Leptin is secreted by bone marrow (BM) adipocytes and stromal cells and was shown to stimulate myeloid proliferation. We here report that primary acute promyelocytic leukemia (APL) cells express high levels of the leptin-receptor (OB-R) long isoform. In cells with regulated promyelocytic leukemia-retinoic acid receptor (PML-RAR␣) expression, inducing PML-RAR␣ was found to increase OB-R levels. We then investigated the effects of leptin produced by BM adipocytes on APL cells using a coculture system with mesenchymal stem cell (MSC)-derived adipocytes. In PML-RAR␣-expressing cells, all-trans retinoic acid (ATRA)-and doxorubicininduced apoptosis were significantly reduced by coculture with adipocytedifferentiated MSCs. This antiapoptotic effect required direct cell-to-cell interactions, was associated with phosphorylation of signal transducer and activator of transcription-3 (STAT3) and mitogenactivated protein kinase (MAPK), and was reduced by blocking OB-R. This report provides a mechanistic basis for the BM adipocyte-leukemia cell interaction and suggests that OB-R receptor blockade may have therapeutic use in APL.
IntroductionLeptin is a 16-kDa protein produced by adipocytes and was originally identified as a cytokine that regulates fat metabolism. 1 Adipocytes are abundant in the bone marrow (BM) microenvironment and might be responsible for the high concentration of leptin in BM. 2 The leptin receptor (OB-R) has recently been detected on human hematopoietic progenitor cells expressing the CD34 antigen, and leptin was reported to induce proliferation and differentiation in these cells. 3,4 Multiple isoforms of OB-R have been identified, including a long isoform and several isoforms with short cytoplasmic domains. 5,6 Although all isoforms share an identical extracellular ligand-binding domain with homology to the class I cytokine receptor family, they differ at the C-terminus. 6 Only the long OB-R isoform, which has the longest (303 amino acids) cytoplasmic domain and encodes all protein motifs, has the signaling capabilities of interleukin-6 (IL-6)-type cytokine receptors and can activate the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signal transduction pathway. [7][8][9] We have reported that leptin induces the proliferation and enhances the survival of primary leukemic cells from patients with acute myeloid leukemia (AML). 10 We have further demonstrated the presence of leptin receptors (OB-Rs) on primary AML cells, with the highest expression of OB-R long isoform on acute promyelocytic leukemia (APL) cells, which was absent on normal promyelocytes. 10 Given that APL is associated with increased body mass index (BMI) 11 and leptin serum levels correlate with body fat percentage, 12,13 leptin may play a role in the pathophysiology of APL. Alternatively, leptin secretion by BM adipocytes in the vicinity of leukemic cells could play a major role in the proliferation and survival of APL cells through paracrine interactions in the marrow microenvironment. The aims of this study we...