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Blood, 1 June 2006, Vol. 107, No. 11, pp. 4549-4553.
Prepublished online as a Blood First Edition Paper on February 7, 2006; DOI 10.1182/blood-2005-07-2829.


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Submitted July 15, 2005
Accepted January 21, 2006

MEK1 inhibition sensitizes primary acute myelogenous leukemia to arsenic trioxide-induced apoptosis

Paolo Lunghi, Antonio Costanzo, Luigi Salvatore, Nelida Noguera, Laura Mazzera, Antonio Tabilio, Francesco Lo-Coco, Massimo Levrero, and Antonio Bonati*

Department of Clinical Sciences, Section of Hemato-Oncology, University of Parma, Parma, Italy
Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy; Rome Oncogenomic Center (ROC), Rome, Italy
Department of Biopathology, Section of Hematology, University of Rome "Tor Vergata", Rome, Italy
Department of Clinical and Experimental Medicine, Section of Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
Department of Internal Medicine, and Laboratory of Gene Expression, Fondazione Andrea Cesalpino, University of Rome "Tor Vergata", Rome, Italy; Department of Experimental Oncology, CRS-Regina Elena Cancer Institute, Rome, Italy; Rome Oncogenomic Center (ROC), Rome, Italy

* Corresponding author; email: antbonny{at}unipr.it.

We have found that MEK1 inhibitor PD184352 strikingly increases apoptosis induced by Arsenic Trioxide (ATO) in twenty-one out of twenty-five primary acute myelogenous leukemia (AML) cases. Isobologram analysis confirmed the synergistic (13/25 cases) or additive (8/25 cases) nature of this interaction. Moreover we demonstrate that the p53-related gene p73 is a molecular target of the combined treatment in AML blasts. Indeed, ATO modulates the expression of the p73 gene by inducing both the pro-apoptotic and anti-proliferative TAp73 and the anti-apoptotic and pro-proliferative {Delta}Np73 isoforms thereby failing to elevate TA/{Delta}Np73 ratio. Conversely the treatment with PD184352 reduces the level of {Delta}Np73 and blunts the arsenic-mediated up-regulation of {Delta}Np73, thus causing a raise of the TA/{Delta}Np73 ratio of dual-treated cells. Moreover, high doses of ATO induce p53 accumulation in 11/21 cases. Combined treatment results in the induction of the proapoptotic p53/p73-target gene p53AIP1 (p53-regulated Apoptosis-Inducing Protein 1), and greatly enhances apoptosis of treated cells.


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