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Blood, 15 January 2006, Vol. 107, No. 2, pp. 716-724.
Prepublished online as a Blood First Edition Paper on September 20, 2005; DOI 10.1182/blood-2005-02-0735.


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Submitted February 23, 2005
Accepted September 1, 2005

Efficient intervention of growth and infiltration of primary adult T-cell leukemia cells by an HIV protease inhibitor, ritonavir

Zahidunnabi Dewan, Jun-nosuke Uchihara, Kazuo Terashima, Mitsuo Honda, Tetsutaro Sata, Mamoru Ito, Nobutaka Fujii, Kimiharu Uozumi, Kunihiro Tsukasaki, Masao Tomonaga, Yoko Kubuki, Akihiko Okayama, Masakazu Toi, Naoki Mori, and Naoki Yamamoto*

Department of Molecular Virology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan; AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
Division of Molecular Virology and Oncology, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan
Department of Molecular Virology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
Central Institute for Experimental Animals, Kanagawa, Japan
Department of Bioorganic Medical Chemistry, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Second Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan
Department of Laboratory Medicine, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan
Division of Clinical Trials and Research, Breast Cancer Research and Treatment Program, Tokyo Metropolitan Komagome Hospital, Tokyo Medical Center for Cancer and Infectious Disease, Tokyo, Japan

* Corresponding author; email: yamamoto.mmb{at}tmd.ac.jp.

Adult T-cell leukemia (ATL), an aggressive malignancy of CD4+ T-cells associated with human T-cell leukemia virus type I (HTLV-I) infection, carries a very poor prognosis due to the resistance of leukemic cells to any conventional regimen including chemotherapy. We examined the effect of ritonavir, an HIV protease inhibitor, on HTLV-I-infected T-cell lines and primary ATL cells and found that it induced apoptosis and inhibited transcriptional activation of NF-{kappa}B in these cells. Furthermore, ritonavir inhibited expression of Bcl-xL, survivin, c-Myc, and cyclin D2, the targets of NF-{kappa}B. In NOD/SCID/{gamma}cnull (NOG) mice, ritonavir very efficiently prevented tumor growth and leukemic infiltration in various organs of NOG mice at the same dose used for treatment of AIDS patients. Our data indicate that ritonavir has potent anti-NF-{kappa}B and anti-tumor effects and might be clinically applicable for treatment of ATL. These results would provide new concept and novel platform for new drug development of leukemia and solid cancer as well.


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