Sarcoma stratification by combined pH2AX and MAP17 (PDZK1IP1) levels for a better outcome on doxorubicin plus olaparib treatment

Sarcomas constitute a rare heterogeneous group of tumors, including a wide variety of histological subtypes. Despite advances in our understanding of the pathophysiology of the disease, first-line sarcoma treatment options are still limited and new treatment approaches are needed. Histone H2AX phosphorylation is a sensitive marker for double strand breaks and has recently emerged as biomarker of DNA damage for new drug development. In this study, we explored the role of H2AX phosphorylation at Ser139 alone or in combination with MAP17 protein, an inducer of DNA damage through ROS increase, as prognostic biomarkers in sarcoma tumors. Next, we proposed doxorubicin and olaparib combination as potential therapeutic strategies against sarcomas displaying high level of both markers. We evaluate retrospectively the levels of pH2AX (Ser139) and MAP17 in a cohort of 69 patients with different sarcoma types and its relationship with clinical and pathological features. We found that the levels of pH2AX and MAP17 were related to clinical features and poor survival. Next, we pursued PARP1 inhibition with olaparib to potentiate the antitumor effect of DNA damaging effect of the DNA damaging agent doxorubicin to achieve an optimal synergy in sarcoma. We demonstrated that the combination of olaparib and doxorubicin was synergistic in vitro, inhibiting cell proliferation and enhancing pH2AX intranuclear accumulation, as a result of DNA damage. The synergism was corroborated in patient-derived xenografts (PDX) where the combination was effective in tumors with high levels of pH2AX and MAP17, suggesting that both biomarkers might potentially identify patients who better benefit from this combined therapy.

Elevated H2AX Phosphorylation Observed with kINPen Plasma Treatment Is Not Caused by ROS-Mediated DNA Damage but Is the Consequence of Apoptosis

Phosphorylated histone 2AX (γH2AX) is a long-standing marker for DNA double-strand breaks (DSBs) from ionizing radiation in the field of radiobiology. This led to the perception of γH2AX being a general marker of direct DNA damage with the treatment of other agents such as low-dose exogenous ROS that unlikely act on cellular DNA directly. Cold physical plasma confers biomedical effects majorly via release of reactive oxygen and nitrogen species (ROS). In vitro, increase of γH2AX has often been observed with plasma treatment, leading to the conclusion that DNA damage is a direct consequence of plasma exposure. However, increase in γH2AX also occurs during apoptosis, which is often observed with plasma treatment as well. Moreover, it must be questioned if plasma-derived ROS can reach into the nucleus and still be reactive enough to damage DNA directly. We investigated γH2AX induction in a lymphocyte cell line upon ROS exposure (plasma, hydrogen peroxide, or hypochlorous acid) or UV-B light. Cytotoxicity and γH2AX induction was abrogated by the use of antioxidants with all types of ROS treatment but not UV radiation. H2AX phosphorylation levels were overall independent of analyzing either all nucleated cells or segmenting γH2AX phosphorylation for each cell cycle phase. SB202190 (p38-MAPK inhibitor) and Z-VAD-FMK (pan-caspase inhibitor) significantly inhibited γH2AX induction upon ROS but not UV treatment. Finally, and despite γH2AX induction, UV but not plasma treatment led to significantly increased micronucleus formation, which is a functional read-out of genotoxic DNA DSBs. We conclude that plasma-mediated and low-ROS γH2AX induction depends on caspase activation and hence is not the cause but consequence of apoptosis induction. Moreover, we could not identify lasting mutagenic effects with plasma treatment despite phosphorylation of H2AX.

DNA repair activation and apoptosis suppression in keratinocytes as a possible mechanism of cytoprotective action of plant polyphenols under conditions of UV-irradiation

The work investigated the responses of cultured human keratinocytes to ultraviolet radiation in the C range (UVC) with and without a number of plant polyphenolic compounds. The experimental data obtained in this work indicate a cytoprotective effect of the PPs added immediately after UVC exposure. The cytoprotective activity of plant polyphenolic compounds was reduced in the series: acacetin, silybin, baikalein, leontopodium acid, quercetin, cyanidine chloride, taxifolin, trans-ferulic acid. The effect of UVC irradiation with and without of acacetin on the process of phosphorylation of histones H2AX, the triggering mechanism for the repair of single-stranded DNA damage, was also investigated in keratinocytes. It has been established that, H2AX phosphorylation is activated in response to UVC radiation and acacetin has a significant effect on the kinetics of this process. It is concluded that the PPs can reduce the destructive effect of UVR on the skin cells, activating the process of repairing genetic damage.

Small Molecule Inhibitors of KDM5 Histone Demethylases Increase Radio-Sensitivity of Breast Cancer Cells Over-Expressing JARID1B

Background: KDM5 enzymes are H3K4 specific histone demethylases involved in transcriptional regulation and DNA repair. These proteins are over-expressed in different kinds of cancer, including breast, prostate and bladder carcinoma, with positive effects on cancer proliferation and chemo-resistance. For these reasons, these enzymes are potential therapeutic cancer targets. Methods: In the present study, we analyzed the effects of three different inhibitors of KDM5 enzymes in MCF-7 breast cancer cells over-expressing JARID1B. In particular we tested H3K4 demethylation (western blot); target gene transcription (RNAseq and real time PCR); radio-sensitivity (citoxicity and clonogenic assays) and damage accumulation (kinetics of H2AX phosphorylation). Results: we show that two compounds with completely different chemical structure can selectively inhibit KDM5 enzymes and that both compounds are capable of increasing sensitivity of breast cancer cells to ionizing radiation and H2AX phosphorylation. Conclusions: These findings confirm the involvement of H3K4 specific demethylases in DNA damage signaling and repair and suggest new strategies for the therapeutic use of their inhibitors.

Super-resolution localization microscopy of radiation-induced histone H2AX-phosphorylation in relation to H3K9-trimethylation in HeLa cells

Ionizing radiation (IR)-induced damage confers functional and conformational changes to nuclear chromatin associated with DNA single and double strand breaks.

Eltrombopag Promotes DNA Repair in Human Hematopoietic Stem and Progenitor Cells: Implications for the Treatment of Fanconi Anemia

Fanconi anemia (FA) is an inherited genomic instability syndrome resulting from loss-of-function mutations in any one of at least 21 FANC genes critical for DNA repair. Accumulation of unresolved DNA double strand breaks (DSBs) results in chromosomal rearrangement, accounting in part for the high incidence of bone marrow failure (BMF) and leukemia in patients with FA. Safe, curative options are currently unavailable. Recent investigations have uncovered a specific function of thrombopoietin (TPO), a key regulator of hematopoietic stem/progenitor cell (HSPC) self-renewal and survival, in promoting DNA damage response in these cells. TPO was shown to specifically increase the efficiency of non-homologous end joining (NHEJ), the predominant repair mechanism for DSBs in HSPCs; however, recombinant TPO is no longer approved for clinical applications. The alternative orally bioavailable small molecule TPO receptor agonist, eltrombopag (epag), was recently used in clinical trials to successfully treat life-threatening cytopenias in patients with acquired BMF. In this study, we investigate whether epag can promote NHEJ DSB repair in human HSPCs and thus provide a potential new therapeutic modality for patients with FA. To assess DNA repair activity of epag in FA CD34+ HSPCs, a population of cells that is markedly reduced in these patients, CD34+ HSPCs from 6 healthy individuals were subjected to CRISPR/Cas9-induced knockout mutations in FANCA, the most commonly mutated gene in FA. These FA HSPCs were cultured for 24 hr in the presence of early-acting cytokines, SCF and Flt3-L (designated "SF"), or SF supplemented with epag ("SFE") or TPO ("SFT") prior to induction of DSBs by exposure to 2Gy γ-irradiation (IR). Cells were then cultured for an additional 1, 5, or 24 hr to assess the kinetics of DNA repair, as measured by decreases in H2AX phosphorylation (γH2AX), an indicator of IR-induced DSBs. Maximal H2AX phosphorylation was observed 1 hr after IR of FA HSPCs and was similar for all culture conditions (>90% γH2AX+ cells), indicating that epag and TPO do not prevent DSB formation or phosphorylation of H2AX. Five hours after IR, most FA HSPCs cultured with epag (Fig. A) or TPO (Fig. B) had resolved the IR-induced DSBs, while much higher percentages of γH2AX+ cells persisted in the control SF group. The observed effect was specific to epag and TPO; removal of SCF had no significant impact on DNA repair. Regardless of culture condition, the majority of FA HSPCs either resolved DSBs or progressed through apoptosis by 24 hr post-IR. These findings indicate that epag and TPO increase the kinetics of DSB repair in FA HSPCs. To gain insight into the primary mechanism of DNA repair promoted by epag and TPO, we inhibited DNA-PK, an essential component of the classical NHEJ (C-NHEJ) pathway. Addition of a DNA-PK inhibitor (NU7441) had no impact on DSB formation measured at 1 hr or on DNA repair at 24 hr, but completely abrogated the enhanced kinetics of DSB repair observed at 5 hr with epag (Fig. A) and TPO (Fig. B). These data indicate that culturing FA HSPCs with epag or TPO promotes the fast-acting DNA-PK-dependent C-NHEJ DNA repair mechanism, a pathway known to promote genomic stability. In contrast, cells cultured without epag or TPO resolved DSBs using a slower, DNA-PK-independent alternative NHEJ (alt-NHEJ) mechanism, a pathway associated with genomic instability. Shunting of DSB repair in rapid C-NHEJ with epag (Fig. C) or TPO (Fig. D) was associated with substantial increase in survival of γ-irradiated FA HSPCs compared with control (SF) groups. In contrast, when C-NHEJ DNA repair was inhibited with NU7441, the cell survival benefit observed with epag (Fig. C) or TPO (Fig. D) was abolished. In colony forming unit (CFU) progenitor assays, γ-irradiated HSPCs cultured with epag or TPO yielded 4- to 6-fold more CFUs than control SF groups (Fig. E). When γ-irradiated HSPCs were transplanted into immunodeficient NSG mice, a 2-fold increase in human cell engraftment was observed in cultures containing epag or TPO compared to controls (p<0.01), suggesting activation of DNA repair activity by these cytokines in cells with long-term repopulating capacity (Fig. F). Overall, our data indicate that epag and TPO enhance DSB repair in human HSPCs by promoting the fast-operating and faithful C-NHEJ pathway. A phase II clinical trial is in development to assess safety and efficacy of epag in the treatment of hematological manifestations of FA. Figure Figure. Disclosures Guenther: Agilent Laboratories: Other: Stipend, Research Funding; Norvartis: Research Funding. Cheruku: Novartis: Other: Stipend, Research Funding. Smith: Novartis: Research Funding; Agilent Laboratories: Research Funding. Larochelle: StemCell Technologies: Patents & Royalties: StemDiff Hematopoietic Kit; Novartis: Research Funding; Novartis: Research Funding.