Intracellular glutathione determines bortezomib cytotoxicity in multiple myeloma cells

Blood Cancer J. 2016 Jul 15;6(7):e446. doi: 10.1038/bcj.2016.56.

Abstract

Multiple myeloma (myeloma in short) is an incurable cancer of antibody-producing plasma cells that comprise 13% of all hematological malignancies. The proteasome inhibitor bortezomib has improved treatment significantly, but inherent and acquired resistance to the drug remains a problem. We here show that bortezomib-induced cytotoxicity was completely dampened when cells were supplemented with cysteine or its derivative, glutathione (GSH) in ANBL-6 and INA-6 myeloma cell lines. GSH is a major component of the antioxidative defense in eukaryotic cells. Increasing intracellular GSH levels fully abolished bortezomib-induced cytotoxicity and transcriptional changes. Elevated intracellular GSH levels blocked bortezomib-induced nuclear factor erythroid 2-related factor 2 (NFE2L2, NRF2)-associated stress responses, including upregulation of the xCT subunit of the Xc- cystine-glutamate antiporter. INA-6 cells conditioned to increasing bortezomib doses displayed reduced bortezomib sensitivity and elevated xCT levels. Inhibiting Xc- activity potentiated bortezomib-induced cytotoxicity in myeloma cell lines and primary cells, and re-established sensitivity to bortezomib in bortezomib-conditioned cells. We propose that intracellular GSH level is the main determinant of bortezomib-induced cytotoxicity in a subset of myeloma cells, and that combined targeting of the proteasome and the Xc- cystine-glutamate antiporter can circumvent bortezomib resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / pharmacology*
  • Apoptosis / drug effects
  • Bortezomib / pharmacology*
  • Cell Line, Tumor
  • Cell Survival / drug effects
  • Cluster Analysis
  • Cysteine / metabolism
  • Dose-Response Relationship, Drug
  • Gene Expression Profiling
  • Glutathione / metabolism*
  • Humans
  • Intracellular Space / metabolism
  • Multiple Myeloma / genetics
  • Multiple Myeloma / metabolism*
  • NF-E2-Related Factor 2 / metabolism
  • Proteasome Endopeptidase Complex / metabolism
  • Stress, Physiological

Substances

  • Antineoplastic Agents
  • NF-E2-Related Factor 2
  • Bortezomib
  • Proteasome Endopeptidase Complex
  • Glutathione
  • Cysteine