Cytidine Triphosphate Synthetase Activity in Lymphoproliferative Disorders1
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[CANCER RESEARCH 43, 1432-1435, March 1983] 0008-5472/83/0043-0000302.00 Cytidine Triphosphate Synthetase Activity in Lymphoproliferative Disorders1 Peter H. Ellims,1 2 T. Eng Gan, and Gabriele Medley Department of Medicine, Monash University, Alfred Hospital, Prahran, 3181, Victoria ¡P.H. £., T. E. G.I, and Division of Anatomical Pathology, Prince Henry's Hospital, Melbourne. 3004. Victoria [G. M.], Australia ABSTRACT has been correlated directly with the growth rate of various rat hepatomas (23, 25), indicating that the enzyme is a marker of Cytidine triphosphate synthetase (CTP synthetase) activity the proliferative rate and biological aggressiveness of these was measured in extracts from normal and malignant lymphoid tumors. Preliminary data show that there is an increase in the cells. A range of enzyme activities was found in the majority of CTP synthetase activity of other rodent tumors and in human the lymphoproliferative disorders examined, with acute lym- renal cell carcinoma, but the tumor specificity of this phenom phocytic leukemia, nodular poorly differentiated lymphocytic enon is unclear (25). In addition, CTP synthetase activity is lymphoma, and diffuse histiocytic (large cell) lymphoma (DHL) thought to be capable of modulating the cytotoxic effect of types exhibiting the widest ranges. The highest levels occurred some pyrimidine antimetabolites. The intracellular CTP levels in acute lymphocytic leukemia, nodular poorly differentiated can influence the effect of 5-azacytidine by its inhibitory effect lymphocytic lymphoma transforming to DHL, and DHL. In on the rate of the uridine-cytidine kinase reaction and by chronic lymphocytic leukemia and diffuse well-differentiated competition with the active metabolite 5-azacytidine triphos lymphocytic lymphoma, a narrow range was encountered, with phate (12). Similarly, the intracellular dCTP pool opposes the individual values falling within that of the controls. The highest CTP synthetase levels in Hodgkin's disease were found in the action of 1-ß-D-arabinofuranosylcytosine triphosphate, the ac tive metabolite of ara-C3 (11), and 5-azadeoxycytidine triphos clinically aggressive lymphocyte-depleted Hodgkin's disease. phate, the active metabolite of 5-azadeoxycytidine (18). Re Statistically significant differences were found between the cently, a mutant type of CTP synthetase has been associated distributions of CTP synthetase activities in acute lymphocytic with expanded intracellular dCTP and CTP pools and, as a leukemia and the chronic leukemias (p < 0.01) and between favorable histological types of non-Hodgkin's lymphoma (dif consequence, resistance to ara-C and thymidine (19). Finally, inhibition of CTP synthetase by the metabolite deazauridine fuse well-differentiated, nodular poorly differentiated, and dif triphosphate is believed to be the primary mode of action of fuse poorly differentiated lymphocytic lymphoma) and the un the investigational antileukemic agent DAU (17). favorable DHL category (p < 0.05). It is suggested that CTP In view of these data, a study was undertaken of the profile synthetase activity is a biochemical marker of the clinical of CTP synthetase activity in lymphoproliferative disorders. aggressiveness of malignant lymphoma. There was not a close correlation (r2 = 0.52) between CTP synthetase and thymidine kinase activities, indicating that other biological factors in ad MATERIALS AND METHODS dition to cell proliferative rate influence the intracellular CTP Materials. [5,6-3H]UTP (43 Ci/mmol) and [6-3H]thymidine (5 Ci/ synthetase level. Furthermore, in view of the heterogeneity of mmol) were purchased from the Radiochemical Centre, Amersham, CTP synthetase activity in leukemia and lymphoma, it is likely England. Nucleotides and Dowex 50W-X8 (200 to 400 mesh) were that the preexisting enzyme level will be an important determi obtained from Sigma Chemical Co., St. Louis, Mo. Polygram CEL 300 nant of the efficacy of the investigational antileukemic agent 3- PEI/UV254 thin-layer chromatography plates were supplied by Brink- deazauridine, which is thought to act by inhibiting CTP synthe mann, Inc., New York, N. Y. PCS scintillation counting fluid was tase. obtained from Amersham, Amersham, England. All other chemicals used were of analytical grade and were obtained from commercial sources. INTRODUCTION Patients Studied. Peripheral blood lymphocytes were obtained from CTP synthetase (UTP:L-glutamine ligase, EC 6.3.4.2) cata a control group, which contained 10 normal volunteers and 9 patients with nonneoplastic disorders. Seven lymph nodes obtained at surgical lyzes the formation of CTP from the substrate DTP. The precise biopsy and showing normal histology or minimal reactive changes biochemical role of mammalian CTP synthetase activity is un formed a second control group. certain, but the enzyme is thought to play an important part in Patients with lymphoproliferative disorders were all previously un the determination of cellular CTP and dCTP pools (19, 25). treated. They included 11 patients with B-CLL,4 all of whom exhibited Recent data suggest that, in addition to this physiological role, an absolute peripheral blood lymphocytosis (range 15,800 to 69,0007 CTP synthetase is uniquely important in the pyrimidine metab olism of mammalian tumors (25). It has been established that 3 The abbreviations used are: ara-C, 1-/8-D-arabinofuranosylcytosine; DAU, 3- deazauridine; B-CLL, bone marrow-derived chronic lymphocytic leukemia; CLL, there is a specific increase in the CTP synthetase activity and chronic lymphocytic leukemia; T-CLL, thymus-derived chronic lymphocytic leu content of rat hepatomas over that found in normal liver (23; kemia; HCL, hairy cell leukemia; ALL, acute lymphocytic leukemia; Thy-ALL, T- cell acute lymphocytic leukemia; C-ALL, common-ALL antigen ALL; null-ALL, 25). Furthermore, the degree of increase in CTP synthetase null-cell ALL; NHL, non-Hodgkin's lymphoma; DWDLL, diffuse well-differentiated lymphocytic lymphoma; NPDLL, nodular poorly differentiated lymphocytic lym ' The investigation was supported in part by grants from the National Health phoma; DPDLL, diffuse poorly differentiated lymphocytic lymphoma; DHL, diffuse histiocytic (large cell) lymphoma; HD, Hodgkin's disease. and Medical Research Council of Australia. 2 Applied Health Fellow of the National Health and Medical Research Council 4 Lymphocyte immunological typing studies were kindly performed by mem of Australia. To whom requests for reprints should be addressed. bers of the Clinical Immunology Unit, Peter MacCallum Clinic, Melbourne, Aus Received April 6, 1982; accepted December 3, 1982. tralia. 1432 CANCER RESEARCH VOL. 43 Downloaded from cancerres.aacrjournals.org on October 2, 2021. © 1983 American Association for Cancer Research. CIP Synthetase of Lymphoproliferative Disorders /il) with the majority of cells exhibiting faint immunofluorescence for the validity of this procedure was confirmed by polyethyleneimine monoclonal IgM or IgM-lgD and mouse erythrocyte receptor positivity. cellulose thin-layer chromatography (26). Under the experimental con Two additional patients with CLL were identified as T-CLL by the ability ditions used, 82 to 87% of [3H]CTP was recovered as [3H]CMP. The of the majority of peripheral blood lymphocytes (range 30,960 to reaction was linear with respect to protein concentration and for up to 75,800//il) to spontaneously bind sheep erythrocytes. Anti-T mono 75 min. Enzyme activity was expressed as nmol of CTP formed per hr clonal antibody studies showed that the majority of peripheral blood per mg of protein. lymphocytes expressed the phenotype of helper T-lymphocytes (OKT4) Thymidine Kinase Assay. Thymidine kinase was assayed as previ in one patient with T-CLL, whereas, in the second patient, the peripheral ously described using [6-3H]thymidine as the radiolabeled substrato (8, blood lymphocytes exhibited the phenotypic features of suppressor T- 9). lymphocytes (OKT8). One patient had HCL with more than 80% of the Protein was determined by the method of Bradford (5) using bovine peripheral blood lymphocytes (32,350/jul) being abnormal and exhibit serum albumin as the standard. ing tartrate-resistant acid phosphatase activity. Seven patients had ALL. Lymphoblasts were the predominant peripheral blood mononu- RESULTS clear cell in all 7 patients. Peripheral blood lymphoblasts from 2 patients (range 8,430 to 22,100//¿I) were identified as Thy-ALL by CTP Synthetase Activity in Control Blood Lymphocytes their ability to form spontaneous rosettes with sheep erythrocytes. and Lymph Nodes. Peripheral blood lymphocytes from normal Peripheral lymphoblasts from 4 patients (range 4,380 to 12,100 fil) did not show T- or B-lymphocyte surface markers but did express the C- individuals and patients with nonneoplastic medical disorders ALL antigen and were classified as C-ALL. One patient was considered had a mean CTP synthetase activity of 0.91 ± 0.20 (S.D.) to have null-ALL on the basis that the peripheral blood lymphoblasts nmol/hr/mg of protein (range, 0.78 to 1.30). Tissue extracts '6,760/jul) did not express T- or B-cell markers or the C-ALL antigen. from normal lymph nodes and those exhibiting minimal reactive Lymph nodes were obtained at surgical biopsy, and the histological changes had a mean enzyme activity of 1.18 ±0.19 nmol/hr/ findings were independently reviewed by G. Medley. In 41 patients, mg of protein (range, 0.95 to 1.40). the histological findings were those of NHL, which were categorized CTP Synthetase Activity in ALL