title: Akt is activated in chronic lymphocytic leukemia cells and delivers a pro-survival signal: the therapeutic potential of Akt inhibition.
abstract: BACKGROUND
  The aims of the present study were to ascertain the activation status of Akt in the primary cells of chronic lymphocytic leukemia and to investigate the effects of specific Akt inhibition on chronic lymphocytic leukemia-cell survival.
  
  
  METHODS
  Anti-phospho-Akt (Ser473 or Thr308) antibodies and western blotting were used to establish the activation status of Akt. The effects of two different, specific small-molecule inhibitors (A-443654 or Akti-1/2) or small interfering RNA on cell survival and downstream targets of Akt were assessed. Apoptosis was determined by fluorescence-activated cell sorting analysis of phosphatidylserine exposure and by measurement of PARP cleavage. The phosphorylation status of GSK-3 and MDM2, two immediate downstream substrates of Akt, levels of the anti-apoptotic proteins BCL2 and MCL1, and expression of p53 and p21 were all measured by western blotting.
  
  
  RESULTS
  Fully activated Akt was demonstrable in all chronic lymphocytic leukemia clones examined (n=26). These results were validated with extensive controls and it was shown that a harsh method of cell extraction is needed for detection of the active enzyme. Specific inhibition of Akt induced extensive apoptosis of chronic lymphocytic leukemia cells, which was associated with both a rapid loss of MCL1 through proteasomal degradation and increased expression of p53. Moreover, the Akt inhibitors, at concentrations that induced extensive apoptosis in chronic lymphocytic leukemia cells, had little or no effect on normal peripheral blood mononuclear cells.
  
  
  CONCLUSIONS
  Chronic lymphocytic leukemia clones consistently contain activated Akt which plays a pivotal role in maintaining cell survival. Inhibition of the Akt pathway may be of potential value as a novel therapeutic strategy in chronic lymphocytic leukemia.
authors.affiliation: Division of Hematology, School of Cancer Studies, University of Liverpool, 3 Floor Duncan Building, Daulby Street, Liverpool L69 3GA, UK. j.zhuang@liv.ac.uk
authors.forename: Jianguo
authors.initials: J
authors.lastname: Zhuang
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Hawkins
authors.forename: Mark A
authors.initials: MA
authors.lastname: Glenn
authors.forename: Ke
authors.initials: K
authors.lastname: Lin
authors.forename: Gillian G
authors.initials: GG
authors.lastname: Johnson
authors.forename: Anthony
authors.initials: A
authors.lastname: Carter
authors.forename: John C
authors.initials: JC
authors.lastname: Cawley
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Pettitt
mesh_terms: D017209:Apoptosis / Q000187:drug effects / Q000502:physiology*; D045744:Cell Line, Tumor; D002470:Cell Survival / Q000187:drug effects / Q000502:physiology; D002999:Clone Cells; D004789:Enzyme Activation / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007191:Indazoles / Q000627:therapeutic use; D007211:Indoles / Q000627:therapeutic use; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D051057:Proto-Oncogene Proteins c-akt / Q000037:antagonists & inhibitors* / Q000378:metabolism* / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology*
chemical_list: C504035:A 443654; D007191:Indazoles; D007211:Indoles; D051057:Proto-Oncogene Proteins c-akt