1. Academic Validation
  2. The selective prolyl hydroxylase inhibitor IOX5 stabilizes HIF-1α and compromises development and progression of acute myeloid leukemia

The selective prolyl hydroxylase inhibitor IOX5 stabilizes HIF-1α and compromises development and progression of acute myeloid leukemia

  • Nat Cancer. 2024 Apr 18. doi: 10.1038/s43018-024-00761-w.
Hannah Lawson # 1 2 James P Holt-Martyn # 3 Vilma Dembitz 2 4 Yuka Kabayama 5 Lydia M Wang 1 2 Aarushi Bellani 1 2 Samanpreet Atwal 3 Nadia Saffoon 3 Jozef Durko 2 Louie N van de Lagemaat 2 5 Azzura L De Pace 5 Anthony Tumber 3 Thomas Corner 3 Eidarus Salah 3 Christine Arndt 3 Lennart Brewitz 3 Matthew Bowen 3 Louis Dubusse 1 2 Derek George 1 2 Lewis Allen 1 2 Amelie V Guitart 5 6 Tsz Kan Fung 7 8 Chi Wai Eric So 7 8 Juerg Schwaller 9 Paolo Gallipoli 2 Donal O'Carroll 5 Christopher J Schofield 10 Kamil R Kranc 11 12
Affiliations

Affiliations

  • 1 The Institute of Cancer Research, London, UK.
  • 2 Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK.
  • 3 Chemistry Research Laboratory, Department of Chemistry and the Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK.
  • 4 Department of Physiology and Immunology and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.
  • 5 Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, UK.
  • 6 Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, Bordeaux, France.
  • 7 Leukemia and Stem Cell Biology Group, Comprehensive Cancer Centre, King's College London, London, UK.
  • 8 Department of Haematological Medicine, King's College Hospital, King's College London, London, UK.
  • 9 University Children's Hospital Basel (UKBB), Department of Biomedicine, University of Basel, Basel, Switzerland.
  • 10 Chemistry Research Laboratory, Department of Chemistry and the Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK. [email protected].
  • 11 The Institute of Cancer Research, London, UK. [email protected].
  • 12 Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK. [email protected].
  • # Contributed equally.
Abstract

Acute myeloid leukemia (AML) is a largely incurable disease, for which new treatments are urgently needed. While leukemogenesis occurs in the hypoxic bone marrow, the therapeutic tractability of the hypoxia-inducible factor (HIF) system remains undefined. Given that inactivation of HIF-1α/HIF-2α promotes AML, a possible clinical strategy is to target the HIF-prolyl hydroxylases (PHDs), which promote HIF-1α/HIF-2α degradation. Here, we reveal that genetic inactivation of Phd1/Phd2 hinders AML initiation and progression, without impacting normal hematopoiesis. We investigated clinically used PHD inhibitors and a new selective PHD inhibitor (IOX5), to stabilize HIF-α in AML cells. PHD inhibition compromises AML in a HIF-1α-dependent manner to disable pro-leukemogenic pathways, re-program metabolism and induce Apoptosis, in part via upregulation of BNIP3. Notably, concurrent inhibition of Bcl-2 by venetoclax potentiates the anti-leukemic effect of PHD inhibition. Thus, PHD inhibition, with consequent HIF-1α stabilization, is a promising nontoxic strategy for AML, including in combination with venetoclax.

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