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Pharmacological inhibition of RAS overcomes FLT3 inhibitor resistance in FLT3-ITD+ AML through AP-1 and RUNX1

Lookup NU author(s): Dan Coleman, Dr Helen Blair, Sandeep Potluri, Professor Olaf Heidenreich

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Author(s). AML is characterized by mutations in genes associated with growth regulation such as internal tandem duplications (ITD) in the receptor kinase FLT3. Inhibitors targeting FLT3 (FLT3i) are being used to treat patients with FLT3-ITD+ but most relapse and become resistant. To elucidate the resistance mechanism, we compared the gene regulatory networks (GRNs) of leukemic cells from patients before and after relapse, which revealed that the GRNs of drug-responsive patients were altered by rewiring their AP-1-RUNX1 axis. Moreover, FLT3i induces the upregulation of signaling genes, and we show that multiple cytokines, including interleukin-3 (IL-3), can overcome FLT3 inhibition and send cells back into cycle. FLT3i leads to loss of AP-1 and RUNX1 chromatin binding, which is counteracted by IL-3. However, cytokine-mediated drug resistance can be overcome by a pan-RAS inhibitor. We show that cytokines instruct AML growth via the transcriptional regulators AP-1 and RUNX1 and that pan-RAS drugs bypass this barrier.


Publication metadata

Author(s): Coleman DJL, Keane P, Chin PS, Ames L, Kellaway S, Blair H, Khan N, Griffin J, Holmes E, Maytum A, Potluri S, Strate L, Koscielniak K, Raghavan M, Bushweller J, Heidenreich O, Rabbitts T, Cockerill PN, Bonifer C

Publication type: Article

Publication status: Published

Journal: iScience

Year: 2024

Volume: 27

Issue: 4

Print publication date: 19/04/2024

Online publication date: 26/03/2024

Acceptance date: 25/03/2024

Date deposited: 18/04/2024

ISSN (electronic): 2589-0042

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.isci.2024.109576

DOI: 10.1016/j.isci.2024.109576

Data Access Statement: All sequencing data produced as part of this study are available on GEO and are publicly available as of the date of publication under the super series GEO: GSE241650. Python scripts used to construct the gene regulatory networks presented in this study, as well as the probability weight matrices for the transcription factor binding motifs and promoter-capture HiC data have been made available on GitHub at https://github.com/ petebio/Gene_regulatory_network_analysis and are free to use under an MIT license, https://doi.org/10.5072/zenodo.268, these scripts have been published previously. Any additional information required to reanalyse the data reported in this paper is available from the lead contact (Constanze Bonifer, c.bonifer@bham.ac.uk) upon request.


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Funding

Funder referenceFunder name
15001
19013
2021/JGF/001
Cancer Research UK
Blood Cancer UK
CGCATF-2021/100011
Kay Kendall Leukemia Fund
KKL 1326
MR/S021469/1Medical Research Council (MRC)
Leukemia UK
National Institutes of Health
RGS\R2\222022
R01 CA234478
Wellcome Trust
The Royal Society
University of Birmingham

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