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The enzyme acetyl-CoA carboxylase (ACC) plays a fundamental role in the fatty acid metabolism. It regulates the first and rate limiting step in the biosynthesis of fatty acids by catalyzing the carboxylation of acetyl-CoA to malonyl-CoA and exists as two different isoforms, ACC1 and ACC2. In the last few years, ACC has been reported as an attractive drug target for treating different diseases, such as insulin resistance, hepatic steatosis, dyslipidemia, obesity, metabolic syndrome and nonalcoholic fatty liver disease. An altered fatty acid metabolism is also associated with cancer cell proliferation. In general, the inhibition of ACC provides two possibilities to regulate the fatty acid metabolism: It blocks the de novo lipogenesis in lipogenic tissues and stimulates the mitochondrial fatty acid β-oxidation. Surprisingly, the role of ACC in human vascular endothelial cells has been neglected so far. This work aimed to investigate the role of the ACC/fatty acid metabolism in regulating important endothelial cell functions like proliferation, migration and tube formation.
To investigate the function of ACC, the ACC-inhibitor soraphen A as well as an siRNA-based approach were used. This study revealed that ACC1 is the predominant isoform both in human umbilical vein endothelial cells (HUVECs) and in human dermal microvascular endothelial cells (HMECs). Inhibition of ACC via soraphen A resulted in decreased levels of malonyl-CoA and shifted the lipid composition of endothelial cell membranes. Consequently, membrane fluidity, filopodia formation and the migratory capacity were attenuated. Increasing amounts of longer acyl chains within the phospholipid subgroup phosphatidylcholine (PC) were suggested to overcompensate the shift towards shorter acyl chains within phosphatidylglycerol (PG), which resulted in a dominating effect on regulating the membrane fluidity. Most importantly, this work provided a link between changes in the phospholipid composition and altered endothelial cell migration. The antimigratory effect of soraphen A was linked to a reduced amount of PG and to an increased amount of polyunsaturated fatty acids (PUFAs) within the phospholipid cell membrane. This link was unknown in the literature so far. Interestingly, a reduced filopodia formation was observed upon ACC inhibition via soraphen A, which presumably caused the impaired migratory capacity.
This work revealed a relationship between ACC/fatty acid metabolism, membrane lipid composition and endothelial cell migration. The natural compound soraphen A emerged as a valuable chemical tool to analyze the role of ACC/fatty acid metabolism in regulating important endothelial cell functions. Furthermore, regulating endothelial cell migration via ACC inhibition promises beneficial therapeutic perspectives for the treatment of cell migration-related disorders, such as ischemia reperfusion injury, diabetic angiopathy, macular degeneration, rheumatoid arthritis, wound healing defects and cancer.
Two main types of methods are used in gene therapy: integrating vectors and nuclease-based genome engineering. Nucleases are site-specific and are efficient for knock-outs, but inefficient at inserting long DNA sequences. Integrating vectors perform this task with high efficiency, but their insertion occurs at random genomic positions. This can result in transformation of target cells, which leads to severe adverse events in a gene therapy context. Thus, it is of great interest to develop novel genome engineering tools that combine the advantages of both technologies. The main focus of this thesis is on generating such a targetable integrating vector.
The integrating vector used in this project is the Sleeping Beauty (SB) transposon, a DNA transposon characterized by high activity across a wide range of cells. The SB transposase was combined with an RNA-guided Cas9 nuclease domain. This nuclease component was meant to direct transposase integration to specific targets defined by RNAs. The SB transposase was fused to cleavage-inactivated Cas9 (dCas9) to tether it to the target sites. In addition, adapter proteins consisting of dCas9 and domains non-covalently interacting with SB transposase or the SB transposon were generated. All constituent domains of these fusion proteins were tested in enzymatic assays and almost all enzymatic activities could be verified.
Combining the fusion protein dCas9-SB100X with a gRNA binding a sequence from the AluY repetitive element resulted in a weak, but statistically significant enrichment around sites bound by the gRNA. This enrichment was ca. 2-fold and occurred within a 300 bp window downstream of target sites, or within the AluY element.
Targeting with adapter proteins and targeting of other targets (L1 elements or single-copy targets) did not result in statistically significant effects. Single-copy targets tested included the HPRT gene and three specifically selected GSH targets that were known to be receptive to SB insertions. The combination with a more sequence-specific transposase mutant also failed to increase specificity to a level allowing targeting of single-copy loci. Genome-wide analysis of insertions however demonstrated, that dCas9-SB100X has a different insertion profile than SB100X, regardless of the gRNA used.
As low efficiency of retargeting is likely a consequence of the high background activity of the SB100X transposase in the fusion constructs, a SB mutant with reduced DNA affinity, SB(C42), was generated. For this mutant, transposition activity was partly dependent on a dCas9 domain being supplied with a multi-copy target gRNA, specifically a 2-fold increase in the presence of a AluY-directed gRNA. Whether using this mutant results in improved targeting remains to be determined.
In a side project, an attempt was made to direct SB insertions to ribosomal DNA by fusing the transposase to a nucleolar protein. This fusion transposase partially localized to nucleoli and insertions catalyzed by this transposase were found to be enriched in nucleolus organizer regions (NORs) and nucleolus-associated domains (NADs).
The aim of a second side project was increasing the ratio between homology-directed repair (HDR) and non-homologous end-joining (NHEJ) at Cas9-mediated double-strand breaks (DSBs). To achieve this, Cas9 was fused to DNA-interacting domains and corresponding binding sequences were fused to the homology donors. While an increased HDR/NHEJ ration could be observed for the fusion proteins, it was not dependent on the presence on the binding sequences in the donor molecules.
As one of the most widespread infectious diseases in the world, it is currently estimated that approximately 296 million people globally are chronically infected with Hepatitis B virus (HBV), the consequences of HBV infection cause more than 620,000 deaths each year. Although safe and effective HBV vaccines have reduced the incidence of new HBV infections in most countries, there are still around 1.5 million new infections each year. HBV remains a major health problem because there is no large-scale effective vaccination strategy in many countries with a high burden of disease, many people with chronic HBV infection are not receiving effective and timely treatment, and a complete cure for chronic infection is still far from being achieved.
Since its discovery, HBV has been identified as an enveloped DNA virus with a diameter of 42 nm. For efficient egress from host cells, HBV is thought to acquire the viral envelope by budding into multivesicular bodies (MVBs) and escape from infected cells via the exosome release pathway. It is clear that HBV hijacks the host vesicle system to complete self-assembly and propagation by interacting with factors that mediate exosome formation. Consequently, the overlap with exosome biogenesis, using MVBs as the release platform, raises the possibility for the release of exosomal HBV particles. Currently, virus containing exosomal vesicles have been described for several viruses. In light of this, this study explored whether intact HBV-virions wrapped in exosomes are released by HBV-producing cells.
First, this study established a robust method for efficient separation of exosomes from HBV virions by a combination of differential ultracentrifugation and iodixanol density gradient centrifugation. Fractionation of the density gradient revealed that two populations of infectious viral particles can be separated from the culture fluids of HBV-producing cells. The population present in the low-density peak co-migrates with the exosome markers. Whereas the population that appeared in the high-density fractions was the classical HBV virions, which are rcDNA-containing nucleocapsids encapsulated by the HBV envelope.
Subsequently, the characterization of this low-density population was performed, namely the highly purified exosome fraction was systematically investigated. Relying on the detergent sensitivity of the exosome membrane and the outer envelope of the HBV virus, disruption of the exosome structure by treatment with limited detergent revealed the presence of HBsAg in the exosomes. At the same time, mild and limited NP-40 treatment of highly purified exosomes and a further combination of density gradient centrifugation resulted in the stepwise release of intact HBV virions and naked capsids from the exosomes generated by HBV-producing cells. This implies the presence of intact HBV particles encapsulated by the host membrane.
The presence of exosome-encapsulated HBV particles was consequently also verified by suppressing the morphogenesis of MVBs or exosomes. Impairment of MVB- or exosome-generation with small molecule inhibitors has significantly inhibited the release of host membrane-encapsulated HBV particles as well. Likewise, silencing of exosome-related proteins caused a diminution of exosome output, which compromised the budding efficiency of wrapped HBV.
Moreover, electron microscopy images of ultra-thin sections combined with immunogold staining visualized the hidden virus in the exosomal structure. Additionally, the presence of LHBs on the surface of exosomes derived from HBV-expressing cells was also observed.
As expected, these exosomal membrane-wrapped HBV particles can spread productive infection in differentiated HepaRG cells. In HBV-susceptible cells, as LHBs on the membrane surface, this type of exosomal HBV appeared to be uptaken in an NTCP receptor-dependent manner.
Taken together these data indicate that a fraction of intact HBV virions can be released as exosomes. This reveals a so far not described release pathway for HBV. Exosomes hijacked by HBV act as a transporter impacting the dissemination of the virus.
Protein quality control systems (PQC), i.e. UPS and aggresome-autophagy pathway, have been suggested to be a promising target in cancer therapy. Simultaneous pharmacological inhibition of both pathways have shown increase efficacy in various tumors, such as ovarian and colon carcinoma. Here, we investigate the effect of concomitant inhibition of 26S proteasome by FDA-approved inhibitor Bortezomib, and HDAC6, as key mediator of the aggresome-autophagy system, by the highly specific inhibitor ST80 in rhabdomyosarcoma (RMS) cell lines. We demonstrated that simultaneous inhibition of 26S proteasome and selective aggresome-autophagy pathway significantly increases apoptosis in all tested RMS cell lines. Interestingly, we observed that a subpopulation of RMS cells was able to survive the co-treatment and, upon drug removal, to recover similarly to untreated cells. In this study, we identified co-chaperone BAG3 as the key mediator of this recovery: BAG3 is transcriptionally up-regulated specifically in the ST80/Bortezomib surviving cells and mediates clearance of cytotoxic protein aggregates by selective autophagy. Impairment of the autophagic pathway during the recovery phase, both by conditional knock-down of ATG7 or by inhibition of lysosomal degradation by BafylomicinA1, triggers accumulation of insoluble protein aggregates, loss of cell recovery and cell death similarly to stable short harpin RNA (shRNA) BAG3 knock-down. Our results are the first demonstration that BAG3 mediated selective autophagy is engaged to cope with proteotoxicity induced by simultaneous inhibition of constitutive PQC systems in cancer cell lines during cell recovery. Moreover, our data give new insights in the regulation of constitutive and on demand PQC mechanisms pointing to BAG3 as a promising target in RMS therapy.
Metastatic rhabdomyosarcoma (RMS) is one of the most challenging tumor entities in pediatric oncology caused by treatment resistances and immune escape. Novel chimeric antigen receptor (CAR) immunotherapies as specific, effective and safe treatment provide antitumor cytotoxicity by soluble factors and ligands/receptor signals. Besides its intrinsic potential as innate immune cell the ErbB2-sprecific CAR-engineered natural killer (NK)-92 cell line NK-92/5.28.z also provides CAR-mediated cytotoxicity, resulting in a high lytic capacity against 2D and 3D RMS cell structures in vitro. Also in a xenograft model using immune deficient NOD/Scid/IL2Rγ-/- (NSG) mice inhibited NK-92/5.28.z the tumor growth as long as the cells were administered and therefore prolonged the survival of the animals. The NK-92/5.28.z were distributed by the blood circulation and subsequently infiltrated the tumor tissue. Due to the malignant origin of the NK-92 cell line the cells must be irradiated prior to the use in patients. While the irradiation hampered the proliferation of NK-92/5.28.z cells, the cytotoxicity against RMS cells in vitro is retained for at least 24 hours. In the xenograft model irradiated NK-92/5.28.z cells inhibited the tumor growth but to a lower extent than untreated cells, as irradiated cells have only a limited life span in vivo no durable persistence and remission was achieved. Therefore, combinatorial approaches were focused and while blocking of the PD-1/PD-L1 axis did not resulted in a significantly enhanced tumor cell lysis, the combinatorial treatment with proteasome inhibitor bortezomib exhibited a significant enhanced cytotoxicity against RMS cells at least in vitro. Bortezomib itself induces caspase mediated apoptosis and also the upregulates the expression of TRAIL receptor DR5. The corresponding ligand TRAIL is expressed on the surface of the NK-92/5.28.z and pursuing experiments with purified TRAIL and bortezomib revealed a synergism. NK-92/5.28.z as an off-the-shelf product is therefore feasible for the therapy of metastatic RMS, but it might be necessary to support the cytotoxicity by additive agents like proteasome inhibitor bortezomib to archive durable remission.
Another cell population suitable for RMS CAR-immunotherapy are cytokine induced killer (CIK) cells, a heterogenous cell population generated from autologous PBMCs consisting of T, NK and T-NK cells. Lentivirally transduced ErbB2-specific CAR-CIK cells were previously shown to inhibit the tumor engraftment in a RMS xenograft model. However, lentiviral transduced adoptive immunotherapies bear risks for the transfer in patients, therefore the Sleeping Beauty Transposon System (SBTS) as a non-viral method, which integrates the CAR coding DNA by a cut-and-paste mechanism from a minicircle (MC) into the CIK cells genome is more feasible for the generation of CAR-CIK cells. The Sleeping beauty transposase mRNA and the MC were transferred in the cell by nucleofection, different factors influence the transfection efficiency and viability of the CIK cells in this harsh procedure. In preliminary experiments with MC Venus, a MC encoding eGFP, the highest transfection efficiency with the best proliferative capacity was achieved with cells on day 3 of CIK culture and without the addition of autologous monocytes as feeder cells. For the CAR construct the protocol was further improved by adjusting crucial factors, for this construct the best results were achieved on day 0, without irradiated PBMCs as feeder cells and cultivation in X-Vivo10 medium supplemented with human fresh frozen plasma. The X-Vivo10 medium enhanced the percentage of NK- and T-NK cells significantly compared to CAR-CIK cells cultured in RPMI. Since the gene transfer by SBTS resulted in CAR-CIK cells stably expressing a CAR in all subpopulations, resulting in a significantly enhanced cytotoxicity against RMS cells in vitro, these cells were compared to lentiviral transduced CAR-CIK cells in vitro and in vivo. While the SBTS CAR-CIK cells were superior to viral CAR-CIK cells in 2D short-term assays, the viral cells showed higher lytic capacity in 3D spheroid long-term assays. In a RMS xenograft model lentiviral CAR-CIK cells significantly prolonged the survival of mice and persisted, whereas SBTS CAR-CIKs did not favor the overall survival compared to untreated controls and also did not persist. Phenotypic analysis revealed a highly cytotoxic CD8+ and late effector memory dominant phenotype for SBTS CAR-CIK cells supporting short-term cytotoxicity but also more prone for exhaustion, while viral CAR-CIK cells showed a more balanced phenotype for memory and cytotoxicity. Therefore, the SBTS is feasible for the ErbB2-CAR gene transfer in CAR-CIK resulting in a stable CAR-expression with high short-term cytotoxicity, but these cells are also more prone to exhaustion and the protocol might be adapted further to prevent this limitation for in vivo application.
This work underlines the hard-to-treat characteristics of metastatic RMS, but also shows some approaches for further evaluation like the combination of NK-92/5.28.z cells with bortezomib and the feasibility of the generation of CAR-CIK cells via SBTS.
Food allergies are defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food. The prevalence of food allergies has increased in the past decade. Epidemiologic studies involving controlled food challenges for the diagnosis of food allergies indicated that between 1 % to 10.8 % of the population have immunemediated non-toxic food hypersensitivity.
Despite the increasing prevalence, no curative treatment has been established for food allergies so far except the complete avoidance of the elicited food. To establish safe and effective immunotherapy for food allergies, it is of crucially importance to elucidate pathological mechanism of such diseases.
Food allergies are classified into IgE-mediated and non-IgE mediated (T-cell mediated) allergies, depending on the immunologic pathways and the role of the IgE on the pathogenesis of the disease. Allergic enteritis (AE) is a gastrointestinal form of food allergy. It is classified as non-IgE-mediated food allergy. However, patients with AE often develop IgE and high levels of IgE have been associated with development of persistent AE. The gastrointestinal symptoms of AE are nonspecific, resulting in the fact that a broad differential diagnoses including diagnostic approaches for allergic diseases are necessary to rule out other gastrointestinal pathologies. Biopsies of patients with allergic enteritis have shown infiltration of inflammatory cells (e.g. mast cells, eosinophils, neutrophils, and T cells) in the lamina propria, disruption of intestinal villi, edema, and presence of goblet cells in the intestine...
P2X receptors are ligand (ATP)-gated ion channels that open an intrinsic cation permeable pathway in response to extracellular ATP released from both neuronal and non-neuronal cells. P2X receptors are abundantly distributed and mediate a wide variety of physiological functions, ranging from fast synaptic transmission in the central, peripheral, and enteric nervous system, to proinflammatory cytokine release from immune cells. The primary aim of this work was to elucidate the pathway that leads to the finally assembled trimeric P2X receptors, including the assessment of a possible role of ER chaperones and folding factors in this process. Additionally, the study was conducted to investigate the various ER quality control processes involved in the selection of “properly folded and assembled” P2X receptors that are suitable for the surface expression.
The Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus that causes high fever, rash, and recurrent arthritis in humans. The majority of symptoms disappear after about one week. However, arthritis can last for months or even years (in about 30% of cases), which makes people unable to work during this period. The virus is endemic in Sub-Saharan Africa, the Indian Ocean islands, India, and Southeast Asia. It has additionally caused several large outbreaks in the last few years, affecting millions of people. The mortality rate is very low (0.1%), but the infection rates are high (sometimes 30%) and the number of asymptomatic cases is rare (about 15%). The first CHIKV outbreak in a country with a moderate climate was detected in Italy in 2007. Furthermore, the virus has spread to the Caribbean in late 2013. Due to climate change, globalization, and vector switching, the virus will most likely continue to cause new worldwide outbreaks. Additionally, more temperate regions of the world like Europe or the USA, which have recently reported their first cases, will likely become targets. Alarmingly, there is no specific treatment or vaccination against CHIKV available so far.
The cell entry process of CHIKV is also not understood in detail, and was thusly the focus of study for this project. The E2 envelope protein is responsible for cell attachment and entry. It consists of the domain C, located close to the viral membrane, domain A, in the center of the protein, and domain B, at the distal end, prominently exposed on the viral surface.
In this work, the important role of cell surface glycosaminoglycans (GAGs) for CHIKV cell attachment was uncovered. GAGs consist of long linear chains of heavily sulfated disaccharide units and can be covalently linked to membrane associated proteins. They play an important role in different cell signaling pathways. So far, solely cell culture passage has revealed an increased GAG-dependency of CHIKV due to mutations in E2 domain A, which was associated with virus attenuation in vivo. However, in this work it could be shown that cell surface GAGs promote CHIKV entry using non-cell culture adapted CHIKV envelope (Env) proteins. Transduction and infection of cell surface GAG-deficient pgsA-745 cells with CHIKV Env pseudotyped vector particles (VPs) and with wild-type CHIKV revealed decreased transduction and replication rates. Furthermore, cell entry and transduction rates of GAG-containing cells were also dose-dependently decreased in the presence of soluble GAGs. In contrast, transduction of pgsA-745 cells with CHIKV Env pseudotyped VPs was enhanced by the addition of soluble GAGs. This data suggests a mechanism by which GAGs activate CHIKV particles for subsequent binding to a cellular receptor. However, at least one GAG-independent entry pathway might exist, as CHIKV entry could not be totally inhibited by soluble GAGs and entry into pgsA-745 was, albeit at a lower rate, still possible. Further binding experiments using recombinant CHIKV E2 domains A, B, and C suggest that domain B is responsible for the GAG binding, domain A possibly for receptor binding, and domain C is not involved in cell binding. These results are in line with the geometry of CHIKV Env on the viral surface. They altogether reveal that GAG binding promotes viral cell entry and that the E2 domain B plays a central role for this mechanism.
As no vaccine against CHIKV has been approved so far, another goal of this project was to test new vaccination approaches. It has been published that a single linear epitope of E2 is the target of the majority of early neutralizing antibodies against CHIKV in patients. Artificial E2-derived proteins were created, expressed in E.coli, and successfully purified. They consisted of 5 repeats of the mentioned linear epitope (L), the surface exposed regions of domain A linked by glycine-serine linkers (sA), the whole domain B plus a part of the β-ribbon connector (B+), or a combination of these 3 modules. Vaccination experiments revealed that B+ was necessary and sufficient to induce a neutralizing immune response in mice, with the protein sAB+ yielding the best results. sAB+, as a protein vaccine, efficiently and significantly reduced viral titers in mice upon CHIKV challenge, which was not the case for recombinant Modified Vaccinia virus Ankara (MVA; MVA-CHIKV-sAB+), as a vaccine platform expressing the same protein. These experiments show that a small rationally designed CHIKV Env derived protein might, after optimization of some vaccination parameters, be sufficient as a safe, easy-to-produce, and cheap CHIKV vaccine.
Epigallocatechin-3-gallate (EGCG) is a catechin found in green tea and was, in this work, found to inhibit the CHIKV life cycle at the entry state in in vitro experiments using CHIKV Env VPs and wild-type virus. EGCG was recently published to inhibit attachment of several viruses to cell surface GAGs, which is in line with the role for GAGs in CHIKV entry revealed in this work. EGCG might serve as a lead compound for the development of a small molecule treatment against CHIKV.
Orthopoxviruses are large DNA viruses that replicate within the cytoplasm of infected cells encoding over a hundred different proteins. The orthopoxviral 68k ankyrin‐like protein (68k‐ank) is highly conserved among orthopoxviruses, and this study aimed at elucidating the function of 68k‐ank. The 68k‐ank protein is composed of four ankyrin repeats (ANK) and an F‐box‐like domain; both motifs are known proteinprotein interaction domains. The F‐box is found in cellular F‐box proteins (FBP), crucial components of cellular E3 ubiquitin (Ub) ligases. With yeast‐two‐hybrid screens and subsequent co‐immunoprecipitation analyses, it was possible to identify S‐phase kinase‐associated protein 1a (Skp1a) as a cellular counterpart of 68k‐ank via binding to the F‐box‐like domain. Additionally, Cullin‐1 was co‐precipitated, suggesting the formation of a viral‐cellular SCF E3 Ub ligase complex. Modified Vaccinia virus Ankara (MVA) ‐ being attenuated and unable to replicate in most mammalian cell lines due to a block in morphogenesis – nevertheless, expresses its complete genetic information attributing to its properties as promising vector vaccine. Conservation of 68k‐ank as the only ANK protein encoded by MVA implied a substantial role of this viral factor. Hence, its function in the viral life cycle was assessed by studying a 68k‐ank knock‐out MVA. A mutant phenotype manifested in nonpermissive mammalian cells characterized by a block succeeding viral early gene expression and by a reduced ability of the virus to shutoff host protein synthesis. Studies with MVA encoding a 68k‐ank F‐box‐like domain truncated protein revealed that viral‐cellular SCF complex formation and maintenance of viral gene expression are two distinct, unrelated functions fulfilled by 68k‐ank. Moreover, K1, a well‐described VACV host range factor of the ANK protein family, is able to complement 68k‐ank function. This suggests that gene expression of MVA putatively depends on the ANKs encoded in 68k‐ank. In addition to the important findings in vitro, first virulence studies with the mouse pox agent, ectromelia virus (ECTV) deleted of the 68k‐ank ortholog (C11) suggested that this factor contributes to ECTV virulence in vivo.
Rhabdomyosarcoma (RMS) is the most frequent pediatric soft-tissue sarcoma comprising two major subtypes – the alveolar and the embryonal rhabdomyosarcoma. The current therapeutic regime is multimodal including surgery, radiation and chemotherapy with cytostatic drugs. Although the prognosis for RMS patients has steadily improved to a 5-year overall survival rate of 70% for ERMS and 50% for ARMS, prognosis for subgroups with primary metastases or relapsed patients is still less than 25%, highlighting the need for development of new therapies for these subgroups. Since cancer cells are addicted to their cancer promoting transcriptional program, remodeling transcription by targeting bromodomain and extraterminal (BET) proteins has emerged as compelling anticancer strategy. However, in many cancer types BET inhibition was proved cytostatic but not cytotoxic emphasizing the need for combination protocols.
In this study we identify a novel synergistic interaction of the BET inhibitor JQ1 with p110α-isoform-specific Phosphoinositid-3-Kinase (PI3K) inhibitor BYL719 (Alpelisib) to induce mitochondrial apoptosis and global reallocation of BRD4 to chromatin. At first, we showed that JQ1 single treatment had cytostatic effects at nanomolar concentrations and inhibited MYC and Hedgehog (Hh) signaling in RMS known to promote proliferation of RMS. However, JQ1 single treatment barely induced cell death in RMS cells even at concentrations of up to 20 µM (< 20% cell death). Thus, we next tested combination approaches to elicit cell death. Since we previously identified synergistic cell death induction of Hh inhibition and PI3K inhibition in RMS cells we tested JQ1 in combination with the pan-PI3K/mTOR inhibitor PI-103 and the p110α-isoform-specific PI3K inhibitor BYL719. In addition, we tested JQ1 in combination with distinct HDAC inhibitors namely JNJ-26481585, SAHA (Vorinostat), MS-275 (Entinostat) and LBH-589 (Panobinostat) since the synergistic interaction of BET and HDAC inhibition has previously been described for other tumor entities.
Interestingly the synergism of cell death induction of JQ1/BYL719 co-treatment is superior to the synergism of JQ1 with pan-PI3K/mTOR inhibitor PI-103 or the tested HDAC inhibitors as confirmed by calculation of combination index. To investigate the molecular mechanisms underlying the synergy of JQ1/BYL719 co-treatment, we performed RNA-Seq and BRD4 ChIP-Seq experiments. RNA-Seq exhibited, that JQ1/BYL719 co-treatment shifted the overall balance of BCL-2 family gene expression towards apoptosis and increased gene expression of proapoptotic BMF, BCL2L11 (BIM) and PMAIP1 (NOXA) while decreasing gene expression of antiapoptotic BCL2L1 (BCL xL). These changes were verified by qRT-PCR and Western blot. Notably, BRD4 is phosphorylated upon JQ1/BYL719 co-treatment and globally reallocates BRD4 to chromatin. This BRD4 reallocation includes enrichment of BRD4 at the super-enhancer site of BMF, at the super-enhancer, typical enhancer and promoter regions of BCL2L11 (BIM) and at the PMAIP1 (NOXA) promoter, while JQ1 alone, as expected, reduces global chromatin binding of BRD4. Integration of RNA-Seq and BRD4 ChIP-Seq data underlines the transcriptional relevance of reallocated BRD4 upon JQ1/BYL719 co-treatment. Immunopreciptation studies showed, that RMS cells are initially primed to undergo mitochondrial apoptosis since BIM is constitutively bound to antiapoptotic BCL-2, BCL xL and MCL-1. JQ1/BYL719 co-treatment increased BIM expression and its neutralization of antiapoptotic BCL-2, BCL-xL and MCL-1 thereby rebalancing the ratio of pro- and antiapoptotic BCL-2 proteins in favor of apoptosis. This promotes activation of BAK and BAX resulting in caspase-dependent apoptosis. The functional relevance of proapoptotic re-balancing for the execution of JQ1/BYL719-mediated apoptosis was confirmed by individual silencing of BMF, BIM, NOXA or overexpression of BCL-2 or MCL-1, which all significantly rescued JQ1/BYL719-induced cell death. Execution of cell death by mitochondrial caspase-dependent apoptosis was veryfied by individual knockdown of BAK and BAX or caspase inhibitor N-Benzyloxycarbonyl-Val-Ala-Asp(O-Me) fluoromethylketone (zVAD.fmk), which all significantly rescued JQ1/BYL719-induced cell death.
In summary, combined BET and PI3Kα inhibition cooperatively induces mitochondrial apoptosis by proapoptotic re-balancing of BCL-2 family proteins accompanied by reallocation of BRD4 to transcriptional regulatory elements of BH3-only proteins.