HIF-1a of bone marrow endothelial cells implies relapse and drug resistance in patients with multiple myeloma and may act as a therapeutic target

Roberto Ria, Ivana Catacchio, Simona Berardi, Annunziata De Luisi, Antonella Caivano, Claudia Piccoli, Vitalba Ruggieri, Maria Antonia Frassanito, Domenico Ribatti, Beatrice Nico, Tiziana Annese, Simona Ruggieri, Attilio Guarini, Carla Minoia, Paolo Ditonno, Emanuele Angelucci, Daniele Derudas, Michele Moschetta, Franco Dammacco, Angelo Vacca

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate the role of hypoxia-inducible factor-1a (HIF-1a) in angiogenesis and drug resistance of bone marrow endothelial cells of patients with multiple myeloma. Experimental Design: HIF-1a mRNA and protein were evaluated in patients with multiple myeloma endothelial cells (MMEC) at diagnosis, at relapse after bortezomib- or lenalidomide-based therapies or on refractory phase to these drugs, at remission; in endothelial cells of patients with monoclonal gammapathies of undetermined significance (MGUS; MGECs), and of those with benign anemia (controls). The effects of HIF-1a inhibition by siRNA or panobinostat (an indirect HIF-1a inhibitor) on the expression of HIF-1a proangiogenic targets, on MMEC angiogenic activities in vitro and in vivo, and on overcoming MMEC resistance to bortezomib and lenalidomide were studied. The overall survival of the patients was also observed. Results: Compared with the other endothelial cell types, only MMECs from 45% of relapsed/refractory patients showed a normoxic HIF-1a protein stabilization and activation that were induced by reactive oxygen species (ROS). The HIF-1a protein correlated with the expression of its proangiogenic targets. The HIF-1a inhibition by either siRNA or panobinostat impaired the MMECs angiogenesis-related functions both in vitro and in vivo and restored MMEC sensitivity to bortezomib and lenalidomide. Patients with MMECs expressing the HIF-1a protein had shorter overall survival. Conclusions: The HIF-1a protein in MMECs may induce angiogenesis and resistance to bortezomib and lenalidomide and may be a plausible target for the antiangiogenic management of patients with well-defined relapsed/ refractorymultiplemyeloma. Itmay also have prognostic significance.

Original languageEnglish
Pages (from-to)847-858
Number of pages12
JournalClinical Cancer Research
Volume20
Issue number4
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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