MDM2 antagonist improves therapeutic activity of azacitidine in myelodysplastic syndromes and chronic myelomonocytic leukemia.

MDM2 antagonist improves therapeutic activity of azacitidine in myelodysplastic syndromes and chronic myelomonocytic leukemia.
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DOI:
10.1080/10428194.2022.2116932
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发表时间:
2022-12
影响因子:
2.6
通讯作者:
--
中科院分区:
医学4区
文献类型:
--
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低甲基化药物(HMA)治疗失败是骨髓增生异常综合征(MDS)和慢性粒单核细胞白血病(CMML)的一个重要问题。最近的研究表明,野生型TP53的功能对HMA治疗的结果有积极影响。我们研究了HMA azacitidine(AZA)与新型TP53负性调节因子MDM2的拮抗剂DS-3032b和DS-5272在MDS和CMML细胞和动物模型中的联合作用。在TP53野生型髓系细胞系中,观察到DS-3032b或DS-5272与AZA的联合作用。在MDS和CMML的TET2基因敲除小鼠模型中,DS-5272和AZA联合应用可改善疾病样表型。小鼠骨髓造血干和祖细胞的RNA-Seq分析表明,DS-5272和AZA联合作用可引起白血病干细胞标志物基因表达下调,激活TP53功能和稳定通路。这些发现表明,MDM2拮抗剂与AZA联合使用有可能改善对TP53野生型MDS和CMML的AZA治疗。
Failure of hypomethylation agent (HMA) treatments is an important issue in myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). Recent studies indicated that function of wildtype TP53 positively impacts outcome of HMA treatments. We investigated the combination of the HMA azacitidine (AZA) with DS-3032b and DS-5272, novel antagonists of the TP53 negative regulator MDM2, in cellular and animal models of MDS and CMML. In TP53 wildtype myeloid cell line, combinational effects of DS-3032b or DS-5272 with AZA were observed. In Tet2-knockout mouse model of MDS and CMML, DS-5272 and AZA combination ameliorated disease-like phenotype. RNA-Seq analysis in mouse bone marrow hematopoietic stem and progenitors indicated that DS-5272 and AZA combination caused down-regulation of leukemia stem cell marker genes and activation of pathways of TP53 function and stability. These findings demonstrate that combining an MDM2 antagonist with AZA has potential to improve AZA treatment in TP53 wildtype MDS and CMML.
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