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Prepublished online as a Blood First Edition Paper on January 9, 2003; DOI 10.1182/blood-2002-10-3067.
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Blood, 15 May 2003, Vol. 101, No. 10, pp. 4105-4114
NEOPLASIA
Potentiation of dexamethasone-, paclitaxel-, and
Ad-p53-induced apoptosis by Bcl-2 antisense oligodeoxynucleotides in
drug-resistant multiple myeloma cells
Qun Liu and
Yair Gazitt
From the University of Texas Health Science Center,
San Antonio.
Overexpression of Bcl-2 in myeloma cells results in resistance to
drugs such as dexamethasone (DEX), adenovirus-mediated delivery of p53
(Ad-p53), and paclitaxel (TAX), which work through the intrinsic
apoptotic pathway. Bcl-2 antisense oligodeoxynucleotides (Bcl-2-ASO)
have been shown to induce apoptosis in cancer cells, as a single agent
or, better, in combination with chemotherapy. We hypothesized that
down-regulation of Bcl-2 by Bcl-2-ASO will sensitize drug-resistant
myeloma cells to undergo apoptosis. In this paper we report a detailed
time/dose study of the effect of Bcl-2-ASO on myeloma cells with
varying levels of Bcl-2. Treatment of myeloma cells expressing
relatively low levels of Bcl-2 with Bcl-2-ASO resulted in a substantial
apoptosis concomitant with a substantial depletion of Bcl-2 protein.
Maximal apoptosis was observed at 5 to 10 µg/mL Bcl-2-ASO, following
4 days of treatment. Down-regulation of Bcl-2 and apoptosis were time
and dose dependent and were sequence specific. In these cell lines,
apoptosis was accompanied by activation of caspase-9 and caspase-3 and
by release of cytochrome c to the cytosol. In contrast,
high Bcl-2-expressing myeloma cells were practically resistant to
Bcl-2-ASO. Most important, however, pretreatment of myeloma cells
expressing high levels of Bcl-2 with Bcl-2-ASO increased the extent of
DEX-, TAX-, and Ad-p53-induced apoptosis from 10%-20% to 70%-90%.
Increased apoptosis was accompanied by additional decrease in Bcl-2
protein. Similar results for down-regulation of Bcl-2 and apoptosis
were obtained with freshly isolated myeloma cells. These data support
development of clinical trials with combinations of Bcl-2-ASO and DEX,
TAX, or Ad-p53 in the treatment of refractory myeloma patients.

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