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Blood, 15 April 2006, Vol. 107, No. 8, pp. 3288-3294.
Prepublished online as a Blood First Edition Paper on December 20, 2005; DOI 10.1182/blood-2005-10-4048.


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Submitted October 11, 2005
Accepted November 15, 2005

Coexistence of multiple mechanisms of PT523-resistance in human leukemia cells harboring three reduced folate carrier alleles: transcriptional silencing, inactivating mutations and allele loss

Yotam Kaufman, Ilan Ifergan, Lilah Rothem, Gerrit Jansen, and Yehuda G Assaraf*

Department of Biology, Technion, Haifa, Israel
Department of Rheumatology, University Hospital VU, Amsterdam, The Netherlands

* Corresponding author; email: assaraf{at}tx.technion.ac.il.

The reduced folate carrier (RFC) is the dominant route for the uptake of various antifolates including PT523, a potent dihydrofolate reductase inhibitor (Ki=0.35 pM) and an excellent transport substrate of the RFC (Kt =0.7 µM). Herein we describe the multiple mechanisms of RFC inactivation in human leukemia PT523-resistant cells originally harboring three RFC alleles. Cellular exposure to gradually increasing PT523 concentrations resulted in sublines displaying up to 3,500-fold resistance to various hydrophilic antifolates that rely on RFC for their cellular uptake. Antifolate-resistant cells lost RFC gene expression (65-99% loss) due to impaired promoter binding of various transcription factors that regulate RFC gene expression. Additionally, DNA sequencing revealed that PT523-resistant cells contained a cluster of four nearly consecutive mutations residing on a single RFC allele including L143P, A147V, R148G and Q150Stop. Southern blot analysis established the loss of an RFC allele in PT523-resistant cells. These alterations resulted in markedly decreased RFC protein levels (~80-99%) and consequently impaired [3H]MTX transport (87%-99%). This study provides the first evidence that acquisition of PT523 resistance in human leukemia cells harboring three RFC alleles is due to multiple coexisting alterations including transcriptional silencing, inactivating mutations and RFC allele loss.


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