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APL:RetinoicAcidandRetinoidPharmacology,aBreakthrough
Today
Zhu G*
The Institute of Oncology,Tehran University of Medical Sciences,Tehran
Volume 1 Issue 1- 2019
Received Date: 23 Apr 2019
Accepted Date: 15 May 2019
Published Date: 22 May 2019
1. Clinical Image
Acute promyelocytic leukemia(APL),a specific characteristic of t(15;17) chromosomal
translocation,molecular gene analyses are conclusive in vivo evidence that oncogenic pml/RARa
fusion plays a crucial role in APL leukemogenesis [1-3]. Since the introduction of initial 13-cis
retinoic acid(13-cis RA)[4],and currently all-trans RA(ATRA) [5] and tamibarotene [6],RA plus
chemotherapy or RA plus As2O3 regimen is currently the standard of care [7]. APL has a very
good prognosis,with long-term survival rates up to near 70%-90%.The elucidation of the molecu-
lar basis of retinoic acid and retinoid pharmacology in APL has been illustrated in several pub-
lications [8-11],the detail molecular model of gene regulation had also been proposed by Zhu in
1990s [12-14]. From the following figure clear shown,oncogenic pml/RARa is a constitutive tran-
scriptional repressor to differentiation block at the promyelocyte stage whereas retinoic acid over-
come the transcriptional repressor activity of pml/RARa,including the dissociation of repressor
complexes N-CoR,SMAT and HDACs from oncogenic pml/RARa. Consequentially,pml/RARa
chimera converted receptor from a repressor to a RA-dependent activator of transcription.This
transcriptional depression occurs at RARE on pml/RARa DNA binding. The resulting pml/RARa
oncoprotein proteolytic degradation occurs through autophagy or the proteasome system(UPS)
or caspase 3 or/and E1-like ubiquitin-activating enzyme(UBE1L) induction. An effect is to relieve
the blockade of pml/RARa-mediated RA dependent promyelocyte differentiation,and induce
promyelocyte maturation. This earliest proposal has now been demonstrated by structure and
functional analysis of oncogenic pml/RARa chimera protein in vitro and in vivo studies [15-27].
This is first described in eukaryotes.
 Moreover,this oncogenic receptor pml/RARa is locked in its “off” regular mode thereby constitu-
tively repressing transcription of genes or key enzymes(for examples AP-1,PTEN,DAPK2,PU.1)
that are critical for differentiation of hematopoietic cells[28-31]. Whether silencing of these RA-
RE-responsive target genes such as myeloid transcription factors such as C/EBPa,PU.1 or other
unknown key enzymes that are really critical for neutrophil differentiation needs to be further
identification and under investigation.
Clinics of Oncology
Citation: Zhu G, APL:Retinoic Acid and Retinoid Pharmacology, a Breakthrough Today Clinics of Oncol-
ogy. 2019; 1(1): 1-3.
clinicsofoncology.com
*Corresponding Author (s): George Zhu, The Institute of Oncology,Tehran University of
Medical Sciences,Tehran, E-mail:sansan4240732@163.com
Clinical Image
ISSN: 2640-1037
Copyright ©2019 Zhu G al This is an open access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and build upon your work non-commercially. 2
Volume 1 Issue 1 -2019 Clinical Image
Reference
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Volume 1 Issue 1 -2019 Clinical Image
clinicsofoncology.com 3

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APL:Retinoic Acid and Retinoid Pharmacology, a Breakthrough Today

  • 1. APL:RetinoicAcidandRetinoidPharmacology,aBreakthrough Today Zhu G* The Institute of Oncology,Tehran University of Medical Sciences,Tehran Volume 1 Issue 1- 2019 Received Date: 23 Apr 2019 Accepted Date: 15 May 2019 Published Date: 22 May 2019 1. Clinical Image Acute promyelocytic leukemia(APL),a specific characteristic of t(15;17) chromosomal translocation,molecular gene analyses are conclusive in vivo evidence that oncogenic pml/RARa fusion plays a crucial role in APL leukemogenesis [1-3]. Since the introduction of initial 13-cis retinoic acid(13-cis RA)[4],and currently all-trans RA(ATRA) [5] and tamibarotene [6],RA plus chemotherapy or RA plus As2O3 regimen is currently the standard of care [7]. APL has a very good prognosis,with long-term survival rates up to near 70%-90%.The elucidation of the molecu- lar basis of retinoic acid and retinoid pharmacology in APL has been illustrated in several pub- lications [8-11],the detail molecular model of gene regulation had also been proposed by Zhu in 1990s [12-14]. From the following figure clear shown,oncogenic pml/RARa is a constitutive tran- scriptional repressor to differentiation block at the promyelocyte stage whereas retinoic acid over- come the transcriptional repressor activity of pml/RARa,including the dissociation of repressor complexes N-CoR,SMAT and HDACs from oncogenic pml/RARa. Consequentially,pml/RARa chimera converted receptor from a repressor to a RA-dependent activator of transcription.This transcriptional depression occurs at RARE on pml/RARa DNA binding. The resulting pml/RARa oncoprotein proteolytic degradation occurs through autophagy or the proteasome system(UPS) or caspase 3 or/and E1-like ubiquitin-activating enzyme(UBE1L) induction. An effect is to relieve the blockade of pml/RARa-mediated RA dependent promyelocyte differentiation,and induce promyelocyte maturation. This earliest proposal has now been demonstrated by structure and functional analysis of oncogenic pml/RARa chimera protein in vitro and in vivo studies [15-27]. This is first described in eukaryotes.  Moreover,this oncogenic receptor pml/RARa is locked in its “off” regular mode thereby constitu- tively repressing transcription of genes or key enzymes(for examples AP-1,PTEN,DAPK2,PU.1) that are critical for differentiation of hematopoietic cells[28-31]. Whether silencing of these RA- RE-responsive target genes such as myeloid transcription factors such as C/EBPa,PU.1 or other unknown key enzymes that are really critical for neutrophil differentiation needs to be further identification and under investigation. Clinics of Oncology Citation: Zhu G, APL:Retinoic Acid and Retinoid Pharmacology, a Breakthrough Today Clinics of Oncol- ogy. 2019; 1(1): 1-3. clinicsofoncology.com *Corresponding Author (s): George Zhu, The Institute of Oncology,Tehran University of Medical Sciences,Tehran, E-mail:sansan4240732@163.com Clinical Image ISSN: 2640-1037
  • 2. Copyright ©2019 Zhu G al This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. 2 Volume 1 Issue 1 -2019 Clinical Image Reference 1. Zhu G. Oncogenic receptor hypothesis (1989-91) VOA (Voice of America).1992; 12:31. 2. Zhu Y. Retinoic acid receptor alpha gene rearrangement as specific marker of acute promyelocytic leukemia and its use in the study of cell differentiation. Zhonghua Yi XueZaZhi. 1992; 72(4);229-33. 3. de The H,Chomienne C,Lanotte M. The t(15;17) translocation of acute promyelocytic leukemia fuses the retinoic acid receptorα gene to a novel transcribed locus. Nature. 1990,;347:558. 4. Flynn TJ, Miller WJ, Weisdorf DJ, Arthur DC, Brunning R, Branda RF. Retinoic acid treatment of acute promyelocytic leukemia: invitro and invivo observation. Blood. 1983; 62:1211-17. 5. Castaigne S, Chomienne C, Daniel MT, Ballerini P, Berger R, Fenaux P, Degos L. All-trans-retinoic acid as a differentiation therapy for acute promyelocytic leukemia. I. clinical results. Blood. 1990; 76:17. 6. Tobita T, Takashita A, Kitamura K. Treatment with a new synthetic ret- inoid, Am80, of acute promyelocytic leukemia relapsed from complete remission induced by all-trans retinoic acid. Blood. 1997; 90(3):967- 973. 7. Tallman MS, Altman JK. How I treat acute promyelocytic leukemia. Blood. 2009; 114(25):5126-35 8. Melnick A, Litcht JD. Deconstructing a disease: RAR, its fusion part- ners, and their roles in the pathogenesis of acute promyelocytic leuke- mia. Blood. 1999; 93(10):3167-3215 9. Marstrand TT, Borup R, Willer A, Borregaad N, Sandelin A, et al. A conceptual framework for the identification of candidate drugs and drug targets in acute promyelocytic leukemia. Leukemia. 2010; 24(7):1265- Figure: Molecular model of the gene regulation of retinoic acid(RA) action(George Zhu,January 1991,revised in 2012 [12], further revised in 2018 [31]) 75 10. Lallemand BV, de THe H. A new oncoprotein catabolism pathway. Blood. 2010; 116:2200-2201. 11. Tomita A, Kiyoi H, Naoe T. Mechanisms of action and resistance to all-trans retinoic acid(ATRA) and arsenic trioxide(As2O3) in acute pro- myelocytic leukemia. Int J Hematol. 2013;97(6):717-725. 12. Zhu G, Mische SE, Seigneres B. Novel treatment of acute promyelo- cytic leukemia: As2O3, retinoic acid and retinoid pharmacology. Curr Pharm Biotechnol.2013;13(9):849-858 13. ZhuG.Discoveryofthemolecularbasisofretinoicacidaction(retinoid signaling) A genetic regulation of eukaryotes in transcription(Abstract). Proceedings of 3nd biotechnology world congress, Dubai, UAE, Febru- ary 10-12,2014;97-98. 14. Zhu G, Saboor-Yaraghi AA, Yarden Y. Targeting oncogenic receptor: From molecular physiology to currently the standard of target therapy. Advance Pharmaceutical Journal. 2017;2(1):10-28. 15. He LZ, Tribioli C, Rivi R, Peruzzi D, Pelicci PG. Acute leukemia with promyelocytic features in pml/RARa transgenic mice. Blood. 1997; 94:5302. 16. He LZ, Guidez F, Tribioli C, Peruzzi D, Pandolfi PP. Distinct inter- actions of PML-RARa and PLZF-RARa with Co-repressors determine differential responses to RA in APL. Nature Genetics. 1998; 18:126-135. 17. Rousselot P, Hardas B, Patel A. The PML-RARa gene products of the t(15;17) translocation inhibits retinoic acid-induced granulocytic differ- entiation and mediated transactivation in human myeloid cells. Onco- gene. 1994; 9(2):545-51. 18. Grignani F, Testa U, Rogaia D. Effects on differentiation by the pro- myelocytic leukemia pml/RAR alpha protein dimerization and RAR al- pha DNA binding domains. EMBO J. 1996;15(18):4949-58. 19. Segalla S, Rinaldi L, Kalstrup-Nielsen C. Retinoic acid receptor al- pha fusion to PML affects its transcriptional and chromatin-remodeling properties. Mol Cell Biol. 2003; 23(23):8795-8808. 20. Jing Y, Xia L, Lu M, Waxman S. The cleavage product delta PML- RARa contributes to all-trans retinoic acid-mediated differentiation in acute promyelocytic leukemia cells. Oncogene. 2003; 22:4083-91. 21. Villa R, Morey L, Raker VA, Burchbeck M, Gutierrez A, et al. The methyl-CpG binding protein MBD is required for PML-RARa fusion. ProcNatlAcadSci USA. 2006; 103(5):1400-05 22. Marinelli A, Bossi D, Pellicci PG, Minucci S. A redundant oncogenic potential of the retinoic acid receptor (RAR) alpha,beta and gamma iso-
  • 3. forms in acute promyelocytic leukemia. Leukemia. 2007; 21:647-50 23. Raelson JV, Nervi C, Rosenauer A, Benedetti L, Monczak Y, et al. The PML/RAR alpha oncoprotein is a direct molecular target of retinoic acid in acute promyelocytic leukemia cells. Blood. 1996;88:2826-32. 24. Yoshida H, Kitamura K, Tanaka K, et al. Accelerated degradation of PML-RARA oncoprotein by ATRA in APL: possible role of the protea- some pathway. Cancer Res. 1996; 56(13):2945-48. 25. Isakson P, Bjoras M,Boe SO, Simonsen A. Autophagy contributes to therapy-induced degradation of the PML/RARA oncoprotein. Blood. 2010; 116:2324-31. 26. Nervi C, Ferrara FF, Fanelli M, Rippo RM, Tomassini B. Caspases mediate retinoic acid-induced degradation of the acute promyelocytic leukemia PML/RARa fusion protein. Blood. 1998;92(7):2244-51. 27. Kitareewan S, Pitha-Rowe I,Sekula D, Lowrey CH, Nemeth MJ. UBE1L is a retinoid target that triggers PML/RAR alpha degradation and apoptosis in acute promyelocytic leukemia. ProcNatlAcadSci USA. 2002; 99(6):3806-11. 28. Doucar V, Brockes JP, Yaniv M, de The H, Dejean A. The PML-reti- noic acid alpha translocation converts the receptor from an inhibitor to a retinoic acid-dependent activator of transcription factor AP-1. Proc- NatlAcadSci USA. 1993; 90:9345-9. 29. Humbert M, Federzoni EA, Britschgi A. The tumor suppressor gene DAPK2 is induced by the myeloid transcript factors PU.1 and C/EBPa during granulocytic differentiation but repressed by PML-RARa in APL. J Leuk Biol. 2014; 95:83-93. 30. Noguera NI, Piredda ML, Taulli R, Catalano G, Angelini G. PML/ RARa inhibits PTEN expression in hematopoietic cells by competing with PU.1 transcriptional activity. Oncotarget. 2016;7(41):66386-397. 31. Zhu G, Ahmed Al-kaf AG. Vitamin A, retinoic acid and tamibaro- tene, a front toward its advances: a review. Universal Journal of Pharma- ceutical Research. 2018; 3(6): 38-48. Volume 1 Issue 1 -2019 Clinical Image clinicsofoncology.com 3