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Blood, 15 June 2001, Vol. 97, No. 12, pp. 3931-3940
NEOPLASIA
Mitochondria-targeting drugs arsenic trioxide and lonidamine
bypass the resistance of TPA-differentiated leukemic cells to
apoptosis
Olivier Sordet,
Cédric Rébé,
Ingrid Leroy,
Jean-Marie Bruey,
Carmen Garrido,
Carole Miguet,
Gérard Lizard,
Stéphanie Plenchette,
Laurent Corcos, and
Eric Solary
From the Faculty of Medicine and Pharmacy, INSERM U517
and INSERM U498, IFR 100, Dijon, France.
Exposure of U937 human leukemic cells to the phorbol ester
12-O-tetradecanoylphorbol 13-acetate (TPA) induces their
differentiation into monocyte/macrophage-like cells. This terminal
differentiation is associated with a resistant phenotype to
apoptosis induced by the topoisomerase II inhibitor etoposide.
The inhibition occurs upstream of the mitochondrial release of
cytochrome c and the activation of procaspase-2, -3, -6, -7, -8, and
-9. By using cell-free systems, it was demonstrated that the
mitochondrial pathway to cell death that involves mitochondrial
membrane depolarization, cytochrome c release and cytosolic activation
of procaspases by cytochrome c/dATP remains functional in
TPA-differentiated U937 cells. Accordingly, 2 drugs recently shown to
target the mitochondria, namely lonidamine and arsenic trioxide, bypass
the resistance of TPA-differentiated U937 cells to classical anticancer
drugs. Cell death induced by the 2 compounds is associated with
mitochondrial membrane depolarization, release of cytochrome c and
Smac/Diablo from the mitochondria, activation of caspases,
poly(ADP-ribose) polymerase cleavage and internucleosomal DNA
fragmentation. Moreover, the decreased glutathione content associated
with the differentiation process amplifies the ability of arsenic
trioxide to activate the mitochondrial pathway to cell death. Similar
results were obtained by comparing undifferentiated and
TPA-differentiated human HL60 leukemic cells. These data demonstrate
that mitochondria-targeting agents bypass the resistance to classical
anticancer drugs induced by TPA-mediated leukemic cell differentiation.

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