Research Papers:

Gli-1/PI3K/AKT/NF-kB pathway mediates resistance to radiation and is a target for reversion of responses in refractory acute myeloid leukemia cells

Xiaodong Li _, Fang Chen, Qiuhua Zhu, Bingjie Ding, Qingxiu Zhong, Kaikai Huang, Xuejie Jiang, Zhixiang Wang, Changxin Yin, Yufeng Zhu, Zhen Li and Fanyi Meng

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Oncotarget. 2016; 7:33004-33015. https://doi.org/10.18632/oncotarget.8844

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Xiaodong Li1, Fang Chen1, Qiuhua Zhu1, Bingjie Ding1, Qingxiu Zhong1,2, Kaikai Huang1, Xuejie Jiang1, Zhixiang Wang1, Changxin Yin1, Yufeng Zhu1, Zhen Li1, Fanyi Meng1,2

1Hematology Department, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China

2Hematology Department, Kanghua Hospital, Dongguan 523080, Guangdong, China

Correspondence to:

Fanyi Meng, email: [email protected]

Keywords: radioresistance, refractory AML, LDE225, Gli-1/PI3K/AKT/NF-kB

Received: December 02, 2015    Accepted: March 29, 2016    Published: April 20, 2016


Total body irradiation combined with chemotherapy is currently the most effective procedure as a preparative myeloablative regimen. However, resistance to radiotherapy and chemotherapy in refractory acute myeloid leukemia is associated with short-time recurrence after allogeneic hematopoietic stem cell transplantation. To address this issue, we used three cell lines, HL60, HL60/ADR (adriamycin-resistant cells), and HL60/RX (a radiation-resistant cell line established from HL60 cells), as cellular models to investigate the mechanism of the Hedgehog (Hh) signaling pathway resulting in radioresistance, and the efficacy of LDE225 (an inhibitor of the Hh pathway) to enhance radiation sensitivity. Our results indicated that HL60/RX and HL60/ADR cells showed an increased in radioresistance and elevated activity of Hh pathway proteins compared with HL60 cells (P<0.001). In addition, LDE225 significantly reduced clonogenic survival with a sensitivity enhancement ratio (SER) of 1.283 for HL60/ADR and 1.245 for HL60/RX cells. The combination of LDE225 with irradiation significantly increased radiation-induced apoptosis and expression of γ-H2AX and BAK compared with single-treatment groups in both HL60/RX and HL60/ADR cells (P<0.001). In vivo, the combination of LDE225 with irradiation exerted a significant antitumor effect compared with the control and single agents in HL60/RX- and HL60/ADR-xenografted mouse models (P<0.001). Furthermore, our data obtained from western blot and IHC analyses showed that the activation of pAKT and NF-kB was reduced by LDE225 treatment in both HL60/ADR and HL60/RX cells. This demonstrates that the Gli-1/PI3K/AKT/NF-kB pathway plays a key role in resistance to radiation, and that inhibition of the Hh pathway sensitizes cells to radiation by overcoming radioresistance.

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