The discovery of the JAK2V617F mutation in most patients with Ph-negative myeloproliferative neoplasms has led to the development of JAK2 kinase inhibitors. However, JAK2 inhibitor therapy has shown limited efficacy and dose-limiting hematopoietic toxicities in clinical trials. In the present study, we describe the effects of vorinostat, a small-molecule inhibitor of histone deacetylase, against cells expressing JAK2V617F and in an animal model of polycythemia vera (PV). We found that vorinostat markedly inhibited proliferation and induced apoptosis
IntroductionMyeloproliferative neoplasms (MPNs) are a group of clonal hematopoietic malignancies that include chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). 1,2 These diseases are characterized by excessive proliferation of myeloid/erythroid lineage cells. A somatic point mutation (V617F) in the JAK2 tyrosine kinase has been found in most patients with PV and in 50%-60% patients with ET and PMF. [3][4][5][6] JAK2V617F is a constitutively active tyrosine kinase that can transform factor-dependent hematopoietic cell lines into cytokine-independent cells. 3,4 Expression of the JAK2V617F mutant activates multiple downstream signaling pathways, such as Stat, Erk, and PI3K/Akt pathways. 3,7,8 Current therapies for MPNs include phlebotomy and myelosuppressive therapy (eg, hydroxyurea and anagrelide) for PV and ET and transfusions and supportive care for PMF. However, these empiric treatments are unlikely to cure or offer remission to patients with MPNs, so there is a clear need for new therapies for MPNs. The discovery of the JAK2V617F mutation in PV, ET, and PMF has led to the development of inhibitors of JAK2. Several JAK2 inhibitors are undergoing clinical trials. Although JAK2 inhibitors are effective in reducing splenomegaly and improving constitutional symptoms, significant hematopoietic toxicities, including anemia and thrombocytopenia, are observed in the majority of patients after this treatment, 9,10 which is consistent with the known function of JAK2 in normal hematopoiesis. 11,12 Ruxolitinib, a JAK1/JAK2 inhibitor, has been approved for the treatment of myelofibrosis. However, a recent report on long-term outcomes with Ruxolitinib treatment found improvement in constitutional symptoms, but no significant benefit in survival for myelofibrosis patients. 13 In addition, there is an increased rate of discontinuation of Ruxolitinib therapy because of severe hematopoietic toxicities or lack of response. 13 It is also possible that drug resistance may emerge in some patients treated with JAK2 inhibitors, similar to what is observed with the ABL inhibitor imatinib in CML patients. 14 Therefore, identifying additional new therapies targeting JAK2V617F or pathways downstream of JAK2V617F would be beneficial for the treatment of patients with MPNs.Acetylation is an important posttranslational modification that serves as a key modulator of chromatin structure and gene transcription, and provides a me...