Therapeutic targeting of ACLY in T-ALL in vivo

T-cell Acute Lymphoblastic Leukemia (T-ALL) is a hematological malignancy in need of novel therapeutic approaches. Here, we identify the ATP-citrate lyase ACLY as a novel therapeutic target in T-ALL. Our results show that ACLY is overexpressed in T-ALL, and its expression correlates with NOTCH1 activity. To test the effects of ACLY in leukemia progression and the response to NOTCH1 inhibition, we developed an isogenic model of NOTCH1-induced Acly conditional knockout leukemia. Importantly, we observed intrinsic antileukemic effects upon loss of ACLY, which further synergized with NOTCH1 inhibition in vivo . Gene expression profiling analyses showed that the transcriptional signature of ACLY loss very significantly correlates with the signature of NOTCH1 inhibition in vivo , with significantly downregulated pathways related to oxidative phosphorylation, electron transport chain, ribosomal biogenesis and nucleosome biology. Consistently, metabolomic profiling upon ACLY loss revealed a metabolic crisis with accumulation of nucleotide intermediates and reduced levels of several amino acids. Overall, our results identify a link between NOTCH1 and ACLY and unveil ACLY as a novel promising target for T-ALL treatment.

Slow TCA flux and ATP production in primary solid tumours but not metastases

Tissues derive ATP from two pathways-glycolysis and the tricarboxylic acid (TCA) cycle coupled to the electron transport chain. Most energy in mammals is produced via TCA metabolism1. In tumours, however, the absolute rates of these pathways remain unclear. Here we optimize tracer infusion approaches to measure the rates of glycolysis and the TCA cycle in healthy mouse tissues, Kras-mutant solid tumours, metastases and leukaemia. Then, given the rates of these two pathways, we calculate total ATP synthesis rates. We find that TCA cycle flux is suppressed in all five primary solid tumour models examined and is increased in lung metastases of breast cancer relative to primary orthotopic tumours. As expected, glycolysis flux is increased in tumours compared with healthy tissues (the Warburg effect2,3), but this increase is insufficient to compensate for low TCA flux in terms of ATP production. Thus, instead of being hypermetabolic, as commonly assumed, solid tumours generally produce ATP at a slower than normal rate. In mouse pancreatic cancer, this is accommodated by the downregulation of protein synthesis, one of this tissue's major energy costs. We propose that, as solid tumours develop, cancer cells shed energetically expensive tissue-specific functions, enabling uncontrolled growth despite a limited ability to produce ATP.

A Therapeutically Targetable NOTCH1-SIRT1-KAT7 Axis in T-cell Leukemia

T-cell acute lymphoblastic leukemia (T-ALL) is a NOTCH1-driven disease in need of novel therapies. Here, we identify a NOTCH1-SIRT1-KAT7 link as a therapeutic vulnerability in T-ALL, in which the histone deacetylase SIRT1 is overexpressed downstream of a NOTCH1-bound enhancer. SIRT1 loss impaired leukemia generation, whereas SIRT1 overexpression accelerated leukemia and conferred resistance to NOTCH1 inhibition in a deacetylase-dependent manner. Moreover, pharmacologic or genetic inhibition of SIRT1 resulted in significant antileukemic effects. Global acetyl proteomics upon SIRT1 loss uncovered hyperacetylation of KAT7 and BRD1, subunits of a histone acetyltransferase complex targeting H4K12. Metabolic and gene-expression profiling revealed metabolic changes together with a transcriptional signature resembling KAT7 deletion. Consistently, SIRT1 loss resulted in reduced H4K12ac, and overexpression of a nonacetylatable KAT7-mutant partly rescued SIRT1 loss-induced proliferation defects. Overall, our results uncover therapeutic targets in T-ALL and reveal a circular feedback mechanism balancing deacetylase/acetyltransferase activation with potentially broad relevance in cancer.

SIGNIFICANCE

We identify a T-ALL axis whereby NOTCH1 activates SIRT1 through an enhancer region, and SIRT1 deacetylates and activates KAT7. Targeting SIRT1 shows antileukemic effects, partly mediated by KAT7 inactivation. Our results reveal T-ALL therapeutic targets and uncover a rheostat mechanism between deacetylase/acetyltransferase activities with potentially broader cancer relevance. This article is highlighted in the In This Issue feature, p. 1.

A mutation affecting laminin alpha 5 polymerisation gives rise to a syndromic developmental disorder

Laminin alpha 5 (LAMA5) is a member of a large family of proteins that trimerise and then polymerise to form a central component of all basement membranes. Consequently, the protein plays an instrumental role in shaping the normal development of the kidney, skin, neural tube, lung and limb, and many other organs and tissues. Pathogenic mutations in some laminins have been shown to cause a range of largely syndromic conditions affecting the competency of the basement membranes to which they contribute. We report the identification of a mutation in the polymerisation domain of LAMA5 in a patient with a complex syndromic disease characterised by defects in kidney, craniofacial and limb development, and by a range of other congenital defects. Using CRISPR-generated mouse models and biochemical assays, we demonstrate the pathogenicity of this variant, showing that the change results in a failure of the polymerisation of α/β/γ laminin trimers. Comparing these in vivo phenotypes with those apparent upon gene deletion in mice provides insights into the specific functional importance of laminin polymerisation during development and tissue homeostasis.

[SEASONAL VARIATION OF MICROVOLT T-WAVE ALTERNANS IN PATIENTS WITH CARDIOVASCULAR DISEASE AND HEALTHY SUBJECTS]

Objective - to access seasonal variation of microvolt T-wave alternans of ECG dispersion mapping in patients with cardiovascular disease and healthy subjects. ECG data of the three groups of healthy subjects have been compared: inhabitants of Beirut, Lebanon (n=51), inhabitants of Moscow, Russia (n=94) and ECG data of healthy subjects (n=44) from the testing ECG database of the PTB - The National Metrology Institute of Germany as well as a group of patients with cardiovascular disease (n=138), inhabitants of Beirut, Lebanon. Microvolt T-wave alternans of ECG dispersion mapping was evaluated in three points - Tbeginning, Tmaximum, Tend. In healthy subjects, the seasonal variation of ECG dispersion mapping microvolt T-wave alternans was nonexistent. Myocardial lesion is characterized by an increase in Tbeg, Tmax, Tend in relation to the healthy individuals. Tbeg values are minimal in winter and summer and increase in spring and autumn. Tend values were reversed - they were maximal in winter and summer, decreasing in spring-autumn period. Seasonal variation of Tmax - Tbeg, and Tmax -Tend was detected: Tmax - Tbeg increased in the winter-summer period and decreased in spring and autumn, Tmax-Tend - increased in the spring-autumn period in relation to the winter-summer period. In patients with cardiovascular disease, in contrast to the healthy, there is a seasonal variation in microvolt T-wave alternans of ECG dispersion mapping, with the maximum differences in the winter and spring seasons, which should be taken into account when applying the method in clinical practice.

Chimeric protein identification of dystrophic, Pierson and other laminin polymerization residues

Laminin polymerization is a key step of basement membrane self-assembly that depends on the binding of the three different N-terminal globular LN domains. Several mutations in the LN domains cause LAMA2-deficient muscular dystrophy and LAMB2-deficient Pierson syndrome. These mutations may affect polymerization. A novel approach to identify the amino acid residues required for polymerization has been applied to an analysis of these and other laminin LN mutations. The approach utilizes laminin-nidogen chimeric fusion proteins that bind to recombinant non-polymerizing laminins to provide a missing functional LN domain. Single amino acid substitutions introduced into these chimeras were tested to determine if polymerization activity and the ability to assemble on cell surfaces were lost. Several laminin-deficient muscular dystrophy mutations, renal Pierson syndrome mutations, and Drosophila mutations causing defects of heart development were identified as ones causing loss of laminin polymerization. In addition, two novel residues required for polymerization were identified in the laminin γ1 LN domain.

[COMBINED COURSE OF BRONCHIAL ASTHMA AND GASTROESOPHAGEAL REFLUX DISEASE: ITS CLINICAL, FUNCTIONAL PECULIARITIES, AND MECHANISMS OF ITS CORRECTION]

The combined course of bronchial asthma (BA) and digestive system pathology is one of the most frequent, severe and clinically varied pathology. The purpose of the paper - to study the influence of gastroesophageal reflux disease (GERD) on the course of BA and the effectiveness of antireflux therapy in combined pathology. Patients with combined pathology were treated in full-time department more frequently than patients with isolated BA (3,4±0,5 per year to - 1,8±0,3; р<0,05). The statistically reliable correlation between frequency of heartburn and frequency of cough, which goes over to asthma attacks was observed (r=0,59; р<0,05). More severe course of BA was observed in patients with combined pathology and was accompanied by reliable decrease in the main functional indicators of external breathing (FEB). The antireflux therapy lead to decrease in cough intensity and frequency of asthma attacks, especially at night time. Also, as a result of antireflux therapy patients were able to refuse to use short-acting ß2-agonists in 51,7 % and significantly decreased the multiplicity of its reception in "on-demand" mode. In patients with GERD more severe course of BA was observed. The reliable decrease in the main indicators of FEB, activation of inflammatory process (mainly allergic character of inflammation with high level of eosinophils in blood and sputum) and increase in level of IL - 4 in the blood. The frequency of hospitalization in patients with combined BA and GERD was 2 times greater than in patients with isolated BA. The complex therapy using antireflux has positive effect on clinical symptoms, functional indicators of external breathing and markers of inflammation in patients with combined BA and GERD.

Synthesis, receptor binding affinities and alpha-MSH releasing activities of TRH analogues

New syntheses of three thyrotropin releasing hormone (TRH) analogues ([Dopa2]THR, [Nic1]TRH, and [Tyr(30NO2)2]TRH) have been reported (Dopa stands for L-3,4-dihydroxyphenylalanine, Nic--for nicotinic acid and Tyr(3-NO2)--for L-3-nitrotyrosine). These three TRH analogues and five already known ones ([Aad1Tca3]TRH, [D-His2]TRH, [D-Pro3]TRH, [Pro-NH-NH2(3)]TRH and [Tyr2]TRH), were studied in vitro for their binding activity to rat pituitary TRH receptors and a-MSH releasing activity in the neuro-intermediate lobe of frogs. Competition of analogues for 3H-TRH binding to rat anterior pituitary membrane fraction was used. One of ten tested analogues ([Aad1, Tca]3 TRH) was as potent as TRH in competing for high-affinity binding sites (Kd = 8.5 nM). The binding activity of diastereoisomers ([D-His2]TRH and [D-Pro3]TRH) was reduced as well as that of analogue [Pro-NH-NH2(3)]TRH. The rest of the analogues were inactive. The binding activities were in good accordance with alpha-MSH releasing activities.