8-CPT-cAMP/all-trans retinoic acid targets t(11;17) acute promyelocytic leukemia through enhanced cell differentiation and PLZF/RARα degradation

Proc Natl Acad Sci U S A. 2013 Feb 26;110(9):3495-500. doi: 10.1073/pnas.1222863110. Epub 2013 Feb 4.

Abstract

The refractoriness of acute promyelocytic leukemia (APL) with t(11;17)(q23;q21) to all-trans retinoic acid (ATRA)-based therapy concerns clinicians and intrigues basic researchers. By using a murine leukemic model carrying both promyelocytic leukemia zinc finger/retinoic acid receptor-α (PLZF/RARα) and RARα/PLZF fusion genes, we discovered that 8-chlorophenylthio adenosine-3', 5'-cyclic monophosphate (8-CPT-cAMP) enhances cellular differentiation and improves gene trans-activation by ATRA in leukemic blasts. Mechanistically, in combination with ATRA, 8-CPT-cAMP activates PKA, causing phosphorylation of PLZF/RARα at Ser765 and resulting in increased dissociation of the silencing mediator for retinoic acid and thyroid hormone receptors/nuclear receptor corepressor from PLZF/RARα. This process results in changes of local chromatin and transcriptional reactivation of the retinoic acid pathway in leukemic cells. Meanwhile, 8-CPT-cAMP also potentiated ATRA-induced degradation of PLZF/RARα through its Ser765 phosphorylation. In vivo treatment of the t(11;17) APL mouse model demonstrated that 8-CPT-cAMP could significantly improve the therapeutic effect of ATRA by targeting a leukemia-initiating cell activity. This combined therapy, which induces enhanced differentiation and oncoprotein degradation, may benefit t(11;17) APL patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cell Differentiation* / drug effects
  • Cell Differentiation* / genetics
  • Chromosomes, Human, Pair 11 / genetics
  • Chromosomes, Human, Pair 17 / genetics
  • Cyclic AMP / analogs & derivatives*
  • Cyclic AMP / pharmacology
  • Cyclic AMP / therapeutic use
  • Cyclic AMP-Dependent Protein Kinases / metabolism
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / genetics
  • Leukemia, Promyelocytic, Acute / pathology
  • Mice
  • Mice, Inbred C57BL
  • Nuclear Receptor Co-Repressor 2 / metabolism
  • Oncogene Proteins, Fusion / metabolism*
  • Phosphorylation / drug effects
  • Phosphoserine / metabolism
  • Proteolysis* / drug effects
  • Signal Transduction / drug effects
  • Survival Analysis
  • Thionucleotides / pharmacology
  • Thionucleotides / therapeutic use*
  • Translocation, Genetic* / drug effects
  • Tretinoin / pharmacology
  • Tretinoin / therapeutic use*

Substances

  • Ncor2 protein, mouse
  • Nuclear Receptor Co-Repressor 2
  • Oncogene Proteins, Fusion
  • PLZF-RARalpha fusion protein, mouse
  • Thionucleotides
  • Phosphoserine
  • 8-((4-chlorophenyl)thio)cyclic-3',5'-AMP
  • Tretinoin
  • Cyclic AMP
  • Cyclic AMP-Dependent Protein Kinases