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216            Part IV:  Molecular and Cellular Hematology                                                                                                Chapter 16:  Cell-Cycle Regulation and Hematologic Disorders             217




               etc.), forming a central node in a complex signaling network that gov-  specific cdk(s), it is now clear that in addition to cell cycle-regulatory
               erns the overall transcriptional and biologic response of cells to activa-  cdks, transcription-regulatory cdks, such as cdk9, represent another
               tion or inhibition of the kinases. 61                  class of therapeutic targets. In addition, P-TEFb forms a complex with
                   Cdk7 plays dual functions in regulation of cell cycle and gene tran-  the HIV  tat  protein  that binds  the transactivation response element.
               scription. In the former case, cdk7, together with its partner cyclin H,   The modification of RNA polymerase II by cdk9/cyclin T facilitates the
                                                                                                      78
               acts as a cdk-activating kinase, which fully activates various cell-cycle–  efficient multiplication of the viral genome.  Other binding partners
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               regulatory cdks (e.g., cdk1, cdk2, cdk4, and cdk6) by phosphorylating   of cdk9 include tumor necrosis factor receptor-associated factor 2,  as
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                                             62
               their T loop in a context-specific manner.  For example, whereas cdk7   well as inhibitory MAQ1 (or HEXIM1) and 7SK small nuclear RNA.
               is required to determine cyclin specificity and activation order of cdc1   Furthermore, cdk9 is expressed throughout the cell cycle  and is also
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               and cdk2 during S and G  phases, it is also required to maintain the   involved in viral (HIV, herpes) replication. 27
                                  2
               activity of cdk4 as cells exiting quiescence and G  progression through   Other members of the transcription-regulatory cdk subfam-
                                                   1
                              63
               the restriction point.  Cdk7, as a component of the general transcrip-  ily include cdk8 and cdk12. Cdk8 is a subunit of the large Mediator
               tion factor TFIIH (cdk7/cyclin H/Mat1 complex), phosphorylates the   complex (~1.2 MDa) composed of 25 to 30 proteins, which acts as a
               carboxy-terminal domain (CTD, serines 5 and 7) of RNA polymerase II,   molecular bridge between DNA-binding transcription factors and RNA
               which is responsible for transcription initiation and promoter clearance,   polymerase II. Cdk8 binds to cyclin C, MED12, and MED13 in the
               a critical step in switching initiation to elongation during transcrip-  cyclin C–cdk8 module of the Mediator.  The cdk8/cyclin C pair facili-
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                   64
               tion.  As transcription factors that co-opt the general transcriptional   tates phosphorylation of both serine 2 and serine 5 at the CTD of RNA
                                                                                83
               machinery to sustain the oncogenic state, pharmacologic inhibition of   polymerase II.  Cdk8 can perform both positive and negative functions
               cdk7 may represent a novel approach to treat tumor types (e.g., T-cell   in transcriptional regulation during different transcription stages (e.g.,
               acute lymphoblastic leukemia [T-ALL]) that are particularly dependent   preinitiation and elongation), which provide a mechanism to respond to
               on transcription. 65                                   different promoter contexts (e.g., transcription factors or cdk8 module
                   Cdk9, as a catalytic subunit, partners with the regulatory sub-  binding).  Unlike cdk7 and cdk9, which govern global gene expression,
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               unit cyclin T, an 87-kDa cyclin C–related protein with three isoforms,   cdk8 promotes only gene-specific transcription. Recently, cdk8 expres-
               to form a complex known as positive transcription elongation fac-  sion has been detected in 70 percent colorectal cancers and correlated
                           66
               tor b (P-TEFb).  The so-called cdk9-related pathway consists of two   with β-catenin activation, suggesting that cdk8 may act as a oncogene
               cdk9 isoforms (cdk9–42 and cdk9–55), cyclin T , cyclin T , cyclin T ,   in certain types of cancer (e.g., colorectal and pancreatic cancer). 84,85
                                                                 2b
                                                         2a
                                                  1
                         27
               and cyclin K.  Cdk9 and its binding partner cyclin T  comprise the   Cdk12 and cdk13 have been identified as CTD kinases, both of which
                                                        1
                     67
               P-TEFb.  P-TEFb hyperphosphorylates the CTD (primarily serine 2) of   are unusually large proteins that contain a central kinase domain and
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               RNA polymerase II, essential for transcription elongation. P-TEFb also   share the same partner, cyclin K.  Cdk12/cyclin K  phosphorylates the
                                                                                                          1
                                                                                                         87
               phosphorylates the negative transcription elongation factors (N-TEFs),   CTD (preferably serine 2) of RNA polymerase II.  Interestingly, cdk12/
               including DRB-sensitivity inducing factor (DSIF) and the negative   cyclin K only regulates expression of a small subset of genes, predom-
               elongation factor (NELF), to release the transcription block (a pause   inantly long genes with high exon numbers and DDR genes, includ-
               immediately after transcription initiation) of both N-TEFs on hypoph-  ing critical regulators of genomic stability, for example, BRCA1, ATR
               osphorylated forms of RNA polymerase II. In addition, cdk9 also plays a   (ataxia-telangiectasia mutated [ATM] and Rad3 related), FANCI, and
               role in ribosomal RNA processing through activation of RNA polymerase   FANCD2. 88
                 68
               II.  In normal cells, the activity of P-TEFb is stringently maintained   The cdk10 gene encodes two different cdk-like putative kinases;
               in a functional equilibrium to accommodate transcriptional demands   it is postulated that they exert their function at the G /M transition.
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                                                                                                             2
                                     69
               for different biologic activities.  As a rule in oncogenic transformation,   These two isoforms predominate in human tissues, except in brain and
               upregulated antiapoptotic or prosurvival proteins in transformed cells   muscle, and the relative isoform levels do not vary during the cell cycle.
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               must be sustained by constitutive RNA polymerase II activity that gov-  Cdk10 interacts with the N-terminus of the Ets2 transcription factor,
               erns transcription elongation, in which cdk9 is the primary processivity   which contains the highly conserved pointed transactivation domain.
               factor.  In other words, transformed cells are addicted to transcription   The pointed domain is implicated in protein–protein interactions and
                    70
               because of the requirement for continuous production of antiapoptotic   Ets2 requires an intact pointed domain to bind Cdk10, which inhibits
               proteins, particularly those with short half-lives. Of note, abnormal   Ets2 transactivation in mammalian cells.  This could be an important
                                                                                                    31
               activities in the cdk9-related pathway occur in many human malignan-  factor for the development of follicular lymphoma, because cdk10 is
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               cies.  For example, high levels of cdk9/cyclin T  expression are found   overexpressed in this cancer.  In addition, cdk10 silencing increases
                  71
                                                  1
               in several types of hematologic malignancies, including B- and T-cell   Ets2-driven transcription of c-RAF, resulting in mitogen-activated pro-
               precursor-derived lymphomas, anaplastic large cell lymphoma, and fol-  tein kinase (MAPK) pathway activation and loss of tumor cell reliance
               licular lymphomas, whereas strong nuclear staining for both proteins   upon estrogen signaling.  Cdk10 promoters are frequently hypermeth-
                                                                                        90
               are observed in Hodgkin and Reed-Sternberg cells of classical Hodgkin   ylated in malignant tumors, resulting in low expression levels of cdk10
               lymphoma. In this context, selective cdk9 inhibitors preferentially target   and impaired cell-cycle regulation. 90
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               malignant cells in preclinical hematologic tumor models, including leu-  Cdk11 is associated with cyclin L.  It is part of the large family
               kemia and multiple myeloma. 72,73  Mcl-1, the Bcl-2 family antiapoptotic   of p34(cdc2)-related kinases whose functions appear to be linked with
               protein with an estimated half-life of less than 3 hours,  represents one   cell-cycle progression, tumorigenesis, and apoptotic signaling. Cdk11
                                                       74
               of the most common downstream targets for cdk9 inhibition.  More-  interacts with the p47 subunit of eukaryotic initiation factor 3 during
                                                            75
               over, cdk9 inhibition disrupts the process of cytoprotective autophagy,   apoptosis and is therefore directly involved in cell death mechanisms.
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               for example, through downregulation of the adaptor protein SQSTM1/  Casein kinase 2 phosphorylates the cdk11 aminoterminal domain,
               p62, resulting in an inefficient form of autophagy from cargo-loading   suggesting that cdk11 participates in signaling pathways that include
               failure, which, in turn, triggers apoptosis via upregulation of the BH3-  casein kinase 2 and that its function may help to coordinate the reg-
                                76
               only protein NBK/Bik.  Moreover, cdk inhibitors also induce upregu-  ulation of RNA transcription and processing events.  So far two iso-
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               lation of other BH3-only proteins such as Bim and Noxa.  Although it   forms of cdk11 have been identified, a larger p110 and a smaller p46
               remains to be determined whether these events stem from inhibition of   isoform. During Fas- or tumor necrosis factor-α–induced apoptosis,
          Kaushansky_chapter 16_p0213-0246.indd   216                                                                   9/18/15   11:56 PM
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