Despite advances in the treatment of T-cell acute lymphoblastic leukemia (T-ALL), the outcome of T-ALL treatment remains unsatisfactory, therefore, more effective treatment is urgently required. The present study examined the cytotoxicities of bortezomib in combination with daunorubicin against human Jurkat and Molt-4 T-ALL cells and primary T-ALL cells. Compared with treatment alone, co-exposure of cells to bortezomib and daunorubicin resulted in a significant increase in cell death in the Jurkat cells, as evidenced by the increased percentage of Annexin V-positive cells, the formation of apoptotic bodies. In addition, the administration sequence of bortezomib and daunorubicin had an effect on cell viability. Treatment with bortezomib followed by daunorubicin treatment was more effective, compared with treatment with daunorubicin followed by bortezomib. Co-treatment with bortezomib and daunorubicin markedly enhanced the activation of caspase-3, -8 and -9, which was reversed by the pan-caspase inhibitor, Z-VAD-FMK. In addition, cotreatment with bortezomib and daunorubicin enhanced the collapse of mitochondrial transmembrane potential and upregulated the proapoptotic protein, B-cell lymphoma 2 (Bcl-2) -interacting mediator of cell death (Bim), but not Bcl-2 or Bcl-extra large. Consistent with this, it was demonstrated that cotreatment of bortezomib and daunorubicin efficiently induced apoptosis in primary T-ALL cells, and cell death was associated with the collapse of mitochondrial transmembrane potential and the upregulation of Bim. Taken together, these findings indicated that the combination of bortezomib and daunorubicin significantly enhanced their apoptosis-inducing effect in T-ALL cells, which may warrant further investigation in preclinical and clinical investigations.

目的:探讨酪氨酸激酶抑制剂伊马替尼联合槲皮素诱导K562细胞凋亡的机制.方法:将250 nmol/L的伊马替尼、25μmol/L的槲皮素单药及联合作用于K562细胞,通过细胞计数检测细胞增殖,流式细胞仪分析细胞凋亡,蛋白印迹法检测相关蛋白的表达.结果:250 nmol/L伊马替尼联合25 μmol/L槲皮素对K562细胞有明显的协同诱导凋亡作用,两药联合较单药处理能明显协同下调p-BCR/ABL、p-Crkl蛋白的表达.结论:伊马替尼和槲皮素协同诱导K562细胞凋亡,其机制可能是主要通过协同抑制BCR/ABL蛋白磷酸化水平,从而抑制下游信号通路的激活,导致细胞凋亡.

This study was aimed to further explore the apoptosis-inducing effect of bortezomib combined with cytarabine (Ara-C) on U937 cell line. Proliferation and apoptosis in U937 cells treated with bortezomib and/or Ara-C were assessed by cell count. Cell cycle distribution and reactive oxygen species (ROS) production level were measured by using flow cytometry. Cell signaling pathway related to apoptosis was analyzed by Western blot. The results showed that 10 nmol/L bortezomib combined with 50 nmol/L Ara-C significantly inhibited U937 cell proliferation. These two drug combination synergistically induced apoptosis in U937 cells, significantly increased cellular ROS level, and up-regulated the expression of phosphorylated form of JNK and P38 and down-regulated phosphorylation of ERK. It is concluded that the apoptosis of U937 cells synergistically induced by bortezomib combined with low concentration Ara-C is possibly associated with up-regulation of phosphorylated form of JNK, P38 and down-regulation of phosphorylation of ERK induced by increase of ROS, resulting in decrease of mitochondrial potential.

This study was aimed to explore the effect of bortezomib and low concentration cytarabine (Ara-C) on proliferation and apoptosis in U937 cell line and its mechanism. The proliferation and apoptosis of U937 cells treated with bortezomib (10 nmol/L) and(or) Ara-C (50 nmol/L) were observed by cell count, cell morphology, flow cytometry and Western blot. The results showed that bortezomib and Ara-C alone inhibited U937 cell proliferation. The inhibitory effect was enhanced by combination of these two drugs, the inhibitory rates of U937 cell proliferation were (55.00 ± 2.81)% and (70.02 ± 3.33)% after treatment for 24 h and 48 h, respectively. Bortezomib and Ara-C synergistically induced apoptosis and decreased mitochondrial membrane potential in U937 cells. The percentage of Rhodamin123 positive cells was (38.70 ± 1.54)%. Bortezomib and Ara-C also synergistically induced activation of caspase-9, caspase-8 and caspase-3. It is concluded that the bortezomib and low concentration Ara-C synergistically induced apoptosis in U937 cells, mainly through mitochondrial pathway, and possibly through death receptor pathway.

第一代BCR-ABL酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)伊马替尼(Imatinib)是慢性粒细胞白血病(chronic myeloid leukemia,CML)慢性期的一线标准治疗.伊马替尼通过直接靶向作用于Bcr-Abl激酶,极大改善了CML病程.近期,第二代TKIs药物尼洛替尼(Nilotinib)和达沙替尼(Dasatinib)又被美国FDA批准为CML的一线治疗.本文主要就CML一线治疗的进展作一综述。