Tumor-selective action of HDAC inhibitors involves TRAIL induction in acute myeloid leukemia cells

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Chromatin is a dynamic macromolecular structure epigenetically modified to regulate specific gene expression. Altered chromatin function can lead to aberrant expression of growth regulators and may, ultimately, cause cancer. That many human diseases have epigenetic etiology has stimulated the development of 'epigenetic' therapies. Inhibitors of histone deacetylases (HDACIs) induce proliferation arrest, maturation and apoptosis of cancer cells, but not normal cells, in vitro and in vivo, and are currently being tested in clinical trials1,2,3,4,5. We investigated the mechanism(s) underlying this tumor selectivity. We report that HDACIs induce, in addition to p21, expression of TRAIL (Apo2L, TNFSF10) by directly activating the TNFSF10 promoter, thereby triggering tumor-selective death signaling in acute myeloid leukemia (AML) cells and the blasts of individuals with AML. RNA interference revealed that the induction of p21, TRAIL and differentiation are separable activities of HDACIs. HDACIs induced proliferation arrest, TRAIL-mediated apoptosis and suppression of AML blast clonogenicity irrespective of French-American-British (FAB) classification status, karyotype and immunophenotype. No apoptosis was seen in normal CD34+ progenitor cells. Our results identify TRAIL as a mediator of the anticancer action of HDACIs.

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Figure 1: MS275 induces proliferation arrest, differentiation and apoptosis of U937 cells.
Figure 2: RNA interference shows that p21 and TRAIL induction are independent activities of MS275
Figure 3: MS275 induces apoptosis and TRAIL expression in the blasts of individuals with AML.


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This work is dedicated to the memory of T. Battista. We are grateful to C. Erb and J.M. Garnier for modifying the pSUPER vector, a gift of R. Bernards, for permanent RNAi, and construction and validation of the siRNA vectors, E. Wilhelm for ChIP assays, A. Scognamiglio, C. Scafoglio and M. DeSimone for discussions, A. Cuomo and R. Verde for technical assistance. A.N. and N.C. were supported by the European Union, E.V. by a fellowship from the Ministère de la Recherche et Technologie and E.G. by a fellowship from the Ligue Nationale Contre le Cancer. This work was supported by grants from the European Union (QLG1-CT2000-01935 and QLK3-CT2002-02029), Regione Campania, Ministero della Salute R.F. 02/184, Associazione Italiana per la Ricerca sul Cancro, Ministero dell'Istruzione, Università e Ricerca (PRIN 2001067229_002, PRIN 2002067514_002, PRIN 2004D55579 and FIRB RBNE0157EH), the Italian-French GALILEO-VINCI program, Fondation de France, Association for International Cancer Research, Association pour la Recherche sur le Cancer, Université Louis Pasteur, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, and Bristol-Myers Squibb.

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Correspondence to Hinrich Gronemeyer or Lucia Altucci.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Fig. 1

Three HDAC inhibitors induce TRAIL mRNA and protein expression in different myeloid cell lines. (PDF 32 kb)

Supplementary Fig. 2

Permanent RNA interference to reveal the specific roles of TRAIL and p21, kinetics of differentiation and apoptosis markers, and TRAIL promoter analysis by ChIP assays. (PDF 82 kb)

Supplementary Fig. 3

MS275-induced TRAIL expression precedes differentiation and is responsible for antitumor activity of MS275 in vivo. (PDF 52 kb)

Supplementary Fig. 4

Effect of MS275 exposure on TRAIL mRNA and protein expression in AML patients' blasts and normal CD34+ progenitors. (PDF 27 kb)

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Nebbioso, A., Clarke, N., Voltz, E. et al. Tumor-selective action of HDAC inhibitors involves TRAIL induction in acute myeloid leukemia cells. Nat Med 11, 77–84 (2005) doi:10.1038/nm1161

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