Atg7 suppression enhances chemotherapeutic agent sensitivity and overcomes stroma-mediated chemoresistance in acute myeloid leukemia

Sujan Piya, Steven M. Kornblau, Vivian R. Ruvolo, Hong Mu, Peter P. Ruvolo, Teresa McQueen, R. Eric Davis, Numsen Hail, Hagop Kantarjian, Michael Andreeff, Gautam Borthakur

Research output: Contribution to journalArticlepeer-review

96 Scopus citations

Abstract

Autophagy is a cellular adaptive mechanism to stress, including that induced by chemotherapeutic agents. Reversephase protein array suggested that high expression of the essential autophagy-related protein, Atg7, was associated with shorter remission in newly diagnosed acute myeloid leukemia (AML) patient samples, indicating a role in chemoresistance. Knockdown of Atg7 in AML cells using short hairpin RNA markedly increased apoptosis and DNA damage following treatment with cytarabine and idarubicin. Interestingly, coculture of AML cells with stromal cells increased autophagy and chemoresistance in the AML cells exposed to chemotherapeutic agents, and this was reversed following Atg7 knockdown. This effect was further enhanced by concomitant knockdown of Atg7 in both AML and stromal cells. These findings strongly suggest that Atg7, and likely microenvironment autophagy in general, plays an important role in AML chemoresistance. Mechanistic studies revealed that Atg7 knockdown induced a proapoptotic phenotype in AML cells, which was manifested by an increased NOXA expression at the transcriptional level. Finally, in a mouse model of human leukemia, Atg7 knockdown extended overall survival after chemotherapy. Thus, the inhibition of Atg7 appears to be a valid strategy to enhance chemosensitivity, and it could indeed improve outcomes in AML therapy.

Original languageEnglish
Pages (from-to)126-1269
Number of pages1144
JournalBlood
Volume128
Issue number9
DOIs
StatePublished - 1 Sep 2016
Externally publishedYes

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