1. Academic Validation
  2. Nrf2 overexpression increases risk of high tumor mutation burden in acute myeloid leukemia by inhibiting MSH2

Nrf2 overexpression increases risk of high tumor mutation burden in acute myeloid leukemia by inhibiting MSH2

  • Cell Death Dis. 2021 Jan 5;12(1):20. doi: 10.1038/s41419-020-03331-x.
Ping Liu 1 2 Dan Ma 1 Ping Wang 1 Chengyun Pan 1 2 Qin Fang 3 Jishi Wang 4 5
Affiliations

Affiliations

  • 1 Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guizhou Province Institute of Hematology, Guizhou Province Laboratory of Hematopoietic Stem Cell Transplantation Centre, 550004, Guiyang, China.
  • 2 Basic Medical College, Guizhou Medical University, 550004, Guiyang, China.
  • 3 Department of Pharmacy, Affiliated Hospital of Guizhou Medical University, 550004, Guiyang, China.
  • 4 Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guizhou Province Institute of Hematology, Guizhou Province Laboratory of Hematopoietic Stem Cell Transplantation Centre, 550004, Guiyang, China. wangjishi9646@163.com.
  • 5 National Clinical Research Center for Hematologic Diseases, the First Affiliated Hospital of Soochow University, 215006, Suzhou, China. wangjishi9646@163.com.
Abstract

Nuclear factor erythroid 2-related factor 2 (Nrf2, also called NFE2L2) plays an important role in Cancer chemoresistance. However, little is known about the role of Nrf2 in tumor mutation burden and the effect of Nrf2 in modulating DNA mismatch repair (MMR) gene in acute myeloid leukemia (AML). Here we show that Nrf2 expression is associated with tumor mutation burden in AML. Patients with Nrf2 overexpression had a higher frequency of gene mutation and drug resistance. Nrf2 overexpression protected the AML cells from Apoptosis induced by cytarabine in vitro and increased the risk of drug resistance associated with a gene mutation in vivo. Furthermore, Nrf2 overexpression inhibited MutS Homolog 2 (MSH2) protein expression, which caused DNA MMR deficiency. Mechanistically, the inhibition of MSH2 by Nrf2 was in a ROS-independent manner. Further studies showed that an increased activation of JNK/c-Jun signaling in Nrf2 overexpression cells inhibited the expression of the MSH2 protein. Our findings provide evidence that high Nrf2 expression can induce gene instability-dependent drug resistance in AML. This study demonstrates the reason why the high Nrf2 expression leads to the increase of gene mutation frequency in AML, and provides a new strategy for clinical practice.

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