Abstract
B cell chronic lymphocytic leukemia (B-CLL) is an incurable clonal disease which shows initial responsiveness to a number of chemotherapeutic drugs. However, in most patients the disease becomes resistant to treatment. Rolipram, a specific inhibitor of phosphodiesterase (PDE) type 4, the PDE predominantly expressed in B-CLL cells, has been shown to induce cAMP-dependent apoptosis in these cells. In the present study, we demonstrate that the extent of rolipram-induced apoptosis is similar to fludarabine-induced apoptosis in vitro. The combination of rolipram and fludarabine results in an enhancement in the number of apoptotic cells compared to apoptosis induced by either agent alone. Second, rolipram suppresses the expression of anti-apoptotic members of the Bcl-2 family and induces the pro-apoptotic protein Bax, thereby shifting the balance between pro- and anti-apoptotic members of the Bcl-2 family towards a pro-apoptotic direction. Finally rolipram-induced apoptosis is caspase-dependent. PDE 4 inhibitors are currently under investigation for chronic obstructive pulmonary disease and asthma in phase III clinical trials showing promising results with tolerable side-effects. In conclusion, by inducing apoptosis, by enhancing apoptosis induced by fludarabine, by suppressing Bcl-2, Bcl-X and by inducing Bax expression, PDE 4 inhibitors may add a new therapeutic option for patients with B-CLL.
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Acknowledgements
We thank Rosemarie Kiefl for excellent technical assistance, Dr Wachtel (Schering AG, Berlin) for making available rolipram and Dr Uta Emmerich for completed investigations that laid the ground for the present study. The experimental data of this study are part of the dissertation of cand. med. Julia Welsch (Medizinische Klinik Innenstadt, Klinikum of the Ludwig-Maximilians-University, Munich, in preparation). These studies were supported by a Novartis Stiftung für Therapeutische Forschung and by a grant from the Deutsche Forschungsgemeinschaft DFG SI 749/2–1 (to BS).
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Siegmund, B., Welsch, J., Loher, F. et al. Phosphodiesterase type 4 inhibitor suppresses expression of anti-apoptotic members of the Bcl-2 family in B-CLL cells and induces caspase-dependent apoptosis. Leukemia 15, 1564–1571 (2001). https://doi.org/10.1038/sj.leu.2402232
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DOI: https://doi.org/10.1038/sj.leu.2402232
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