Chemoresistance is one of the main causes of failure of anticancer chemotherapy. Vacuolar-type ATPase (V-ATPase) is an ATP-dependent proton pump involved in the regulation of the pH in cells, cell organelles and the intracellular space. A significant acidification of the extracellular space and intracellular compartments occurs in connection with the metabolism of tumour cells (glucose metabolism, hypoxia, insufficient blood perfusion of the cancer tissue). Basic drugs are transferred into acidic organelles based on the pH gradient, where they are then protonated and accumulated. This mechanism is called lysosomal sequestration and is one of the mechanisms how tumour cells resist to applied drugs, which then do not reach their target site in cancer cell. An increased expression of V-ATPases has been described in relation to chemoresistance and the progression of tumours. This dissertation is focused on observing the membrane subunit V0d from the complex of V-ATPase and the changes in resistance to ellipticine caused by the silencing of this subunit's gene in human neuroblastoma cell lines UKF-NB-4 (sensitive) and UKF-NB-4ELLI (resistant to ellipticine). The expression of the V0d protein was first examined on mRNA level using real-time polymerase chain reaction (RT-PCR). The silencing of selected...

Notre groupe a montré que l’hypoxie sévère (0.1% O2) induit un arrêt du cycle cellulaire en G0 des cellules humaines CD34+ et des cellules murines FDCP mix. Peu d’études ont exploré l’existence de Cellules Initiatrices de Leucémie (CIL) dans les LAL et leur rôle dans les rechutes. Notre projet s’est focalisé sur l’effet de l’hypoxie sévère sur la quiescence des CIL dans les LAL, qui pourrait être responsable d’un pourcentage de rechutes. En effet dans la niche hématopoïétique, ou sont localisées les Cellules souches hématopoïétiques et probablement les CIL, la concentration d’oxygène avoisinerait 0,1%.Nous avons utilisé la lignée de LAL NALM6 pour explorer les effets de l’hypoxie sévère sur leur survie, leur cycle cellulaire et leur chimiorésistance. Nos résultats ont mis en évidence qu’une culture à 0.1% O2 durant 7 jours de la lignée NALM6: - inhibe leur prolifération sans surmortalité, - révèle une population restreinte de CIL quiescentes et chimiorésistantes capables d’induire une leucémie dans des souris. Nous avons recherché les relations entre l’hypoxie sévère et quelques caractéristiques des cellules primaires de patients atteints de LAL : existence et rôle de CIL résistantes à l’hypoxie et aux agents thérapeutiques conventionnels des LAL ; localisation de ces cellules résiduelles dans la moelle osseuse des souris xénogreffées. Nos résultats suggèrent que certaines rechutes de LAL pourraient être dues à la persistance à long terme de « quiescent/dormant » CIL dans les niches hypoxiques de la moelle osseuse. Ce modèle est intéressant pour explorer les mécanismes in vitro et in vivo de chimiorésistance dans les LAL et le rôle de l’environnement dans ce phénomène. / Our group showed that severe hypoxia (0.1% O2) induces G0 cell-cycle-arrest of human CD34+ cells and of murine FDCP-mix Cells. Few studies explored the existence of quiescent Leukemia Initiating Cells (LIC) in ALL and their role in primary chemoresistance and relapses. Our project is focused on the effect of very low O2 concentrations in the maintenance of quiescent LIC in ALL, that could be responsible of a percentage of relapses. Indeed in bone marrow niches, where hematopoietic stem cells and probably LIC are located, the O2 concentrations are below 0.1%.In the present study we used the NALM-6 ALL cell line to explore the effects of culture at 0.1% O2 on their survival, cell cycle and chemoresistance. Our results evidence that a 7 days culture of NALM-6 cells at 0.1% O2: - inhibits their proliferation without major cell death; - reveals a restricted LIC population of quiescent and chemoresistant LIC; - maintains quiescent chemoresistant LIC that induce leukemia when injected in immunodeficient mice. We investigated the relationships between severe hypoxia and some characteristics of ALL primary cells obtained from patients: existence and role of quiescent chemoresistant LICs in ALL relapses; location of these residual cells inside the bone marrow of engrafted mice. Our results suggest that some ALL relapses could be due to the long term persistence of “quiescent / dormant” LIC in hypoxic bone marrow niches. This model is of interest for exploring the in vitro and in vivo (xenograft) mechanisms of chemoresistance in ALL and the role of the bone marrow environment in this phenomenon.

No description available.

Interstrand cross-links (ICLs) are a type of DNA damage that prevents strand separation required for basic cellular processes. ICL-based anti-cancer therapies exploit the cytotoxic consequences of replication and transcription inhibition, however, they are limited by the ability of the cell to repair DNA crosslinks. The challenge of ICL repair involves coordinating multiple DNA repair pathways to remove damage occurring on both strands of DNA. Participation of factors that are both exclusive and essential to crosslink repair suggests a pathway requirement to process unique structures and/or intermediates arising only in ICL repair. SNM1A is a nuclease required for survival of human cells in response to ICL exposure, but the specific function and role of SNM1A remain unclear. Here we show that, in addition to known 5’-3’exonuclease activity, SNM1A possesses single-strand specific endonuclease activity. Furthermore, SNM1A exhibits translesion nuclease activity on crosslinks which deform the helical backbone, but not non-distorting stable ICLs. We report the identification and characterization of nine small molecules inhibitors of SNM1A, isolated from an in vitro high-throughput screen of nearly 4,000 bioactive compounds. Finally, we demonstrate that inhibitors of SNM1A potentiate the cytotoxicity of ICL-inducing agent cisplatin in HeLa cells. The work in this thesis expands the possible roles of SNM1A in ICL repair and lays the groundwork for SNM1A inhibition in ICL sensitization efforts. / Thesis / Doctor of Philosophy (PhD)

La surexpression de pompes d’efflux par les cellules cancéreuses permet l’élimination d’agents cytotoxiques, induisant alors une résistance à la chimiothérapie. Trois transporteurs ABC sont principalement impliqués dans cette résistance : ABCB1 (aussi appelé P-gp), ABCC1 (ou MRP1) et ABCG2 (ou BCRP, MXR, ABCP). Du fait de leur implication dans le phénotype de « MultiDrug Resistance », il est essentiel de mieux comprendre le fonctionnement de ces transporteurs. Une étude par mutagenèse dirigée a montré que les boucles intracellulaires, ICL0 et ICL1 sont impliquées dans le transport des substrats. Deux résidus sont particulièrement intéressants : W379 qui agirait comme un filtre des substrats ; et H457 qui participerait à la reconnaissance ou à la fixation des substrats. Par ailleurs, il est important de moduler cette chimiorésistance. Dans ce contexte nous avons développé une nouvelle classe d’inhibiteurs d’ABCB1 et ABCG2 non compétitifs basés sur un motif dipeptidique. Les composés les plus efficaces, CT1347 pour ABCB1 et CT1364 pour ABCG2, s’avèrent, d’une part peu ou pas cytotoxiques à fortes concentrations, abolissent d’autre part la résistance induite par ABCB1 ou ABCG2 et se comportent comme des inhibiteurs non compétitifs du Hoechst 33342 et de la daunorubicine. De plus, CT1364 inhibe l’activité ATPasique d’ABCG2 et induit une diminution rapide de l’expression de la protéine. Enfin, les 1ers tests in vivo de ce composé montrent que l’association avec l’irinotécan ralentit la croissance des xénogreffes de petite taille chez des souris / Resistance to chemotherapy is partly due to efflux pumps expressed in the plasma membrane which prevent the accumulation of anticancer drugs in the tumour cells. Three human ATP-binding Cassette (ABC) transporters are particularly involved in this phenotype: P-gp/ABCB1, MRP1/ABCC1, and the last discovered BCRP/ABCG2. Because of their involvement in chemoresistance, it is critical to understand the mechanism by which those ABC transporters recognize and transport drugs. The mutagenesis study of the intracellular loops, ICL0 and 1 shows that these loops are involved in this mechanism. Two amino acids were particularly remarkable: W379 which act as a substrate filter and H457 which can be involved in substrate recognition and binding. In order to restore the cancer cell sensitivity to chemotherapeutic drugs, we have developed a new class of peptide inhibitors, specific to one transporter. A structure-activity relationship study has been performed and made it possible to develop a second generation of molecules. The most efficient compound inhibiting ABCB1 (CT1347) or ABCG2 (CT1364) have none or limitated cytotoxic effects. These compounds restore the activity of chemotherapeutic drugs and act as non competitive inhibitors. Moreover, CT1364 inhibits the ATP hydrolysis activity and lead to a rapid reduction of ABCG2 expression. Initial in vivo tests that have been carried out with CT1364 associated with irinotecan allow to observe a growth reduction of small mice xenografts

Le mélanome malin (MM) est un cancer très réfractaire aux thérapies anticancéreuses, dont les vincalcaloïdes (VAs). Afin d'étudier le rôle de la GSTM1 (glutathion S-transférase 1) et la MRP1 (multidrug resistance protein 1) dans la résistance acquise du MM aux VAs, nous avons établi 4 modèles cellulaires de résistance à la vincristine (CAL1R-VCR), à la vindésine (CAL1R-VDS), à la vinorelbine (CAL1R-VRB) et à la vinflunine (CAL1R-VFL), par exposition continue de cellules du MM (CAL1-wt), pendant un an, à ces anticancéreux. L'expression d'ne GSTM1 fonctionnelle est spécifiquement observée (RT-PCR, western blot, activité GST totale) dans les cellules résistantes. Le curcumin (inhibiteur de GSTM1), la BSO (inhibiteur de synthèse de glutathion) et le MK571 (inhibiteur de MRP1), réduisent considérablement le résistance acquise à la VCR et à la VDS mais pas à la VRB ou à la VFL. Toutefois, tous ces VAs réduisent spécifiquement l'activité GSTM1. Ces données montrent l'implication différentielle de GSTM1 et MRP1 dans la résistance aux VAs. Pour déterminer les mécanismes moléculaires de cette chimiorésistance, nous avons réalisé une étude pangénomique (biopuces Affymetrix HG-U133 Plus 2.00) sur les lignées CAL1 (wt et R). Le regroupement hiérarchique (par Cluster et TreeView) des données des puces a révélé une similarité entre les profils d'expression génique de CAL1R-VRB et CAL1-wt mais aussi entre ceux de CAL1R-VCR et CAL1R-VDS. L'analyse bioinformatique (par IPA) des transcrits les plus différemment exprimés entre les lignées cellulaires, a mis en évidence 6 réseaux géniques connus pour leur rôle dans la chimiorésistance tumorale. Le programme FatiGO a révélé 3 termes biologiques sur-représentés (> 60%) dans CAL1R (ribosome, filaments intermédiaires du cytosquelette, récepteurs olfactifs) tandis que l'étude fonctionnelle (invalidation génique par siRNA, test de viabilité) de GPR143, KIT et SLC45A2 (gènes interagissant avec NF-κB et CCND1 (facteurs de la chimiorésistance tumorale), très exprimés dans CAL1-wt et muets dans CAL1R) a montré la faible tendance des deux premiers à être impliqués dans la résistance aux VAs. / Malignant melanoma (MM) is a very refractory tumor to anticancer therapies, including vinca alkaloïds (VAs). To investigate the role of GSTM1 (glutathione S-transferase μ1) and MRP1 (multidrug resistance protein 1) in MM acquired resistance to VAs, we established 4 cellular models of resistance to vincristine (CAL1R-VCR), to vindesine (CAL1R-VDS), to vinorelbine (CAL1R-VRB) and to vinflunine (CAL1R-VFL), by continuous exposure of MM cells (CAL1-wt), for one year, to these anticancer agents. The expression of a functional GSTM1 is specifically observed (RT-PCR, western blot, total GST activity) in resistant cells. Curcumin (GSTM1 inhibitor), BSO (glutathione synthesis inhibitor) and MK571 (MRP1 inhibitor), considerably reduce the acquired resistance to VCR and VDS but not that to VRB or VFL. However, all these VAs specifically reduce GSTM1 activity. These data show the differential involvement of GSTM1 and MRP1 in resistance to VAs. To determine the molecular mechanisms of this chemoresistance, we performed a pangenomic study (Affymetrix HG-U133 Plus 2.00 microarrays) on the CAL1 lines (wt and R). The hierarchical clustering (by Cluster and TreeView) of array data revealed a similarity between the gene expression profiles of CAL1R-VRB and CAL1-wt, but also between those of CAL1R-VCR and CAL1R-VDS. The bioinformatic analysis (by IPA) of the most differentially expressed transcripts between cell lines, highlighted 6 gene networks known for their role in tumor chemoresistance. FatiGO program revealed 3 biological terms overrepresented (>60%) in CAL1R (ribosome, intermediate filaments of cytoskeleton, olfactory receptors), while functional study (gene invalidation by siRNA, viability test) of GPR143, KIT and SLC45A2 (genes interacting with NF-kB and CCND1 (tumor chemoresistance factors), highly expressed in CAL1-wt and mute in CAL1R) showed the weak trend of the two formers to be involved in resistance to VAs.

Tumorzellen können vielfältige Resistenzmechanismen gegenüber Zytostatika entwickeln. Untersuchungen an drei humanen Tumorzellinien und ihren cisplatinresistenten Varianten zeigten eine Assoziation von erhöhter MRP2-Expression und dem Auftreten von Cisplatinresistenz. Darüberhinaus waren die cisplatinresistenten Zellinien gegenüber Carboplatin kreuzresistent. Um weitere Faktoren im Zusammenhang mit der Cisplatinresistenz zu untersuchen, wurde der Mutationsstatus von p53 und der zelluläre Glutathiongehalt in den Zellinien bestimmt. Der offene Leserahmen von MRP2 aus der cisplatinresistenten Ovarialkarzinomzellinie A2780RCIS wurde für die Transfektion in die cisplatinsensitive Zellinie A2780 genutzt. Die Transfektanten zeigten eine Überexpression von MRP2 und wiesen eine Resistenz gegenüber Cisplatin und Carboplatin auf. Dies konnte in Zellzyklus- und Apoptose-Untersuchungen unter Cisplatinbehandlung gestätigt werden. Durch computergestützte Faltungsanalysen von Abschnitten der MRP2-mRNA wurden zwei potentielle Ribozymschnittstellen ausgewählt. Die konstruierten Anti-MRP2-Hammerhead-Ribozyme RzM1 und RzM2 wurden im zellfreien System auf ihre Schnittaktivität getestet und erwiesen sich als katalytisch aktiv. Es wurden verschiedene kinetische Parameter für RzM1 und RzM2 ermittelt und mit anderen Ribozymen verglichen. Die Ribozyme zeigten eine gute Effektivität bei der Spaltung ihres Zielmoleküls, wobei RzM1 die höhere Effektivität aufwies. Beide Ribozyme wurden auf ihre Wirksamkeit durch Transfektion in die Zellinie A2780RCIS getestet. Die untersuchten Transfektanten zeigten eine geringere Expression von MRP2 auf mRNA- und Proteinebene und wiesen eine verminderte Resistenz gegenüber Cisplatin, Carboplatin, Daunorubicin und Etoposid auf. Die Ribozyme RzM1 und RzM2 waren gleichermaßen für die Expressionsregulierung von MRP2 in Tumorzellen geeignet. In Zellzyklus- und Apoptose-Untersuchungen wurde funktionell bestätigt, daß die A2780RCIS-Anti-MRP2-Ribozym-Transfektanten auf eine Cisplatinbehandlung stärker ansprechen als die cisplatinresistente Ausgangszellinie A2780RCIS. Die Anwendung der Ribozyme RzM1 und RzM2 zur Unterstützung der Chemotherapie von Tumorzellen scheint daher vielversprechend. / Tumour cells can develop a lot of resistance mechanisms against cytostatic drugs. Examinations of three human tumour cell lines and their cisplatinresistant variants showed an association of elevated MRP2 expression and the occurrance of cisplatinresistance. Moreover, the cisplatinresistant cell lines were crossresistant against carboplatin. To examine further factors in context of cisplatinresistance the mutation status of p53 and the cellular glutathione content of the cell lines were determined. The MRP2-open reading frame of the cisplatinresistant ovarian carcinoma cell line A2780RCIS was used for transfection into the cisplatinsensitive cell line A2780. The transfectants showed an overexpression of MRP2 and a resistance against cisplatin and carboplatin. This could be confirmed with analysis of the cell cycle and apoptosis induction after treatment with cisplatin. Using computer aided folding analysis of MRP2 mRNA parts two possible ribozyme cleavage sites were selected. The constructed anti-MRP2 hammerhead ribozymes RzM1 and RzM2 were tested in a cell-free system with respect to their cleavage activities and were found to be catalytic active. Various kinetic parameters of RzM1 and RzM2 were determined and compared with other ribozymes. The ribozymes showed a good effectivity for the substrate cleavage, although RzM1 had the better effectivity. Both ribozymes were tested for their effectiveness after transfection into the cell line A2780RCIS. The transfectants showed a lower MRP2 expression on mRNA and protein level and also a reduced resistance against cisplatin, carboplatin, daunorubicin, and etoposide. The ribozymes RzM1 and RzM2 were both equally suitable for the regulation of MRP2 expression in tumour cells. Analysis of cell cycle and apoptosis induction could confirm functionally the higher sensitivity of the A2780RCIS-anti-MRP2 ribozyme transfectants after treatment with cisplatin in comparison to the cisplatinresistant cell line A2780RCIS. Therefore, the application of the ribozymes RzM1 and RzM2 for the support of cancer chemotherapy seems to be promising.

Palliative Therapie inklusive Chemotherapie und andere Behandlungsmethoden wie Hyperthermie ist oftmals die einzig verbleibende Option bei der Behandlung von bestimmten soliden Tumoren wie Magen- und Pankreaskarzinom. Leider ist der Erfolg dieser Therapien limitiert durch geringes Ansprechen der Tumoren auf die Behandlung und die Entwicklung einer Therapieresistenz. In dieser Arbeit wurde die globale Proteinexpression von chemo- und thermoresistenten Varianten der Magenkarzinomzellinie EPG85-257 und der Pankreaskarzinomzellinie EPP85-181 mit Hilfe von Proteomics (Kombination aus zweidimensionaler Elektrophorese, computergestützter Gel-Analyse und Massenspektrometrie) in vitro untersucht, um Kandidatenproteine zu finden, die potentiell mit Thermoresistenz bzw. Chemoresistenz assoziiert sind. In diesem Zusammenhang wurde eine mit Maldi-TOF kompatible Spezialsilberfärbung neu entwickelt. Es zeigte sich eine differentielle Expression einer Vielzahl von Proteinen in den thermoresistenten Zellen, darunter eine Hochregulation von Proteinen mit Chaperonaktivität aus nahezu allen subzellulären Kompartimenten sowie eine Überexpression von Enzymen des Arzneimittelmetabolismus in Zellen mit sowohl chemo- als auch thermoresistentem Phänotyp. Darüber hinaus wurden weitere Proteine identifiziert, welche hinsichtlich ihrer Beteiligung an Resistenzphänomenen im Vorfeld noch gar nicht charakterisiert worden sind (u.a. Aldehyd-Dehydrogenase 1, Transgelin, Phosphoglyceromutase). / Palliative treatment including chemotherapy and other modes of treatment, e.g. hyperthermia, is often the only remaining option in the management of certain solid tumours including gastric and pancreatic carcinoma. Unfortunately, its efficacy is poor due to low tumour sensitivity and the development of therapy resistance. The aim was to study in vitro global protein expression of chemo- and thermoresistant variants of the stomach cancer cell line EPG85-257 and the pancreatic cancer cell line EPP85-181 using proteomics (two-dimensional electrophoresis in combination with computer-assisted image analysis and mass spectrometry) to identify candidate proteins potentially associated with thermoresistance alone or in combination with chemoresistance. In this context, a special silver stain compatible with Maldi-TOF was developed. A large number of proteins was found to be differentially expressed in thermoresistant cells including up-regulation of molecular chaperones at practically every sub-cellular level as well as over-expression of enzymes involved in drug metabolism in both chemo- and thermoresistant cells. Furthermore, other proteins were identified that have not yet been linked to resistance phenomena (e.g. aldehyde dehydrogenase 1, transgelin, phosphoglycerate mutase).

Das BCL-2 Gen wurde als Onkogen der t (14;18)(q32;q21)-Translokation bei follikulären Non- Hodgkin-Lymphomen identifiziert. Die biologische Wirkung des BCL-2 Proteins liegt in der Hemmung der Apoptose. Bei der AML wird eine vermehrte BCL-2 Expression und eine dem- entsprechend verminderte Apoptose bei unreifen malignen myeloischen Vorläuferzellen gefun- den. Diese Krankheit ist teilweise auch chemoresistent. Goldstandard der Induktionstherapie bei AML ist eine Kombination aus Ara-C und Idarubicin, welche Doppel- und Einzelstrang- brüche der DNA induzieren. Apoptose der Leukämiezellen wird durch Schädigung der DNA ausgelöst. BCL-2 kann die Zellen durch Hemmung der Apoptose schützen, indem es die Cy- tochrom-C-Freisetzung blockiert. Darüber hinaus befinden sich die BCL-2- überexprimierenden Zellen in der G0-Phase und sprechen dabei schlecht auf die Chemothera- pie an. Deshalb stellt BCL-2 den Leukämiezellen "doppelten" Schutz zur Verfügung. BCL-2 spielt somit eine wichtige Rolle bei der Chemoresistenz. Ob ein Therapieprotokoll in der Be- handlung der AML effektiv ist, schlägt sich in der Kinetik der zunehmenden oder abnehmen- den BCL-2-Transkripte nieder. Zur Kontrolle des BCL-2-Transkriptes ist die quantitative PCR der qualitativen PCR überlegen. Die Quantifizierung dieses Transkriptes wurde mittels Echtzeit-Fluoreszenz-PCR realisiert. Bei der Echtzeit-Fluoreszenz-PCR wird die Reaktion im geschlossenen Reaktionsgefäß durchge- führt, sodass die Gefahr von Kontamination minimiert werden kann. Da keine Post-PCR Schrit- te nötig sind, wird die Überprüfung zahlreicher Proben durch ein 96-well-Format innerhalb eines Laufes ermöglicht. Die Echtzeit-Fluoreszenz-PCR garantiert ihre Spezifität durch eine spezifi- sche Sonde-Zielsequenz-Bindung und erlaubt eine exakte Quantifizierung der BCL-2- Transkriptzahl. In der vorliegenden Arbeit wurde die BCL-2-Expression in 53 AML-Fällen mittels Echtzeit- Fluoreszenz-PCR untersucht. Das ?-Actin Gen wurde als Referenzgen benutzt. Für die BCL-2- Expression wurde eine Ratio aus der Transkriptzahl des BCL-2 Gens und des ?-Actin Gens ge- bildet. Bei 53 AML-Fällen, die den sieben AML-Subtypen zugeordnet werden konnten(FAB M0-M7), konnte eine BCL-2-Expression nachgewiesen werden. Trotz der unterschiedlich hohen BCL-2-Expression bei diesen Patienten, ergab sich keine signifikante Korrelation zwischen der BCL-2-Expression und den FAB-Subtypen. Außerdem wurde die BCL-2-Expression in T- Zellen, B-Zellen und Granulozyten aus 5 AML-Patienten nachgewiesen. Die BCL-2-Expression wurde nicht von den Subpoplationen der mononukleären Zellen wie z.B. T-Zellen, B-Zellen, Granulozyten beeinflusst. Bei sieben Patienten wurden Proben im Verlauf untersucht. Dabei korrelierte eine hohe oder ansteigende BCL-2-Expression mit einem Rückfall der AML. Die Anzahl der untersuchten Proben im Verlauf ist jedoch zu klein, um definitive Schlußfolgerungen zu ziehen. Eine prospektive Untersuchung von größeren Patientenzahlen erscheint sinnvoll. / The bcl-2 oncogene was discovered by virtue of its association with the translocation, t(14;18) (q32;q21), observed in most follicular lymphomas. The bcl-2 protein is a 26 kDa integral membrane protein which functions by enhancing cell viability through the inhibition of apoptotic death. Acute myeloid leukemia is a lethal malignant disease characterized by an abnormal proliferation and differentiation of myeloid progenitor cells. The bcl-2 oncogene contributes to leukemogenesis by prolonging the life span of defected progenitor cells. Although the expression of bcl-2 in blast cells of acute myeloid leukemia is heterogeneous, a significant proportion of blast cells are shown to have high bcl-2 levels. The highest bcl-2 levels are found in cells that grow autonomously in vitro and also in blast cells expressing the CD34 surface antigen. These groups of AML patients are tranditionally the ones in which the prognosis is poor, because most of the chemotherapeutic agents like cytosine-arabinoside (Ara-C) exert their effect by triggering apoptosis. The high level of the bcl-2 gene that inhibits apoptosis is implicated in the resistance of AML blast cells to chemotherapy and leads to unfavorable prognosis. In this study, a real time fluorescence PCR assay was used to monitor the expression of the bcl-2 transcript in the therapeutic course of AML patients. By applying this rapid new developed quantitative method, the changes of the bcl-2 transcript with chemotherapy can help to evaluate the efficacy of therapeutic interventions in AML. The real time fluorescence PCR has many advantages over traditional measures. First, the assay is extremely rapid because post-PCR processing steps are unnecessary. All relevant data are collected real time during the course of a 2h PCR cycle program; data analysis can be completed in less than 10 min. Second, the assay from reaction set-up to data collection and analysis is a closed-tube system, which reduces the risk of false positive resulting from PCR product carry- over contamination and eliminates variation from additional pipetting steps. Finally, the real time fluorescence PCR is highly specific for the gene target of interest. Here the expression levels of the bcl-2 gene were measured in 53 patients with acute myeloid leukemia and normalized by ?-actin, a house-keeping gene expression as endogenous reference. The bcl-2/?-actin ratio from the 53 patients with AML was various, but not related to FAB subtypes. And also, this transcript ratio was not affected by mononucleated cell types. The samples from seven patients were measured to evaluate the association between the bcl-2 expression and the responsiveness of AML patients to the chemotherapy. The high or gradual elevation of the bcl-2 expression demonstrated the loss of effect in update-therapy protocol and the relapse in AML patients. Although the amount of samples are not large enough to reach the final conclusion, it is of significance that a number of patients will be analyzed in the future.

Glioblastoma multiforme (GBM) is a grade IV astrocytoma and is the most aggressive malignant primary brain tumor in adults. Without treatment, patients are expected to survive an average of three months. Conversely, current treatment regimens only extend survival to 12-14 months. Characteristically, GBM tumors are highly proliferative, invasive and stop responding to treatments relatively fast due to therapy resistance. Interestingly, GBM also exhibits high metabolic activity but manages to maintain a low level of reactive oxygen species (ROS). These ROS neutralization capabilities are sustained by system Xc–, a sodium-independent, electro neutral transporter that is found in the plasma membrane of GBM cells. System Xc– is composed of a regulatory heavy subunit (4F2hc) linked to a 12 transmembrane domain catalytic light chain subunit (xCT) that mediates the uptake of L-cystine into the cell, and L-glutamate out of the cell, at a 1:1 ratio. Imported cystine is quickly reduced to L- cysteine, the rate limiting substrate in glutathione (GSH) synthesis. Glutathione is a major antioxidant in the central nervous system that is responsible for maintaining intracellular redox homeostasis by neutralizing ROS by direct and indirect methods. The function of chemo and radiation therapy is to generate significant levels of ROS that tigger the cell to undergo apoptosis. High intracellular GSH levels in cancer cells are associated with drug resistance and detoxification of alkylating agents such as temozolomide (TMZ). Therefore, system Xc– represents a potential target to reduce glioma cell survival and reduce tumor progression. Sulfasalazine is an FDA approved drug in the treatment of arthritis and Crohne’s disease and has been shown to inhibit system Xc–. In vitro SASP studies demonstrated a strong antitumor potential in preclinical mouse models of malignant glioma. However, two clinical trials using sulfasalazine with standard chemo and radiation therapy to treat GBM patients were terminated due to off-target effects. Both results showed high toxicity and no change in the overall survival of patients. These studies demonstrate the need for a more effective inhibitor of system Xc–. To further elucidate the role of system Xc– in GBM survival, stable xCT knock-down and over-expressing U251 glioma cells were generated. These lines were characterized for survival, proliferation, apoptosis and resistance to oxidative and genotoxic insult. As expected xCT-knockdown cells exhibited lower GSH levels, increased intracellular ROS and markers for apoptosis after oxidative and genotoxic insult. The xCT-over-expressing cells displayed higher levels of GSH, increased resistance to hydrogen peroxide and various chemotherapy drugs including TMZ. An interesting unforeseen result of xCT over-expression in glioma cells was an increase in the metabolic activity as a result of increased mitochondria. Using xCT-modified glioma lines stably, we demonstrate for the first time that system XC– over-expression not only promotes survival under oxidative stress but may also decreases sensitivity to chemotherapy treatment and increase metabolic properties. Therefore, therapeutic manipulation of this transporter either alone or in combination with other treatments may improve clinical outcome in patients diagnosed with GBM.