Schcolnik-Cabrera Alejandro, Domínguez-Gómez Guadalupe, Dueñas-González Alfonso
Division of Basic Research, Instituto Nacional De Cancerología México.
Unidad De Investigacion Biomédica En Cancer, Instituto De Investigaciones Biomédicas UNAM/Instituto Nacional De Cancerología México.
Am J Blood Res. 2018 Jun 5;8(2):5-16. eCollection 2018.
Cutaneous T-cell lymphoma (CTCL) is an uncommon extranodal non-Hodgkin T-cell lymphoma that originates from mature T lymphocytes homed at the skin. Epigenetic alterations observed in CTCL are not limited to overexpression of Histone Deacetylases but also to DNA hypermethylation. The known synergy between Histone deacetylase inhibitors (HDACi) and DNA methyltransferases inhibitors (DNMTi) suggests that combining these agent classes could be effective for CTCL.
In this study, the combinations of the HDACi and DNMTi hydralazine/valproate (HV) and vorinostat/decitabine (VD) were compared in regard to viability inhibition, clonogenicity, pharmacological interaction and cell cycle effects in the CTCL cell line Hut78. In addition, the effect of these combinations was evaluated in normal peripheral blood mononuclear cells.
The results show that each of the DNMTi and HDACi exerts growth inhibition, mostly by inducing apoptosis as shown in the cell cycle distribution. However, in the combination of HV the interaction is more synergic and also it inhibits the clonogenic capacity of cells over time. Additionally, the HV combination seems to affect in a minor degree the viability of peripheral blood mononuclear cells.
The results of this study and the preclinical and clinical evidence on the efficacy of combining HDACi with DNMTi strongly suggest that more studies are needed with this drug class combination in CTCL, particularly with the hydralazine-valproate scheme, which is safe, and these drugs are widely available and administered by oral route.
皮肤T细胞淋巴瘤(CTCL)是一种罕见的结外非霍奇金T细胞淋巴瘤,起源于归巢至皮肤的成熟T淋巴细胞。在CTCL中观察到的表观遗传改变不仅限于组蛋白去乙酰化酶的过表达,还包括DNA高甲基化。组蛋白去乙酰化酶抑制剂(HDACi)与DNA甲基转移酶抑制剂(DNMTi)之间已知的协同作用表明,联合使用这些药物类别可能对CTCL有效。
在本研究中,比较了HDACi与DNMTi肼屈嗪/丙戊酸盐(HV)和伏立诺他/地西他滨(VD)在CTCL细胞系Hut78中的活力抑制、克隆形成能力、药理相互作用和细胞周期效应。此外,还评估了这些联合用药对正常外周血单核细胞的影响。
结果表明,每种DNMTi和HDACi均发挥生长抑制作用,主要通过诱导细胞凋亡,如细胞周期分布所示。然而,在HV联合用药中,相互作用更具协同性,并且随着时间的推移还能抑制细胞的克隆形成能力。此外,HV联合用药对外周血单核细胞活力的影响似乎较小。
本研究结果以及HDACi与DNMTi联合用药疗效的临床前和临床证据强烈表明,需要对CTCL中这种药物类别联合用药进行更多研究,特别是使用安全且广泛可用并通过口服给药的肼屈嗪-丙戊酸盐方案。