title: Eradication of acute promyelocytic leukemia-initiating cells through PML-RARA degradation.
abstract: Retinoic acid and arsenic trioxide target the protein stability and transcriptional repression activity of the fusion oncoprotein PML-RARA, resulting in regression of acute promyelocytic leukemia (APL). Phenotypically, retinoic acid induces differentiation of APL cells. Here we show that retinoic acid also triggers growth arrest of leukemia-initiating cells (LICs) ex vivo and their clearance in PML-RARA mouse APL in vivo. Retinoic acid treatment of mouse APLs expressing the fusion protein PLZF-RARA triggers full differentiation, but not LIC loss or disease remission, establishing that differentiation and LIC loss can be uncoupled. Although retinoic acid and arsenic synergize to clear LICs through cooperative PML-RARA degradation, this combination does not enhance differentiation. A cyclic AMP (cAMP)-dependent phosphorylation site in PML-RARA is crucial for retinoic acid-induced PML-RARA degradation and LIC clearance. Moreover, activation of cAMP signaling enhances LIC loss by retinoic acid, identifying cAMP as another potential APL therapy. Thus, whereas transcriptional activation of PML-RARA is likely to control differentiation, its catabolism triggers LIC eradication and long-term remission of mouse APL. Therapy-triggered degradation of oncoproteins could be a general strategy to eradicate cancer stem cells.
authors.affiliation: Université de Paris 7/CNRS UMR 7151, Equipe labellisée N degrees 11 Ligue Nationale Contre le Cancer, Service de Biochimie, Hôpital St Louis, Paris Cedex 10, France.
authors.forename: Rihab
authors.initials: R
authors.lastname: Nasr
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Guillemin
authors.forename: Omar
authors.initials: O
authors.lastname: Ferhi
authors.forename: Hassan
authors.initials: H
authors.lastname: Soilihi
authors.forename: Laurent
authors.initials: L
authors.lastname: Peres
authors.forename: Caroline
authors.initials: C
authors.lastname: Berthier
authors.forename: Philippe
authors.initials: P
authors.lastname: Rousselot
authors.forename: Macarena
authors.initials: M
authors.lastname: Robledo-Sarmiento
authors.forename: Valérie
authors.initials: V
authors.lastname: Lallemand-Breitenbach
authors.forename: Bernard
authors.initials: B
authors.lastname: Gourmel
authors.forename: Dominique
authors.initials: D
authors.lastname: Vitoux
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Pandolfi
authors.forename: Cécile
authors.initials: C
authors.lastname: Rochette-Egly
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: Hugues
authors.initials: H
authors.lastname: de Thé
mesh_terms: D000818:Animals; D002454:Cell Differentiation / Q000187:drug effects; D045744:Cell Line, Tumor; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D000242:Cyclic AMP / Q000494:pharmacology; D017868:Cyclic AMP-Dependent Protein Kinases / Q000378:metabolism; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D051379:Mice; D008819:Mice, Nude; D015514:Oncogene Proteins, Fusion / Q000235:genetics / Q000378:metabolism*; D010766:Phosphorylation; D012694:Serine / Q000235:genetics / Q000378:metabolism; D015398:Signal Transduction; D014212:Tretinoin / Q000494:pharmacology; D023041:Xenograft Model Antitumor Assays
chemical_list: D015514:Oncogene Proteins, Fusion; C492209:PLZF-RARalpha fusion protein, mouse; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D012694:Serine; D014212:Tretinoin; D000242:Cyclic AMP; D017868:Cyclic AMP-Dependent Protein Kinases