未经证实:第二代和第三代BCR-ABL1酪氨酸激酶抑制剂(TKIs)与费城染色体阳性(Ph+)白血病患者的心血管不良事件(CVAE)相关。
未经证实:我们假设第二代和第三代BCR-ABL1TKIs可能通过激活含Rho相关卷曲螺旋激酶(ROCK)引起CVAE。
UNASSIGNED:通过毛细管电泳评估了53名接受TKI的Ph+患者和15名无Ph+白血病的对照患者的外周血单核细胞的ROCK活性(中位随访时间=26个月[Q1-Q3:5-37个月])。我们还研究了TKIs和ROCK在体外对内皮功能障碍的影响,这可能会导致CVAE。
未经证实:接受第二代和第三代TKIs的患者与接受伊马替尼的患者和对照组患者相比,ROCK活性高1.6倍。在Ph+白血病患者中,ROCK活性升高与CVAE的发生率增加相关。在体外内皮细胞中,我们发现达沙替尼和普纳替尼治疗导致肌动蛋白强度和内皮通透性的变化,这可以通过岩石的药理抑制逆转。Ponatinib导致细胞增殖减少,但这并不伴随衰老。达沙替尼和普纳替尼治疗导致内皮型一氧化氮合酶的磷抑制和一氧化氮产生减少。ROCK抑制逆转内皮通透性和内皮型一氧化氮合酶相关内皮功能障碍。伊马替尼和尼洛替尼诱导p190RhoGAP磷酸化。
未经批准:我们的研究结果表明,在接受BCR-ABL1TKIs的患者中,ROCK活性可能是CVAE的预后指标。随着进一步的研究,ROCK抑制可能是减少与第二代和第三代BCR-ABL1TKIs相关的CVAE发生率的有希望的方法。
UNASSIGNED: Second- and third-generation BCR-ABL1 tyrosine kinase inhibitors (TKIs) are associated with cardiovascular adverse events (CVAEs) in patients with Philadelphia chromosome-positive (Ph+) leukemia.
UNASSIGNED: We hypothesized that second- and third-generation BCR-ABL1 TKIs may cause CVAEs through the activation of Rho-associated coiled-coil containing kinase (ROCK).
UNASSIGNED: Peripheral blood mononuclear cells from 53 Ph+ patients on TKIs and 15 control patients without Ph+ leukemia were assessed for ROCK activity through capillary electrophoresis (median follow-up = 26 months [Q1-Q3: 5-37 months]). We also investigated the effects of TKIs and ROCK on endothelial dysfunction in vitro, which could contribute to CVAEs.
UNASSIGNED: Patients receiving second- and third-generation TKIs had 1.6-fold greater ROCK activity compared with patients receiving imatinib and control patients. Elevated ROCK activity was associated with an increased incidence of CVAEs in Ph+ leukemia patients. In endothelial cells in vitro, we found that dasatinib and ponatinib treatment led to changes in actin intensity and endothelial permeability, which can be reversed by pharmacologic inhibition of ROCK. Ponatinib led to decreased cell proliferation, but this was not accompanied by senescence. Dasatinib and ponatinib treatment led to phosphor-inhibition of endothelial nitric oxide synthase and decreased nitric oxide production. ROCK inhibition reversed endothelial permeability and endothelial nitric oxide synthase-related endothelial dysfunction. Imatinib and nilotinib induce phosphorylation of p190RhoGAP.
UNASSIGNED: Our findings suggest ROCK activity may be a prognostic indicator of CVAEs in patients receiving BCR-ABL1 TKIs. With further study, ROCK inhibition may be a promising approach to reduce the incidence of CVAEs associated with second- and third-generation BCR-ABL1 TKIs.