AI Article Synopsis

  • T-cell acute lymphoblastic leukemia (T-ALL) is a rare and aggressive cancer that often relapses, with many patients having mutations in Notch1, leading to problematic signaling pathways.
  • Clinical trials using γ-secretase inhibitors (GSIs) alone have not been effective, but this study shows that the inhibitor DAPT can downregulate the active form of Notch1 and increase the sensitivity of T-ALL cells to TRAIL, a pro-apoptotic factor.
  • Combining DAPT with TRAIL significantly enhances cell death in T-ALL through an extrinsic pathway, suggesting that targeting γ-secretase could be a promising approach to treat this form of leukemia more effectively.

Article Abstract

T-cell acute lymphoblastic leukemia (T-ALL) is a rare and aggressive hematopoietic malignancy prone to relapse and drug resistance. Half of all T-ALL patients exhibit mutations in Notch1, which leads to aberrant Notch1 associated signaling cascades. Notch1 activation is mediated by the γ-secretase cleavage of the Notch1 receptor into the active intracellular domain of Notch1 (NCID). Clinical trials of γ-secretase small molecule inhibitors (GSIs) as single agents for the treatment of T-ALL have been unsuccessful. The present study demonstrated, using immunofluorescence and western blotting, that blocking γ-secretase activity in T-ALL cells with -[(3,5-difluorophenyl) acetyl]-L-alanyl-2-phenyl] glycine-1,1-dimethylethyl ester (DAPT) downregulated NCID and upregulated the tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) death receptor 5 (DR5). Upregulation of DR5 restored the sensitivity of T-ALL cells to TRAIL. Combination index revealed that the combined treatment of DAPT and TRAIL synergistically enhanced apoptosis compared with treatment with either drug alone. TRAIL combined with the clinically evaluated γ-secretase inhibitor 3-[(1r, 4s)-4-(4-chlorophenylsulfonyl)-4-(2, 5-difluorophenyl) cyclohexyl] propanoic acid (MK-0752) also significantly enhanced TRAIL-induced cell death compared with either drug alone. DAPT/TRAIL apoptotic synergy was dependent on the extrinsic apoptotic pathway and was associated with a decrease in BH3 interacting-domain death agonist and x-linked inhibitor of apoptosis. In conclusion, γ-secretase inhibition represents a potential therapeutic strategy to overcome TRAIL resistance for the treatment of T-ALL.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038361PMC
http://dx.doi.org/10.3892/ol.2016.5011DOI Listing

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