• Sox4 is required for survival, progression, and proliferation in pre-B acute lymphoblastic leukemia.• Sox4 activates critical survival signaling pathways and correlates with poor clinical outcome.
IntroductionThe Sox4 (SRY-related HMG-box) transcription factor is expressed in early B-and T-cell development similar to LEF1. 1 In the absence of Sox4, B-cell development is arrested at the pro-B to pre-B cell transition. 2 In Sox4 Ϫ/Ϫ mice, pro-B cells fail to proliferate in response to IL7 and to expand and differentiate past the pre-B cell receptor checkpoint. 2 Interestingly, SOX4 functions as transcription factor yet closely interacts with membrane-proximal cytokine receptor signaling. 3 The PDZ domain-containing adaptor protein syntenin (SDCBP) recruits the Sox4 protein directly to the cytoplasmic tail of the IL5R␣ chain. 3 With regard to its receptor-proximal activation, Sox4 resembles the SMAD and STAT transcription factors. In addition to its IL5R␣ interaction, Sox4/syntenin associates with the cytoplasmic tails of other transmembrane receptors, including syndecans and ephrins. 4,5 Because IL5R␣ signaling is dispensable for early B-cell development, the receptor system that recruits syntenin-mediated activation of Sox4 in early B-cell development remains to be identified. A role for Sox4 in acute myeloid leukemia was proposed based on the identification of viral insertions, activating Sox4 expression in leukemias developing in mice carrying endogenous retroviruses. 6 Overexpression of Sox4 was also found to block differentiation of myeloid progenitor cells. 7 Importantly, Sox4 overexpression causes myeloid leukemia 6 and thereby cooperates with haplo-insufficiency of the myeloid differentiation factor PU.1. 8 In acute lymphoblastic leukemia (ALL), we found SOX4 was strongly up-regulated on tyrosine kinase inhibitor (TKI) treatment and high expression of SOX4 correlates with poor clinical outcome of patients with ALL. However, the role of Sox4 in ALL cells remains unclear. In this study, using a conditional Sox4 knockout mouse model, we showed that the deletion of Sox4 compromised proliferation and viability of leukemia cells and that SOX4 plays as a central mediator of oncogenic PI3K/AKT and MAPK signaling in ALL.
Methods
Pre-B and leukemia cell cultureThe work described here involves animal experiments (approved by Children's Hospital Los Angeles Institutional Animal Care and Use Committee) and analysis of clinical data (No Human Subjects, Exempt No. 4; IRB approval under Children's Oncology Group (COG) and Eastern Cooperative Oncology Group study protocols). Primary human leukemia cells were cultured on OP9 stroma cells in ␣ minimum essential medium without ribonucleotides and deoxyribonucleotides (MEM␣; Invitrogen), supplemented with 20% FBS, 2mM L-glutamine, 1mM sodium pyruvate, 100 IU/mL penicillin and 100 mg/mL streptomycin. Human ALL cell lines were maintained in RPMI with GlutaMAX (Invitrogen) containing 20% FBS, 100 IU/mL penicillin, and 100 mg/mL streptomycin. Mouse BCR-ABL1 transformed pre-B ce...