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Blood, 30 April 2009, Vol. 113, No. 18, pp. 4300-4308.
Prepublished online as a Blood First Edition Paper on February 3, 2009; DOI 10.1182/blood-2008-11-187708.


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LYMPHOID NEOPLASIA

Nutlin-3 up-regulates the expression of Notch1 in both myeloid and lymphoid leukemic cells, as part of a negative feedback antiapoptotic mechanism

Paola Secchiero1, Elisabetta Melloni1, Maria Grazia di Iasio1, Mario Tiribelli2, Erika Rimondi1, Federica Corallini1, Valter Gattei3, and Giorgio Zauli1

1 Department of Morphology and Embryology, University of Ferrara, Ferrara, Italy; 2 Department of Medical and Morphological Research, Division of Hematology and Bone Marrow Transplantation, University Hospital, Udine, Italy; 3 Clinical and Experimental Hematology Research Unit, Centro di Riferimento Oncologico, Istituti di ricovero e cura a carattere scientifico (IRCCS), Aviano (PN), Italy

The small molecule inhibitor of the MDM2/p53 interaction Nutlin-3 significantly up-regulated the steady-state mRNA and protein levels of Notch1 in TP53wild-type (OCI, SKW6.4) but not in TP53deleted (HL-60) or TP53mutated (BJAB) leukemic cell lines. A direct demonstration that NOTCH1 was a transcriptional target of p53 in leukemic cells was obtained in experiments carried out with siRNA for p53. Moreover, inhibition of Notch1 expression using Notch1-specific siRNA significantly increased cytotoxicity in TP53wild-type leukemic cells. Of note, Nutlin-3 up-regulated Notch1 expression also in primary TP53wild-type B-chronic lymphocytic leukemia (B-CLL) cells and the combined use of Nutlin-3 plus pharmacological {gamma}-secretase inhibitors of the Notch signaling showed a synergistic cytotoxicity in both TP53wild-type leukemic cell lines and primary B-CLL cells. A potential drawback of {gamma}-secretase inhibitors was their ability to enhance osteoclastic maturation of normal circulating preosteoclasts induced by RANKL + M-CSF. Notwithstanding, Nutlin-3 completely suppressed osteoclastogenesis irrespective of the presence of {gamma}-secretase inhibitors. Taken together, these data indicate that the p53-dependent up-regulation of Notch1 in response to Nutlin-3 represents an antiapoptotic feedback mechanism able to restrain the potential therapeutic efficacy of Nutlin-3 in hematologic malignancies. Therefore, therapeutic combinations of Nutlin-3 + {gamma}-secretase inhibitors might potentiate the cytotoxicity of Nutlin-3 in p53wild-type leukemic cells.


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