title: Relation of P-glycoprotein expression with spontaneous in vitro apoptosis in B-cell chronic lymphocytic leukemia.
abstract: Prolonged lifespan of monoclonal lymphocytes in B-cell lymphocytic leukemia (B-CLL) arises from their resistance to programmed cell death. In contrast, when cultured in vitro, B-CLL tumour cells rapidly undergo apoptosis. There is mounting evidence that P-glycoprotein (P-gp), an adenosine triphosphate-binding cassette (ABC) family transporter, plays a significant role in the regulation of apoptosis induced by various stimuli. Since P-gp is commonly expressed in B-CLL cells, we aimed to establish whether its expression level influences resistance to spontaneous apoptosis in B-CLL. For that purpose, P-gp expression by UIC2 antibody staining and P-gp activity by rhodamine 123 (Rh123) efflux in presence or absence of P-gp inhibitor verapamil were studied in peripheral blood lymphocytes obtained from 43 previously untreated B-CLL patients. Simultaneously, the percentage of cells undergoing spontaneous in vitro apoptosis (apoptotic index, AI) by means of activation of caspases and annexin-V-based assays was evaluated. The AI were higher in B-CLL cells than in normal peripheral blood mononuclear cells (medians of AI 27.7% vs 3.9%, p=0.0001 and 34.7% vs 7.4%, p=0.0038, in 24 and 48-hour culture respectively). The AI were also higher among female patients as compared to male patients (medians: 29.7 vs 19.2 p=0.048). Interestingly, we found moderate inverse correlation between P-gp protein expression and AI after 24-hour culture in analysed B-CLL samples (r= -0.36, p=0.019). Moreover, P-gp positive B-CLL samples expressed significantly higher AI than P-gp negative samples with an arbitrary cut-off at Kolmogorov-Smirnov statistics D-value 0.2 (medians of AI 18.4% vs 29.7%, p=0.026). Based on these results we suggest that P-gp expression has some protective effect on B-CLL cell survival in vitro. The difference in the rates of spontaneous apoptosis among male and female patients may contribute to gender-dependent variations in clinical outcome in B-CLL.
authors.affiliation: Department of Hematology, Medical University of Lodz, 93-513, Poland. krzysztof.jamroziak@wp.pl
authors.forename: K
authors.initials: K
authors.lastname: Jamroziak
authors.forename: P
authors.initials: P
authors.lastname: Smolewski
authors.forename: B
authors.initials: B
authors.lastname: Cebula
authors.forename: A
authors.initials: A
authors.lastname: Szmigielska-Kaplon
authors.forename: Z
authors.initials: Z
authors.lastname: Darzynkiewicz
authors.forename: T
authors.initials: T
authors.lastname: Robak
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000096:biosynthesis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology*; D002470:Cell Survival; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D014407:Tumor Cells, Cultured
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1