Overview of thioredoxin system and targeted therapies for acute leukemia

The thioredoxin (Trx) system is a major antioxidant system for keeping the intracellular redox state in almost all forms of life, including Trx, Trx reductase (TrxR) and NADPH. It regulates many signaling pathways related to antioxidative action, growth promotion, anti-apoptosis, cell migration, inflammatory modulation, immune function, etc. The oxidative stress has been proved to promote cancer occurrence and the readjustment of Trx system. Considerable results have demonstrated overexpression of Trx in cancer cells, moreover, the over expression of Trx is closely related to high risk of cancer recurrence and drug resistance. This review focuses on the relationship between Trx system and acute leukemia (AL). The crux of the development of any useful therapy is a knowledge of disease etiology and progression. The potential of thioredoxin system inhibitors as therapeutic agents for acute leukemia is highlighted. Furthermore, targeting Trx as an anti-leukemic strategy is clinically beneficial to AL patients.