The NADPH oxidase NOX2 is a marker of adverse prognosis involved in chemoresistance of acute myeloid leukemias

Haematologica. 2022 Nov 1;107(11):2562-2575. doi: 10.3324/haematol.2021.279889.

Abstract

Resistance to chemotherapeutic drugs is a major cause of treatment failure in acute myeloid leukemias (AML). To better characterize the mechanisms of chemoresistance, we first identified genes whose expression is dysregulated in AML cells resistant to daunorubicin or cytarabine, the main drugs used for induction therapy. The genes found to be activated are mostly linked to immune signaling and inflammation. Among them, we identified a strong upregulation of the NOX2 NAPDH oxidase subunit genes (CYBB, CYBA, NCF1, NCF2, NCF4 and RAC2). The ensuing increase in NADPH oxidase expression and production of reactive oxygen species, which is particularly strong in daunorubicin-resistant cells, participates in the acquisition and/or maintenance of resistance to daunorubicin. Gp91phox (CYBB-encoded Nox2 catalytic subunit), was found to be more expressed and active in leukemic cells from patients with the French-American-British (FAB) M4/M5 subtypes of AML than in those from patients with the FAB M0-M2 ones. Moreover, its expression was increased at the surface of patients' chemotherapy-resistant AML cells. Finally, using a gene expression based score we demonstrated that high expression of NOX2 subunit genes is a marker of adverse prognosis in AML patients. The prognostic NOX score we defined is independent of the cytogenetic-based risk classification, FAB subtype, FLT3/NPM1 mutational status and age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Daunorubicin
  • Drug Resistance, Neoplasm / genetics
  • Humans
  • Leukemia, Myeloid, Acute* / genetics
  • NADPH Oxidase 2* / genetics
  • Prognosis

Substances

  • Daunorubicin
  • NADPH Oxidase 2
  • CYBB protein, human

Grants and funding

Funding: Funding was provided by the CNRS, the Fondation ARC pour la Recherche sur le Cancer, Ligue Nationale contre le Cancer (Programme Equipe Labellisée), the INCA (ROSAML), the ANR (“Investissements d’avenir” program; ANR-16-IDEX-0006), the Fondation pour la Recherche Médicale (FRM) to LG and the Ligue Nationale contre le Cancer to MB. The HEMODIAG_2020 collection of clinical data and patients’ samples was funded by the Montpellier University Hospital, the Montpellier SIRIC and the Languedoc Roussillon Region. MGX acknowledges financial support from the France Génomique National infrastructure, funded as part of “Investissements d’Avenir” program managed by the Agence Nationale pour la Recherche (contract ANR-10-INBS-09).