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Prepublished online as a Blood First Edition Paper on June 28, 2002; DOI 10.1182/blood-2002-03-0720.

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Blood, 15 November 2002, Vol. 100, No. 10, pp. 3719-3730

NEOPLASIA

Bis-indols: a novel class of molecules enhancing the cytodifferentiating properties of retinoids in myeloid leukemia cells

Claudio Pisano, Peter Kollar, Maurizio Gianní, Yesim Kalac, Vincenzo Giordano, Fabiana Fosca Ferrara, Richard Tancredi, Antonio Devoto, Alessandra Rinaldi, Alessandro Rambaldi, Sergio Penco, Mauro Marzi, Giampiero Moretti, Loredana Vesci, Ornella Tinti, Paolo Carminati, Mineko Terao, and Enrico Garattini

From the Istituto di Ricerche Farmacologiche "Mario Negri," Laboratory of Molecular Biology, Centro Catullo e Daniela Borgomainerio, Milano, Italy; the University of Istanbul, Faculty of Science, Department of Biology, Vezneciler, Istanbul, Turkey; the Department of Oncology, Sigma-Tau Industrie Farmaceutiche Riunite S.p.A., Pomezia, Italy; and the Division of Hematology, Ospedali Riuniti di Bergamo, Largo Barozzi, Bergamo, Italy.

Enhancing the pharmacologic activity of all-trans retinoic acid (ATRA) is potentially useful in the management of acute promyelocytic leukemia (APL) and other types of myeloid leukemia. In this report, we identify a novel class of experimental agents selectively potentiating the cytodifferentiating activity of ATRA and synthetic retinoic acid receptor alpha  agonists in APL and other myeloid leukemia cell lines. These agents have a bis-indolic structure (BISINDS), and ST1346 is the prototypical compound of the series. Gene-profiling experiments and determination of the level of expression of myeloid-associated markers indicate that ST1346 stimulates many aspects of the granulocytic maturation process set in motion by ATRA. Stimulation of the cytodifferentiating activity of ATRA by ST1346 enhances the efficacy of the retinoid in vivo, as demonstrated in the APL model of the severe combined immunodeficiency (SCID) mouse receiving transplants of NB4 cells. Although the molecular mechanisms underlying the ATRA-potentiating action of ST1346 and congeners have not been completely clarified, bis-indols are not ligands and do not exert any direct effect on the ATRA-dependent transactivation of nuclear receptors. However, ST1346 inhibits the down-regulation of cyclic adenosine monophosphate (cAMP)-dependent CREB transcriptional complexes and enhances the level of expression of signal transducers and activators of transcription-1 (STAT1), 2 putative molecular determinants of the differentiation process activated by ATRA in APL cells. More importantly, ST1346 relieves the down-regulation of Jun N-terminal kinases (JNK) afforded by ATRA. In addition, a specific JNK inhibitor blocks the enhancing effect of ST1346 on ATRA-induced maturation of NB4 cells. This demonstrates an important role for the mitogen-activated protein kinase in the molecular mechanisms underlying the pharmacologic activity of the bis-indol.

© 2002 by The American Society of Hematology.
 

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