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Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias

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A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Oncology".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 26469

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Special Issue Editors

Dr. Ana Cristina Gonçalves

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Faculty of Medicine, Laboratory of Oncobiology and Hematology, Institute for Clinical and Biomedical Research (iCBR)—Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, 3000-548 Coimbra, Portugal
Interests: hematologic diseases; oncobiology; oncogenetics/epigenetics; nutrition; drug resistance; DNA damage repair; cancer metabolism; targeted therapies; translational research; personalized oncology
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ana Bela Sarmento Ribeiro

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Faculty of Medicine, Laboratory of Oncobiology and Hematology, Institute for Clinical and Biomedical Research (iCBR) – Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, 3000-548 Coimbra, Portugal
Interests: hematology; oncobiology; cellular and molecular mechanism of cancer; drug resistance; biomarkers; targeted therapies; translational research; personalized oncology
Special Issues, Collections and Topics in MDPI journals

Dr. Raquel Alves

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Faculty of Medicine, Laboratory of Oncobiology and Hematology, Institute for Clinical and Biomedical Research (iCBR) – Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, 3000-548 Coimbra, Portugal
Interests: oncobiology; drug resistance; hematology; microRNAs; targeted therapies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hematologic neoplasias are a broad category of cancers of the hematopoietic system, including leukemias, lymphomas, multiple myeloma, myeloproliferative neoplasias, and myelodysplastic syndromes. Among the new cancer cases estimated to be diagnosed in the US in 2021, about 10% are expected to be leukemias, lymphomas, and myelomas, with leukemia in the top 10 of more lethal cancers worldwide.

The advances in molecular oncology provide new knowledge in the mechanisms of carcinogenesis, the genomic and proteomic landscape of cancer, cancer metabolism, immune evasion, drug resistance, and relapse, among others. This information also helps to identify new molecular drug targets and biomarkers for diagnosis, prognosis, patient monitoring, and therapy response, which could be applied in clinical settings. In the last decades, targeted therapies and cancer biomarkers have significantly improved patients' survival and quality of life with hematological and solid neoplasias. Cancer biomarkers comprise several biological molecules such as proteins, nucleic acids, and metabolites and have several biological sources like plasma, circulating tumor cells, extracellular vesicles, tumor-educated platelets, etc.

This Special Issue aims to publish current research related to the discovery of novel biomarkers and molecular drug targets in hematological malignancies. Original research articles and review articles covering these knowledge fields are strongly invited, including: genetic and epigenetic alterations; cellular and molecular mechanisms; genomic, proteomic, and metabolic profiles; biomarkers of diagnosis, prognosis, monitoring, and therapy response; risk factors; and preclinical studies.

Prof. Dr. Ana Cristina Gonçalves
Prof. Dr. Ana Bela Sarmento Ribeiro
Dr. Raquel Alves
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. There is an Article Processing Charge (APC) for publication in this open access journal. For details about the APC please see here. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

leukemia
lymphoma
multiple myeloma
myeloproliferative neoplasias
myelodysplastic syndromes biomarkers
liquid biopsies
molecular targets
new targeted therapies
risk-factors
molecular mechanisms
screening
tumor biology

Published Papers (11 papers)

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Research

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15 pages, 4354 KiB

Open AccessArticle

Identification of NRF2 Activation as a Prognostic Biomarker in T-Cell Acute Lymphoblastic Leukaemia

by María Villa-Morales, Laura Pérez-Gómez, Eduardo Pérez-Gómez, Pilar López-Nieva, Pablo Fernández-Navarro and Javier Santos

Int. J. Mol. Sci. 2023, 24(12), 10350; https://doi.org/10.3390/ijms241210350 - 19 Jun 2023

Viewed by 1170

Abstract

The standard-of-care treatment of T-cell acute lymphoblastic leukaemia (T-ALL) with chemotherapy usually achieves reasonable rates of initial complete response. However, patients who relapse or do not respond to conventional therapy show dismal outcomes, with cure rates below 10% and limited therapeutic options. To ameliorate the clinical management of these patients, it is urgent to identify biomarkers able to predict their outcomes. In this work, we investigate whether NRF2 activation constitutes a biomarker with prognostic value in T-ALL. Using transcriptomic, genomic, and clinical data, we found that T-ALL patients with high NFE2L2 levels had shorter overall survival. Our results demonstrate that the PI3K-AKT-mTOR pathway is involved in the oncogenic signalling induced by NRF2 in T-ALL. Furthermore, T-ALL patients with high NFE2L2 levels displayed genetic programs of drug resistance that may be provided by NRF2-induced biosynthesis of glutathione. Altogether, our results indicate that high levels of NFE2L2 may be a predictive biomarker of poor treatment response in T-ALL patients, which would explain the poor prognosis associated with these patients. This enhanced understanding of NRF2 biology in T-ALL may allow a more refined stratification of patients and the proposal of targeted therapies, with the ultimate goal of improving the outcome of relapsed/refractory T-ALL patients. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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15 pages, 2854 KiB

Open AccessArticle

Parthenolide Induces ROS-Mediated Apoptosis in Lymphoid Malignancies

by Joana Jorge, Joana Neves, Raquel Alves, Catarina Geraldes, Ana Cristina Gonçalves and Ana Bela Sarmento-Ribeiro

Int. J. Mol. Sci. 2023, 24(11), 9167; https://doi.org/10.3390/ijms24119167 - 23 May 2023

Cited by 6 | Viewed by 1667

Abstract

Lymphoid malignancies are a group of highly heterogeneous diseases frequently associated with constitutive activation of the nuclear factor kappa B (NF-κB) signaling pathway. Parthenolide is a natural compound used to treat migraines and arthritis and found to act as a potent NF-κB signaling inhibitor. This study evaluated in vitro parthenolide efficacy in lymphoid neoplasms. We assessed parthenolide metabolic activity in NCI-H929 (MM), Farage (GCB-DLBCL), Raji (BL), 697 and KOPN-8 (B-ALL), and CEM and MOLT-4 (T-ALL), by resazurin assay. Cell death, cell cycle, mitochondrial membrane potential (ΔΨ_mit), reactive oxygen species (ROS) and reduced glutathione (GSH) levels, activated caspase-3, FAS-ligand, and phosphorylated NF-κB p65 were evaluated using flow cytometry. CMYC, TP53, GPX1, and TXRND1 expression levels were assessed using qPCR. Our results showed that parthenolide promoted a metabolic activity decrease in all cell lines in a time-, dose-, and cell-line-dependent manner. The mechanism induced by parthenolide was demonstrated to be cell line dependent. Nonetheless, parthenolide promoted cell death by apoptosis with significant ROS increase (peroxides and superoxide anion) and GSH decrease combined with a ΔΨ_mit reduction across all studied cell lines. Despite the need to further understand parthenolide mechanisms, parthenolide should be considered as a possible new therapeutic approach for B- and T-lymphoid malignancies. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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22 pages, 2918 KiB

Open AccessArticle

Detection of Measurable Residual Disease Biomarkers in Extracellular Vesicles from Liquid Biopsies of Multiple Myeloma Patients—A Proof of Concept

by Rui Bergantim, Sara Peixoto da Silva, Bárbara Polónia, Mélanie A. G. Barbosa, André Albergaria, Jorge Lima, Hugo R. Caires, José E. Guimarães and M. Helena Vasconcelos

Int. J. Mol. Sci. 2022, 23(22), 13686; https://doi.org/10.3390/ijms232213686 - 08 Nov 2022

Cited by 3 | Viewed by 1573

Abstract

Monitoring measurable residual disease (MRD) is crucial to assess treatment response in Multiple Myeloma (MM). Detection of MRD in peripheral blood (PB) by exploring Extracellular Vesicles (EVs), and their cargo, would allow frequent and minimally invasive monitoring of MM. This work aims to detect biomarkers of MRD in EVs isolated from MM patient samples at diagnosis and remission and compare the MRD-associated content between BM and PB EVs. EVs were isolated by size-exclusion chromatography, concentrated by ultrafiltration, and characterized according to their size and concentration, morphology, protein concentration, and the presence of EV-associated protein markers. EVs from healthy blood donors were used as controls. It was possible to isolate EVs from PB and BM carrying MM markers. Diagnostic samples had different levels of MM markers between PB and BM paired samples, but no differences between PB and BM were found at remission. EVs concentration was lower in the PB of healthy controls than of patients, and MM markers were mostly not detected in EVs from controls. This study pinpoints the potential of PB EVs from MM remission patients as a source of MM biomarkers and as a non-invasive approach for monitoring MRD. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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20 pages, 7262 KiB

Open AccessArticle

Alpha-Ketoglutarate or 5-HMF: Single Compounds Effectively Eliminate Leukemia Cells via Caspase-3 Apoptosis and Antioxidative Pathways

by Joachim Greilberger, Ralf Herwig, Mehtap Kacar, Naime Brajshori, Georg Feigl, Philipp Stiegler and Reinhold Wintersteiger

Int. J. Mol. Sci. 2022, 23(16), 9034; https://doi.org/10.3390/ijms23169034 - 12 Aug 2022

Viewed by 2138

Abstract

Background: We recently showed that a combined solution containing alpha-ketoglutarate (aKG) and 5-hydroxymethyl-furfural (5-HMF) has a solid antitumoral effect on the Jurkat cell line due to the fact of its antioxidative, caspase-3 and apoptosis activities, but no negative effect on human fibroblasts was obtained. The question arises how the single compounds, aKG and 5-HMF, affect peroxynitrite (ONOO⁻) and nitration of tyrosine residues, Jurkat cell proliferation and caspase-activated apoptosis. Methods: The ONOO⁻ luminol-induced chemiluminescence reaction was used to measure the ONOO⁻ scavenging function of aKG or 5-HMF, and their protection against nitration of tyrosine residues on bovine serum albumin was estimated with the ELISA technique. The Jurkat cell line was cultivated in the absence or presence of aKG or 5-HMF solutions between 0 and 3.5 µM aKG or 0 and 4 µM 5-HMF. Jurkat cells were tested for cell proliferation, mitochondrial activity and caspase-activated apoptosis. Results: aKG showed a concentration-dependent reduction in ONOO⁻, resulting in a 90% elimination of ONOO⁻ using 200 mM aKG. In addition, 20 and 200 mM 5-HMF were able to reduce ONOO⁻ only by 20%, while lower concentrations of 5-HMF remained stable in the presence of ONOO⁻. Nitration of tyrosine residues was inhibited 4 fold more effectively with 5-HMF compared to aKG measuring the IC50%. Both substances, aKG and 5-HMF, were shown to cause a reduction in Jurkat cell growth that was dependent on the dose and incubation time. The aKG effectively reduced Jurkat cell growth down to 50% after 48 and 72 h of incubation using the highest concentration of 3.5 µM, and 1, 1.6, 2, 3 and 4 µM 5-HMF inhibited any cell growth within (i) 24 h; 1.6, 2, 3 and 4 µM 5-HMF within 48 h (ii); 2, 3 and 4 µM 5-HMF within 72 h (iii). Furthermore, 4 µM was able to eliminate the starting cell number of 20,000 cells after 48 and 72 h down to 11,233 cells. The mitochondrial activity measurements supported the data on aKG or 5-HMF regarding cell growth in Jurkat cells, in both a dose- and incubation-time-dependent manner: the highest concentration of 3.5 µM aKG reduced the mitochondrial activity over 24 h (67.7%), 48 h (57.9%) and 72 h (46.8%) of incubation with Jurkat cells compared to the control incubation without aKG (100%). 5-HMF was more effective compared to aKG; the mitochondrial activity in the presence of 4 µM 5-HMF decreased after 24 h down to 68.4%, after 48 h to 42.9% and after 72 h to 32.0%. Moreover, 1.7 and 3.4 µM aKG had no effect on caspase-3-activated apoptosis (0.58% and 0.56%) in the Jurkat cell line. However, 2 and 4 µM 5-HMF increased the caspase-3-activated apoptosis up to 22.1% and 42.5% compared to the control (2.9%). A combined solution of 1.7 µM aKG + 0.7 µM 5-HMF showed a higher caspase-3-activated apoptosis (15.7%) compared to 1.7 µM aKG or 2 µM 5-HMF alone. In addition, 3.5 µM µg/mL aKG + 1.7 µM 5-HMF induced caspase-activated apoptosis up to 55.6% compared to 4.5% or 35.6% caspase-3 activity using 3.5 µM aKG or 4 µM 5-HMF. Conclusion: Both substances showed high antioxidative potential in eliminating either peroxynitrite or nitration of tyrosine residues, which results in a better inhibition of cell growth and mitochondrial activity of 5-HMF compared to aKG. However, caspase-3-activated apoptosis measurements revealed that the combination of both substances synergistically is the most effective compared to single compounds. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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Review

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21 pages, 1451 KiB

Open AccessReview

Treatment Refractoriness in Chronic Lymphocytic Leukemia: Old and New Molecular Biomarkers

by Nawar Maher, Samir Mouhssine, Bassam Francis Matti, Alaa Fadhil Alwan and Gianluca Gaidano

Int. J. Mol. Sci. 2023, 24(12), 10374; https://doi.org/10.3390/ijms241210374 - 20 Jun 2023

Cited by 6 | Viewed by 2141

Abstract

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. Despite its indolent clinical course, therapy refractoriness and disease progression still represent an unmet clinical need. Before the advent of pathway inhibitors, chemoimmunotherapy (CIT) was the commonest option for CLL treatment and is still widely used in areas with limited access to pathway inhibitors. Several biomarkers of refractoriness to CIT have been highlighted, including the unmutated status of immunoglobulin heavy chain variable genes and genetic lesions of TP53, BIRC3 and NOTCH1. In order to overcome resistance to CIT, targeted pathway inhibitors have become the standard of care for the treatment of CLL, with practice-changing results obtained through the inhibitors of Bruton tyrosine kinase (BTK) and BCL2. However, several acquired genetic lesions causing resistance to covalent and noncovalent BTK inhibitors have been reported, including point mutations of both BTK (e.g., C481S and L528W) and PLCG2 (e.g., R665W). Multiple mechanisms are involved in resistance to the BCL2 inhibitor venetoclax, including point mutations that impair drug binding, the upregulation of BCL2-related anti-apoptotic family members, and microenvironmental alterations. Recently, immune checkpoint inhibitors and CAR-T cells have been tested for CLL treatment, obtaining conflicting results. Potential refractoriness biomarkers to immunotherapy were identified, including abnormal levels of circulating IL-10 and IL-6 and the reduced presence of CD27⁺CD45RO⁻ CD8⁺ T cells. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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13 pages, 1603 KiB

Open AccessReview

DIS3: The Enigmatic Gene in Multiple Myeloma

by Yasuyo Ohguchi and Hiroto Ohguchi

Int. J. Mol. Sci. 2023, 24(4), 4079; https://doi.org/10.3390/ijms24044079 - 17 Feb 2023

Cited by 3 | Viewed by 2292

Abstract

Recent studies have revealed the genetic aberrations involved in the initiation and progression of various cancers, including multiple myeloma (MM), via next-generation sequencing analysis. Notably, DIS3 mutations have been identified in approximately 10% of patients with MM. Moreover, deletions of the long arm of chromosome 13, that includes DIS3, are present in approximately 40% of patients with MM. Regardless of the high incidence of DIS3 mutations and deletions, their contribution to the pathogenesis of MM has not yet been determined. Herein, we summarize the molecular and physiological functions of DIS3, focusing on hematopoiesis, and discuss the characteristics and potential roles of DIS3 mutations in MM. Recent findings highlight the essential roles of DIS3 in RNA homeostasis and normal hematopoiesis and suggest that the reduced activity of DIS3 may be involved in myelomagenesis by increasing genome instability. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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27 pages, 2514 KiB

Open AccessReview

Autophagy and Apoptosis: Current Challenges of Treatment and Drug Resistance in Multiple Myeloma

by Omar S. Al-Odat, Daniel A. Guirguis, Nicole K. Schmalbach, Gabriella Yao, Tulin Budak-Alpdogan, Subash C. Jonnalagadda and Manoj K. Pandey

Int. J. Mol. Sci. 2023, 24(1), 644; https://doi.org/10.3390/ijms24010644 - 30 Dec 2022

Cited by 8 | Viewed by 2581

Abstract

Over the past two decades, the natural history of multiple myeloma (MM) has evolved dramatically, owing primarily to novel agents targeting MM in the bone marrow microenvironment (BMM) pathways. However, the mechanisms of resistance acquisition remain a mystery and are poorly understood. Autophagy and apoptosis are tightly controlled processes and play a critical role in the cell growth, development, and survival of MM. Genetic instability and abnormalities are two hallmarks of MM. During MM progression, plasma malignant cells become genetically unstable and activate various signaling pathways, resulting in the overexpression of abnormal proteins that disrupt autophagy and apoptosis biological processes. Thus, achieving a better understanding of the autophagy and apoptosis processes and the proteins that crosslinked both pathways, could provide new insights for the MM treatment and improve the development of novel therapeutic strategies to overcome resistance. This review presents a sufficient overview of the roles of autophagy and apoptosis and how they crosslink and control MM progression and drug resistance. Potential combination targeting of both pathways for improving outcomes in MM patients also has been addressed. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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16 pages, 1898 KiB

Open AccessReview

LAIR1, an ITIM-Containing Receptor Involved in Immune Disorders and in Hematological Neoplasms

by François Van Laethem, Lucie Donaty, Emmanuelle Tchernonog, Vanessa Lacheretz-Szablewski, Jennifer Russello, Delphine Buthiau, Marion Almeras, Jérôme Moreaux and Caroline Bret

Int. J. Mol. Sci. 2022, 23(24), 16136; https://doi.org/10.3390/ijms232416136 - 17 Dec 2022

Cited by 6 | Viewed by 2715

Abstract

Leukocyte-associated immunoglobulin (Ig)-like receptor 1 (LAIR1, CD305) belongs to the family of immune-inhibitory receptors and is widely expressed on hematopoietic mature cells, particularly on immune cells. Four different types of ligands of LAIR1 have been described, including collagens, suggesting a potential immune-regulatory function on the extracellular matrix. By modulating cytokine secretion and cellular functions, LAIR1 displays distinct patterns of expression among NK cell and T/B lymphocyte subsets during their differentiation and cellular activation and plays a major negative immunoregulatory role. Beyond its implications in physiology, the activity of LAIR1 can be inappropriately involved in various autoimmune or inflammatory disorders and has been implicated in cancer physiopathology, including hematological neoplasms. Its action as an inhibitory receptor can result in the dysregulation of immune cellular responses and in immune escape within the tumor microenvironment. Furthermore, when expressed by tumor cells, LAIR1 can modulate their proliferation or invasion properties, with contradictory pro- or anti-tumoral effects depending on tumor type. In this review, we will focus on its role in normal physiological conditions, as well as during pathological situations, including hematological malignancies. We will also discuss potential therapeutic strategies targeting LAIR1 for the treatment of various autoimmune diseases and cancer settings. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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29 pages, 1582 KiB

Open AccessReview

Patient-Derived Multiple Myeloma 3D Models for Personalized Medicine—Are We There Yet?

by Diana Lourenço, Raquel Lopes, Carolina Pestana, Ana C. Queirós, Cristina João and Emilie Arnault Carneiro

Int. J. Mol. Sci. 2022, 23(21), 12888; https://doi.org/10.3390/ijms232112888 - 25 Oct 2022

Cited by 5 | Viewed by 2898

Abstract

Despite the wide variety of existing therapies, multiple myeloma (MM) remains a disease with dismal prognosis. Choosing the right treatment for each patient remains one of the major challenges. A new approach being explored is the use of ex vivo models for personalized medicine. Two-dimensional culture or animal models often fail to predict clinical outcomes. Three-dimensional ex vivo models using patients’ bone marrow (BM) cells may better reproduce the complexity and heterogeneity of the BM microenvironment. Here, we review the strengths and limitations of currently existing patient-derived ex vivo three-dimensional MM models. We analyze their biochemical and biophysical properties, molecular and cellular characteristics, as well as their potential for drug testing and identification of disease biomarkers. Furthermore, we discuss the remaining challenges and give some insight on how to achieve a more biomimetic and accurate MM BM model. Overall, there is still a need for standardized culture methods and refined readout techniques. Including both myeloma and other cells of the BM microenvironment in a simple and reproducible three-dimensional scaffold is the key to faithfully mapping and examining the relationship between these players in MM. This will allow a patient-personalized profile, providing a powerful tool for clinical and research applications. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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18 pages, 746 KiB

Open AccessReview

The Role of RNA-Binding Proteins in Hematological Malignancies

by Pedro Aguilar-Garrido, Álvaro Otero-Sobrino, Miguel Ángel Navarro-Aguadero, María Velasco-Estévez and Miguel Gallardo

Int. J. Mol. Sci. 2022, 23(17), 9552; https://doi.org/10.3390/ijms23179552 - 23 Aug 2022

Cited by 5 | Viewed by 1962

Abstract

Hematological malignancies comprise a plethora of different neoplasms, such as leukemia, lymphoma, and myeloma, plus a myriad of dysplasia, such as myelodysplastic syndromes or anemias. Despite all the advances in patient care and the development of new therapies, some of these malignancies remain incurable, mainly due to resistance and refractoriness to treatment. Therefore, there is an unmet clinical need to identify new biomarkers and potential therapeutic targets that play a role in treatment resistance and contribute to the poor outcomes of these tumors. RNA-binding proteins (RBPs) are a diverse class of proteins that interact with transcripts and noncoding RNAs and are involved in every step of the post-transcriptional processing of transcripts. Dysregulation of RBPs has been associated with the development of hematological malignancies, making them potential valuable biomarkers and potential therapeutic targets. Although a number of dysregulated RBPs have been identified in hematological malignancies, there is a critical need to understand the biology underlying their contribution to pathology, such as the spatiotemporal context and molecular mechanisms involved. In this review, we emphasize the importance of deciphering the regulatory mechanisms of RBPs to pinpoint novel therapeutic targets that could drive or contribute to hematological malignancy biology. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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16 pages, 903 KiB

Open AccessReview

New Frontiers in Monoclonal Antibodies for the Targeted Therapy of Acute Myeloid Leukemia and Myelodysplastic Syndromes

by Marco Gallazzi, Maghalie Anais Marie Ucciero, Danilo Giuseppe Faraci, Abdurraouf Mokhtar Mahmoud, Wael Al Essa, Gianluca Gaidano, Samir Mouhssine and Elena Crisà

Int. J. Mol. Sci. 2022, 23(14), 7542; https://doi.org/10.3390/ijms23147542 - 07 Jul 2022

Cited by 16 | Viewed by 4228

Abstract

Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) represent an unmet clinical need whose prognosis is still dismal. Alterations of immune response play a prominent role in AML/MDS pathogenesis, revealing novel options for immunotherapy. Among immune system regulators, CD47, immune checkpoints, and toll-like receptor 2 (TLR2) are major targets. Magrolimab antagonizes CD47, which is overexpressed by AML and MDS cells, thus inducing macrophage phagocytosis with clinical activity in AML/MDS. Sabatolimab, an inhibitor of T-cell immunoglobulin and mucin domain-containing protein 3 (TIM3), which disrupts its binding to galectin-9, has shown promising results in AML/MDS, enhancing the effector functions of lymphocytes and triggering tumor cell death. Several other surface molecules, namely CD33, CD123, CD45, and CD70, can be targeted with monoclonal antibodies (mAbs) that exert different mechanisms of action and include naked and conjugated antibodies, bispecific T-cell engagers, trispecific killer engagers, and fusion proteins linked to toxins. These novel mAbs are currently under investigation for use as monotherapy or in combination with hypomethylating agents, BCL2 inhibitors, and chemotherapy in various clinical trials at different phases of development. Here, we review the main molecular targets and modes of action of novel mAb-based immunotherapies, which can represent the future of AML and higher risk MDS treatment. Full article

(This article belongs to the Special Issue Insights in New Biomarkers and Molecular Drug Targets in Hematological Neoplasias)

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