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Blood, 15 August 2000, Vol. 96, No. 4, pp. 1525-1530
NEOPLASIA
Arsenic trioxide induces dose- and time-dependent apoptosis of
endothelium and may exert an antileukemic effect via inhibition of
angiogenesis
Gail J. Roboz,
Sergio Dias,
George Lam,
William J. Lane,
Steven L. Soignet,
Raymond P. Warrell Jr, and
Shahin Rafii
From the Division of Hematology and Oncology,
Weill Medical College of Cornell University, New York, NY; Memorial
Sloan Kettering Cancer Center, New York, NY.
Arsenic trioxide (As2O3) has recently
been used successfully in the treatment of acute promyelocytic leukemia
and has been shown to induce partial differentiation and apoptosis of
leukemic cells in vitro. However, the mechanism by which
As2O3 exerts its antileukemic effect remains
uncertain. Emerging data suggest that the endothelium and angiogenesis
play a seminal role in the proliferation of liquid tumors, such as
leukemia. We have shown that activated endothelial cells release
cytokines that may stimulate leukemic cell growth. Leukemic cells, in
turn, can release endothelial growth factors, such as vascular
endothelial growth factor (VEGF). On the basis of these observations,
we hypothesized that As2O3 may interrupt a
reciprocal loop between leukemic cells and the endothelium by direct
action on both cell types. We have shown that treatment of
proliferating layers of human umbilical vein endothelial cells (HUVECs)
with a variety of concentrations of As2O3
results in a reproducible dose- and time-dependent sequence of events
marked by change to an activated morphology, up-regulation of
endothelial cell adhesion markers, and apoptosis. Also, treatment with
As2O3 caused inhibition of VEGF
production in the leukemic cell line HEL. Finally, incubation of
HUVECs with As2O3 prevented capillary
tubule and branch formation in an in vitro endothelial cell-differentiation assay. In conclusion, we believe that
As2O3 interrupts a reciprocal stimulatory loop
between leukemic cells and endothelial cells by causing apoptosis of
both cell types and by inhibiting leukemic cell VEGF production.

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