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Novel retinoic acid, 9-cis retinoic acid, in combination with all-trans
retinoic acid is an effective inducer of differentiation of retinoic
acid-resistant HL-60 cells
M Kizaki, H Nakajima, S Mori, T Koike, M Morikawa, M Ohta, M Saito, HP Koeffler and Y Ikeda
Division of Hematology, Keio University School of Medicine, Tokyo, Japan.
Recent studies have shown that a high proportion of patients with acute
promyelocytic leukemia (APL) achieve complete remission after treatment
with all-trans retinoic acid (RA). Nevertheless, despite an initial good
response, most patients that received continuous treatment with all-trans
RA relapse and develop RA-resistant disease. The 9-cis RA is a
high-affinity ligand for retinoid X receptors (RXRs) and also binds
efficiently to retinoic acid receptors (RARs); all-trans RA is a ligand for
RARs. Both alone are able to induce differentiation of wild-type HL- 60
cells. We found that neither all-trans RA nor 9-cis RA (< 2 x 10(-6)
mol/L) induced differentiation of RA-resistant HL-60 cells into either
mature granulocytes or monocytes. However, morphologic differentiation of
the RA-resistant HL-60 cells was induced by 10(-6) mol/L all-trans RA
combined with various concentrations (10(-12) to 10(-6) mol/L) of 9- cis
RA. Electron microscopic examination also confirmed that the combination of
both retinoids induced RA-resistant HL-60 cells to differentiate to mature
granulocytes. Functional analysis of differentiation (NBT reduction
activity) confirmed the necessity of both analogs to induce
differentiation. Also, expression of myeloid- specific differentiation
antigens (CD11b and CD14) as well as migration inhibitory factor-related
protein (MRP)-8/14 mRNAs were upregulated only in the presence of both
retinoids in a dose-dependent manner. In these conditions 3H-thymidine
incorporation was inhibited and numbers of viable cells were decreased,
suggesting that all-trans RA with 9-cis RA may inhibit cell growth and
induce differentiation of RA-resistant HL-60 cells into mature
granulocytes. These studies suggest that 9-cis RA in combination with
all-trans RA is an effective inducer of RA- resistant HL-60 cells and may
have implications for both the biology of retinoids and clinical treatment
of RA-resistant acute myelogenous leukemia, including APL patients.
Volume 83,
Issue 11,
pp. 3289-3297,
06/01/1994
Copyright © 1994 by The American Society of Hematology

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