期刊
JOURNAL OF CLINICAL INVESTIGATION
卷 119, 期 5, 页码 1109-1123出版社
AMER SOC CLINICAL INVESTIGATION INC
DOI: 10.1172/JCI35660
关键词
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资金
- Medical Research Council, United Kingdom
- Leukaemia Research Fund, United Kingdom
- NCI [PO1 CA78890]
- American-Italian Foundation for Cancer Research (AIFCR)
- MRC [G0600782, MC_U132664972, MC_U132670601, MC_U132670597] Funding Source: UKRI
- Medical Research Council [MC_U132664972, G0600782, MC_U132670597, MC_U132670601] Funding Source: researchfish
Imatinib mesylate (IM), a potent inhibitor of the BCR/ABL tyrosine kinase, has become standard first-line therapy for patients with chronic myeloid leukemia (CML), but the frequency of resistance increases in advancing stages of disease. Elimination of BCR/ABL-dependent intracellular signals triggers apoptosis, but it is unclear whether this activates additional cell survival and/or death pathways. We have shown here that IM induces autophagy in CML blast crisis cell lines, CML primary cells, and p210(BCR/ABL)-expressing myeloid precursor cells. IM-induced autophagy did not involve c-Abl or Bcl-2 activity but was associated with ER stress and was suppressed by depletion of intracellular Ca2+, suggesting it is mechanistically nonoverlapping with IM-induced apoptosis. We further demonstrated that suppression of autophagy using either pharmacological inhibitors or RNA interference of essential autophagy genes enhanced cell death induced by IM in cell lines and primary CML cells. Critically, the combination of a tyrosine kinase inhibitor (TKI), i.e., IM, nilotinib, or dasatinib, with inhibitors of autophagy resulted in near complete elimination of phenotypically and functionally defined CML stem cells. Together, these findings suggest that autophagy inhibitors may enhance the therapeutic effects of TKIs in the treatment of CML.
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