Koca D, et al: Therapeutic Potentials of Inhibition of Jumonji C Domain-containing Demethylases in Acute Myeloid LeukemiaTurk J Hematol 2020;37:5-12Figure 6. Changes in mRNA levels of anti-apoptotic BCL2 and BCL2L1 genes. Statistical significance was detected by using two-wayanalysis of variance and p<0.001 was considered to be highly significant.Figure 7. Effects of methylstat on cell cycle progression of HL-60 cells. Three independent experiments were conducted for datapoints.treatment strategy for cancer due to the overexpression ofhistone demethylases in various cancer types [23].Over the last decade, many studies have focused on the JmjCfamily of histone demethylases. A number of researchershave indicated the association between JHDMs and severalphysiological and pathological circumstances including cancer,inflammation, development, metabolism, and neurologicaldisorders. The relevance of dysregulation of JHDMs in variousFigure 8. Synergistic cytotoxic effects of doxorubicin incombination with methylstat (72 h). The results are the means of4 independent experiments and error bars indicate the standarddeviations. Statistical significance was detected by using onewayanalysis of variance and p<0.001 was considered to be highlysignificant.types of cancer makes them a potential candidate to target. Ifabnormal JmjC demethylase activity is modulated, it can leadto normal transcriptional arrangements. Therefore, JmjC domaininhibitors might have therapeutic potentials for the treatmentof cancer [24,25,26,27].Here, we addressed the particular question of whether aselectively active inhibitor of JHDMs has anti-proliferativeeffects. There is no significant knowledge about the relevance10
Turk J Hematol 2020;37:5-12Koca D, et al: Therapeutic Potentials of Inhibition of Jumonji C Domain-containing Demethylases in Acute Myeloid Leukemiaof JHDMs for AML. In this study, we aimed to detect thecytotoxic, cytostatic, and apoptotic effects of methylstaton HL-60 acute pre-myelocytic leukemia cells. The cellswere treated with increasing concentrations of methylstat.Methylstat showed cytotoxic/antiproliferative effects in adose-dependent manner. To determine the apoptotic effectsof methylstat, annexin FITC/PI double staining, caspase-3enzyme activity, and the loss of MMP were studied (72 h).With respect to these apoptotic assays, methylstat exhibiteda dose-dependent induction of apoptosis and increased thepercentage of apoptotic cells as compared to untreatedcontrols. The mRNA expression levels of the foremost antiapoptoticgenes, BCL2 and BCL2L1, were detected by RT-PCR. The results supported the previous apoptotic assays andindicated that BCL2 and BCL2L1 expressions were decreasedwith incremental concentrations of methylstat. Besides theinduction of apoptosis, cytostatic effects were checked tosee how methylstat mediates cell cycle arrest in HL-60 cells.Incubation of HL-60 cells for 72 h with methylstat led to cellcycle arrest at the G2/M and S phases. On the other hand, toincrease the therapeutic effects and to reduce the side effects,it might be better to combine conventional therapies withepigenetic modifiers such as demethylase inhibitors. Therefore,in our study, we combined methylstat with the most commonchemotherapy agent, doxorubicin, in order to see whether theyhave synergistic effects. Doxorubicin had 2 times more antiproliferativeeffect together with an IC 20value of methylstaton HL-60 cells.ConclusionAccording to our results, methylstat has potent apoptoticeffects on HL-60 cells. It might have therapeutic potentialto treat AML through the induction of apoptosis and antiproliferativeeffects. However, it would be more effective toshow the chemotherapy response of methylstat with more celllines and on mouse models of human AML. That could be morehelpful for a better understanding of the clinical implicationsof methylstat.Chemotherapy targets both healthy, normal cells and cancercells. Therefore, it is important for an inhibitor to be specificfor cancer cells in order to minimize the side effects. For furtherinvestigations, it might be better to apply methylstat to humanleukocyte cultures, expecting a higher IC 50value compared toAML cell lines. Furthermore, mice xenografts might be helpfulto comprehend the possible potential of methylstat for clinicalimplications. In addition, there are a number of JmjC typesubfamilies and it would help to understand which of themare overexpressed specifically for AML. Depending on that, newspecific therapeutic inhibitors for these JmjC demethylasesmight be designed and applied in vivo and in vitro.AcknowledgmentsThe National Scholarship Program granted this project forundergraduate scientists supported by the Scientific andTechnological Research Council of Turkey (BİDEB 2209-A). Weare grateful to Prof. Udo Oppermann for supplying us withmethylstat from the University of Oxford (United Kingdom). Theauthors acknowledge the assistance of the Bioengineering andBiotechnology Application and Research Center staff of İzmirInstitute of Technology. We are deeply thankful to Miray Ünlü,PhD student, for her assistance with the apoptotic assays.EthicsEthics Committee Approval: There is no need for ethicalcommittee approval and informed consent since there were noanimal and human samples used in this study.Informed Consent: There is no need for ethical committeeapproval and informed consent since there were no animal andhuman samples used in this study.Authorship ContributionsConsept: D.K., N.H.; Design: Y.B.; Data Collection or Processing:Y.B., S.E., Y.K., G.T.U., D.Ç.; Experiments: D.K., N.H.; Writing: Y.B.Conflict of Interest: The authors declare no conflict of interest.Financial Disclosure: The authors declare that this studyreceived no financial support.References1. Chen WL, Wang YY, Zhao A, Xia L, Xie G, Su M, Zhao L, Liu J, Qu C3 WeiR, Rajani C, Ni Y, Cheng Z, Chen Z, Chen SJ, Jia W. Enhanced fructoseutilization mediated by SLC2A5 is a unique metabolic feature of acutemyeloid leukemia with therapeutic potential. Cancer Cell 2016;30:779-791.2. Takam Kamga P, Bassi G, Cassaro A, Midolo M, Di Trapani M, Gatti A,Carusone R, Resci F, Perbellini O, Gottardi M, Bonifacio M, Nwabo KamdjeAH, Ambrosetti A, Krampera M. Notch signalling drives bone marrow stromalcell-mediated chemoresistance in acute myeloid leukemia. Oncotarget2016;7:21713-21727.3. Dulau Florea AE, Braylan RC, Schafernak KT, Williams KW, Daub J, GoyalRK, Puck JM, Rao VK, Pittaluga S, Holland SM, Uzel G, Calvo KR. AbnormalB-cell maturation in the bone marrow of patients with germline mutationsin PIK3CD. J Allergy Clin Immunol 2017;139:1032-1035.e6.4. Paci A, Veal G, Bardin C, Levêque D, Widmer N, Beijnen J, Astier A, ChatelutE. Review of therapeutic drug monitoring of anticancer drugs part 1 –Cytotoxics. Eur J Cancer 2014;50:2010-2019.5. Dombret H, Gardin C. An update of current treatments for adult acutemyeloid leukemia. Blood 2016;127:53-61.6. Suguna E, Farhana R, Kanimozhi E, Kumar PS, Kumaramanickavel G, KumarCS. 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