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NEOPLASIA
From the Departments of Bioimmunotherapy and Leukemia,
M. D. Anderson Cancer Center, University of Texas, Houston, TX.
Several signaling cascades are engaged by expression of the p210
bcr-abl tyrosine kinase, and evidence suggests that these signals drive
leukemogenesis. In this report, signaling pathways were examined and
compared between cells derived from leukemic patients and cells
expressing a bcr-abl construct (MBA). The effects of acute inhibition
of bcr-abl with STI-571 on these signals and the survival of
bcr-abl-expressing cells were also evaluated. Expression of bcr-abl in
interleukin-3 (IL-3)/granulocyte-macrophage colony-stimulating factor (GM-CSF)-dependent Mo7e cells (MBA) resulted
in growth factor independence, constitutive activation of Stat-5
phosphorylation, engagement of mitogen-activated protein (MAP) kinase
signals, and increased expression of PTP1B and bcl-xL. STI-571 inhibited cell growth and induced apoptosis in
bcr-abl-expressing cells (MBA, K562, BV-173, KBM5) but not in
bcr-abl Adult-onset leukemia is a heterogeneous
hematopoietic stem cell disorder characterized by the overproduction or
maturation of hematopoietic cells of several distinct
lineages.1 Evidence suggests that most of these tumors
arise through the aberrant expression of transcription factors or the
engagement of signaling pathways that control their
activation.2-4 Specific cytogenetic abnormalities, first
described as the Philadelphia chromosome (9:22 translocation) in
patients with leukemia, are common in chronic myelogenous and, to a
lesser extent, acute lymphocytic leukemia, and much attention has been
focused on understanding the consequence and cause of this
alteration.5-7
Reciprocal 9:22 chromosomal translocation alters transcriptional
control of the c-abl gene, recently shown to play a role in
stress-induced signaling.8 Translocation places the
c-abl gene under the transcriptional control of the bcr
locus, allowing expression of a hybrid protein encoded by 1 to 3 exons
of the bcr gene and by all but the first exon of
c-abl. This chimeric bcr-abl protein (p190 or p210)
expresses intrinsic tyrosine kinase activity with altered
compartmentalization and distinctions in substrates when compared to
the predominantly nuclear c-abl protein.7,9 Tyrosine
kinase activity is essential for the transforming function of bcr-abl,
and the expression of bcr-abl in stem cells of immune-deficient mice
results in altered hematopoiesis resembling human leukemia-like disorders.10-13 Thus, bcr-abl expression plays a central
role in leukemogenesis and provides an appropriate and specific target for therapeutic intervention.
Expression of bcr-abl alters several signaling pathways that deregulate
cellular growth and prolong survival.9,13,14 These signals
are engaged through adaptor molecule recruitment to the bcr-abl protein
or through direct phosphorylation of specific substrates.13-15 Alterations in either the Src homology 2 (SH2) or the SH3 domain affect the transformed phenotype, but tyrosine phosphorylation is critical for leukemogenesis and
transformation.13,14 Downstream signals engaged by bcr-abl
expression are common to a number of oncogenes (ras,
MAPK, PI3K, Akt), but others appear to
be shared with growth factor-cytokine signaling cascades involved in
normal hematopoiesis and stem cell differentiation
(Jak/Stat).13-16 Several points of convergence between
cytokine-growth factor signaling and bcr-abl oncogenesis have been
described, and cells expressing bcr-abl no longer require exogenous
cytokines Because of the selective expression of bcr-abl tyrosine kinase in
leukemic cells but not normal cells, inhibitors that target this kinase
have been developed and are under evaluation for clinical safety and
efficacy.21-23 A selective inhibitor termed STI-571 (Novartis, Basel, Switzerland) is undergoing clinical trials
for bcr-abl+ diseases and has shown antileukemic activity
with limited toxicity. However, though the cellular targets of this
inhibitor are known, the mechanism of its antileukemic and apoptotic
effects are not completely understood. In this study, the effects of
bcr-abl expression and STI-571-mediated inhibition on signaling and
survival pathways were investigated. Findings suggest that bcr-abl
activates Stat-5 and increases bcl-xL expression, but,
because of the down-regulation of other key signaling proteins,
cytokine-supported cell survival is abrogated, resulting in apoptosis.
The state of differentiation/maturation of bcr-abl+
leukemic cells and the chronic activation of downstream signaling cascades may determine the efficacy of STI-571 and the ability of
exogenous factors to rescue treated cells from bcr-abl inhibition.
Cell lines, antibodies, growth factors, cytokines, and
inhibitors
STI-571 was provided by Dr E. Buchdunger (Novartis) and was prepared as
a 5-mM stock solution in dimethyl sulfoxide (DMSO). Stock solution was
diluted in cell culture media and added directly to cells with no more
than 0.2% final DMSO concentration.
Antibodies used in these studies include PARP (Boehringer-Mannheim,
Indianapolis, IN), phosphotyrosine, phospho-Jak-2, phospho-Stat-5 (UBI,
Lake Placid, NY), Stat-1 and phospho-Stat-1 (Geneka, Montreal, QC,
Canada), PTP1B and c-abl (Oncogene Sciences, Boston, MA), bcl-xL (Santa Cruz Biotechnology, Santa Cruz, CA),
mitogen-activated protein kinase (MAPK) and phospho-MAPK (Promega,
Madison, WI), Akt and phospho-Akt (New England Biolabs, Beverly, MA),
and actin (Sigma, St Louis, MO). IL-3/GM-CSF/IL-5 receptor common
Wortmannin and LY29002 (Calbiochem, San Diego, CA) were also used in
these studies and were prepared as stock solutions in DMSO. Recombinant
IL-3 was purchased from R&D Systems (Minneapolis, MN). Interferon Apoptosis and cell survival measurement
Analysis of signal transduction Cell signal activation was analyzed by immunoblotting equal protein cell lysates (bicinchoninic acid protein assay; Pierce Chemical, Rockford, IL) with antibodies against phosphorylated (activated) forms of signaling intermediates. Blots were subsequently stripped of primary antibody24 and reprobed with antibodies that recognize protein domains independent of the state of activation or phosphorylation. All immunoblots were developed with secondary antibodies and enhanced chemiluminescence (ECL) reagent (Amersham, Piscataway, NJ).Immunoprecipitation of IL-3/5/GM-CSF receptor common
-chain was analyzed by immunoprecipitation and
immunoblotting as previously described.25 Briefly, equal
protein cell lysates (150-400 µg in lysis buffer)25 were
subjected to -chain immunoprecipitation (2 µg; Santa Cruz
Biotechnology) with Protein G (Sigma), washed extensively, and resolved
by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Resolved
precipitate was immunoblotted with anti- -chain (Santa Cruz) and
detected with secondary antibody and ECL reagent.
Detection of Stat-5 activation by electrophoretic mobility shift assay Consensus Stat-5 DNA binding oligomers ( -casein or mutated
sequences) were obtained from Santa Cruz Biotechnology and radiolabeled to 5 × 106 cpm/pmol DNA. Nuclear protein was extracted
from MBA cells and incubated with radiolabeled DNA, as previously
described.27 DNA-protein complexes were analyzed by
electrophoretic mobility shift assay (EMSA) on native polyacrylamide
gels. The gels were dried and exposed to x-ray film, and radioactive
signals were quantitated by Phosphorimager (Molecular Dynamics,
Sunnyvale, CA).
The effect of bcr-abl expression on signaling cascades and
cellular sensitivity to STI-571 was examined in Mo7e megakaryocytic cells cultured in the presence of exogenous GM-CSF (500 U/mL). As shown
in Figure 1A, bcr-abl expression in Mo7e
cells (MBA) correlated with increased tyrosine phosphorylation,
detectable activation of the MAP kinase cascade, increased Stat-5
phosphorylation, and increased levels of both bcl-xL and
PTP1B. By MTT assay (Figure 1B) and apoptotic characteristics,
including caspase 3 activation and PARP cleavage (Figure 1C),
bcr-abl+ MBA cells underwent time-dependent apoptosis in
the presence of STI-571, whereas cytokine-dependent Mo7e cell survival
was not affected by inhibitor. Exogenous GM-CSF (or IL-3) did not affect the apoptotic activity of STI-571 (see below). Parallel studies of other bcr-abl+ (KBM5, BV-173, K562) and
bcr-abl
Inhibition of bcr-abl and Stat-5 activation after incubation with
STI-571 were examined in bcr-abl+ and bcr-abl
Bcr-abl expression increases the levels of several genes, including
antiapoptotic proteins (bcl-xL) and regulators of tyrosine phosphorylation (PTP1B).13,18,19,28-30 Induction of these
genes may be dependent on bcr-abl tyrosine kinase activity or Stat-5 activation, as demonstrated in studies of hematopoietic cytokine signaling.31 To determine whether bcr-abl inhibition
alters the level of these proteins, STI-571-treated
bcr-abl+ and bcr-abl In Ph+ K562 cells, STI-571 reduced bcr-abl, Stat-5, and MAPK activation (similar to responses in MBA cells) but did not inhibit Akt phosphorylation (Figure 2D). Both an irreversible (wortmannin) and a reversible (LY294002) inhibitor of phosphatidylinositol-3'-kinase (PI3K) suppressed Akt phosphorylation in K562 cells without affecting Stat-5 or MAPK activation. However, neither PI3K inhibitor induced apoptosis in K562 cells, suggesting only minimal dependence of these cells on the PI3K-Akt axis for survival (data not shown). Based on these observations and on earlier reports of Stat-5 involvement in cytokine signaling,13,18-20,28,29 the results predict a significant role for the interruption of Stat-5 activation (and possibly other pathways) in the apoptotic actions of STI-571 on bcr-abl+ cells. Other cytokines are known to activate Stat proteins and to require
tyrosine phosphorylation to initiate signal
transduction.31 To determine whether the phosphorylation
of other Stat proteins was affected by STI-571, Stat-1 phosphorylation
after IFN-
IL-3/GM-CSF plays a major role in the proliferation and sustained
survival of hematopoietic stem cells through the activation of
receptor-initiated Jak/Stat cascades.17,31,32 Expression of bcr-abl results in growth factor-cytokine independence, suggesting similar downstream effects of bcr-abl expression and IL-3-GM-CSF signaling. As shown in Figure 4A, GM-CSF
was able to rapidly activate Stat-5 in Mo7e cells but had no apparent
effect on constitutively activated Stat-5 in MBA cells. Further,
STI-571 did not affect IL-3-mediated Stat-5 activation in Mo7e cells
(Figure 4B), and exogenous IL-3 (or GM-CSF) did not protect MBA cells
from STI-571-mediated cell death (see below). To determine whether
these cytokines were able to induce phosphorylation of Stat-5 in
bcr-abl-inhibited cells, MBA cells were pretreated with kinase
inhibitor and subsequently stimulated with IL-3 or GM-CSF before Stat-5
activation was examined. As shown in Figure 4C, the inhibition of
bcr-abl reduced Stat-5 activation levels, and the challenge with
cytokines failed to reactivate Stat-5 phosphorylation. Similar results
were obtained in K562 cells, in which bcr-abl inhibition blocked both
Stat-5 and MAPK activation (Figure 4D). Failure of cytokines to
reactivate Stat-5 phosphorylation may underlie their inability to
provide apoptotic protection after bcr-abl inhibition with STI-571.
To explore the potential mechanism of altered cytokine signaling in
bcr-abl+ Mo7e cells, expression of a key component of
IL-3/GM-CSF signaling
In support of this hypothesis, IL-3 was unable to induce tyrosine
phosphorylation of
Several studies have demonstrated the strong influence of bcr-abl expression on signaling events in leukemic and other cells.7,13,14,18,19,28,29 Most recent information suggests that bcr-abl expression results in the activation of similar cascades shared by cytokines that stimulate proliferation or that increase survival in cells of hematopoietic origin.18,19,28 In this regard, the activation of Stat-5 plays a major role in normal hematopoiesis, and aberrant regulation is associated with leukemia and other diseases.33,34 In the present report, bcr-abl expression results in clear alterations in signal transduction and gene expression profiles that are associated with cytokine independence. However, bcr-abl expression also renders these cells vulnerable to apoptosis upon bcr-abl-tyrosine kinase inhibition. Understanding the mechanism of apoptotic vulnerability is essential to the clinical prediction of STI-571 efficacy and is the focus of this report. Bcr-abl expression in Mo7e cells resulted in increased tyrosine phosphorylation and constitutive activation of Stat-5 tyrosine phosphorylation, whereas only minimal changes in MAP kinase activation were measurable. In addition, when compared to epithelial tumors, PI3'-kinase activity and Akt phosphorylation were only minimally detectable in bcr-abl+ cells (data not shown). These observations are supported by our studies with inhibitors of this survival axis that did not increase cellular sensitivity to STI-571 or have major apoptotic effects on bcr-abl+ cells. These results contrast with those of recent reports describing the involvement of this cascade (PI3K, Akt, BAD) in leukemogenesis and bcr-abl transformation, which predict that inhibition of this axis would increase apoptotic responsiveness to STI-571.14,35,36 Because other leukemic models predict the involvement of both BAD-dependent and -independent survival influences by bcr-abl,14 our results suggest that Akt activation may be independent of direct bcr-abl regulation in K562 and MBA cells and may not be a dominant target for STI-571-mediated inhibition. Other upstream regulatory distinctions (PTEN/MMAC mutation/deletion) and downstream targets of PI3K (mTOR) may exist and influence the contribution of PI3K to bcr-abl signaling and response to STI-571 in leukemic cell targets.37,38 Autophosphorylation of bcr-abl recruits adaptor molecules, such as Grb2, that contribute to the activation of ras and other downstream signals.9,12,15,16 However, tyrosine phosphorylation at this and other sites may be regulated by the induction of PTP1B and other tyrosine phosphatases (SHP-2) that are coexpressed in bcr-abl+ cells.30,39 Our studies confirm the increased expression of PTP1B in bcr-abl-expressing Mo7e cells (and other bcr-abl+ populations), and, though inhibition of bcr-abl blocked Stat-5 activation and reduced bcl-xL levels, PTP1B levels remained largely unchanged before the onset of apoptosis (Figure 2). This may be due to the relatively long t1/2 of PTP1B, as measured in other cell models.40 However, the sustained expression of PTP1B in STI-571-treated, bcr-abl-expressing cells may prevent the activation of bcr-abl signaling through reduced recruitment of SH2-domain interactive proteins. The role of PTP1B in bcr-abl+ cells and its contribution to STI-571-mediated cell death is under investigation. PTP1B may play a role in regulating other cell-signaling cascades (IGF-1 and insulin).41,42 Bcr-abl promotes the increased expression of bcl-xL through
the activation of Stat proteins, as demonstrated in studies of IL-3,
GM-CSF, and other cytokine-mediated signaling pathways that regulate
Stat phosphorylation.28,29,32 As expected, bcr-abl inhibition reduced bcl-xL expression levels, lowering
apoptotic thresholds and engaging caspase 3 activation (Figures 1, 2)
in bcr-abl+ cells. Stat-5 activated by mechanisms
independent of bcr-abl expression (exogenous growth factors such as
GM-CSF or IL-3 [Mo7e] or other leukemogenic mechanisms [KG-1
cells]) were not affected by STI-571, and kinase inhibitor did not
induce apoptosis in these cells. These results support earlier
observations of a role for bcr-abl-mediated activation of Stat-5 in
chronic myelogenous leukemia (CML) cells and the selective inactivation
of Stat-5 signaling by STI-571 in bcr-abl+
cells.13,19,28,29 The mechanism of bcr-abl-mediated
Stat-5 tyrosine phosphorylation is unknown, and, though earlier studies suggested the involvement of Jak-2 in bcr-abl signaling in MBA3.16 cells,43 the coexpression of Jak-2-dominant-negative with
bcr-abl did not alter Stat-5 activation in other cell
models.44 The MBA cells used in the present study
represent a distinct MBA clone (MBA.1) that expresses autocrine growth
factors but does not appear to be dependent on these factors for
sustained growth or survival.17 In support of cytokine
independence in MBA.1 cells, Jak-2 kinase inhibitor (AG490; up to 80 µM) had minimal effects on MBA.1 cells but induced apoptosis in Mo7e
cells in the presence of IL-3 or GM-CSF (data not shown). Although
earlier reports of constitutive Jak-2/ Recent studies support a role for downstream components of cytokine
signaling and transcriptional regulation of bcl-xL and other genes13,18,19,28,29,32 as mediators of survival in STI-571-treated, bcr-abl-expressing cells. Although bcr-abl activates several Stat proteins, there was a distinct defect in the reactivation of some, but not all, of these cascades after STI-571
treatment.44-46 Kinase inhibitor suppressed both Stat-1
and Stat-5 phosphorylation in bcr-abl+ cells. However, only
Stat-1 phosphorylation could be reactivated by cytokines (IFN- Overall, the studies described here predict that Stat-5 activation and
down-regulation of the
Submitted May 17, 2000; accepted January 11, 2001.
Supported by National Institutes of Health grant CA-73018.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: Nicholas J. Donato, Department of Bioimmunotherapy, Box 422, M. D. Anderson Cancer Center, University of Texas, 1515 Holcombe Blvd, Houston, TX 77030; e-mail: ndonato{at}mdanderson.org.
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M. Benekli, H. Baumann, and M. Wetzler Targeting Signal Transducer and Activator of Transcription Signaling Pathway in Leukemias J. Clin. Oncol., September 10, 2009; 27(26): 4422 - 4432. [Abstract] [Full Text] [PDF] |
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K. M. Heinonen, N. Dube, A. Bourdeau, W. S. Lapp, and M. L. Tremblay Protein tyrosine phosphatase 1B negatively regulates macrophage development through CSF-1 signaling PNAS, February 21, 2006; 103(8): 2776 - 2781. [Abstract] [Full Text] [PDF] |
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R. Piva, P. Gianferretti, A. Ciucci, R. Taulli, G. Belardo, and M. G. Santoro 15-Deoxy-{Delta}12,14-prostaglandin J2 induces apoptosis in human malignant B cells: an effect associated with inhibition of NF-{kappa}B activity and down-regulation of antiapoptotic proteins Blood, February 15, 2005; 105(4): 1750 - 1758. [Abstract] [Full Text] [PDF] |
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N. J. Donato, J. Y. Wu, J. Stapley, H. Lin, R. Arlinghaus, B. Aggarwal, S. Shishodin, M. Albitar, K. Hayes, H. Kantarjian, et al. Imatinib Mesylate Resistance Through BCR-ABL Independence in Chronic Myelogenous Leukemia Cancer Res., January 15, 2004; 64(2): 672 - 677. [Abstract] [Full Text] [PDF] |
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R. Kurzrock, H. M. Kantarjian, B. J. Druker, and M. Talpaz Philadelphia Chromosome-Positive Leukemias: From Basic Mechanisms to Molecular Therapeutics Ann Intern Med, May 20, 2003; 138(10): 819 - 830. [Abstract] [Full Text] [PDF] |
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M. Benekli, M. R. Baer, H. Baumann, and M. Wetzler Signal transducer and activator of transcription proteins in leukemias Blood, April 15, 2003; 101(8): 2940 - 2954. [Abstract] [Full Text] [PDF] |
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J. M. Golas, K. Arndt, C. Etienne, J. Lucas, D. Nardin, J. Gibbons, P. Frost, F. Ye, D. H. Boschelli, and F. Boschelli SKI-606, a 4-Anilino-3-quinolinecarbonitrile Dual Inhibitor of Src and Abl Kinases, Is a Potent Antiproliferative Agent against Chronic Myelogenous Leukemia Cells in Culture and Causes Regression of K562 Xenografts in Nude Mice Cancer Res., January 15, 2003; 63(2): 375 - 381. [Abstract] [Full Text] [PDF] |
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N. J. Donato, J. Y. Wu, J. Stapley, G. Gallick, H. Lin, R. Arlinghaus, and M. Talpaz BCR-ABL independence and LYN kinase overexpression in chronic myelogenous leukemia cells selected for resistance to STI571 Blood, January 15, 2003; 101(2): 690 - 698. [Abstract] [Full Text] [PDF] |
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R. Buettner, L. B. Mora, and R. Jove Activated STAT Signaling in Human Tumors Provides Novel Molecular Targets for Therapeutic Intervention Clin. Cancer Res., April 1, 2002; 8(4): 945 - 954. [Abstract] [Full Text] [PDF] |
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