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De Falco F, Rompietti C, Sorcini D, Esposito A, Scialdone A, Baldoni S, Del Papa B, Adamo FM, Silva Barcelos EC, Dorillo E, Stella A, Di Ianni M, Screpanti I, Sportoletti P, Rosati E. GSK3β is a critical, druggable component of the network regulating the active NOTCH1 protein and cell viability in CLL. Cell Death Dis 2022; 13:755. [PMID: 36050315 PMCID: PMC9436923 DOI: 10.1038/s41419-022-05178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 01/21/2023]
Abstract
NOTCH1 alterations have been associated with chronic lymphocytic leukemia (CLL), but the molecular mechanisms underlying NOTCH1 activation in CLL cells are not completely understood. Here, we show that GSK3β downregulates the constitutive levels of the active NOTCH1 intracellular domain (N1-ICD) in CLL cells. Indeed, GSK3β silencing by small interfering RNA increases N1-ICD levels, whereas expression of an active GSK3β mutant reduces them. Additionally, the GSK3β inhibitor SB216763 enhances N1-ICD stability at a concentration at which it also increases CLL cell viability. We also show that N1-ICD is physically associated with GSK3β in CLL cells. SB216763 reduces GSK3β/N1-ICD interactions and the levels of ubiquitinated N1-ICD, indicating a reduction in N1-ICD proteasomal degradation when GSK3β is less active. We then modulated the activity of two upstream regulators of GSK3β and examined the impact on N1-ICD levels and CLL cell viability. Specifically, we inhibited AKT that is a negative regulator of GSK3β and is constitutively active in CLL cells. Furthermore, we activated the protein phosphatase 2 A (PP2A) that is a positive regulator of GSK3β, and has an impaired activity in CLL. Results show that either AKT inhibition or PP2A activation reduce N1-ICD expression and CLL cell viability in vitro, through mechanisms mediated by GSK3β activity. Notably, for PP2A activation, we used the highly specific activator DT-061, that also reduces leukemic burden in peripheral blood, spleen and bone marrow in the Eµ-TCL1 adoptive transfer model of CLL, with a concomitant decrease in N1-ICD expression. Overall, we identify in GSK3β a key component of the network regulating N1-ICD stability in CLL, and in AKT and PP2A new druggable targets for disrupting NOTCH1 signaling with therapeutic potential.
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Affiliation(s)
- Filomena De Falco
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Chiara Rompietti
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Daniele Sorcini
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Angela Esposito
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Annarita Scialdone
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Stefano Baldoni
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy ,grid.412451.70000 0001 2181 4941Department of Medicine and Sciences of Aging, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Beatrice Del Papa
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Francesco Maria Adamo
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Estevão Carlos Silva Barcelos
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Erica Dorillo
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Arianna Stella
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Mauro Di Ianni
- grid.412451.70000 0001 2181 4941Department of Medicine and Sciences of Aging, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy ,grid.461844.bDepartment of Oncology and Hematology, Ospedale Civile “Santo Spirito”, ASL Pescara, Pescara, Italy
| | - Isabella Screpanti
- grid.7841.aDepartment of Molecular Medicine, University of Rome “La Sapienza”, Rome, Italy
| | - Paolo Sportoletti
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Emanuela Rosati
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Guarente V, Sportoletti P. Lessons, Challenges and Future Therapeutic Opportunities for PI3K Inhibition in CLL. Cancers (Basel) 2021; 13:cancers13061280. [PMID: 33805745 PMCID: PMC7999552 DOI: 10.3390/cancers13061280] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary The phosphoinositide 3-kinase (PI3K) is a family of kinases that play a key role in the biology of chronic lymphocytic leukemia (CLL). Inhibitors of PI3K demonstrated efficacy in the treatment of CLL, associated with significant adverse events that limited the clinical use of this drugs. In this review, we underlined the relevance of PI3K inhibitors in CLL, we collected recent data about the use of these molecules in clinical practice and in clinical trial discussing strategies for the management of adverse events, which could help to improve the use of these therapies in the treatment of CLL. Abstract Chronic lymphocytic leukemia (CLL) shows constitutive phosphatidylinositol 3-kinase (PI3K) activation resulting from aberrant regulation of the B-cell receptor (BCR) signaling. PI3K inhibitors have been evaluated in CLL therapy, bringing a new treatment opportunity for patients with this disease. Despite the proven therapeutic efficacy, the use of approved PI3K inhibitors is limited by severe immune-mediated toxicities and given the availability of other more tolerable agents. This article reviews the relevance of PI3K signaling and pharmacologic inhibition in CLL. Data on efficacy and toxicity of PI3K inhibitors are also presented, as well as strategies for overcoming barriers for their clinical use in CLL treatment.
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Del Papa B, Baldoni S, Dorillo E, De Falco F, Rompietti C, Cecchini D, Cantelmi MG, Sorcini D, Nogarotto M, Adamo FM, Mezzasoma F, Silva Barcelos EC, Albi E, Iacucci Ostini R, Di Tommaso A, Marra A, Montanaro G, Martelli MP, Falzetti F, Di Ianni M, Rosati E, Sportoletti P. Decreased NOTCH1 Activation Correlates with Response to Ibrutinib in Chronic Lymphocytic Leukemia. Clin Cancer Res 2019; 25:7540-7553. [PMID: 31578228 DOI: 10.1158/1078-0432.ccr-19-1009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/02/2019] [Accepted: 09/24/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Ibrutinib, a Bruton tyrosine kinase inhibitor (BTKi), has improved the outcomes of chronic lymphocytic leukemia (CLL), but primary resistance or relapse are issues of increasing significance. While the predominant mechanism of action of BTKi is the B-cell receptor (BCR) blockade, many off-target effects are unknown. We investigated potential interactions between BCR pathway and NOTCH1 activity in ibrutinib-treated CLL to identify new mechanisms of therapy resistance and markers to monitor disease response. EXPERIMENTAL DESIGN NOTCH activations was evaluated either in vitro and ex vivo in CLL samples after ibrutinib treatment by Western blotting. Confocal proximity ligation assay (PLA) experiments and analyses of down-targets of NOTCH1 by qRT-PCR were used to investigate the cross-talk between BTK and NOTCH1. RESULTS In vitro ibrutinib treatment of CLL significantly reduced activated NOTCH1/2 and induced dephosphorylation of eIF4E, a NOTCH target in CLL. BCR stimulation increased the expression of activated NOTCH1 that accumulated in the nucleus leading to HES1, DTX1, and c-MYC transcription. Results of in situ PLA experiments revealed the presence of NOTCH1-ICD/BTK complexes, whose number was reduced after ibrutinib treatment. In ibrutinib-treated CLL patients, leukemic cells showed NOTCH1 activity downregulation that deepened over time. The NOTCH1 signaling was restored at relapse and remained activated in ibrutinib-resistant CLL cells. CONCLUSIONS We demonstrated a strong clinical activity of ibrutinib in a real-life context. The ibrutinib clinical efficacy was associated with NOTCH1 activity downregulation that deepened over time. Our data point to NOTCH1 as a new molecular partner in BCR signaling with potential to further improve CLL-targeted treatments.
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Affiliation(s)
- Beatrice Del Papa
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Stefano Baldoni
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy.,Department of Life, Health and Environmental Sciences, Hematology Section, University of L'Aquila, L'Aquila, Italy
| | - Erica Dorillo
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Filomena De Falco
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Chiara Rompietti
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Debora Cecchini
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Maria Grazia Cantelmi
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Daniele Sorcini
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Manuel Nogarotto
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Francesco Maria Adamo
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Federica Mezzasoma
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Estevão Carlos Silva Barcelos
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy.,Department of Biological Sciences, Postgraduate Program in Biotechnology (UFES), Federal University of Espirito Santo, Vitória-ES, Brazil
| | - Elisa Albi
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Roberta Iacucci Ostini
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Ambra Di Tommaso
- Department of Life, Health and Environmental Sciences, Hematology Section, University of L'Aquila, L'Aquila, Italy
| | - Andrea Marra
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Guido Montanaro
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy.,Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy
| | - Maria Paola Martelli
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Franca Falzetti
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Mauro Di Ianni
- Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy.,Department of Medicine and Aging Sciences, University of Chieti Pescara, Chieti, Italy
| | - Emanuela Rosati
- Department of Experimental Medicine, Biosciences and Medical Embriology Section, University of Perugia, Perugia, Italy
| | - Paolo Sportoletti
- Institute of Hematology-Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy.
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4
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Pelullo M, Zema S, Nardozza F, Checquolo S, Screpanti I, Bellavia D. Wnt, Notch, and TGF-β Pathways Impinge on Hedgehog Signaling Complexity: An Open Window on Cancer. Front Genet 2019; 10:711. [PMID: 31552081 PMCID: PMC6736567 DOI: 10.3389/fgene.2019.00711] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/05/2019] [Indexed: 12/22/2022] Open
Abstract
Constitutive activation of the Hedgehog (Hh) signaling pathway is associated with increased risk of developing several malignancies. The biological and pathogenic importance of Hh signaling emphasizes the need to control its action tightly, both physiologically and therapeutically. Evidence of crosstalk between Hh and other signaling pathways is reported in many tumor types. Here, we provide an overview of the current knowledge about the communication between Hh and major signaling pathways, such as Notch, Wnt, and transforming growth factor β (TGF-β), which play critical roles in both embryonic and adult life. When these pathways are unbalanced, impaired crosstalk contributes to disease development. It is reported that more than one of these pathways are active in different type of tumors, at the same time. Therefore, starting from a plethora of stimuli that activate multiple signaling pathways, we describe the signals that preferentially converge on the Hh signaling cascade that influence its activity. Moreover, we highlight several connection points between Hh and Notch, Wnt, or TGF-β pathways, showing a reciprocal synergism that contributes to tumorigenesis, supporting a more malignant behavior by tumor cells, such as in leukemia and brain tumors. Understanding the importance of these molecular interlinking networks will provide a rational basis for combined anticancer drug development.
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Affiliation(s)
- Maria Pelullo
- Center of Life Nano Science Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Sabrina Zema
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | | | - Saula Checquolo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | | | - Diana Bellavia
- Department of Molecular Medicine, Sapienza University, Rome, Italy
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Diminished interaction between mutant NOTCH1 and the NuRD corepressor complex upregulates CCL17 in chronic lymphocytic leukemia. Leukemia 2019; 33:2951-2956. [DOI: 10.1038/s41375-019-0526-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/12/2019] [Accepted: 05/31/2019] [Indexed: 12/26/2022]
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6
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Hu B, Patel KP, Chen H, Wang X, Wang F, Luthra R, Routbort MJ, Kanagal‐Shamanna R, Medeiros LJ, Yin CC, Zuo Z, Ok CY, Loghavi S, Tang G, Tambaro FP, Thompson P, Burger J, Jain N, Ferrajoli A, Bose P, Estrov Z, Keating MJ, Wierda WG. Routine sequencing inCLLhas prognostic implications and provides new insight into pathogenesis and targeted treatments. Br J Haematol 2019; 185:852-864. [DOI: 10.1111/bjh.15877] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/10/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Boyu Hu
- Division of Hematology and Hematologic Malignancies Huntsman Cancer Institute/University of Utah Salt Lake City UT USA
| | - Keyur P. Patel
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Hsiang‐Chun Chen
- Department of Biostatistics the University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Xuemei Wang
- Department of Biostatistics the University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Feng Wang
- Department of Genomic Medicine the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Rajyalakshmi Luthra
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Mark J. Routbort
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | | | - Leonard J. Medeiros
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Cheng C. Yin
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Zhuang Zuo
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Chi Y. Ok
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Sanam Loghavi
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Guilin Tang
- Department of Hematopathology The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | | | - Philip Thompson
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Jan Burger
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Nitin Jain
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Alessandra Ferrajoli
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Prithviraj Bose
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Zeev Estrov
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - Michael J. Keating
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
| | - William G. Wierda
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston TX USA
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IL-4-dependent Jagged1 expression/processing is associated with survival of chronic lymphocytic leukemia cells but not with Notch activation. Cell Death Dis 2018; 9:1160. [PMID: 30478302 PMCID: PMC6255763 DOI: 10.1038/s41419-018-1185-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 12/15/2022]
Abstract
As previously reported, chronic lymphocytic leukemia (CLL) cells show constitutive Notch1/2 activation and express the Notchligand Jagged1. Despite increasing knowledge of the impact of Notch alterations on CLL biology and pathogenesis, the role of Jagged1 expressed in CLL cells remains undefined. In other cell types, it has been shown that after Notch engagement, Jagged1 not only activates Notch in signal-receiving cell, but also undergoes proteolytic activation in signal-sending cell, triggering a signaling with biological effects. We investigated whether Jagged1 expressed in CLL cells undergoes proteolytic processing and/or is able to induce Notch activation through autocrine/paracrine loops, focusing on the effect that CLL prosurvival factor IL-4 could exert on the Notch-Jagged1 system in these cells. We found that Jagged1 was constitutively processed in CLL cells and generated an intracellular fragment that translocated into the nucleus, and an extracellular fragment released into the culture supernatant. IL-4 enhanced expression of Jagged1 and its intracellular fragments, as well as Notch1/2 activation. The IL-4-induced increase in Notch1/2 activation was independent of the concomitant upregulated Jagged1 levels. Indeed, blocking Notch-Jagged1 interactions among CLL cells with Jagged1 neutralizing antibodies did not affect the expression of the Notch target Hes1. Notably, anti-Jagged1 antibodies partially prevented the IL-4-induced increase in Jagged1 processing and cell viability, suggesting that Jagged1 processing is one of the events contributing to IL-4-induced CLL cell survival. Consistent with this, Jagged1 silencing by small interfering RNA partially counteracted the capacity of IL-4 to promote CLL cell survival. Investigating the pathways whereby IL-4 promoted Notch1/2 activation in CLL cells independent of Jagged1, we found that PI3Kδ/AKT and PKCδ were involved in upregulating Notch1 and Notch2 proteins, respectively. Overall, this study provides new insights into the Notch-ligand system in CLL cells and suggests that targeting this system may be exploited as a novel/additional therapy approach for CLL.
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8
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Baldoni S, Del Papa B, Dorillo E, Aureli P, De Falco F, Rompietti C, Sorcini D, Varasano E, Cecchini D, Zei T, Di Tommaso A, Rosati E, Alexe G, Roti G, Stegmaier K, Di Ianni M, Falzetti F, Sportoletti P. Bepridil exhibits anti-leukemic activity associated with NOTCH1 pathway inhibition in chronic lymphocytic leukemia. Int J Cancer 2018; 143:958-970. [PMID: 29508386 PMCID: PMC6055653 DOI: 10.1002/ijc.31355] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/15/2018] [Accepted: 02/21/2018] [Indexed: 12/30/2022]
Abstract
Dysregulated NOTCH1 signaling, by either gene mutations or microenvironment interactions, has been increasingly linked to chronic lymphocytic leukemia (CLL). Thus, inhibiting NOTCH1 activity represents a potential therapeutic opportunity for this disease. Using gene expression-based screening, we identified the calcium channel modulator bepridil as a new NOTCH1 pathway inhibitor. In primary CLL cells, bepridil induced selective apoptosis even in the presence of the protective stroma. Cytotoxic effects of bepridil were independent of NOTCH1 mutation and other prognostic markers. The antitumor efficacy of bepridil was associated with inhibition of NOTCH1 activity through a decrement in trans-membrane and activated NOTCH1 protein levels with unchanged NOTCH2 protein levels. In a CLL xenotransplant model, bepridil significantly reduced the percentage of leukemic cells infiltrating the spleen via enhanced apoptosis and decreased NOTCH1 activation. In conclusion, we report in vitro and in vivo anti-leukemic activity of bepridil associated with inhibition of the NOTCH1 pathway in CLL. These data provide a rationale for the clinical development of bepridil as anti-NOTCH1 targeted therapy for CLL patients.
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MESH Headings
- Animals
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Bepridil/pharmacology
- Biomarkers, Tumor/metabolism
- Calcium Channel Blockers/pharmacology
- Chemotaxis/drug effects
- Drug Screening Assays, Antitumor
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Mesenchymal Stem Cells/cytology
- Mesenchymal Stem Cells/drug effects
- Mice
- Mutation
- Prognosis
- Receptor, Notch1/antagonists & inhibitors
- Receptor, Notch1/genetics
- Receptor, Notch1/metabolism
- Tumor Microenvironment
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Stefano Baldoni
- Hematology Section, Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Beatrice Del Papa
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Erica Dorillo
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Patrizia Aureli
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Filomena De Falco
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Chiara Rompietti
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Daniele Sorcini
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Emanuela Varasano
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Debora Cecchini
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Tiziana Zei
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Ambra Di Tommaso
- Hematology Section, Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Emanuela Rosati
- Biosciences and Medical Embryology Section, Department of Experimental MedicineUniversity of PerugiaPerugiaItaly
| | - Gabriela Alexe
- Department of Pediatric OncologyDana‐Farber Cancer Institute and Boston Children's Hospital, Harvard Medical SchoolBostonMA
| | - Giovanni Roti
- Hematology and BMT Unit, Department of Medicine and SurgeryUniversity of ParmaParmaItaly
| | - Kimberly Stegmaier
- Department of Pediatric OncologyDana‐Farber Cancer Institute and Boston Children's Hospital, Harvard Medical SchoolBostonMA
| | - Mauro Di Ianni
- Department of Medicine and Aging SciencesUniversity of Chieti PescaraChietiItaly
- Department of HematologyTransfusion Medicine and Biotechnologies, Ospedale CivilePescaraItaly
| | - Franca Falzetti
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
| | - Paolo Sportoletti
- Institute of Hematology‐Centro di Ricerche Emato‐Oncologiche (CREO), University of PerugiaPerugiaItaly
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9
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Rosati E, Baldoni S, De Falco F, Del Papa B, Dorillo E, Rompietti C, Albi E, Falzetti F, Di Ianni M, Sportoletti P. NOTCH1 Aberrations in Chronic Lymphocytic Leukemia. Front Oncol 2018; 8:229. [PMID: 29998084 PMCID: PMC6030253 DOI: 10.3389/fonc.2018.00229] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/05/2018] [Indexed: 01/13/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is an incurable B-cell neoplasm characterized by highly variable clinical outcomes. In recent years, genomic and molecular studies revealed a remarkable heterogeneity in CLL, which mirrored the clinical diversity of this disease. These studies profoundly enhanced our understanding of leukemia cell biology and led to the identification of new biomarkers with potential prognostic and therapeutic significance. Accumulating evidence indicates a key role of deregulated NOTCH1 signaling and NOTCH1 mutations in CLL. This review highlights recent discoveries that improve our understanding of the pathophysiological NOTCH1 signaling in CLL and the clinical impact of NOTCH1 mutations in retrospective and prospective trials. In addition, we discuss the rationale for a therapeutic strategy aiming at inhibiting NOTCH1 signaling in CLL, along with an overview on the currently available NOTCH1-directed approaches.
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Affiliation(s)
- Emanuela Rosati
- Department of Experimental Medicine, Biosciences and Medical Embryology Section, University of Perugia, Perugia, Italy
| | - Stefano Baldoni
- Department of Life, Hematology Section, Health and Environmental Sciences, University of L'Aquila, Perugia, Italy
| | - Filomena De Falco
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Beatrice Del Papa
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Erica Dorillo
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Chiara Rompietti
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Elisa Albi
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Franca Falzetti
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Mauro Di Ianni
- Department of Medicine and Aging Sciences, University of Chieti Pescara, Chieti, Italy.,Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy
| | - Paolo Sportoletti
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
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Di Ianni M, Baldoni S, Del Papa B, Aureli P, Dorillo E, De Falco F, Albi E, Varasano E, Di Tommaso A, Giancola R, Accorsi P, Rotta G, Rompietti C, Silva Barcelos EC, Campese AF, Di Bartolomeo P, Screpanti I, Rosati E, Falzetti F, Sportoletti P. NOTCH1 Is Aberrantly Activated in Chronic Lymphocytic Leukemia Hematopoietic Stem Cells. Front Oncol 2018; 8:105. [PMID: 29732315 PMCID: PMC5919960 DOI: 10.3389/fonc.2018.00105] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/23/2018] [Indexed: 11/13/2022] Open
Abstract
To investigate chronic lymphocytic leukemia (CLL)-initiating cells, we assessed NOTCH1 mutation/expression in hematopoietic stem cells (HSCs). In NOTCH1-mutated CLL, we detected subclonal mutations in 57% CD34+/CD38− HSCs. NOTCH1 mutation was present in 66% CD34+/CD38+ progenitor cells displaying an increased mutational burden compared to HSCs. Flow cytometric analysis revealed significantly higher NOTCH1 activation in CD34+/CD38− and CD34+/CD38+ cells from CLL patients, regardless NOTCH1 mutation compared to healthy donors. Activated NOTCH1 resulted in overexpression of the NOTCH1 target c-MYC. We conclude that activated NOTCH1 is an early event in CLL that may contribute to aberrant HSCs in this disease.
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Affiliation(s)
- Mauro Di Ianni
- Department of Medicine and Aging Sciences, University of Chieti Pescara, Chieti, Italy.,Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy
| | - Stefano Baldoni
- Department of Life, Health and Environmental Sciences, Hematology Section, University of L'Aquila, L'Aquila, Italy
| | - Beatrice Del Papa
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Patrizia Aureli
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Erica Dorillo
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Filomena De Falco
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Elisa Albi
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Emanuela Varasano
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Ambra Di Tommaso
- Department of Life, Health and Environmental Sciences, Hematology Section, University of L'Aquila, L'Aquila, Italy
| | - Raffaella Giancola
- Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy
| | - Patrizia Accorsi
- Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy
| | | | - Chiara Rompietti
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Estevão Carlos Silva Barcelos
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy.,Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Paolo Di Bartolomeo
- Department of Hematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy
| | - Isabella Screpanti
- Department of Molecular Medicine, Sapienza, University of Rome, Rome, Italy
| | - Emanuela Rosati
- Department of Experimental Medicine, Biosciences and Medical Embriology Section, University of Perugia, Perugia, Italy
| | - Franca Falzetti
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Paolo Sportoletti
- Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
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Abstract
The recent discovery of genes mutated in chronic lymphocytic leukemia (CLL) has stimulated new research into the role of these genes in CLL pathogenesis. CLL cases carry approximately 5-20 mutated genes per exome, a lower number than detected in many human tumors. Of the recurrently mutated genes in CLL, all are mutated in 10% or less of patients when assayed in unselected CLL cohorts at diagnosis. Mutations in TP53 are of major clinical relevance, are often associated with del17p and gain in frequency over time. TP53 mutated and associated del17p states substantially lower response rates, remission duration, and survival in CLL. Mutations in NOTCH1 and SF3B1 are recurrent, often associated with progressive CLL that is also IgVH unmutated and ZAP70-positive and are under investigation as targets for novel therapies and as factors influencing CLL outcome. There are an estimated 20-50 additional mutated genes with frequencies of 1%-5% in CLL; more work is needed to identify these and to study their significance. Finally, of the major biological aberration categories influencing CLL as a disease, gene mutations will need to be placed into context with regard to their ultimate role and importance. Such calibrated appreciation necessitates studies incorporating multiple CLL driver aberrations into biological and clinical analyses.
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Affiliation(s)
- Nisar A Amin
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Sami N Malek
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA.
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Ruffalo M, Koyutürk M, Sharan R. Network-Based Integration of Disparate Omic Data To Identify "Silent Players" in Cancer. PLoS Comput Biol 2015; 11:e1004595. [PMID: 26683094 PMCID: PMC4684294 DOI: 10.1371/journal.pcbi.1004595] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/12/2015] [Indexed: 11/18/2022] Open
Abstract
Development of high-throughput monitoring technologies enables interrogation of cancer samples at various levels of cellular activity. Capitalizing on these developments, various public efforts such as The Cancer Genome Atlas (TCGA) generate disparate omic data for large patient cohorts. As demonstrated by recent studies, these heterogeneous data sources provide the opportunity to gain insights into the molecular changes that drive cancer pathogenesis and progression. However, these insights are limited by the vast search space and as a result low statistical power to make new discoveries. In this paper, we propose methods for integrating disparate omic data using molecular interaction networks, with a view to gaining mechanistic insights into the relationship between molecular changes at different levels of cellular activity. Namely, we hypothesize that genes that play a role in cancer development and progression may be implicated by neither frequent mutation nor differential expression, and that network-based integration of mutation and differential expression data can reveal these “silent players”. For this purpose, we utilize network-propagation algorithms to simulate the information flow in the cell at a sample-specific resolution. We then use the propagated mutation and expression signals to identify genes that are not necessarily mutated or differentially expressed genes, but have an essential role in tumor development and patient outcome. We test the proposed method on breast cancer and glioblastoma multiforme data obtained from TCGA. Our results show that the proposed method can identify important proteins that are not readily revealed by molecular data, providing insights beyond what can be gleaned by analyzing different types of molecular data in isolation. Identification of cancer-related genes is an important task, made more difficult by heterogeneity between samples and even within individual patients. Methods for identifying disease-related genes typically focus on individual data sets such as mutational and differential expression data, and therefore are limited to genes that are implicated by each data set in isolation. In this work we propose a method that uses protein interaction network information to integrate mutational and differential expression data on a sample-specific level, and combine this information across samples in ways that respect the commonalities and differences between distinct mutation and differential expression profiles. We use this information to identify genes that are associated with cancer but not readily identifiable by mutations or differential expression alone. Our method highlights the features that significantly predict a gene’s association with cancer, shows improved predictive power in recovering cancer-related genes in known pathways, and identifies genes that are neither frequently mutated nor differentially expressed but show significant association with survival.
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Affiliation(s)
- Matthew Ruffalo
- Department of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Mehmet Koyutürk
- Department of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, Ohio, United States of America
- Center for Proteomics and Bioinformatics, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (MK); (RS)
| | - Roded Sharan
- School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- * E-mail: (MK); (RS)
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