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Blood, 15 February 2008, Vol. 111, No. 4, pp. 2200-2210.
Prepublished online as a Blood First Edition Paper on November 16, 2007; DOI 10.1182/blood-2006-11-055723.


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NEOPLASIA

Targeting of heat shock protein 32 (Hsp32)/heme oxygenase-1 (HO-1) in leukemic cells in chronic myeloid leukemia: a novel approach to overcome resistance against imatinib

Matthias Mayerhofer1,2, Karoline V. Gleixner1, Julia Mayerhofer1, Gregor Hoermann1,2, Eva Jaeger2, Karl J. Aichberger1, Rene G. Ott4, Khaled Greish4, Hideaki Nakamura4, Sophia Derdak5, Puchit Samorapoompichit6, Winfried F. Pickl5, Veronika Sexl3, Harald Esterbauer2, Ilse Schwarzinger2, Christian Sillaber1, Hiroshi Maeda4, and Peter Valent1

1 Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; 2 Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria; 3 Department of Pharmacology, Medical University of Vienna, Vienna, Austria; 4 Department of Microbiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; 5 Institute of Immunology, Medical University of Vienna, Vienna, Austria; and 6 Institute of Histology and Embryology, Medical University of Vienna, Vienna, Austria

Resistance toward imatinib and other BCR/ABL tyrosine kinase inhibitors remains an increasing clinical problem in the treatment of advanced stages of chronic myeloid leukemia (CML). We recently have identified the heat shock protein 32 (Hsp32)/heme oxygenase-1 (HO-1) as a BCR/ABL-dependent survival molecule in CML cells. We here show that silencing Hsp32/HO-1 in CML cells by an siRNA approach results in induction of apoptosis. Moreover, targeting Hsp32/HO-1 by either pegylated zinc protoporphyrine (PEG-ZnPP) or styrene maleic acid-micelle–encapsulated ZnPP (SMA-ZnPP) resulted in growth inhibition of BCR/ABL-transformed cells. The effects of PEG-ZnPP and SMA-ZnPP were demonstrable in Ba/F3 cells carrying various imatinib-resistant mutants of BCR/ABL, including the T315I mutant, which exhibits resistance against all clinically available BCR/ABL tyrosine kinase inhibitors. Growth-inhibitory effects of PEG-ZnPP and SMA-ZnPP also were observed in the CML-derived human cell lines K562 and KU812 as well as in primary leukemic cells obtained from patients with freshly diagnosed CML or imatinib-resistant CML. Finally, Hsp32/HO-1–targeting compounds were found to synergize with either imatinib or nilotinib in producing growth inhibition in imatinib-resistant K562 cells and in Ba/F3 cells harboring the T315I mutant of BCR/ABL. In summary, these data show that HO-1 is a promising novel target in imatinib-resistant CML.


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