Mantle Cell lymphoma (MCL) is an aggressive form of B cell non-Hodgkin lymphoma which makes up 5%–10% of all human non-Hodgkins lymphomas.(
1) It involves pre-germinal center B cells present in the mantle zone. MCL is generally characterized by the chromosomal translocation t(
11;
14)(q13;q32) leading to over-expression of cyclin D1.(
2) In addition to cyclin D1 deregulation, MCL is one of the lymphoid malignancies associated with high chromosomal aberrations likely to play an important role in progression of the disease. TP53 mutations(
3,
4) and INK4a/ARF deletion are some of the secondary genetic lesions associated with MCL that lead to high proliferation. The majority of MCL patients show a complete or partial clinical response to first line chemotherapeutic agents mainly based on the CHOP combination or hyperCVAD(
2), but relapse is almost certain resulting in a median disease free survival of 3–4 years.(
1)
In 2006 the FDA approved the proteasome inhibitor Bortezomib (PS-341, Velcade) for treatment of relapsed and refractory MCL.(
3) Bortezomib has also been approved for treatment of refractory multiple myeloma.(
4) Bortezomib is a boronic acid dipeptide that binds reversibly to the chymotrypsin–like site in the 20S core of the 26S proteasome.(
5) Inhibition of the cellular proteasome activity by Bortezomib can alter multiple signaling pathways and bring about cytotoxicity. Bortezomib has been shown to inactivate the NFκB pathway in MCL as well as in multiple myeloma.(
6) However, recent findings have shown that Bortezomib is active in MCL with proteasome-insensitive activation of NFκB.(
7,
8) This indicates Bortezomib must also target other pathways. Bortezomib has been shown to induce apoptosis through the generation of reactive oxygen species (ROS) and activation of the NOXA pathway in MCL.(
9) NOXA is a pro-apoptotic Bcl2 protein that can bind to anti-apoptotic Mcl-1 protein, thus releasing Bak from the Mcl-1 complex and promoting apoptosis of the cell. Besides involvement of these pathways, studies in multiple myeloma and some solid tumors such as head and neck cancers have revealed that Bortezomib can induce apoptosis by inducing ER stress due to the accumulation of misfolded proteins(
10,
11) Improperly folded proteins can build up in the ER leading to activation of the stress signaling pathway known as the unfolded protein response (UPR). UPR is a three-pronged pathway comprising IRE1, pancreatic ER kinase (PERK) and activating transcription factor 6 (ATF6).(
12) If ER stress is prolonged or severe UPR activation leads to cell cycle arrest and induction of apoptosis(
13,
14).
PR Domain Zinc Finger Protein 1 (also known as PRDM1, Blimp-1, and PRDI-BF1) is a transcriptional repressor, required for terminal differentiation of B cells into antibody secreting plasma cells. During differentiation of mature B cells to plasma cells, PRDM1 represses several key target genes required for maintaining the B cell phenotype and in maintaining cellular proliferation such as CIITA, PAX5, Spi-B, Id3 and c-myc (
15–
19). PRDM1 functions as a repressor by recruiting to the DNA multiple co-repressor proteins including the histone H3 methyltransferase, G9a,(
20) the histone deacetylase HDAC2, (
21) and the arginine methyltransferase PRMT5(
22). In addition PRDM1 may displace IRF transcriptional activators through DNA binding site competition at some promoters.(
23) PRDM1 exists in two isoforms, the full length PRDM1α and a truncated form, PRDM1β. The truncated PRDM1β which is abundantly expressed in proliferating myeloma cells and myeloma cell lines is functionally impaired.(
24) Recently, PRDM1 expression has been detected in a subset of diffuse large B cell lymphomas (DLBCL).(
25–
27) However, inactivating mutations were observed in each case, indicating a tumor suppressor role for PRDM1.(
25,
26) Additionally, ectopic expression of PRDM1 in lymphoma cells can induce apoptosis.(
28) Moreover, induction of PRDM1 transcription in lymphoma cells by anti-IgM treatment induces apoptosis in these cells.(
29–
31) PRDM1 also has been linked to cellular stress and the unfolded protein response.(
32) Together this suggests that PRDM1 is capable of inducing apoptosis in B cells when expressed outside of the plasma cell transition stage.
PRDM1 has not previously been investigated in the context of Bortezomib treatment of lymphoma. This report demonstrates that in MCL PRDM1 is required for the apoptotic effect of Bortezomib. Bortezomib induced PRDM1 functions at least in part through direct repression of MKI67 and PCNA and inhibits NOXA activity. These findings reveal that PRDM1 is an essential component of the apoptotic response in MCL and a potential important marker for the effectiveness of Bortezomib therapy.