Treatment of patients with
adult T-cell leukemia-lymphoma (
ATLL) using conventional
chemotherapy has limited benefit because human
T-cell leukemia virus type 1 (HTLV-1) cells are resistant to most apoptosis-inducing agents. The recent report that
arsenic trioxide induces apoptosis in HTLV-1-transformed cells prompted investigation of the mechanism of action of this
drug in HTLV-1 and HTLV-2 interleukin-2-independent T cells and in HTLV-1-immortalized cells or in ex vivo
ATLL samples. Fluorescence-activated cell sorter analysis, fluorescence microscopy, and measures of mitochondrial membrane potential (Delta Psi m) demonstrated that
arsenic trioxide alone was sufficient to induce programmed cell death in all HTLV-1 and -2 cells tested and in
ATLL patient samples.
I kappa B-alpha phosphorylation strongly decreased, and
NF-kappa B translocation to the nucleus was abrogated. Expression of the antiapoptotic
protein Bcl-X(L), whose promoter is
NF-kappa B dependent, was down-regulated. The collapse of Delta Psi m and the release of
cytochrome c to the cytosol resulted in the activation of
caspase-3, as demonstrated by the cleavage of PARP. A specific
caspase-3 inhibitor (
Ac-DEVD-CHO) could reverse this phenotype. The antiapoptotic factor Bcl-2 was then cleaved, converting it to a Bax-like death effector. These results demonstrated that
arsenic trioxide induces apoptosis in HTLV-1- and -2-infected cells through activation of the
caspase pathway.