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Blood, 1 May 2002, Vol. 99, No. 9, pp. 3367-3375
NEOPLASIA
MDM2 induces NF- B/p65 expression transcriptionally through
Sp1-binding sites: a novel, p53-independent role of MDM2 in
doxorubicin resistance in acute lymphoblastic
leukemia
Lubing Gu,
Harry W. Findley, and
Muxiang Zhou
From the Division of Pediatric Hematology/Oncology/BMT,
Emory University School of Medicine, Atlanta, GA.
MDM2 protein is thought to exhibit tumorigenic activity by binding
to the p53 tumor-suppressor protein and inhibiting its function.
Alternatively, MDM2 may have oncogenic roles other than those resulting
from p53 interactions. Here we report that MDM2 can induce expression
of the p65 subunit of NF- B, which is an anti-apoptotic factor
expressed in certain neoplastic cells in response to chemotherapy.
Initially, we noted that the overexpression of MDM2 protein in leukemic
bone marrow cells of patients with B-cell precursor acute lymphoblastic
leukemia (BCP-ALL), and an ALL cell line (EU-4) transfected with the
MDM2 gene was associated with elevated expression
of p65 and in vitro resistance to doxorubicin (Adriamycin). By
cotransfection of the MDM2 gene and p65-promoter-reporter constructs into EU-4 cells, we found that transient and high-level MDM2
expression induced p65 promoter activity. In the presence of wild-type
(wt) p53, MDM2 increased p65 promoter activity by reversing
p53-mediated suppression of p65. In the absence of p53, MDM2 directly
increased p65 promoter activity. Deletion and mutation analysis of the
p65 promoter indicated that the region between nt 575 and 178,
which contains the first and second Sp1-binding sites, was required for
activation by MDM2. Further studies using chromatin immunoprecipitation
(CHIP) and electrophoretic mobility shift assay (EMSA) showed that MDM2
was able to directly bind to the Sp1 site of the p65 promoter. Our
findings suggest that by inducing p65 expression, MDM2 has a
p53-independent role in tumorigenesis, which may further elucidate the
association between MDM2 overexpression and resistant disease in
childhood ALL.

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