초록
급성 전골수성 백혈병은 염색체 전위의 결과로 생긴 PML/RAR$({\alpha})$ 융합 단백의 과발현으로 영향을 받은 전골 수세포의 분화 정지로 발생하는 골수성 백혈병의 일종이다. 삼산화 비소는 세포고사를 유발하여 급성전골수성 백혈병의 관해를 유도한다는 것이 밝혀졌으나 이 약제에 대한 감수성이 다양하여 고형암에 적용하기에는 제한점이 있다. All-trans-retinoic acid (ATRA)에 감수성인 NB4 세포주와 내성인 UF-1 세포주 모두에 삼산화 비소가 세포고사를 유도하였다. 백혈병 세포주를 삼산화 비소로 처리하여, 세포내 GSH 농도가 낮아지고 세포고사의 감수성이 높아지는 상관관계를 찾았으며 전골수성 암세포를 수지상 세포 표면 표식자를 가진 세포로 분화시켰다. ATRA에 대한 감수성인 세포주와 내성인 세포주의 삼산화 비소에 대한 반응의 차이를 이해하고, 전골수 세포가 수지상 세포로 분화하는 과정을 규명한다면, 삼산화 비소에 의한 전골수성 백혈병의 완전관해의 기전을 밝힐 수 있고 또한 임상적용을 확대할 수 있을 것이다.
Acute promyelocytic leukemia (APL) is a myeloid leukemia caused by over-expression of fusion protein, PML/RAR$({\alpha})$, which was the result of chromosomal translocation and induces the blockage of differentiation of affected promyelocytes. Pharmacological dose of retinoic acid induces the activation of and subsequent degradation of PML/RAR$({\alpha})$ fusion protein, and then APL cells undergo through the normal differentiation pathway. Arsenic trioxide has proved effective in causing remission of acute promyelocytic leukemia by inducing apoptosis of this tumor cells, whereas the heterogeneity of cellular susceptibility to this cytotoxic agent limited its usage on more types of tumors in clinic. This work showed that arsenic trioxide could induce apoptosis of a panel of acute promyelocytic leukemic cell lines, all-trans-retinoic acid (ATRA) sensitive NB4 cells and ATRA resistant UF-1 cell. They were investigated with regard to the correlation between the inherent or intrinsic cellular level of GSH and the apoptotic susceptibility of the cells to arsenic trioxide. We manifested, in two cell types, the inherently existed difference in intracellular GSH level reactive to the arsenic trioxide, and a positive correlation between the GSH level and their apoptotic sensitivity to arsenic trioxide. And it showed that arsenic trioxide could differentiate promyelocytic cancer cells to the cells possessed of dendritic cell surface markers. Unravelling the cause of the different susceptibility between leukemic cells and proving that promyelocyte could be differentiated to dendritic cells by arsenic trioxide will help not only to understand the mechanism underlying the complete remission of acute promyelocytic leukemia induced by arsenic trioxide, but also to expand its clinical usage.
