The acetyltransferase GCN5 maintains ATRA-resistance in non-APL AML

Leukemia. 2019 Nov;33(11):2628-2639. doi: 10.1038/s41375-019-0581-y. Epub 2019 Oct 1.

Abstract

To date, only one subtype of acute myeloid leukemia (AML), acute promyelocytic leukemia (APL) can be effectively treated by differentiation therapy utilizing all-trans retinoic acid (ATRA). Non-APL AMLs are resistant to ATRA. Here we demonstrate that the acetyltransferase GCN5 contributes to ATRA resistance in non-APL AML via aberrant acetylation of histone 3 lysine 9 (H3K9ac) residues maintaining the expression of stemness and leukemia associated genes. We show that inhibition of GCN5 unlocks an ATRA-driven therapeutic response. This response is potentiated by coinhibition of the lysine demethylase LSD1, leading to differentiation in most non-APL AML. Induction of differentiation was not correlated to a specific AML subtype, cytogenetic, or mutational status. Our study shows a previously uncharacterized role of GCN5 in maintaining the immature state of leukemic blasts and identifies GCN5 as a therapeutic target in AML. The high efficacy of the combined epigenetic treatment with GCN5 and LSD1 inhibitors may enable the use of ATRA for differentiation therapy of non-APL AML. Furthermore, it supports a strategy of combined targeting of epigenetic factors to improve treatment, a concept potentially applicable for a broad range of malignancies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apoptosis
  • Bone Marrow / metabolism
  • Cell Differentiation
  • Cell Line, Tumor
  • Cell Membrane / metabolism
  • Drug Resistance, Neoplasm*
  • Epigenesis, Genetic
  • Genotype
  • HEK293 Cells
  • HL-60 Cells
  • Histone Demethylases / antagonists & inhibitors
  • Histones / chemistry
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukocytes, Mononuclear / cytology
  • Tretinoin / pharmacology*
  • p300-CBP Transcription Factors / metabolism*

Substances

  • Histones
  • Tretinoin
  • Histone Demethylases
  • KDM1A protein, human
  • p300-CBP Transcription Factors
  • p300-CBP-associated factor