JNK activation is a mediator of arsenic trioxide-induced apoptosis in acute promyelocytic leukemia cells

Arsenic trioxide induces c-jun N-terminal kinase (JNK) activation and apoptosis in acute promyelocytic leukemia (APL), where it has major clinical activity, but whether JNK is necessary to induce apoptosis is unknown. To clarify this necessity, we established 2 arsenic trioxide (As2O3)-resistant subclones of the APL cell line, NB4. Both resistant lines showed little activation of JNK1 following treatment with As2O3, even at doses sufficient to elicit robust activation in NB4 cells. One mechanism of resistance in these cells is up-regulated glutathione (GSH) content, and GSH depletion by L-buthionine-[S,R]-sulfoximine (BSO) restores JNK activation and As2O3 sensitivity. This correlation between JNK activation and apoptosis led us to test whether inhibition of JNK would protect cells from As2O3-induced apoptosis. SEK1(-/-) mouse embryo fibroblasts (MEFs) showed diminished JNK activation following As2O3 treatment and were protected from As2O3 induced but not doxorubicin-induced apoptosis. Furthermore, treatment of arsenic trioxide-sensitive APL cells with the JNK inhibitor, dicumarol, significantly increased growth and survival in response to As2O3 but did not protect cells from doxorubicin. Together, these data support an essential role for JNK signaling in the induction of growth inhibition and apoptosis by As2O3 and suggest that activating JNK may provide a therapeutic advantage in the treatment of cancers that do not respond to arsenic alone. (C) 2004 by The American Society of Hematology.