RRC ID 58114
著者 Shinojima N, Fujimoto K, Makino K, Todaka K, Yamada K, Mikami Y, Oda K, Nakamura K, Jono H, Kuratsu JI, Nakamura H, Yano S, Mukasa A.
タイトル Clinical significance of polyglutamylation in primary central nervous system lymphoma.
ジャーナル Acta Neuropathol Commun
Abstract The therapeutic response to high-dose methotrexate (HD-MTX) therapy for primary central nervous system lymphoma (PCNSL) varies. Polyglutamylation is a reversible protein modification with a high occurrence rate in tumor cells. MTX incorporated into cells is polyglutamylated and strongly binds to dihydrofolate reductase without competitive inhibition by leucovorin (LV). Tumor cells with high polyglutamylation levels are selectively killed, whereas normal cells with lower polyglutamylation are rescued by LV. We hypothesized that the extent of polyglutamylation in tumor cells determines treatment resistance. Here, we investigated the therapeutic response of PCNSL to HD-MTX therapy with LV rescue based on polyglutamylation status. Among 113 consecutive PCNSL patients who underwent HD-MTX therapy in our department between 2001 and 2014, polyglutamylation was evaluated by immunostaining in 82 cases, with relationships between polyglutamylation and therapeutic response retrospectively examined. Human malignant lymphoma lines were used for in vitro experiments, and folpolyglutamate synthetase (FPGS), which induces polyglutamylation, was knocked down with short-hairpin RNA, and a stable cell line with a low rate of polyglutamylation was established. Cell viability after MTX treatment with LV rescue was evaluated using sodium butyrate (NaBu), a histone-deacetylase inhibitor that induces polyglutamylation by elevating FPGS expression. The complete response rate was significantly higher in the group with polyglutamylation than in the non-polyglutamylation group [58.1% (25/43) and 33.3% (13/39), respectively] (p < 0.05), and progression-free survival was also significantly increased in the group with polyglutamylation (p < 0.01). In vitro, the relief effect of LV after MTX administration was significantly enhanced after FPGS knockdown in al cell lines, whereas enhancement of FPGS expression by NaBu treatment significantly reduced this relief effect. These findings suggested that polyglutamylation could be a predictor of therapeutic response to HD-MTX therapy with LV rescue in PCNSL. Combination therapy with HD-MTX and polyglutamylation-inducing agents might represent a promising strategy for PCNSL treatment.
巻・号 6(1)
ページ 15
公開日 2018-2-23
DOI 10.1186/s40478-018-0522-4
PII 10.1186/s40478-018-0522-4
PMID 29475458
PMC PMC6389236
MeSH Adult Aged Aged, 80 and over Antimetabolites, Antineoplastic / pharmacokinetics Antimetabolites, Antineoplastic / therapeutic use* Cell Line, Tumor Cell Survival / drug effects Central Nervous System Neoplasms / drug therapy* Central Nervous System Neoplasms / metabolism* Central Nervous System Neoplasms / pathology Dose-Response Relationship, Drug Drug Resistance, Neoplasm / physiology Female Humans Leucovorin / therapeutic use Lymphoma / drug therapy* Lymphoma / metabolism* Lymphoma / pathology Male Methotrexate / pharmacokinetics Methotrexate / therapeutic use* Middle Aged Treatment Outcome Vitamin B Complex / therapeutic use
IF 5.883
引用数 0
リソース情報
ヒト・動物細胞 HKBML(RCB0820) RAJI(RCB1647) TL-1(RCB1871)