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Blood, 15 December 2006, Vol. 108, No. 13, pp. 4170-4177.
Prepublished online as a Blood First Edition Paper on August 29, 2006; DOI 10.1182/blood-2006-05-023093.
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NEOPLASIA
Inhibition of overactivated p38 MAPK can restore hematopoiesis in myelodysplastic syndrome progenitors
Tony A. Navas,
Mani Mohindru,
Myka Estes,
Jing Ying Ma,
Lubomir Sokol,
Perry Pahanish,
Simrit Parmar,
Edwin Haghnazari,
Li Zhou,
Robert Collins,
Irene Kerr,
Aaron N. Nguyen,
Yin Xu,
Leonidas C. Platanias,
Alan A. List,
Linda S. Higgins, and
Amit Verma
From the Albert Einstein College of Medicine, Bronx, NY; the University of Texas Southwestern Medical School, Dallas, TX; the Dallas Veterans Affairs Medical Center, Dallas, TX; Scios Inc, Fremont, CA; the Northwestern University Robert H. Lurie Cancer Center, Chicago, IL; and the Moffit Cancer Center, Tampa, FL.
The myelodysplastic syndromes (MDSs) are collections of heterogeneous hematologic diseases characterized by refractory cytopenias as a result of ineffective hematopoiesis. Development of effective treatments has been impeded by limited insights into any unifying pathogenic pathways. We provide evidence that the p38 MAP kinase is constitutively activated or phosphorylated in MDS bone marrows. Such activation is uniformly observed in varied morphologic subtypes of low-risk MDS and correlates with enhanced apoptosis observed in MDS hematopoietic progenitors. Most importantly, pharmacologic inhibition of p38 by a novel small molecule inhibitor, SCIO-469, decreases apoptosis in MDS CD34+ progenitors and leads to dose-dependant increases in erythroid and myeloid colony formation. Down-regulation of the dominant p38 isoform by siRNA also leads to enhancement of hematopoiesis in MDS bone marrow progenitors in vitro. These data implicate p38 MAPK in the pathobiology of ineffective hematopoiesis in lowrisk MDS and provide a strong rationale for clinical investigation of SCIO-469 in MDS.

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