1. Academic Validation
  2. GLI2 inhibition abrogates human leukemia stem cell dormancy

GLI2 inhibition abrogates human leukemia stem cell dormancy

  • J Transl Med. 2015 Mar 21;13:98. doi: 10.1186/s12967-015-0453-9.
Anil Sadarangani 1 2 Gabriel Pineda 3 Kathleen M Lennon 4 Hye-Jung Chun 5 Alice Shih 6 Annelie E Schairer 7 Angela C Court 8 Daniel J Goff 9 Sacha L Prashad 10 Ifat Geron 11 Russell Wall 12 John D McPherson 13 Richard A Moore 14 Minya Pu 15 Lei Bao 16 Amy Jackson-Fisher 17 Michael Munchhof 18 Todd VanArsdale 19 Tannishtha Reya 20 Sheldon R Morris 21 Mark D Minden 22 23 Karen Messer 24 Hanna K A Mikkola 25 Marco A Marra 26 Thomas J Hudson 27 Catriona H M Jamieson 28 29
Affiliations

Affiliations

  • 1 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 2 Division of Regenerative Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0820, USA. [email protected].
  • 3 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 4 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 5 Canada's Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, BC, Canada. [email protected].
  • 6 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 7 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 8 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 9 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 10 Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, CA, USA. [email protected].
  • 11 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 12 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 13 Ontario Institute for Cancer Research, Toronto, ON, Canada. [email protected].
  • 14 Canada's Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, BC, Canada. [email protected].
  • 15 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 16 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 17 Pfizer, La Jolla, CA, USA. [email protected].
  • 18 Pfizer, La Jolla, CA, USA. [email protected].
  • 19 Pfizer, La Jolla, CA, USA. [email protected].
  • 20 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 21 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 22 Department of Medicine, University of Toronto, Toronto, ON, Canada. [email protected].
  • 23 Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada. [email protected].
  • 24 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 25 Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, CA, USA. [email protected].
  • 26 Canada's Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, BC, Canada. [email protected].
  • 27 Ontario Institute for Cancer Research, Toronto, ON, Canada. [email protected].
  • 28 Department of Medicine, Stem Cell Program and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, 92037, CA, USA. [email protected].
  • 29 Division of Regenerative Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0820, USA. [email protected].
Abstract

Background: Dormant leukemia stem cells (LSC) promote therapeutic resistance and leukemic progression as a result of unbridled activation of stem cell gene expression programs. Thus, we hypothesized that 1) deregulation of the Hedgehog (Hh) stem cell self-renewal and cell cycle regulatory pathway would promote dormant human LSC generation and 2) that PF-04449913, a clinical antagonist of the GLI2 transcriptional activator, smoothened (Smo), would enhance dormant human LSC eradication.

Methods: To test these postulates, whole transcriptome RNA sequencing (RNA-seq), microarray, qRT-PCR, stromal co-culture, confocal fluorescence microscopic, nanoproteomic, serial transplantation and cell cycle analyses were performed on FACS purified normal, chronic phase (CP) chronic myeloid leukemia (CML), blast crisis (BC) phase CML progenitors with or without PF-04449913 treatment.

Results: Notably, RNA-seq analyses revealed that Hh pathway and cell cycle regulatory gene overexpression correlated with leukemic progression. While lentivirally enforced GLI2 expression enhanced leukemic progenitor dormancy in stromal co-cultures, this was not observed with a mutant GLI2 lacking a transactivation domain, suggesting that GLI2 expression prevented cell cycle transit. Selective Smo inhibition with PF-04449913 in humanized stromal co-cultures and LSC xenografts reduced downstream GLI2 protein and cell cycle regulatory gene expression. Moreover, Smo inhibition enhanced cell cycle transit and sensitized BC LSC to tyrosine kinase inhibition in vivo at doses that spare normal HSC.

Conclusion: In summary, while GLI2, forms part of a core HH pathway transcriptional regulatory network that promotes human myeloid leukemic progression and dormant LSC generation, selective inhibition with PF-04449913 reduces the dormant LSC burden thereby providing a strong rationale for clinical trials predicated on Smo inhibition in combination with TKIs or chemotherapeutic agents with the ultimate aim of obviating leukemic therapeutic resistance, persistence and progression.

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