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CEBPβ/IL-1β/TNFα Feedback Loop Drives Drug Resistance to BCL2 and MDM2 Inhibitors in Monocytic Leukemia Cells

ABSTRACT: Ventoclax-based combinations are a new standard of care for patients with acute myeloid leukemia (AML) who are not eligible for intensive chemotherapy, but not all patients respond to these treatments, and those who do may relapse. MDM2 inhibitors are promising therapeutics for treating TP53 wild-type tumors, including most de novo AML cases, but clinical trials have shown modest and variable clinical activity. Functional genomic data suggest that venetoclax and the MDM2 inhibitor, idasanutlin, may be ineffective against monocytic leukemia (FAB M4/M5) or leukemia cells with a high immune signature. We hypothesize upregulated myeloid transcription factors and enrichment of certain environmental cues that confer intrinsic and extrinsic drug resistance to these cells. We show that monocytic leukemia cells express a high level of CEBPB and CEBPB overexpression confers drug resistance to a broad range of BH3 mimetics, venetoclax combinations, and MDM2 inhibitors by downregulating CASP3, CASP6, BCL2, and p53 pathway targets, while upregulating MCL1, BCL2A1, and the NFKB/IL1/TNFA pathway. Moreover, leukemia monocytes can extrinsically protect leukemia blasts from venetoclax and MDM2 inhibition by secreting elevated IL1 and TNFA, which drive myelo/monocytic differentiation and upregulate inflammatory cytokines and receptors, including IL1/TNFA pathway in an autoregulatory loop. Remarkably, IL1A/IL1B and TNFA uniquely upregulate CEBPB expression in M4/M5 cells and protect them from apoptosis induced by venetoclax and MDM2 inhibitors. Conversely, TNFA treatment enhances extrinsic apoptosis in M0/M1 leukemia cells. Inhibitors of IRAK or MAPK14 (p38), which block IL1/TNFA signaling, showed synergistic cytotoxicity in M4/M5 AML when combined with venetoclax and idasanutlin. In summary, we described a targetable, positive feedback loop between CEBPB and IL1/TNFA in monocytic leukemia that drives intrinsic and extrinsic drug resistance to BCL2 and MDM2 inhibitors, offering promising therapeutic strategies to enhance treatment efficacy for monocytic leukemia.

ORGANISM(S): Homo sapiens

PROVIDER: GSE245597 | GEO | 2024/10/17

REPOSITORIES: GEO

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Project description:Human corneal endothelial cells (CECs) are not able to proliferate or regenerate within the eye. However, limited in vitro expansion of primary human CECs has been demonstrated by several laboratories, including ours. Due to the nature of these primary cells, various culture conditions supporting the active proliferation of these cells also drives them towards an endothelial-to-mesenchymal transformation (EMT) into fibroblastic-like cells. The occurrence of such a phenomenon has been observed as early as after the first round of passage. However, it should be noted that the degree of such transformation is highly heterogeneous, due likely to donor variability. In the current study, propagation of primary human CECs was carried out using a novel dual media approach, where M4 (F99: HamM-bM-^@M-^Ys F12/M199, 5% FBS, 20 M-NM-<g/ml ascorbic acid, 1% ITS, 1% antibiotic/antimycotic and 10 ng/ml bFGF) was used to promote the proliferation of the CECs, and M5 (Endo: Human Endothelial-SFM, 5% FBS and 1% antibiotic/antimycotic), was used to stabilized these primary CECs when they reached 80% to 90% confluence.Primary cultures exposed to M5 were able to maintain the unique cellular structure of the human corneal endothelial cells and do not undergo EMT. In order to better understand the observed morphological changes at the molecular level following the switch from the proliferative M4 medium to the maintainance M5 medium, high throughput microarray analysis was performed on human CECs isolated from two donors and cultivated to the third passage. Subsequently, the global gene expression profile of the confluent human CECs expanded in M4 for the first (D17p) and second donor (D18p), were compared to the same set of the confluent human CECs maintained in M5 medium (D17m and D18m) for a further seven days. Primary human CECs were expanded using the dual media approach to the third passage. Total RNA obtained from confluent P3 human CECs samples grown in the proliferative M4 medium (D17p and D18p) were compared to the same set of primary cultures that were exposed to M5 for a further 7 days (D17m and D18m).

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CEBPβ/IL-1β/TNFα Feedback Loop Drives Drug Resistance to BCL2 and MDM2 Inhibitors in Monocytic Leukemia Cells

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