IMR Press / FBL / Volume 28 / Issue 9 / DOI: 10.31083/j.fbl2809195
Open Access Original Research
Oridonin Synergistically Enhances the Pro-Apoptotic Effect of Venetoclax on Acute Myeloid Leukemia Cells by Inhibiting AKT Signaling
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1 Hematology Department, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 450008 Zhengzhou, Henan, China
2 Central Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 450008 Zhengzhou, Henan, China
*Correspondence: xudongwei@zzu.edu.cn (Xudong Wei)
Front. Biosci. (Landmark Ed) 2023, 28(9), 195; https://doi.org/10.31083/j.fbl2809195
Submitted: 31 March 2023 | Revised: 26 June 2023 | Accepted: 7 July 2023 | Published: 6 September 2023
(This article belongs to the Special Issue Apoptosis in Cancer)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Acute myeloid leukemia (AML) is a recurrence-prone hematologic malignancy. The advent of molecularly targeted therapies provides new opportunities to enhance the effectiveness of AML treatments. Venetoclax, a selective inhibitor of the anti-apoptotic protein Bcl-2, has shown promising results; however, resistance often arises due to elevated expression of the Mcl-1 protein, among other factors. Overcoming this resistance to improve therapeutic outcomes is a pressing issue that requires further investigation. Studies have demonstrated that oridonin, by inhibiting AKT signaling that regulates Mcl-1 expression, can effectively suppress tumor cell growth. This study aims to investigate whether oridonin can synergistically enhance the anti-leukemic effects of venetoclax and explore the underlying mechanisms behind this effect. Methods: In vitro experiments were performed to evaluate the effects of the combination of oridonin and venetoclax on AML cell proliferation, apoptosis, cell cycle distribution, and mitochondrial membrane potential. Transcriptome sequencing was used to elucidate the molecular mechanisms underlying the synergistic induction of AML cell apoptosis by the combination therapy. Western blotting and reverse transcription quantitative polymerase chain reaction (RT-qPCR) techniques were used to validate the findings. Additionally, an AML mouse model was established to observe the synergistic anti-AML effects of venetoclax combined with oridonin in vivo. Results: Both venetoclax and oridonin individually exhibited inhibitory effects on AML cell proliferation, resulted in cell cycle arrest, and induced cell apoptosis. Moreover, combination of the two drugs resulted in a synergistic effect. We also observed that oridonin inhibited AKT phosphorylation, upregulated the expression of Bim and Bax proteins, facilitated Mcl-1 degradation, and enhanced the apoptotic effects of venetoclax in AML cells. Finally, in vivo experiments demonstrated that the combination of oridonin and venetoclax effectively inhibited the growth of AML xenograft tumors in mice and prolonged the survival time of tumor-bearing mice. Conclusions: Oridonin and venetoclax synergistically promote AML cell apoptosis by inhibiting AKT signaling.

Keywords
oridonin
venetoclax
AKT signaling pathway
acute myeloid leukemia (AML)
apoptosis
Funding
SBGJ202003012/Henan Medical Science and Technology Research Project
LHGJ20210185/Henan Medical Science and Technology Research Project
Figures
Fig. 1.
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