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Experimental Therapeutics, Molecular Targets, and Chemical Biology |
1 Section of Molecular Hematology and Therapy, Department of Blood and Marrow Transplantation and Departments of 2 Leukemia, 3 Experimental Therapeutics, and 4 Molecular Therapeutics, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; and Departments of 5 Clinical Pathology, 6 Biochemistry, and 7 Transfusion Medicine and Stem Cell Regulation, Juntendo University School of Medicine, Tokyo, Japan
Requests for reprints: Marina Konopleva, Section of Molecular Hematology and Therapy, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 448, Houston, TX 77030. Phone: 713-794-1628; Fax: 713-794-4747; E-mail: mkonople{at}mdanderson.org.
| Abstract |
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| Introduction |
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4ß1 integrin) on leukemic blasts and fibronectin on stromal cells activates phosphatidylinositol 3-kinase (PI3K)/Akt/Bcl-2 signaling, an important determinant of AML chemosensitivity and the level of minimal residual disease of AML patients (3). Thus, activation of the signaling cascades downstream of integrin engagement may play a critical role in the well-documented chemoresistance of bone marrowresident AML cells. Integrin-linked kinase (ILK) was proposed to play a central role in integrin activation and signaling (4). ILK is a highly conserved ankyrin repeatcontaining serine-threonine protein kinase that links the cell adhesion receptors, integrins, and growth factors to the downstream signaling pathways. The activity of ILK that is modulated by integrin ligation in a PI3K-dependent manner (5) stimulates the phosphorylation of AktSer473 (6). Activated Akt phosphorylates and inactivates glycogen synthase kinase 3ß (GSK3ß), resulting in the nuclear localization of ß-catenin and activated transcription, cell cycle progression, and cell proliferation (5). Furthermore, ILK directly phosphorylates GSK3ß and inhibits its activity in neuroblastoma cells (7). Recent studies indicate that ILK expression and activity are significantly up-regulated in several types of cancers (811), hence providing a potential target for cancer therapy.
The active cross-talk between signaling pathways responsible for cell survival and apoptosis has recently been elucidated. In particular, inhibition of GSK3ß in the Wnt signaling system induces Hes1 (12), which encodes a basic helix-loop-helix transcription factor downstream of Notch and positively regulates the self-renewal of hematopoietic stem cells (13). Cross-talk between the Notch/Hes1 pathway and the Janus-activated kinase (JAK) 2/signal transducers and activators of transcription 3 (STAT3) pathway has also been shown (14). Further, extracellular signal-regulated kinase (ERK) 1/2 has recently been identified as a target of ILK signaling in a cell culture model of renal epithelial morphogenesis (15). Thus, it is possible that ILK functions upstream in the hierarchy of these pathways such that its inhibition in turn inhibits the activation of multiple pathways involved in tumor cell survival and proliferation.
In this study, we used pharmacologic inhibitors of PI3K and ILK to determine the role of the respective pathways in bone marrow stromasupported AML cell survival and examined the mechanisms that coordinate PI3K/ILK/Akt signaling with stroma-induced activation of other pathways. Our results elucidated the prominent role of ILK in the interaction of bone marrow stromal cells and leukemic cells that leads to the survival of leukemic cells. In turn, pharmacologic blockade of PI3K/ILK axis inhibited activation not only of Akt and GSK3ß signaling pathways but also of multiple prosurvival signaling pathways in both leukemic and stromal cells, indicating its proximal role in the leukemia/stroma interactions.
| Materials and Methods |
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with 20% FBS, 1% L-glutamine, and penicillin-streptomycin. Passage 3 or 4 MSCs were used for the coculture experiments. Leukemic cells were cultured at a starting concentration of 5 x 105/mL with and without 0.2 x 105/cm2 MSC stromal layer in serum-free (for NB4, U937, Raji, and REH cells) or cytokine-free conditions (for MO7e cells). To study the effects of the soluble factors produced by MSCs, conditioned serum-free medium from the culture of 1-day-old MSCs was added to the NB4 cell culture.
Samples of bone marrow or peripheral blood were obtained for in vitro studies from patients with newly diagnosed or recurrent AML with high (>70%) blast count after informed consent according to the institutional guidelines (Table 1
). Mononuclear cells were purified by Ficoll-Hypaque (Sigma Chemical Co., St. Louis, MO) density gradient centrifugation and cocultured with MSC for 24 h in MEM
with 10% FBS, 1% L-glutamine, and penicillin-streptomycin, after which they were exposed to LY294002 (20 µmol/L) or QLT0267 (10 µmol/L) for 48 h.
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To verify lack of significant contamination in collected leukemic cells and MSC fractions and to evaluate cell typespecific phosphorylation, the expression of phosphorylated (p)-STAT3 and p-ERK1/2 in cocultured leukemic cells and trypsinized MSCs was measured by two-color flow cytometry using CD45 as a discriminator between leukemic cells and MSCs. Briefly, cells were counterstained with allophycocyanin-conjugated anti-CD45 and isotype control IgG1 antibody to distinguish CD45+ leukemic cells and CD45 MSCs. Cells were then fixed using 2% formaldehyde at 37°C for 10 min and then resuspended in 90% ice-cold methanol for 30 min. Next, cell suspensions were centrifuged and washed once with PBS containing 4% bovine serum albumin and labeled with the FITC-conjugated p-STAT3Tyr705, p-ERK1/2Thr202/Tyr204, or isotype control IgG1 antibody (BD Biosciences, San Jose, CA) for 30 min at 4°C. After one wash, samples were analyzed immediately by a FACSCalibur flow cytometer. Data acquisition and analysis were done using the CellQuest software.
Reagents. The ILK inhibitor QLT0267 was obtained from QLT, Inc. (Vancouver, British Columbia, Canada; refs. 10, 11). QLT0267 is a submicromolar inhibitor of the phosphotransferase activity of ILK toward a specific peptide substrate, which was identified in the high-throughput screening of a rationally designed small-molecule library against the target ILK. QLT0267 has been shown to inhibit the kinase activity at 26 nmol/L and possess 1,000-fold selectivity over other kinases, including CK2, CSK, DNA-PK, PIM1, protein kinase B or Akt kinase, and protein kinase C; and 100-fold selectivity over ERK1, GSK3ß, LCK, protein kinase A, p70S6K, and RSK1 (QLT; refs. 8, 10, 17). Recently, the specificity of QLT0267 as the ILK inhibitor has been confirmed using the constitutively active mutant of ILK, which protected cells from the inhibitory effect of QLT0267 (9). The PI3K inhibitor LY294002, mitogen-activated protein kinase (MAPK)/ERK kinase (MEK) inhibitor PD98059, JAK2 inhibitor tyrphostin AG490, GSK3 inhibitor IX (2'Z,3'E)-6-bromoindirubin-3'-oxime (BIO), and
-secretase inhibitor XII (Z-IL-CHO) were purchased from Calbiochem (Novabiochem Corp., La Jolla, CA). The STAT3 inhibitor WP1066 (18), QLT0267 (10 µmol/L), LY294002 (20 µmol/L), WP1066 (2 µmol/L), AG490 (20 µmol/L), PD98059 (20 µmol/L), BIO (100 nmol/L), and
-secretase inhibitor XII (10 µmol/L) were prepared by diluting to the appropriate concentration in DMSO and stored at 20°C with the culture medium before the in vitro exposure of cells.
Cell viability assay. Viable cells were identified by using the trypan blue dye exclusion method and were counted in a hemocytometer.
Apoptosis and cell cycle analysis. For the propidium iodide/Annexin V binding studies done to analyze apoptosis, leukemic cells were washed twice with PBS and then counterstained with allophycocyanin-conjugated anti-CD45 (NB4 cells) or anti-CD90 (primary AML cells) and isotype control IgG1 antibody to exclude contamination of MSCs. Cells were then resuspended in binding buffer [10 mmol/L HEPES/NaOH (pH 7.4), 140 mmol/L NaCl, 2.5 mmol/L CaCl2; all from Sigma-Aldrich, St. Louis, MO], and FITC-conjugated Annexin V (Roche Diagnostics Co., Indianapolis, IN) was added at a final concentration of 1 µg/mL. The mixture was incubated at room temperature for 15 min in the dark before flow cytometric analysis. Membrane integrity was simultaneously assessed by propidium iodide staining (0.25 µg/mL). Flow cytometry done using Annexin V fluorescence was determined using a FACSCalibur flow cytometer (BD Biosciences), and data acquisition and analysis were done with CellQuest software (BD Biosciences).
The cell cycle distribution was determined by flow cytometry analysis of propidium iodidestained nuclei. Briefly, NB4 cells were washed twice with PBS, fixed in ice-cold ethanol [70% (v/v) in water], and stained with the propidium iodide solution [25 µg/mL propidium iodide, 180 units/mL RNase, 0.15% Triton X-100, and 30 mg/mL polyethylene glycol in 4 mmol/L citrate buffer (pH 7.8); all from Sigma-Aldrich]. The DNA content was determined using a FACSCalibur flow cytometer, and the ModFit computer program (Verity Software House, Topsham, ME) was used for cell cycle analysis. Cells with a sub-G1 DNA content were considered apoptotic.
Western blot analysis. NB4 cells and trypsinized MSCs were washed twice with PBS and lysed in cell lysis buffer (10 mmol/L NaF, 1 mmol/L Na3VO4, 150 mmol/L NaCl, 1 mmol/L MgCl2, 1 mmol/L CaCl2, 0.1% NaN3, 10 mmol/L iodoacetamide, 3 mmol/L phenylmethylsulfonyl fluoride, 1% Triton X-100) supplemented with a protease inhibitor cocktail (Roche Diagnostics). Equal amounts of lysate (equivalent to 30 µg protein) were separated on 10% polyacrylamide gels (Bio-Rad Laboratories, Inc., Hercules, CA). Proteins were transferred to Hybond-P membranes (Amersham Pharmacia Biotech, Little Chalfont, Buckinghamshire, United Kingdom) and immunoblotted with primary antibodies to the following: ILK (Upstate, Lake Placid, NY); Akt, p-AktSer473, p-GSK3
/ßSer9/12, STAT3, p-STAT3Tyr705, p-STAT3Ser727, and p-MAPKThr202/Tyr204 (p-ERK1/2; Cell Signaling Technology, Danvers, MA); p42MAPK (ERK1/2) and Notch1 (Santa Cruz Biotechnology, Santa Cruz, CA); Hes1 (provided by Dr. Tetsuo Sudo, Toray Research Center, Tsukuba, Japan; ref. 19); and ß-actin (Abcam, Cambridge, MA). Membranes were then probed with a horseradish peroxidaseconjugated secondary antibody and reacted with electrochemiluminescence reagent (Amersham Biosciences, Baie d'Urfe, Quebec, Canada). Signals were detected by a luminescent image analyzer (LAS-100 Plus, Fujifilm, Tokyo, Japan) and quantified by Image Gauge (Fujifilm).
ILK kinase assay. ILK kinase assay was done using nonradioactive Akt kinase kit (Cell Signaling Technology) as described previously (10). Briefly, ILK was immunoprecipitated from 200 µg of cell lysate using 1 µg of a specific anti-ILK antibody and protein A agarose (Life Technologies, Rockville, MD). The ILK-containing agarose pellet was washed twice in assay buffer and twice in kinase buffer (both from Cell Signaling Technology) followed by incubation with 200 µmol/L ATP and 1 µg of GSK3 fusion protein for 30 min at 30°C. The reaction was terminated with 20 µL of 3x SDS sample buffer, and the supernatants were boiled for 5 min and loaded onto 10% SDS-polyacrylamide gel. Phosphorylation of the substrate was detected by Western blot analysis with the antip-GSK3
/ßSer9/12 antibody. The amount of ILK immunoprecipitated from 30 µg of the cell lysate was determined by immunoblot with anti-ILK antibody.
Immunofluorescence staining. Cells were washed with PBS, fixed with 4% paraformaldehyde in PBS for 10 min at room temperature, permeabilized with 90% methanol in TBST buffer (10 mmol/L Tris, 15 mmol/L NaCl, 0.1% Triton X-100) for 15 min, and rinsed with PBS for 5 min. Next, cells were blocked with 5% goat serum in PBS for 30 min and incubated with antiß-catenin (Cell Signaling Technology), Notch1 (extracellular domain), cleaved Notch1 (intracellular domain), Hes1, p-AktSer473, p-GSK3ßSer9 (Cell Signaling Technology), p-STAT3Tyr705, and p-ERK1/2Thr202/Tyr204 antibodies (1:100) overnight at 4°C. Excess antibody was removed by washing with PBS. Cells were then incubated with secondary antibody, either FITC-labeled anti-rabbit or anti-mouse IgG (H+L; 1:250; Caltag, Burlingame, CA), for 30 min at 37°C. Cells were washed with PBS, mounted on slides, and analyzed under a Zeiss LSM 510 laser confocal microscope (Carl Zeiss, Thornwood, NY).
Statistical analysis. Statistical analysis was done using ANOVA and Fisher's post hoc tests, and P < 0.05 was considered statistically significant. The results are expressed as the mean ± SD or mean ± SE.
| Results |
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Because the ß1 integrin cytoplasmic domain was reported to activate ERK1/2 (23) and the mammalian target of rapamycin (mTOR) pathway downstream of Akt can phosphorylate STAT3 on Ser727 (24), we next examined changes in the activation of STAT3 and MAPK in NB4 cells cultured with and without MSCs. The NB4 cells cultured with MSCs showed a considerable increase in p-ERK1/2 and p-STAT3Tyr705 (Fig. 1B) but not p-STAT3Ser727 (data not shown). Phosphorylation of ERK1/2 was induced within the first 5 min, whereas STAT3Tyr705 phosphorylation was delayed and remained at markedly high levels at 24 h of cocultivation with MSCs (Fig. 1B). We confirmed specific induction of p-ERK and p-STAT3 in leukemic cells identified by CD45 immunofluorescence in two-color flow cytometry analysis (Fig. 1D). Thus, from this, it seems that multiple prosurvival signaling cascades, including the PI3K/ILK/Akt/GSK3ß, with the nuclear localization of ß-catenin, JAK2/STAT3, and MEK/ERK1/2 pathways are activated in leukemic cells cultured in direct contact with bone marrow stromal cells.
Pharmacologic PI3K or ILK inhibitors block activation of PI3K/ILK/Akt, JAK/STAT3, and MAPK/ERK pathways in NB4 cells cultured with MSCs. Because multiple prosurvival pathways are activated in leukemic cells by virtue of their interactions with MSC, we next attempted to dissect a functional role of each of these pathways by use of the respective pharmacologic inhibitors. To determine whether the stroma-induced phosphorylation of Akt and GSK3ß is ILK dependent, we first assessed the effects of the specific ILK inhibitor QLT0267 on p-Akt and p-GSK3ß levels in NB4 cells cocultured with MSCs. QLT0267 suppressed MSC-induced p-AktSer473 and p-GSK3ßSer9 (Fig. 2A ), which inhibited the translocation of ß-catenin into the nucleus (MSC+, compare control and QLT0267; Fig. 1C). No effect on phosphorylation of Thr308 of Akt (PDK-1 site) was noted (data not shown). Unexpectedly, QLT0267 also decreased MSC-triggered p-ERK1/2 and p-STAT3Tyr705 (Fig. 2A). Similar changes were induced by the PI3K inhibitor LY294002, suggesting that ILK induces Akt and GSK3ß phosphorylation and ß-catenin translocation into cell nuclei in a PI3K-dependent manner. Likewise, QLT0267 abrogated MSC-induced p-AktSer473, p-ERK1/2, and p-STAT3Tyr705 expression in two other leukemic cell lines, REH and MO7e cells (Fig. 2B).
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Cross-talk among ILK/Akt/GSK3ß, Notch/Hes, and JAK/STAT3 signaling. Wnt and Notch signaling pathways are critical regulators of normal and leukemia stem cell survival (12, 25). To determine if coculture with MSCs activates Notch signaling, we examined the expression of the intracellular form of active (cleaved) Notch1 and of Hes1, a transcriptional target of Notch1 (26), in NB4 cells by Western blot and confocal microscopic analyses. The endogenous Notch1 was expressed in NB4 cells as determined by immunofluorescence staining with antibody that recognizes extracellular domain of Notch1 (Fig. 3A ). MSC coculture activated Notch signaling as shown by increased expression of cleaved intracellular Notch1 (MSC control versus MSC+ control; Fig. 3A) and Hes1 (MSC control versus MSC+ control; Fig. 3B, i and ii), which was evident after 60 min of MSC coculture (Fig. 3B, i).
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-secretase inhibitor, prevented MSC-induced cleaved Notch1 (Fig. 3A) and Hes1 (Fig. 3B, ii) and significantly decreased p-STAT3Tyr705 expression (Fig. 3D), indicating contribution of Notch in the activation of JAK2/STAT3 signaling. In contrast, blockade of STAT3 or MAPK activation by WP1066 or PD98059, respectively, did not affect Hes1 expression (data not shown). MSCs prevent serum deprivationinduced apoptosis but not QLT0267-induced apoptosis in NB4 cells. We next examined the ability of MSCs to support survival of leukemic cells under conditions of serum deprivation. NB4 cells cultured without serum rapidly undergo apoptosis at 48 h as determined by Annexin V positivity. In contrast, coculture with MSC significantly protected NB4 cells from apoptosis (Fig. 4A ). This finding was confirmed by DNA flow cytometry, in which the number of sub-G1 cells among the NB4 cells cultured with MSCs was diminished compared with cells cultured alone (MSC versus MSC+: 39.5 ± 3.4% versus 28.6 ± 5.9%; P < 0.05; data not shown). These data suggest that the MSCs inhibit serum deprivationinduced apoptosis in the NB4 cells in confirmation of our reported findings (29).
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Next, we examined the effects of LY294002, PD98059, and WP1066 in NB4/MSC cocultures. Whereas MSC cocultivation did not protect NB4 cells from LY294002-induced apoptosis, WP1066- and PD98059-induced apoptosis was partially but significantly inhibited by MSCs (Fig. 4A). The effect of the JAK2 inhibitor AG490 was similar to that of WP1066 (AG490-induced Annexin V positivity in NB4 cells: MSC 49.3 ± 5.4% versus MSC+ 40.9 ± 3.2%; P = 0.04; data not shown). These data indicate that inhibition of stroma-induced PI3K/ILK, but not of ERK1/2 or STAT3 signaling, is able to overcome the protective effects of MSCs on survival of leukemic cells. On the contrary, blockade of Notch signaling by
-secretase inhibitor promoted apoptosis of NB4 cells both in MSC and MSC+ conditions (Fig. 4A) similar to the effects of PI3K/ILK inhibition.
The effects of MSCs and QLT0267 on serum deprivation or cytokine deprivationinduced apoptosis in REH and MO7e cells were further examined. As shown in Fig. 4B, MSC coculture protected viability in REH cells; however, MSC enhanced QLT0267- and LY294002-induced apoptosis. Similarly, QLT0267-induced apoptosis was enhanced when MSCs were cocultured with cytokine-deprived MO7e cells, and modest apoptosis induced by LY294002 was not inhibited by MSC.
We next investigated the effects of QLT0267 and LY294002 in seven primary AML samples cocultured with MSC (Fig. 4C; Table 1). In five of seven primary AML samples, MSC coculture protected AML cells from spontaneous apoptosis (% CD90 Annexin V+ cells, AML control in medium only, 35.8 ± 5.9%; AML + MSC, 21.0 ± 3.5%; P = 0.03), whereas in two additional samples no spontaneous apoptosis was observed. To correct for differences in spontaneous apoptosis, we calculated percentage specific apoptosis as [test (inhibitor-induced apoptosis) control (spontaneous apoptosis)] x 100 / (100 control). As shown in Fig. 4C, inhibition of PI3K/ILK signaling induced apoptosis in both suspension and MSC cocultured AML cells. Importantly, QLT0267 induced a higher degree of specific apoptosis in five of seven and LY294002 in four of seven AML samples cocultured with MSC compared with AML cells cultured in medium. This resulted in corresponding loss of viability as determined by cell counts with trypan blue exclusion (Fig. 4C).
NB4 cells prevent serum deprivationinduced apoptosis in MSCs and up-regulate p-Akt, p-STAT3, Hes1, and Bcl-2 protein in MSCs in part through activation of PI3K/ILK/Akt signaling. The phenomenon of "tumor-associated fibroblasts" that are activated by tumor cells and acquire the ability to further promote tumor growth has been recently characterized (30); however, no data are available on the activation of bone marrow stroma in leukemias. Notably, ILK activation was reported in tumor-associated fibroblasts (11) and endothelial cells (31). We therefore hypothesized that cell-to-cell contact with NB4 cells activates the ß1 integrin-ILK/PI3K/Akt signaling pathway in MSCs, which may contribute to their ability to support growth of leukemic cells. The phosphorylation levels of Akt, GSK3ß, STAT3, and ERK1/2 and the expression of Hes1 and antiapoptotic protein Bcl-2 were examined in MSCs isolated after coculture with or without NB4 cells. The purity of isolated MSCs was assured by flow cytometry using anti-CD45 antibody (>94% CD45 cells; data not shown). We found a time-dependent increase in the phosphorylation of Akt, GSK3ß, ERK1/2, and STAT3Tyr705 that was induced within the first 10 min and remained at markedly high levels at 24 h of cocultivation with NB4 (Fig. 5A ). The p-AktSer473, p-STAT3Tyr705, and p-ERK1/2 up-regulation in MSCs cultured with NB4 cells was confirmed by flow cytometric analyses using cell size and CD45 staining as a discriminator of leukemic cells from MSC (data not shown).
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| Discussion |
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Although the constitutive activation of ILK is known to promote cell survival by stimulating AktSer473 phosphorylation (6, 8, 9), the mechanisms that coordinate PI3K/ILK/Akt signaling with other signaling pathways are poorly understood. Our data provide evidence of cross-talk between the PI3K/ILK/Akt pathway and other signaling pathways that have overlapping roles in cell survival (i.e., the Notch/Hes1, JAK2/STAT3, and MEK/ERK pathways; Fig. 5C). In particular, the Notch/Hes1 signaling pathway plays a critical role in cell proliferation, differentiation, and apoptosis (33). Wnt signaling, by repressing GSK3, was shown to cause accumulation of ß-catenin and intracellular fragments of Notch in the nucleus, which results in the activation of Notch targets, such as Hes1 (26). Notably, ILK activity has been shown to modulate Wnt-mediated ß-catenin stabilization and nuclear translocation via inhibitory GSK3ß phosphorylation (17). Moreover, GSK3 inhibition can modulate gene targets of Wnt, Hedgehog, and Notch pathways in primitive hematopoietic stem cells (28). Other studies using the genetic and pharmacologic inhibitors of PI3K and/or Akt have identified Akt as an intermediate critical to Notch1 signaling (34). In our coculture system, the marked increase in cleaved Notch1 and Hes1 expression in NB4 cells induced by MSCs was blocked by QLT0267 and LY294002. Conversely, the GSK3 inhibitor BIO induced reciprocal increase in cleaved Notch1 expression. These data indicate that stroma-activated PI3K and ILK, the upstream kinases of GSK3, trigger activation of Notch signaling, which may be one of the critical mediators of leukemia cell survival in the bone marrow microenvironment. Notch receptors (Notch1, Notch2, Notch3, and Notch4) and ligands (Delta-like 1, Delta-like 4, and Jagged1) are expressed on both hematopoietic progenitors and stromal cells (35, 36), and the overexpression of the intracellular domain of Notch promotes their self-renewal (37) through up-regulation of the expression of Hes1, a direct target of Notch (12, 13, 26, 27). On the other hand, Notch signaling was reported to induce cell cycle arrest (38, 39) and bone marrow stromamediated activation of Notch1 signaling was reported to up-regulate p21, resulting in growth inhibition and protection from chemotherapy-induced apoptosis of myeloma cells (40). Curiously, both the oncogenic and tumor-suppressive properties of Notch1 are known to take place at the same time, and the final outcome is dependent on the cellular context (41). Notably, Notch signaling blockade by
-secretase inhibitor promoted apoptosis of NB4 cells both in MSC and MSC+ conditions, perhaps recapitulating the effects of PI3K/ILK inhibition. The studies elucidating detailed molecular mechanisms and functional role of activation of Notch signaling in leukemic cells by bone marrow stroma are ongoing.
We found that MSCs induced the phosphorylation of STAT3Tyr705 but not STAT3Ser727 in NB4 cells, which was inhibited by QLT0267 and LY294002. This observation is concordant with findings in pancreatic cancer cells in which ILK inhibition was shown to block phosphorylation of STAT3Tyr705 (42). The mTOR pathway downstream of Akt is responsible for STAT3Ser727 phosphorylation, whereas STAT3Tyr705 is phosphorylated through JAK2 or receptor and nonreceptor tyrosine kinases at the plasma membrane before dimerization and translocation to the nucleus for phosphorylation of the serine site by mTOR (42). The recently reported cross-talk between Notch/Hes1 and JAK2/STAT3 showed that the Hes1 protein functions as a nonreceptor scaffold protein that allows JAK2 to phosphorylate STAT3Tyr705 (14). It is possible that the phosphorylation of STAT3Tyr705 is indirectly induced by ILK/Akt through activation of Notch/Hes1 signaling. Consistent with this hypothesis, blockade of Notch signaling by
-secretase inhibitor abrogated STAT3Tyr705 phosphorylation in NB4 cells cocultured with MSC.
PI3K/mTOR and MEK signaling pathways have been reported to synergistically cooperate in the ability of stroma to support survival of leukemic cells (43). Notably, transgenic mice expressing ILK in the mammary epithelium (mouse mammary tumor virus/ILK mice) developed a hyperplastic mammary phenotype accompanied by the constitutive phosphorylation of protein kinase B/Akt, GSK3ß, and MAPK (44). In the coculture system, MSCs stimulated the phosphorylation of ERK1/2 in leukemic cells, and this effect was efficiently blocked by QLT0267 or LY294002. Inhibition of ERK activity by PD98059 or inhibition of JAK2/STAT3 signaling by WP1066 or AG490 did not affect MSC-dependent stimulation of p-Akt and p-GSK3ß. These data indicate that stroma-activated ILK can at least partially regulate ERK1/2 and STAT3 activation. Recently, the direct interplay between tumor cell and neighboring endothelial cells through MAPK and Notch signaling pathways was characterized (45). Further studies are required to fully dissect the contribution of ERK1/2 and STAT3 signaling in the supportive role of stromal cells in leukemic cell survival.
Our data therefore place ILK upstream of Notch1/Hes1, JAK2/STAT3, and MEK/ERK1/2 signaling in the leukemia/MSC interplay and suggest that bone marrow stromal cells activate ILK in a PI3K-dependent manner at a point where the stimulatory signals converge (Fig. 5C). In agreement with these results, the small-molecule ILK inhibitor QLT0267 and PI3K inhibitor LY294002 abrogated the ability of stroma to protect NB4 cells from apoptosis; this was accompanied by the specific inhibition of stroma-induced phosphorylation of Akt and GSK3ß. Analogous results were obtained in MO7e and REH leukemic cells and in a subset of primary AML samples. In contrast to well-documented inhibition of chemotherapy-induced apoptosis (29), MSC failed to protect primary AML cells from apoptosis triggered in response to PI3K/ILK activation and in fact enhanced cell death in approximately half of the case studied. These findings indicate that the proapoptotic responses of AML cells to ILK and/or PI3K inhibition are preserved in the context of bone marrow microenvironment due to specific activation of this pathway as a consequence of leukemia/stroma cell interactions.
Consistent with the recent finding that ß1 integrinactivated ILK in fibroblasts regulates cell viability via an Akt-dependent mechanism (46), we found that leukemic cells induce a "leukemia-associated stroma" phenotype in MSC, with phosphorylation and increases of p-AktSer473, p-GSK3ß, Hes1, p-ERK1/2, and Bcl-2, which were abrogated by ILK and PI3K inhibitors. Although we did not investigate in detail the molecular mechanisms underlying induction of antiapoptotic protein Bcl-2 in MSCs, ILK-induced Akt activation has been reported to contribute to the integrin-dependent up-regulation of Bcl-2 (47). Alternatively, Notch overexpression was shown to increase Notch-dependent Hes1 transcription in stromal cells (48), and the intracellular domain of Notch1 increases the expression of antiapoptotic Bcl-2 protein (49). Notably, Notch1 and its ligand Jagged1 proteins are widely expressed in AML cells (50), providing a plausible explanation for this phenomenon. As such, leukemic cells may activate stromal cells as it was shown in the models of solid tumors (43), and this possibly results in reciprocal secretion of cytokines by stroma and further supports survival of leukemic cells.
In summary, our data suggest that the PI3K/ILK/Akt pathway is a critical prosurvival pathway activated in both leukemic and bone marrow stromal cells on their interactions. In turn, inhibition of ILK/Akt signaling may overcome the protective effects of the bone marrow microenvironment on leukemic cells and thereby potentially ameliorate chemoresistance. Hence, targeting both leukemic and stromal cells via selective blockade of ILK represents a novel therapeutic approach to eradicate leukemia in the bone marrow microenvironment. Although further studies are required for the elucidation of the role of the bone marrow microenvironment and its ability to activate specific signaling pathways in the pathogenesis of leukemias, focus on this stroma-leukemia cross-talk may result in the development of strategies that alleviate the acquisition of a chemoresistant phenotype and enhance the efficacy of therapies in hematologic malignancies.
| Acknowledgments |
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
We thank Dr. Tetsuo Sudo for anti-Hes1 antibody; Nobuko Tanaka, Hiroaki Miyajima, and Akemi Koyanagi for technical assistance; Betty Notzon for the review of the manuscript; and Rosemarie Lauzon and Zhihong Zeng for excellent administrative assistance.
Received 8/29/06. Accepted 11/ 9/06.
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(5)ß(1) integrin stimulates Bcl-2 expression and cell survival through Akt, focal adhesion kinase, and Ca(2+)/calmodulin-dependent protein kinase IV. J Cell Biochem 2005;95:121423.[CrossRef][Medline]This article has been cited by other articles:
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