ATRA resolves the differentiation block in t(15;17) acute myeloid leukemia by restoring PU.1 expression
Open accessAbstract
Tightly regulated expression of the transcription factor PU.1 is crucial for normal hematopoiesis. PU.1 knockdown mice develop acute myeloid leukemia (AML), and PU.1 mutations have been observed in some populations of patients with AML. Here we found that conditional expression of promyelocytic leukemia-retinoic acid receptor alpha (PML-RARA), the protein encoded by the t(15;17) translocation found in acute promyelocytic leukemia (APL), suppressed PU.1 expression, while treatment of APL cell lines and primary cells with all-trans retinoic acid (ATRA) restored PU.1 expression and induced neutrophil differentiation. ATRA-induced activation was mediated by a region in the PU.1 promoter to which CEBPB and OCT-1 binding were induced. Finally, conditional expression of PU.1 in human APL cells was sufficient to trigger neutrophil differentiation, whereas reduction of PU.1 by small interfering RNA (siRNA) blocked ATRA-induced neutrophil differentiation. This is the first report to show that PU.1 is suppressed in acute promyelocytic leukemia, and that ATRA restores PU.1 expression in cells harboring t(15;17).
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ATRA restores myeloid differentiation by resolving PU.1 expression in AML.
“all-trans retinoic acid (ATRA) restores myeloid differentiation by resolving PU.1 expression in AML (31)”
From FBW7 Inhibits Myeloid Differentiation in Acute Myeloid Leukemia via GSK3-Dependent Ubiquitination of PU.1 (2021) · cites this paper as [31]
The Introduction and Discussion report that ATRA restores PU.1 expression and induces myeloid differentiation in PML-RARA-positive, t(15;17) acute promyelocytic leukemia cells. The claim extends that finding to AML generally, which the paper does not establish. (LLM, conf=0.88)
Experimental — accuracy not yet measuredModerate PU.1 inhibition is common in AML patients.
“yet moderate PU.1 inhibition is common in AML patients”
From Minimal PU.1 reduction induces a preleukemic state and promotes development of acute myeloid leukemia (2015) · cites this paper as [18]
The Results (page not available) report that the t(15;17) APL subgroup had approximately half the PU.1 RNA of AML-M2 and AML-M4 patients, although the difference was not statistically significant. The Discussion describes PU.1 suppression in APL, but the paper does not establish that moderate inhibition is common across AML patients. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSeveral AML-typic mutations, such as NPM1c, FLT3-ITD/TDK, or AML1-ETO, moderately compromise the regulation or function of PU.1.
“Several AML-typic mutations, such as NPM1c, FLT3-ITD/TDK, or AML1-ETO, moderately compromise the regulation or function of PU.1 (19–22)”
From PU.1-Dependent Enhancer Inhibition Separates <i>Tet2</i> -Deficient Hematopoiesis from Malignant Transformation (2022) · cites this paper as [22]
The Discussion (page unavailable) reports that the AML-associated PML-RARA fusion suppresses PU.1, supporting the general point that an AML-associated genetic alteration can affect PU.1. The paper does not address NPM1c, FLT3-ITD/TDK, or AML1-ETO, or establish that those mutations moderately compromise PU.1 regulation or function. (LLM, conf=0.82)
Experimental — accuracy not yet measuredDespite moderately reduced PU.1 mRNA levels, its broader transcriptional network appears intact.
“Despite moderately reduced PU.1 mRNA levels, its broader transcriptional network appears intact, in line with the essentiality of the transcription factor in maintaining normal and malignant hematopoiesis (20, 22, 23, 46, 48).”
From PU.1-Dependent Enhancer Inhibition Separates <i>Tet2</i> -Deficient Hematopoiesis from Malignant Transformation (2022) · cites this paper as [22]
The Results report approximately half as much PU.1 RNA in t(15;17) AML samples as in AML-M2 and AML-M4 samples, although the difference was not statistically significant. The Discussion describes PU.1 as crucial to normal myeloid development and implicated in leukemia. The paper does not show that the broader PU.1 transcriptional network remains intact; its Results instead report loss of binding activity at a PU.1 target site in one APL cell line. Page numbers were not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPU.1 is inhibited in most patients with AML through various molecular pathways.
“PU.1 is also inhibited in most patients with AML through various molecular pathways (19, 20, 22, 46, 47).”
From PU.1-Dependent Enhancer Inhibition Separates <i>Tet2</i> -Deficient Hematopoiesis from Malignant Transformation (2022) · cites this paper as [22]
The Discussion reports PU.1 suppression in acute promyelocytic leukemia (APL) and mentions PU.1 mutations in patients with other AML subtypes. It does not establish that PU.1 is inhibited in most patients with AML; the Results found a nonsignificant difference in PU.1 RNA between the t(15;17) group and two other AML groups. (LLM, conf=0.87)
Experimental — accuracy not yet measured
ATRA restores PU.1 expression in AMLs bearing t(15;17).
“Moreover, because ATRA also restores PU.1 expression in AMLs bearing t(15;17) (31), we hypothesized that GSK3b negatively regulated PU.1 levels leading to AML”
From FBW7 Inhibits Myeloid Differentiation in Acute Myeloid Leukemia via GSK3-Dependent Ubiquitination of PU.1 (2021) · cites this paper as [31]
A wide array of myeloid leukemia-associated oncogenic lesions can interfere with PU.1 expression or function, including PML/RARA, AML1-ETO, NPM1c, CEBPA, and mitogenic kinase mutations in BCR/ABL and Flt3ITD.
“a wide array of myeloid leukemia–associated oncogenic lesions can interfere with PU.1 expression or function, including PML/RARA, AML1-ETO, NPM1c, CEBPA, and mitogenic kinase mutations in BCR/ABL and Flt3ITD (Gerloff et al., 2015; McKenzie et al., 2019; Mueller et al., 2006; Noguera et al., 2016; Vangala et al., 2003; Yang et al., 2012).”
From PU.1 enforces quiescence and limits hematopoietic stem cell expansion during inflammatory stress (2021) · cites this paper as Mueller et al., 2006
In acute promyelocytic leukaemia, the PML-RAR-α fusion protein lowers PU.1 expression.
“Likewise, the expression of the PML-RAR-α fusion protein in acute promyelocytic leukaemia (APL) reduces PU.1 expression [122].”
From PU.1 and partners: regulation of haematopoietic stem cell fate in normal and malignant haematopoiesis (2009) · cites this paper as [122]
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- Authors
- Mueller, B. U., Pabst, T., Fos, J., Petkovic, V., Fey, M. F., Asou, N., Buergi, U., & Tenen, D. G.
- Affiliations
- Harvard University (US)
- From the Department of Internal Medicine and the Department of Clinical Research, University Hospital, Bern, Switzerland; the Institute of Medical Oncology, University Hospital, Bern, Switzerland; Kumamoto University Hospital, Kumamoto, Japan; and Harvard Institutes of Medicine, Harvard Medical School, Boston, MA.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2006-04-15
- Volume
- 107
- Issue
- 8
- Pages
- 3330-3338
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC1895760
- OpenAlex
- W2135132221
- Cited by
- 207
- References
- 33
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 2 · 2023: 10 · 2022: 7 · 2021: 6 · 2020: 14 · 2019: 13 · 2018: 6 · 2017: 9 · 2016: 14 · 2015: 11 · 2014: 11 · 2013: 12 · 2012: 9
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion)
- Funders
- National Cancer Institute (CA 41456, #CA66996, R01CA041456, P01CA066996)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Genomics and Chromatin Dynamics
- Keywords
- PU.1, acute promyelocytic leukemia, PML-RARA fusion, all-trans retinoic acid, granulocytic differentiation, differentiation block, CEBPB, Oct-1, transcriptional regulation, hematopoiesis
- MeSH terms
- Proto-Oncogene Protein Spi-1, Animals, Antineoplastic Agents, Cell Differentiation, Chromosomes, Human, Pair 15, Chromosomes, Human, Pair 17, Humans, Neoplasm Proteins, Neutrophils, Proto-Oncogene Proteins, Translocation, Genetic, Tretinoin, Leukemia, Myeloid, Acute, Oncogene Proteins, Fusion, Trans-Activators, Gene Expression Regulation, Leukemic, Mice, Knockout, Cell Line, Tumor, Octamer Transcription Factor-1, Mice
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