Systemic mastocytosis (SM) is a myeloid neoplasm characterized by increased survival and accumulation of neoplastic mast cells (MCs). In most patients, the D816V-mutated variant of KIT is detectable. We report here that heat shock protein 32 (Hsp32), also known as heme oxygenase-1 (HO-1), is a novel KIT-inducible survival factor in neoplastic
IntroductionSystemic mastocytosis (SM) is a myeloid neoplasm characterized by increased survival and accumulation of neoplastic mast cells (MCs) in internal organs. [1][2][3][4][5] Indolent and aggressive variants of SM have been described. [1][2][3][4][5][6][7] In patients with aggressive SM (ASM) or MC leukemia (MCL), the response to conventional drugs is poor, and the prognosis is grave. [4][5][6][7] These patients are candidates for cytoreductive or experimental therapy. [4][5][6][7][8][9][10] Indeed, several attempts have been made to identify novel therapeutic targets in neoplastic MCs. 4,5,[8][9][10] In most patients with SM, including those with ASM or MCL, the KIT mutation D816V is detectable. [5][6][7][11][12][13][14][15] This mutation is associated with ligand-independent activation of KIT. 16 Therefore, a number of attempts have been made to identify drugs interfering with the tyrosine kinase (TK) activity of KIT D816V. 9,10,[17][18][19][20][21] One of these drugs is PKC412, which counteracts in vitro growth of neoplastic MCs harboring KIT D816V. 17,18 In addition, PKC412 was found to inhibit growth of neoplastic MCs in a patient with MCL. 19 However, despite its impressive effects, PKC412 alone may not be sufficient to induce long-lasting complete responses in ASM/MCL. 19 Therefore, current research focuses on additional drug targets in neoplastic MCs and respective targeted drugs. 9 One attractive type of target are the survival factors expressed in neoplastic MCs.Heat shock protein 32 (Hsp32), also known as heme oxygenase-1 (HO-1), is a stress-related survival factor [22][23][24] that is expressed constitutively in various neoplastic cells. [25][26][27][28][29][30][31] Thus, whereas previous studies have pointed to the protective role of Hsp32 in mesenchymal cells in inflammatory reactions and the related stress response, [22][23][24] more recent data suggest that neoplastic cells also use Hsp32 as a survival-related molecule. [25][26][27][28][29][30][31] Moreover, Hsp32-targeting drugs have been described as counteracting in vivo growth of experimental tumors in mice. [25][26][27] We have recently shown that Hsp32/HO-1 is constitutively expressed in neoplastic cells in chronic myeloid leukemia (CML), and that the CMLspecific oncoprotein BCR-ABL promotes expression of Hsp32. 29 With regard to MCs, little is known about the expression of Hsp32. In rats, normal tissue MCs express low baseline levels of Hsp32, and its expression may increase after cell activation. 32 It has also been shown that activated rat MCs can use Hsp32 as a cytoprotective survival factor. 32 So far, however, expression of Hsp32 has not been examined in the context of mastocytosis. In the...