Noreen Ersing

Biological effects and clinical significance of lenalidomide-induced tumour flare reaction in patients with chronic lymphocytic leukaemia: in vivo evidence of immune activation and antitumour response.

Lenalidomide has demonstrated impressive antileukaemic effects in patients with chronic lymphocytic leukaemia (CLL). The mechanism(s) by which it mediates these effects remain unclear. Clinically, CLL patients treated with lenalidomide demonstrate an acute inflammatory reaction, the tumour flare reaction that is suggestive of an immune activation phenomenon. Samples from CLL patients treated with lenalidomide were used to evaluate its effect on the tumour cell and components of its microenvironment (immune cellular and cytokine). Lenalidomide was unable to directly induce apoptosis in CLL cells in vitro, however it modulated costimulatory (CD80, CD83, CD86) surface molecules on CLL cells in vitro and in vivo. Concurrently, we demonstrated that NK cell proliferation was induced by lenalidomide treatment in patients and correlated with clinical response. Cytokine analysis showed increase in levels of TNF‐α post‐lenalidomide treatment, consistent with acute inflammatory reaction. Furthermore, the basal cytokine profile (high IL‐8, MIG, IP‐10 and IL‐4 levels and low IL‐5, MIP1a, MIP1b, IL12/p70) was predictive of clinical response to lenalidomide. Collectively, our correlative studies provide further evidence that the antileukaemic effect of lenalidomide in CLL is mediated not only through modulation of the leukaemic clone but also through elements of the tumour microenvironment.

Loss of the SMRT/NCoR2 Corepressor Correlates with JAG2 Overexpression in Multiple Myeloma

Multiple myeloma (MM) is a clonal B-cell neoplasm that accounts for 10% of all malignant hematologic neoplasms and that affects terminally differentiated B cells (i.e., plasma cells). It is now well recognized that the cytokine interleukin-6 (IL-6) is a major cytokine that promotes the proliferation of malignant plasma cells in MM. The IL-6 gene can be regulated by the NOTCH genes products. We have previously shown that the NOTCH ligand, JAG2, is overexpressed in MM. To investigate the mechanism(s) leading to JAG2 overexpression in MM, we assessed potential epigenetic modifications of the JAG2 promoter. We showed that the JAG2 promoter region is aberrantly acetylated in MM cell lines and patient samples. The acetylation state of histones is regulated by the recruitment of histone deacetylases (HDAC). HDACs are typically recruited to promoter regions through interaction with nuclear corepressors such as SMRT. SMRT levels were therefore investigated. Interestingly, MM cell lines and patient samples presented significantly reduced SMRT levels. The experiments suggest a correlation between constitutive acetylation of the JAG2 core promoter in the MM cell lines and reduced levels of the SMRT corepressor that recruits HDAC to promoter regions. Finally, SMRT function restoration induced JAG2 down-regulation as well as MM cell apoptosis.

Tumors in fish from the Detroit River

A fish tumor survey was conducted in the Lower Detroit River during 1985 to 1987. Five species of fish were collected from sediment deposition zones and were examined for neoplasia. Neoplasms and related lesions were found in bullhead (Ictalurus nebulosus), walleye (Stizostedion vitreum), redhorse sucker (Moxostoma, sp), white sucker (Catostomus commersoni), and bowfin (Amia calva). Overall, 8.2 percent of the fish examined had oral/dermal lesions and 10.1 percent had liver lesions. Liver and skin tumors were found to be age-related in bullheads and size-related in walleye. Based on the fish surveyed, the incidence of tumors in fish from the Detroit River was similar to that observed in other chemically contaminated waterways.

Mutagenicity of Sediments from the Detroit River

Abstract Sediment samples from 30 sites in the lower Detroit River and one site in Lake Michigan were extracted with organic solvent and were tested for mutagenicity in the Ames test. Without metabolic activation, sediment samples were either non-mutagenic or weakly mutagenic. With metabolic activation, mutagenic responses (defined as doubling of the spontaneous mutation rate at one or more concentrations of organic extract) were observed in 16 of 31 samples. Mutation rates ranged from 20 to 370 histidine positive revertants per mg of organic extract. These results demonstrate the existence of compounds in sediments of the Detroit River that can be activated to mutagens. The sediments thus are a potential source of mutagenic and possibly carcinogenic compounds for fish and other organisms.

Downregulation of BCL2 by AT‐101 enhances the antileukaemic effect of lenalidomide both by an immune dependant and independent manner

Over‐expression of anti‐apoptotic BCL2 has been reported in chronic lymphocytic leukaemia (CLL), but targeting BCL2 alone did not yield appreciable clinical results. However, it was demonstrated that BCL2 inhibitors enhanced the clinical efficacy of chemo and immunotherapeutics. Lenalidomide, an immunomodulator, is clinically effective in CLL and can enhance the anti‐CLL effects of CD20 targeting monoclonal antibody, rituximab. Here, we investigated the mechanism of immune‐directed killing of lenalidomide in CLL and evaluated if concurrent targeting of CD20 and BCL2 can enhance this effect. In vitro treatment with lenalidomide enhanced the antibody‐mediated cellular cytotoxicity (ADCC) directed by rituximab in autologous leukaemic cells. Furthermore, peripheral blood mononuclear cells obtained from patients after treatment with lenalidomide and rituximab showed increased ADCC in vitro versus control (pre‐treatment sample). This effect was further enhanced with pre‐treatment of tumour cells with AT‐101 (a BH3 mimetic that functions as BCL2 antagonist). Our data suggest that AT‐101 in combination with lenalidomide can potentially be an effective therapeutic regimen for CLL.

Mutations induced in a shuttle vector plasmid exposed to monofunctionally activated mitomycin C.

Reductive activation of mitomycin C leads to its covalent binding to DNA, forming monoadducts and cross‐links. The cytotoxicity of mitomycin C has been attributed to cross‐link formation, whereas monoadducts are assumed to cause mutagenicity. We have developed a 32P‐postlabeling technique to measure mitomycin C DNA adducts. Using this technique, we have measured monoadduct formation in the shuttle vector plasmid pSP189 and have determined mutations induced by monoadduct formation. The shuttle vector plasmid was incubated with mitomycin C under conditions favoring monofunctional activation of mitomycin C. The plasmid was then replicated in human Ad293 cells, rescued in bacteria, and analyzed for mutations in the supF tRNA gene sequence of pSP189. One major mitomycin C/DNA adduct was observed by 32P‐postla‐beling and was characterized as a monoadduct ofguanine. When pSP189 was exposed to monofunctionally activated mitomycin C, increases in adduct levels and mutation frequency were found to be related to mitomycin C concentration. The majority of the mutations involved single bases, with base substitutions making up 59.1% of the total mutations observed. Of the base substitutions, 67.2% were transversions and 32.8% were transitions, with nearly 80% of all base substitutions involving G:C base pairs. Deletions, either as single bases or large deletions, also involved G:C base pairs the majority of the time. The observed bias of mutations atG:C and the formation of a mitomycin C/DNA monoadduct involving guanine suggests that monoadduct formation may be responsible for the mutations. Environ. Mol. Mutagen. 29:143–151, 1997.

Mutagenic Potential of Sediments from the Grand Calumet River

The Grand Calumet River/Indiana Harbor Canal is one of the International Joint Commissions Great Lakes Areas of Concern (AOC). Like many other AOCs, the Grand Calumet River is in a heavily industrialized area and has a history of chemical contamination. Many of the chemicals found in the industrial and municipal wastes that enter the waterway end up in sediment where they are concentrated to high levels. In order to assess the potential genotoxicity of sediments from the Grand Calumet River, the authors determined the mutagenic potential of organic extracts of sediments. The sediment extracts were assayed in the Salmonella/microsome mutagenicity test. In the Ames test, all ten sediment samples assayed were found to be mutagenic. In general, chemicals found in the sediments required metabolic activation before a positive mutagenic response was observed.

Neem leaf extract induces cell death by apoptosis and autophagy in B-chronic lymphocytic leukemia cells

Abstract Chronic lymphocytic leukemia (CLL) is the most common adult leukemia and is currently incurable. To expand the therapeutic armamentarium, we investigated neem leaf extract (NLE) after a patient with CLL demonstrated disease regression upon taking oral NLE. NLE-mediated apoptosis was examined in peripheral blood mononuclear cells (PBMCs) from 41 patients with CLL. NLE induced a dose-dependent reduction in CLL cell viability with significant apoptosis observed at 0.06% (w/v) by 24 h. Annexin-V staining and poly(ADP-ribose) polymerase 1 (PARP-1) and caspase 3 cleavage were observed after NLE treatment. However, a pan-caspase inhibitor only partially blocked NLE-mediated cell death. NLE also caused loss of mitochondrial outer membrane permeability and nuclear translocation of apoptosis-inducing factor. Furthermore, NLE treatment resulted in LC3-I cleavage. Biochemical analyses revealed that NLE also inhibits Bcl-2 and p53 proteins. In summary, NLE exhibits anti-leukemic properties in patient primary CLL cells and demonstrates clinical efficacy, warranting further investigation as a potential therapy for CLL.

Altered benzo[a]pyrene metabolism in C3H/10T1/2 cells transformed by aflatoxin B1 or 3-methylcholanthrene.

C3H/10T1/2 clone 8 (10T1/2) cells possess Phase I and Phase II xenobiotic metabolizing enzymes associated with the metabolism of polycyclic aromatic hydrocarbons to activated or detoxified species. We compared the metabolism of benzo[a]pyrene (BaP) by these cells to an aflatoxin B1 (AFB1)-transformed line (7SA) and a 3-methylcholanthrene (3-MC)-transformed line (MCA) isolated from carcinogen-treated 10T1/2 cells. Relative to 10T1/2 cells, basal levels of cytochrome P450-mediated aryl hydrocarbon hydroxylase (AHH) were significantly depressed in 7SA cells by about 30%. The inducibility of AHH by BaP treatment was depressed by 30-70% in MCA and 7SA cells over a 36-hr time course. 10T1/2 and MCA cells accumulated similar intracellular amounts of 3-OH-BaP by 12 and 24 hr, respectively; in contrast the accumulation of 3-OH-BaP in 7SA cells was 70% lower. During 36 hr of BaP treatment, total BaP-DNA adduct levels formed in 7SA and MCA cells, determined by 32P-postlabeling analysis, were 90 and 83% lower, respectively, than those found in 10T1/2 cells. These differences in response to BaP treatment were not related to cellular differences in the uptake or efflux of BaP. Relative to 10T1/2 or MCA cells, 7SA cells were found to have at least a twofold increase in UDP-glucuronyltransferase activity, which correlated with the lower intracellular accumulation of 3-OH-BaP and enhanced formation of extracellular polar metabolites. MCA cells had an almost twofold increase in glutathione S-transferase activity relative to parental 10T1/2 cells but produced lower levels of extracellular polar metabolites. These results demonstrate an association between chemical transformation of 10T1/2 cells and altered xenobiotic metabolism. This system may provide an in vitro model for examining the molecular events responsible for the biochemically altered phenotype of the malignantly transformed cell.