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Investigation of the role of the KEAP1-NRF2 antioxidant pathway in the therapy of secondary acute myeloid leukaemia
Myšáková, Michaela ; Pimková, Kristýna (advisor) ; Suttnar, Jiří (referee)
The development of therapy resistance is a long-standing problem in treating cancer, particularly in the treatment of myelodysplastic syndrome (MDS) and acute myeloid leukaemia (AML), where the hypomethylating agent 5-azacytidine (AZA) is the first choice of treatment. To enhance therapeutic efficacy, AZA is often combined with other agents such as pevonedistat (Pevo), a NEDDylation inhibitor targeting the ubiquitin-proteasome system. While initial results showed a synergistic effect of the AZA and Pevo combination in treating MDS and AML, dual resistance has been described, underlining the importance of understanding the mechanisms behind the resistance development. Our previous data demonstrated an essential role of redox homeostasis and antioxidant system represented by Nuclear factor erythroid 2-related factor 2 (NRF2) in AZA resistance. The Kelch-like ECH-associated protein 1 (KEAP1)-NRF2 pathway is the master regulator of antioxidative defence in cells crucial for maintaining redox balance. However, hyperactivation of NRF2 has been implicated in therapy resistance and cancer progression. We hypothesised that NRF2 is crucial in MDS/AML therapy resistance, particularly in resistance to combined AZA and Pevo therapy. We worked with cells sensitive and resistant to AZA and Pevo and monitored...
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