title: Mcl-1 is a relevant therapeutic target in acute and chronic lymphoid malignancies: down-regulation enhances rituximab-mediated apoptosis and complement-dependent cytotoxicity.
abstract: OBJECTIVE
  The antiapoptotic Bcl-2 family member protein Mcl-1 is dynamically regulated in transformed B-cells, has a short mRNA and protein half-life, and is rapidly processed during apoptosis. Multiple therapies cause down-regulation of Mcl-1 in chronic and acute lymphoid leukemia (CLL and ALL) cells. Mcl-1 has also been reported to mediate resistance to rituximab in CLL. We therefore investigated whether direct reduction of Mcl-1 was sufficient to induce apoptosis and increase sensitivity to rituximab.
  
  
  METHODS
  We used Mcl-1-specific small interfering RNA in ALL cell lines and tumor cells from CLL patients to block transcription of Mcl-1.
  
  
  RESULTS
  We show that Mcl-1 down-regulation alone is sufficient to promote mitochondrial membrane depolarization and apoptosis in ALL and CLL cells. Given the importance of rituximab in B-cell malignancies, we next assessed the influence of Mcl-1 down-regulation on antibody-mediated killing. Mcl-1 down-regulation by small interfering RNA increased sensitivity to rituximab-mediated killing both by direct apoptosis and complement-dependent cytotoxicity, but did not enhance antibody-dependent cellular cytotoxicity.
  
  
  CONCLUSIONS
  These results show that Mcl-1 is a relevant therapeutic target for ALL and CLL, and its down-regulation has the potential to enhance the therapeutic effect of rituximab in CD20-bearing lymphoid cells.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Syed-Rehan A
authors.initials: SR
authors.lastname: Hussain
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Cheney
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Johnson
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Lin
authors.forename: Michael R
authors.initials: MR
authors.lastname: Grever
authors.forename: Michael A
authors.initials: MA
authors.lastname: Caligiuri
authors.forename: David M
authors.initials: DM
authors.lastname: Lucas
authors.forename: John C
authors.initials: JC
authors.lastname: Byrd
mesh_terms: D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects / Q000502:physiology*; D015153:Blotting, Western; D045744:Cell Line, Tumor; D003165:Complement System Proteins; D003602:Cytotoxicity, Immunologic / Q000187:drug effects; D015536:Down-Regulation; D005434:Flow Cytometry; D006801:Humans; D007945:Leukemia, Lymphoid / Q000378:metabolism*; D008564:Membrane Potentials / Q000187:drug effects; D051336:Mitochondrial Membranes / Q000378:metabolism / Q000473:pathology; D064549:Myeloid Cell Leukemia Sequence 1 Protein; D009363:Neoplasm Proteins / Q000187:drug effects / Q000378:metabolism*; D016133:Polymerase Chain Reaction; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000187:drug effects / Q000378:metabolism*; D034741:RNA, Small Interfering; D000069283:Rituximab; D014162:Transfection
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D064549:Myeloid Cell Leukemia Sequence 1 Protein; D009363:Neoplasm Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D034741:RNA, Small Interfering; D000069283:Rituximab; D003165:Complement System Proteins