Proteasome inhibitors exert cytotoxicity and increase chemosensitivity via transcriptional repression of Notch1 in T-cell acute lymphoblastic leukemia

D Koyama, J Kikuchi, N Hiraoka, T Wada, H Kurosawa… - Leukemia, 2014 - nature.com
D Koyama, J Kikuchi, N Hiraoka, T Wada, H Kurosawa, S Chiba, Y Furukawa
Leukemia, 2014nature.com
The Notch signaling pathway has been recognized as a key factor for the pathogenesis of T-
cell acute lymphoblastic leukemia (T-ALL), because of the high incidence of activating
mutations of Notch1. Notch inhibition could serve as a new treatment strategy for T-ALL;
however, the attempts to perturb Notch signaling pathways have been unsuccessful so far.
In this study, we found that proteasome inhibitors exert cytotoxic effects on T-ALL cells with
constitutive activation of Notch1 to a similar extent as myeloma cells. The proteasome …
Abstract
The Notch signaling pathway has been recognized as a key factor for the pathogenesis of T-cell acute lymphoblastic leukemia (T-ALL), because of the high incidence of activating mutations of Notch1. Notch inhibition could serve as a new treatment strategy for T-ALL; however, the attempts to perturb Notch signaling pathways have been unsuccessful so far. In this study, we found that proteasome inhibitors exert cytotoxic effects on T-ALL cells with constitutive activation of Notch1 to a similar extent as myeloma cells. The proteasome inhibitor bortezomib repressed the transcription of Notch1 and downstream effectors including Hes1, GATA3, RUNX3 and nuclear factor-κB (NF-κB)(p65 and p50), coincided with downregulation of the major transactivator Sp1 and its dissociation from Notch1 promoter. Overexpression of the Notch1 intracellular domain (NICD) significantly ameliorated bortezomib-induced cytotoxicity against T-ALL cells. Drug combination studies revealed that bortezomib showed synergistic or additive effects with key drugs for the treatment of T-ALL such as dexamethasone (DEX), doxorubicin and cyclophosphamide, which were readily abolished by NICD overexpression. The synergy of bortezomib and DEX was confirmed in vivo using a murine xenograft model. Our findings provide a molecular basis and rationale for the inclusion of proteasome inhibitors in treatment strategies for T-ALL.
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