BH3 domains as BCL-2 inhibitors: prototype cancer therapeutics

It is likely that most, if not all, cancer cells possess a mechanism for opposing programmed cell death, or apoptosis. One mechanism often used by cancer cells to escape apoptosis is the overexpression of B cell leukaemia/lymphoma-2 protein (BCL-2) or related antiapoptotic proteins. Inhibiting BCL-2, therefore, is an anticancer strategy worthy of attention. BCL-2 homology 3 (BH3) domains are alpha-helical segments found in BCL-2 family member proteins. In pro-apoptotic members, the BH3 domain is necessary for pro-apoptotic function. It has been shown that short peptides derived from the BH3 region possess intrinsic pro-death activity. Furthermore, certain peptides of this group exert their pro-death function by specifically binding BCL-2 and opposing BCL-2's antideath function. Therefore, BH3 domains are prototype BCL-2 inhibitors. Mimetics of BH3 domains, whether derived from peptides or small molecules, have promise as cancer therapeutics.     

BH3 Peptides Induce Mitochondrial Fission and Cell Death Independent of BAX/BAK

BH3 only proteins trigger cell death by interacting with pro- and anti-apoptotic members of the BCL-2 family of proteins. Here we report that BH3 peptides corresponding to the death domain of BH3-only proteins, which bind all the pro-survival BCL-2 family proteins, induce cell death in the absence of BAX and BAK. The BH3 peptides did not cause the release of cytochrome c from isolated mitochondria or from mitochondria in cells. However, the BH3 peptides did cause a decrease in mitochondrial membrane potential but did not induce the opening of the mitochondrial permeability transition pore. Interestingly, the BH3 peptides induced mitochondria to undergo fission in the absence of BAX and BAK. The binding of BCL-X_L with dynamin-related protein 1 (DRP1), a GTPase known to regulate mitochondrial fission, increased in the presence of BH3 peptides. These results suggest that pro-survival BCL-2 proteins regulate mitochondrial fission and cell death in the absence of BAX and BAK.     

A stapled BIM peptide overcomes apoptotic resistance in hematologic cancers

Cancer cells subvert the natural balance between cellular life and death, achieving immortality through pathologic enforcement of survival pathways and blockade of cell death mechanisms. Pro-apoptotic BCL-2 family proteins are frequently disarmed in relapsed and refractory cancer through genetic deletion or interaction-based neutralization by overexpressed antiapoptotic proteins, resulting in resistance to chemotherapy and radiation treatments. New pharmacologic strategies are urgently needed to overcome these formidable apoptotic blockades. We harnessed the natural killing activity of BCL-2-interacting mediator of cell death (BIM), which contains one of the most potent BH3 death domains of the BCL-2 protein family, to restore BH3-dependent cell death in resistant hematologic cancers. A hydrocarbon-stapled peptide modeled after the BIM BH3 helix broadly targeted BCL-2 family proteins with high affinity, blocked inhibitory antiapoptotic interactions, directly triggered proapoptotic activity, and induced dose-responsive and BH3 sequence-specific cell death of hematologic cancer cells. The therapeutic potential of stapled BIM BH3 was highlighted by the selective activation of cell death in the aberrant lymphoid infiltrates of mice reconstituted with BIM-deficient bone marrow and in a human AML xenograft model. Thus, we found that broad and multimodal targeting of the BCL-2 family pathway can overcome pathologic barriers to cell death.     

Therapeutic potential of a peptide targeting BCL-2 cell guardians in cancer

A promising approach to cancer therapy is to elicit apoptosis with "BH3 mimetic" drugs, which target proteins of the BCL-2 family. As of yet, however, such drugs can target only certain BCL-2 family proteins. Hence, in this issue of the JCI, LaBelle et al. assess instead the therapeutic potential of a "stapled" BH3 peptide from the BIM protein, which inactivates all its prosurvival relatives. The peptide killed cultured hematologic tumor cells and abated growth of a leukemia xenograft, without perturbing the hematopoietic compartment. Hence, such peptides might eventually provide a new way to treat refractory leukemias.     

Sequence and helicity requirements for the proapoptotic activity of Bax BH3 peptides

Overexpression of the antiapoptotic proteins Bcl-2 and Bcl-XL is commonly observed in human malignancies and contributes to chemotherapy and radiation resistance. Bcl-2 and Bcl-XL inhibit apoptosis by binding to proapoptotic proteins such as Bax, thereby preventing chemotherapy-induced or radiation-induced release of cytochrome c from mitochondria and subsequent activation of the caspase protease cascade. Efforts to inhibit Bcl-2 or Bcl-XL function in tumor cells have focused on developing agents to inhibit the interactions of these proteins with proapoptotic proteins. Peptides derived from the BH3 domains of proapoptotic proteins have been shown to disrupt the interactions of Bcl-2 and Bcl-XL with key binding partners in cell-free reactions and to promote cellular apoptosis. However, less is known about the targets of BH3 peptides in intact cells as well as the sequence, length, and conformational requirements for peptide biological activity. In this report, we show that cell-permeable Bax BH3 peptides physically disrupt Bax/Bcl-2 heterodimerization in intact cells and that this disruption correlates with peptide-induced cell death. A point-mutant, control peptide that failed to disrupt intracellular Bax/Bcl-2 interactions also failed to promote apoptosis. To determine important sequence, length, and structural requirements for peptide activity, we generated and systematically analyzed the biological activities of 17 Bax BH3 peptide variants. Peptides were quantitatively examined for their ability to inhibit Bax/Bcl-2 and Bax/Bcl-XL heterodimerization in vitro and to promote cytochrome c release from mitochondria isolated from Jurkat, HL-60, U937, and PC-3 cells. Our results define 15 amino acids as the minimal length required for Bax BH3 peptide biological activity and show that amino acids COOH terminal to the BH3 core sequence are less critical than those located NH2 terminal to the core. In addition, circular dichroism spectroscopy revealed that high alpha-helical content generally correlated with, but was not sufficient for, peptide activity. Taken together, these studies provide a basis for future optimization of Bax BH3 peptide as a therapeutic anticancer agent.     

Molecular targeting of drug delivery systems to ovarian cancer by BH3 and LHRH peptides.

Novel targeted proapoptotic anticancer drug delivery systems were developed and evaluated. Poly(ethyleneglycol) (PEG) conjugates were used as carriers. Camptothecin (CPT) was used as an anticancer agent-apoptosis inductor. Two types of molecular targets were investigated: (1) an extracellular membrane receptor specific to ovarian cancer and (2) intracellular controlling mechanisms of apoptosis. Synthetic peptides similar to luteinizing hormone-releasing hormone (LHRH) and BCL-2 homology 3 (BH3) peptide were used as a targeting moiety and a suppressor of cellular antiapoptotic defense, respectively. Three different conjugates (CPT-PEG, CPT-PEG-BH3 and CPT-PEG-LHRH) were synthesized and examined in A2780 human ovarian cancer cells. Cytotoxicity, expression of genes encoding BCL-2, BCL-XL, SMAC, APAF-1 proteins and caspases 3 and 9, the activity of caspases 3 and 9 and apoptosis induction were studied. Taken together the results indicate much higher cytotoxicity and apoptosis-inducing activity of PEG-CPT conjugates when compared to free CPT. Moreover, the effects of targeted CPT-PEG-BH3 and CPT-PEG-LHRH conjugates were more pronounced than the non-targeted PEG-CPT conjugate. The results confirmed the feasibility of this new two-tier molecular targeting strategy for enhancing the efficacy of cancer chemotherapy.     

The proteasome inhibitor bortezomib sensitizes cells to killing by death receptor ligand TRAIL via BH3-only proteins Bik and Bim

Previously, we showed that the proteasome inhibitor bortezomib/Velcade (formerly PS-341) synergizes with the protein tumor necrosis factor alpha-related apoptosis-inducing ligand (TRAIL), a ligand for certain death receptors, to induce apoptosis in cell lines derived from prostate and colon cancers. Because apoptosis is often triggered by BH3-only proteins of the Bcl-2 family, we have explored the hypothesis that bortezomib contributes to the apoptosis by up-regulating their levels. Indeed, bortezomib induced increases of Bik and/or Bim in multiple cell lines but not notably of two other BH3-only proteins (Puma and Bid) nor other family members (Bax, Bak, Bcl-2, and Bcl-xL). The increase in Bik levels seems to reflect inhibition by bortezomib of its proteasome-mediated degradation. Importantly, both Bik and Bim seem central to the proapoptotic function of bortezomib, because mouse embryo fibroblasts in which the genes for both Bik and Bim had been disrupted were refractory to its cytotoxic action. Similarly, the synergy between bortezomib and TRAIL in killing human prostate cancer cells was impaired in cells in which both Bik and Bim were down-regulated by RNA interference. Further evidence that bortezomib acts through the mitochondrial pathway regulated by the Bcl-2 family is that deficiency for APAF-1, which acts downstream of Bcl-2, also blocked its apoptotic effect. These results implicate BH3-only proteins, in particular both Bik and Bim, as important mediators of the antitumor action of bortezomib and establish their role in its enhancement of TRAIL-induced apoptosis.     

Chronic lymphocytic leukemia requires BCL2 to sequester prodeath BIM, explaining sensitivity to BCL2 antagonist ABT-737

Antiapoptotic B cell leukemia/lymphoma 2 (BCL2) family proteins are expressed in many cancers, but the circumstances under which these proteins are necessary for tumor maintenance are poorly understood. We exploited a novel functional assay that uses BCL2 homology domain 3 (BH3) peptides to predict dependence on antiapoptotic proteins, a strategy we call BH3 profiling. BH3 profiling accurately predicts sensitivity to BCL2 antagonist ABT-737 in primary chronic lymphocytic leukemia (CLL) cells. BH3 profiling also accurately distinguishes myeloid cell leukemia sequence 1 (MCL1) from BCL2 dependence in myeloma cell lines. We show that the special sensitivity of CLL cells to BCL2 antagonism arises from the requirement that BCL2 tonically sequester proapoptotic BIM in CLL. ABT-737 displaced BIM from BCL2's BH3-binding pocket, allowing BIM to activate BAX, induce mitochondrial permeabilization, and rapidly commit the CLL cell to death. Our experiments demonstrate that BCL2 expression alone does not dictate sensitivity to ABT-737. Instead, BCL2 complexed to BIM is the critical target for ABT-737 in CLL. An important implication is that in cancer, BCL2 may not effectively buffer chemotherapy death signals if it is already sequestering proapoptotic BH3-only proteins. Indeed, activator BH3-only occupation of BCL2 may prime cancer cells for death, offering a potential explanation for the marked chemosensitivity of certain cancers that express abundant BCL2, such as CLL and follicular lymphoma.     

Enhancement of radiation sensitivity with BH3I-1 in non-small cell lung cancer

BACKGROUND: Anti-apoptotic proteins, such as Bcl-2 and Bcl-xL, are frequently over-expressed in human malignancies, and this is correlated with resistance to chemotherapeutic drugs and gamma- radiation. Recently identified small organic molecules capable of inhibiting Bcl-2 and/or Bcl-xL function, may enhance radiation sensitivity of cancer cells in which they are over expressed. We examined whether specific blockade of the BH3-domain binding to Bcl-xL could sensitize cancer cells to gamma- radiation. METHODS: Human non-small-cell lung cancer H460 cells with wild-type p53 and H1792 cells with mutant p53 were exposed to various doses of radiation and/or BH3I-1 and for different points of time to BH3I-1 treatment. XTT and clonogenic survival assays were used to evaluate the growth-inhibitory effects of the antagonist BH3I-1, ionizing radiation or both. Western blot analysis was used to examine the cellular effect of the expression of Bcl-xL, Bax, and p53. Apoptosis and cell cycle distribution were analyzed by confocal microscopy with Hoechst 33258 staining and cytochrome c, and flow cytometry, respectively. RESULTS: BH3I-1 appeared to induce a dose- and time-dependent apoptosis in H460 and H1792 cells, regardless of p53 status. After 2 days of BH3I-1 treatment, the cells that remained attached were exposed to ionizing radiation. Followed by clonogenic assay, BH3I-1 treatment enhanced the radiation sensitivity of H1792 surviving cells with mutant p53, but not in H460 cells with wild-type p53. A transient time-dependent cell cycle blockade at G2-M phase was identified for H1792 cells without subsequent modification of cell cycle distribution. CONCLUSION: These findings suggest a potential role for the small molecule inhibitor as a novel radiation sensitizer in non-small cell lung cancer.     

β-榄香烯对人骨髓瘤细胞RPMI-8226增殖与凋亡的影响

为了研究β-榄香烯对人骨髓瘤细胞系RPMI-8226增殖、凋亡的影响,探讨其作用的分子机制,用MTT法检测β-榄香烯对人骨髓瘤细胞系RPMI-8226增殖的影响;Annexin V/PI双染色流式术检测β-榄香烯对RPMI-8226骨髓瘤细胞凋亡的作用;Western blot法检测β-榄香烯对RPMI-8226骨髓瘤细胞BCL-2、caspase-3、DR-4和NF-κB P65蛋白表达影响。结果表明:β-榄香烯对RPMI-8226骨髓瘤细胞生长具有明显抑制作用,且呈浓度和时间依赖性;10-80μmol/Lβ-榄香烯作用48小时可诱导骨髓瘤细胞凋亡,凋亡率随药物浓度而递增;β-榄香烯以时间依赖方式上调caspase-3、DR-4蛋白表达,并可下调BCL-2、NF-κB P65蛋白表达。结论:β-榄香烯通过诱导细胞凋亡有效抑制骨髓瘤细胞增殖,其诱导细胞凋亡与细胞内、外凋亡通路激活、抗凋亡机制被抑制有关。     

Gambogic acid is an antagonist of antiapoptotic Bcl-2 family proteins

The natural product gambogic acid (GA) has been reported to have cytotoxic activity against tumor cells in culture and was identified as an active compound in a cell-based high-throughput screening assay for activators of caspases, proteases involved in apoptosis. Using the antiapoptotic Bcl-2 family protein, Bfl-1, as a target for screening of a library of natural products, we identified GA as a competitive inhibitor that displaced BH3 peptides from Bfl-1 in a fluorescence polarization assay. Analysis of competition for BH3 peptide binding revealed that GA inhibits all six human Bcl-2 family proteins to various extents, with Mcl-1 and Bcl-B the most potently inhibited [concentrations required for 50% inhibition (IC(50)), < 1 micromol/L]. Competition for BH3 peptide binding was also confirmed using a time-resolved fluorescence resonance energy transfer assay. GA functionally inhibited the antiapoptotic Bcl-2 family proteins as shown by experiments using isolated mitochondria in which recombinant purified Bcl-2 family proteins suppress SMAC release in vitro, showing that GA neutralizes their suppressive effects on mitochondria in a concentration-dependent manner. GA killed tumor cell lines via an apoptotic mechanism, whereas analogues of GA with greatly reduced potency at BH3 peptide displacement showed little or no cytotoxic activity. However, GA retained cytotoxic activity against bax-/-bak-/- cells in which antiapoptotic Bcl-2 family proteins lack a cytoprotective phenotype, implying that GA also has additional targets that contribute to its cytotoxic mechanism. Altogether, the findings suggest that suppression of antiapoptotic Bcl-2 family proteins may be among the cytotoxic mechanisms by which GA kills tumor cells.     

BCL-2、Caspase-3、NF-KB在黄芪总苷诱导人白血病NB4细胞凋亡过程中作用

本研究探讨黄芪总苷（astragaloside,AST）对急性早幼粒细胞白血病（APL）NB4细胞株的凋亡诱导作用及其分子机制。采用AST处理人APL细胞株NB4,CCK-8比色法检测细胞增殖抑制率,FITC—Annexinv／PI双染流式细胞术检测细胞凋亡率;不同浓度AST作用NB4细胞后RT-PCR检测BCL-2mRNA表达,Westernblot检测NF-KB、BCL-2、caspase-3蛋白表达水平。结果表明,AST作用NB4细胞48h后,浓度依赖性地抑制NB4细胞的增殖,且随着AST的浓度增加,细胞凋亡率也由4．69％上升到40．85％。RT—PCR结果显示,BCL-2mRNA表达减弱;Westernblot结果显示,NF—KB及BCL-2蛋白表达减弱,caspase-3表达增强。结论：降低NF-KB、BCL-2表达并最终激活caspase-3的表达可能是AsT诱导NB4细胞株凋亡的机制之一。     

高三尖杉酯碱对K562细胞NF-κB和BCL-2蛋白表达的影响

本研究旨在探讨高三尖杉酯碱（HHT）对K562细胞增殖、凋亡及BCL-2和NF-κB蛋白表达的影响。不同浓度HHT作用K562细胞后用MTT法、流式细胞仪、Western blot等方法分别检测细胞增殖、凋亡、BCL-2及NF-κB蛋白表达水平。结果表明,HHT作用48h,浓度依赖性抑制K562细胞增殖,Ic50为43．89rig／ml。HHT10ng／ml作用48h,K562细胞凋亡率明显增高;细胞周期阻滞于G0／G1期;BCL-2和NF-κB蛋白表达水平明显低于对照组（P〈0．05）。结论：HHT对K562细胞有显著的增殖抑制、细胞周期阻滞和凋亡诱导作用,抑制NF-κB和BCL-2表达可能是其抗CML的机制之一。     

Loss of the BH3-only protein Bmf impairs B cell homeostasis and accelerates gamma irradiation-induced thymic lymphoma development

Members of the Bcl-2 protein family play crucial roles in the maintenance of tissue homeostasis by regulating apoptosis in response to developmental cues or exogenous stress. Proapoptotic BH3-only members of the Bcl-2 family are essential for initiation of cell death, and they function by activating the proapoptotic Bcl-2 family members Bax and/or Bak, either directly or indirectly through binding to prosurvival Bcl-2 family members. Bax and Bak then elicit the downstream events in apoptosis signaling. Mammals have at least eight BH3-only proteins and they are activated in a stimulus-specific, as well as a cell type-specific, manner. We have generated mice lacking the BH3-only protein Bcl-2-modifying factor (Bmf) to investigate its role in cell death signaling. Our studies reveal that Bmf is dispensable for embryonic development and certain forms of stress-induced apoptosis, including loss of cell attachment (anoikis) or UV irradiation. Remarkably, loss of Bmf protected lymphocytes against apoptosis induced by glucocorticoids or histone deacetylase inhibition. Moreover, bmf(-/-) mice develop a B cell-restricted lymphadenopathy caused by the abnormal resistance of these cells to a range of apoptotic stimuli. Finally, Bmf-deficiency accelerated the development of gamma irradiation-induced thymic lymphomas. Our results demonstrate that Bmf plays a critical role in apoptosis signaling and can function as a tumor suppressor.     

多西他赛对人骨髓瘤细胞RPMI8226增殖与凋亡的影响

本研究旨在观察多西他赛对人骨髓瘤细胞系RPM18226增殖和凋亡的影响,探讨其作用的分子机制。采用MTT法检测骨髓瘤细胞增殖抑制率,光学显微镜及电子显微镜观察多西他赛对骨髓瘤细胞形态的影响,Annex-in-VFITC／PI双染流式细胞术检测细胞凋亡率,PI染色流式细胞术检测骨髓瘤细胞周期分布情况,半定量RT-PCR检测多西他赛对B观-2、caspase-8及caspase-3mRNA表达影响,Westernblot法检测多西他赛作用前后骨髓瘤细胞BCL-2蛋白表达变化。结果显示：0．25-8．0μg／ml终浓度的多西他赛均可抑制RPM18226细胞增殖,抑制率呈时间（r=0．927）和浓度（r=0．726）依赖性;多西他赛处理组光学显微镜下可见细胞数量明显减少,排列紊乱,高倍镜可见凋亡细胞,偶见坏死细胞;电子显微镜下可见细胞典型凋亡改变以及少数坏死细胞;多西他赛可明显诱导骨髓瘤细胞凋亡（P〈0．01）,主要将细胞阻滞于G2／M期（P〈0．01）,作用48h时BCL-2mRNA与BCL-2蛋白表达量减少（P〈0．05）,caspase-8、caspase-3mRNA表达量增加（P〈0．05）。结论：多西他赛通过诱导细胞凋亡可抑制骨髓瘤细胞增殖,其诱导细胞凋亡可能与细胞周期阻滞,激活细胞内、外源性凋亡通路有关。     

辛伐他汀对急性单核细胞白血病SHI-1细胞增殖和凋亡的影响

本研究探讨辛伐他汀(simvastatin,SIM)对急性单核细胞白血病SHI-1细胞增殖和凋亡的影响及其作用机制。用MTT法检测不同浓度SIM作用不同时间对SHI-1细胞生长的抑制作用;实验分为阴性对照及辛伐他汀处理组(终浓度分别为5、10、20μmol/L),处理48小时后,用流式细胞仪检测细胞凋亡及周期分布;半定量RT-PCR法检测caspase-3、BCL-2mRNA的表达;Western blot法检测caspase-3、BCL-2蛋白表达。结果表明,辛伐他汀对SHI-1细胞的生长有明显抑制作用,且呈时间与剂量依赖性。与对照组相比,辛伐他汀处理SHI-1细胞48小时后,各浓度组S期细胞百分比明显增多,5μmol/L辛伐他汀处理SHI-1细胞能明显阻滞细胞周期进程,但不能诱导细胞凋亡。细胞中BCL-2mRNA表达随辛伐他汀浓度增加而下降,caspase-3mRNA表达随辛伐他汀浓度增加而增高(p<0.05)。SHI-1细胞中BCL-2蛋白表达随辛伐他汀浓度升高而降低,caspase-3蛋白表达随辛伐他汀浓度升高而增加(p<0.05)。结论 :辛伐他汀能抑制SHI-1细胞增殖并诱导其凋亡,其机制可能与其下调BCL-2和上调caspase-3表达有关。     

Selective targeting of antiapoptotic BCL-2 proteins in cancer

Circumvention of apoptotic machinery is one of the distinctive properties of carcinogenesis. Extensively established key effectors of such apoptotic bypass mechanisms, the antiapoptotic BCL-2 (apoptosis regulator BCL-2) proteins, determine the response of cancer cells to chemotherapeutics. Within this background, research and development of antiapoptotic BCL-2 inhibitors were considered to have a tremendous amount of potential toward the discovery of novel pharmacological modulators in cancer. In this review, milestone achievements in the development of selective antiapoptotic BCL-2 proteins inhibitors for BCL-2, BCL-XL (BCL-2-like protein 1), and MCL-1 (induced myeloid leukemia cell differentiation protein MCL-1) were summarized and their future implications were discussed. In the first section, the design and development of BCL-2/BCL-XL dual inhibitor navitoclax, as well as the recent advances and clinical experience with selective BCL-2 inhibitor venetoclax, were synopsized. Preclinical data from selective BCL-XL inhibitors, which are currently undergoing extensive testing as a single agent or in combination with other therapeutic agents, were further summarized. In the second section, MCL-1 inhibitors developed as potential anticancer agents were reviewed regarding their specificity toward MCL-1. Explicitly, studies leading to the identification of MCL-1, nonselective and selective targeting of MCL-1, and recently initiated clinical trials were compiled in chronological order. Based on these concepts, future directions were further discussed for increasing selectivity in the design of prosurvival BCL-2 member inhibitors.     

体外Rituximab增敏吉西他滨/长春瑞宾细胞毒作用的实验研究

本研究探讨抗CD20单抗利妥昔(Rituximab,RTX)对Gemcitabine和Navelbine的化疗增敏作用及其可能的作用机制。体外培养Daudi、Ramos、Namalwa和Raji细胞,采用XTT法测定细胞增殖抑制率,计算出各自的IC50;比较Gemcitabine或Navelbine单药及Gemcitabine或Navelbine分别与RTX两药协同作用的IC50;用Western blot测定Daudi、Ramos、Raji和Namlwa细胞经RTX20μg/ml作用24小时后抗凋亡蛋白BCL-2的表达情况。结果表明:单药抗CD20单克隆抗体对4株细胞无明显诱导凋亡作用,抑制率在3%-10%之间波动。RTX可使Gemcitabine或Navelbine对Daudi、Namalwa和Raji细胞株的细胞毒作用有明显增强;在Namalwa和Raji细胞株经RTX作用24小时后,BCL-2蛋白表达下调。结论:RTX对新一代细胞毒药物Gemcitabine或Navelbine有明显的细胞毒增敏作用。Namalwa和Raji细胞株经RTX作用24小时后BCL-2表达下调,这可能是RTX增敏细胞毒药物的机制之一。