ALBERT

Description: TNF-related apoptosis-inducing ligand/Apo2 ligand (TRAIL/Apo2L) selectively induces apoptosis in various cancer cells including myeloma (MM) cells. Although TRAIL-mediated immunotherapy is as attractive maneuver against MM because of its tumor-specific cytotoxic activity, the susceptibility of MM cells to TRAIL has been demonstrated to vary among MM cells, which limits clinical applications of TRAIL-mediated immunotherapy. TRAIL is known to bind to 2 different proapoptotic receptors, death receptor 4 (DR4) and DR5. The membrane-bound TRAIL receptors have been reported to be subjected to proteolytic cleavage in melanoma cells in a manner inhibitable by tissue inhibitor of metalloproteinases-3 (TIMP-3), an endogenous inhibitor for TNF-alpha converting enzyme (TACE) (Ahonen M, Oncogene. 2003). Although TACE is regarded as a sheddase for TNF-like ligands/receptors, the role for TACE in TRAIL-mediated cytotoxicity in MM cells is largely unknown. In the present study, we therefore investigated the role for TACE in TRAIL and its receptor editing as well as the effect of TACE inhibition on TRAIL-triggered cytotoxicity in MM cells. MM cells constitutively expressed DR4 on their surface as determined in flow cytometry, while the expression of DR5 as well as TRAIL was negligible. TACE mRNA was constitutively overexpressed in all MM cell lines including RPMI8226, MM.1S, KMS12 and U266, whereas its endogenous inhibitor, TIMP-3, was not detected, suggesting enhanced TACE activity along with down-regulation of TIMP-3 in MM cells. TAPI-0, a TACE inhibitor, up-regulated the cell-surface expression of DR4 about 2-fold in RPMI8226 and U266 cells, while DR5 and TRAIL expression remained undetectable. Immunoblot analyses for DR4 revealed that conditioned media from RPMI8226 and U266 cells contained DR4 protein with a molecular size smaller than that observed in their cell lysates. Interestingly, TAPI-0 treatment down-regulated DR4 levels in culture supernatants of these MM cells, while increasing DR4 levels in their cell lysates as well as on their surface, suggesting ectodomain shedding of DR4 by TACE in MM cells. Importantly, TAPI-0 treatment potentiated TRAIL-triggered cytotoxicity against MM cells including RPMI8226 and MM.1S, which was almost completely antagonized by addition of osteoprotegerin, a soluble inhibitor for TRAIL, indicating a TRAIL-dependent mechanism. Taken together, the present observations demonstrate that cell-surface TRAIL receptor expression is post-transcriptionally down-regulated by endogenous TACE activity enhanced in MM cells, which may protect MM cells from TRAIL-mediated apoptosis by surrounding immune cells expressing TRAIL, and that up-regulation of TRAIL receptor expression by inhibiting TACE activity is able to restore the susceptibility of MM cells to TRAIL. Therefore, these preclinical data provide that TACE inhibitors in combination with TRAIL-based immunotherapy may be a novel therapeutic approach against MM which can not be cured by the present chemotherapeutic modalities.

Description: Multiple myeloma (MM) is a plasma cell malignancy characterized by the accumulation of neoplastic plasma cells in the bone marrow. Although new classes of agents such as thalidomide, lenalidomide, and bortezomib have shown marked anti-MM activity in clinical settings, MM remains an incurable disease due to increased resistance to these agents. Therefore, alternative approaches are necessary to overcome drug resistance in MM. KRN5500 is a new derivative of spicamycin produced by Streptomyces alanosinicus (Kirin Pharma, Tokyo, Japan). This drug potently decreases protein synthesis and inhibits cell growth in human tumor cell lines both in vitro and in vivo. Several phase I studies of KRN5500 were conducted in patients with solid tumors, which showed Cmax values of 1000–3000 nM at the maximum tolerated doses. However, no objective anti-tumor response to KRN5500 alone was observed in these patients. In this study, we examined the anti-tumor activity of KRN5500 against MM cells and evaluated its therapeutic potential in combination with other anti-MM agents. MM cell lines and freshly-isolated MM cells were incubated with various concentrations of KRN5500 for 24 hours. Cell proliferation assay showed marked inhibition of cell growth in MM cells such as RPMI 8226, KMS12-BM, and UTMC-2 (IC50 = 10–40 nM), and U266, MM.1S, and primary MM cells (IC50 = 500–1000 nM). Importantly, a chemotherapy-resistant subclone of RPMI 8226 had a similar sensitivity to KRN5500. Annexin V/propidium iodide staining confirmed that KRN5500 induced apoptosis of MM cells in a dose- and time-dependent manner. Moreover, cleavage of poly (ADP-ribose) polymerase (PARP) was detected after 24 hours with only modest activation of caspase-8, -9, and -3 by immunoblotting. Flow cytometric analysis of anti-apoptotic proteins revealed that apoptosis induced by KRN5500 was associated with down-regulation of Mcl-1 and Bcl-2 expression. To determine the effect of KRN5500 on the unfolded protein response (UPR), splicing of XBP-1 mRNA was analyzed by reverse transcription-polymerase chain reaction. In response to stimulation with KRN5500, splicing of XBP-1 mRNA occurred after 24 hours in RPMI 8226 cells, suggesting that KRN5500-induced apoptosis is mediated in part by the inhibition of UPR. Furthermore, synergistic effects on MM cells were observed when KRN5500 was combined with anti-MM agents including melphalan, dexamethasone, and bortezomib. These results suggest that KRN5500 induces apoptosis in MM cells mainly by the caspase-independent pathway and that its unique mechanism of action provides a valuable therapeutic option to overcome drug resistance in patients with MM.

Description: Myeloma (MM) cells stimulate bone resorption by enhancing osteoclast (OC) formation and suppress bone formation by inhibiting osteoblast differentiation, leading to destructive bone lesions. In these lesions, OCs and stromal cells with defective osteoblast differentiation create a microenvironment suitable for myeloma cell growth and survival (a MM niche) to protect MM cells from various apoptotic insults. IL-6 and the TNF family members BAFF and APRIL have been demonstrated to be among predominant anti-apoptotic cytokines for MM cells elaborated by the bone marrow microenvironment in MM. The serine/threonine kinase Pim-2 is a novel apoptotic inhibitor which is transcriptionally up-regulated to promote survival of hematopoietic cells in response to environmental growth factors and cytokines. Up-regulation of Pim-2 expression has also been observed in various malignancies including MM. However, the roles for Pim-2 in growth and survival of MM cells are largely unknown. In the present study we therefore investigated the regulatory mechanism for Pim-2 expression in MM cells and the impact of Pim-2 on MM cell growth and survival with special reference to the interaction between MM cells and bone marrow components. Pim-2 protein is constitutively overexpressed in the absence of IL-6 in IL-6-dependent INA-6 as well as IL-6-independent RPMI8226 and U266 MM cell lines. Addition of IL-6, BAFF and TNFalpha up-regulated Pim-2 protein expression in INA-6 and RPMI8226 cells. A JAK/STAT3 inhibitor, cucurbitacin I, suppresses Pim-2 expression induced by IL-6, indicating Pim-2 as a downstream target of a JAK/STAT3 pathway. Stromal cells and OCs are regarded as a predominant cell type in MM bone marrow microenvironment to produce IL-6 and the TNF family members BAFF and APRIL, respectively. Co-cultures with stromal cells as well as OCs enhanced Pim-2 expression in INA-6 cells, suggesting up-regulation of Pim-2 in MM cells by surrounding cells in the bone marrow. In order to clarify the roles for Pim-2 in growth and survival of MM cells we next looked at the effects of Pim-2 siRNA. Suppression of Pim-2 expression by Pim-2 siRNA partly reduced the proliferation of INA-6 cells stimulated by IL-6 as well as the co-cultures with stromal cells or OCs. Pim-2 silencing also enhanced the cytotoxic effects of dexamethason on MM cells. Interestingly, further addition of rapamycin, an inhibitor of mammalian target of rapamycin (mTOR), induces cell death in concert with Pim-2 silencing in INA-6 cells, suggesting a cooperative roles for PI3K/Akt and Pim-2-mediated pathways in growth and survival of MM cells. Furthermore, Pim-2 silencing induced the cleavage of caspase9 but not caspase8; enforced expression of Pim-2 phosphorylated the BH3 only protein Bad; Pim-2 silencing suppressed phosphorylation of Bad by IL-6. Thus, Pim-2 appears to activate the intrinsic pathway of apoptotic machinery involving Bad phosphorylation. Taken together, our results suggest that Pim-2 is an important prosurvival mediator in MM cells, and that up-regulation of its expression in MM cells by bone marrow components may at least in part contribute to resistance to spontaneous and drug-induced apoptosis in MM cells. Therefore, Pim-2 may become a target for novel therapeutic strategies against MM.