Kornmann
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm 89081, Germany
| | - Uwe Knippschild
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm 89081, Germany
| | - Joachim Bischof
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm 89081, Germany
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Qeadan F, Bansal P, Hanson JA, Beswick EJ. The MK2 pathway is linked to G-CSF, cytokine production and metastasis in gastric cancer: a novel intercorrelation analysis approach. J Transl Med 2020; 18:137. [PMID: 32216812 PMCID: PMC7098132 DOI: 10.1186/s12967-020-02294-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 03/11/2020] [Indexed: 02/07/2023] Open
Abstract
Background Gastric cancer is associated with chronic inflammation, but there is still much to understand about the tumor microenvironment and the underlying tumor-promoting mechanisms. The Map kinase-activated protein kinase 2 (MK2) pathway is a regulator of inflammatory cytokine production that we have been studying in gastrointestinal cancers. Here, we set out to determine the significance of this gene in gastric cancer along with its downstream mediators and if there were differences in the primary tumors with and without metastasis. Methods Human gastric cancer tissues with and without metastasis were examined for MK2 expression and cytokine profile in organ culture supernatants. Advanced statistical methods including a lower triangular correlation matrix, novel rooted correlation network, linear and logistic regression modeling along with Kruskal–Wallis testing with Sidak correction for multiple testing were applied to gain understanding of cytokines/chemokines linked to metastasis. Results The MK2 pathway is strongly linked with metastasis and a panel of cytokines. Gene expression was able to classify gastric cancer metastasis 85.7% of the time. A significant association with a panel of cytokines was found, including G-CSF, GM-CSF, Mip-1β, IFN-α, MCP-1, IL-1β, IL-6, and TNF-α. Mip-1β was found to have the strongest association with MK2 and metastasis after Sidak correction for multiple testing. Conclusions MK2 gene expression and a novel associated cytokine panel are linked to gastric cancer metastasis. G-CSF is the strongest cytokine to differentiate between metastasis and non-metastasis patients and had the lowest P value, while Mip-1β showed the strongest association with MK2 and metastasis after Sidak correction. MK2 and associated cytokines are potential biomarkers for gastric cancer metastasis. The novel intercorrelation analysis approach is a promising method for understanding the complex nature of cytokine/chemokine regulation and links to disease outcome.
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Affiliation(s)
- Fares Qeadan
- Department of Family and Preventative Medicine, University of Utah, Salt Lake City, UT, USA
| | - Pranshu Bansal
- New Mexico Oncology Hematology Consultants, Albuquerque, NM, USA
| | - Joshua A Hanson
- Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Ellen J Beswick
- Division of Gastroenterology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
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Phoa AF, Recasens A, Gurgis FMS, Betts TA, Menezes SV, Chau D, Nordfors K, Haapasalo J, Haapasalo H, Johns TG, Stringer BW, Day BW, Buckland ME, Lalaoui N, Munoz L. MK2 Inhibition Induces p53-Dependent Senescence in Glioblastoma Cells. Cancers (Basel) 2020; 12:cancers12030654. [PMID: 32168910 PMCID: PMC7139970 DOI: 10.3390/cancers12030654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 11/16/2022] Open
Abstract
MAPK-activated protein kinase 2 (MK2) has diverse roles in cancer. In response to chemotherapy, MK2 inhibition is synthetically lethal to p53-deficiency. While TP53 deletion is rare in glioblastomas, these tumors often carry TP53 mutations. Here, we show that MK2 inhibition strongly attenuated glioblastoma cell proliferation through p53wt stabilization and senescence. The senescence-inducing efficacy of MK2 inhibition was particularly strong when cells were co-treated with the standard-of-care temozolomide. However, MK2 inhibition also increased the stability of p53 mutants and enhanced the proliferation of p53-mutant stem cells. These observations reveal that in response to DNA damaging chemotherapy, targeting MK2 in p53-mutated cells produces a phenotype that is distinct from the p53-deficient phenotype. Thus, MK2 represents a novel drug target in 70% glioblastomas harboring intact TP53 gene. However, targeting MK2 in tumors with TP53 mutations may accelerate disease progression. These findings are highly relevant since TP53 mutations occur in over 50% of all cancers.
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Affiliation(s)
- Athena F. Phoa
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
| | - Ariadna Recasens
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
| | - Fadi M. S. Gurgis
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
| | - Tara A. Betts
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
| | - Sharleen V. Menezes
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
| | - Diep Chau
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia; (D.C.); (N.L.)
- Department of Medical Biology, University of Melbourne, Parkville, Victoria 3050, Australia
| | - Kristiina Nordfors
- Department of Pediatrics, Tampere University Hospital, 33521 Tampere, Finland;
- Tampere Center for Child Health Research, University of Tampere, 33014 Tampere, Finland
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;
| | - Joonas Haapasalo
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, FI-33521 Tampere, Finland;
| | - Hannu Haapasalo
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, FI-33521 Tampere, Finland;
| | - Terrance G. Johns
- Oncogenic Signalling Laboratory, Telethon Kids Institute, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia;
| | - Brett W. Stringer
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; (B.W.S.); (B.W.D.)
| | - Bryan W. Day
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; (B.W.S.); (B.W.D.)
| | - Michael E. Buckland
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
- Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Najoua Lalaoui
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia; (D.C.); (N.L.)
- Department of Medical Biology, University of Melbourne, Parkville, Victoria 3050, Australia
| | - Lenka Munoz
- School of Medical Sciences, Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia; (A.F.P.); (A.R.); (F.M.S.G.); (T.A.B.); (S.V.M.); (M.E.B.)
- Correspondence: ; Tel.: +61-293-512-315
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Wang R, Liu H, Shao Y, Wang K, Yin S, Qiu Y, Wu H, Liu E, Wang T, Gao X, Yu H. Sophoridine Inhibits Human Colorectal Cancer Progression via Targeting MAPKAPK2. Mol Cancer Res 2019; 17:2469-2479. [DOI: 10.1158/1541-7786.mcr-19-0553] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/23/2019] [Accepted: 09/27/2019] [Indexed: 12/24/2022]
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Guo M, Sun D, Fan Z, Yuan Y, Shao M, Hou J, Zhu Y, Wei R, Zhu Y, Qian J, Li F, Yang Y, Gu C. Targeting MK2 Is a Novel Approach to Interfere in Multiple Myeloma. Front Oncol 2019; 9:722. [PMID: 31440466 PMCID: PMC6694709 DOI: 10.3389/fonc.2019.00722] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/19/2019] [Indexed: 01/21/2023] Open
Abstract
MAPKAPK2 (MK2), the direct substrate of p38 MAPK, has been well-acknowledged as an attractive drug target for cancer therapy. However, few studies have assessed the functions of it in multiple myeloma (MM). In the present study, MK2 expression of MM patients was analyzed by gene expression profiling (GEP) and array-based comparative genomic hybridization (aCGH). Several experiments in vitro including MTT assay, Western blot and flow cytometry analysis were performed to identify the function of MK2 in MM. In addition, we conducted mouse survival experiments to explain the effects of MK2 on MM in vivo. mRNA level of MK2 and chromosomal gain of MK2 locus in MM cells significantly increased compared to normal samples. Furthermore, MM patients with high expression of MK2 were associated with a poor outcome. Follow-up studies showed that MK2 exerted a remarkably positive effect on MM cell proliferation and drug-resistance. Further exploration focusing on MK2 inhibitor IV revealed its inhibitory action on MM growth and drug-resistance, as well as improving survival in mouse models. In addition, a combination of MK2 inhibitor IV and the key MM therapeutic agents including bortezomib, doxorubicin, or dexamethasone facilitated curative effects on inhibiting MM cell proliferation. Taken together, our study reveals the clinical relevance of MK2 inhibition in MM and demonstrates that targeting MK2 may afford a new therapeutic approach to MM.
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Affiliation(s)
- Mengjie Guo
- The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Dongdong Sun
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhimin Fan
- The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuxia Yuan
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Miaomiao Shao
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianhao Hou
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuqi Zhu
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Rongfang Wei
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Zhu
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jinjun Qian
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fei Li
- Department of Hematology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ye Yang
- School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China.,School of Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunyan Gu
- The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, Nanjing, China
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