Khalaf, Ahmed and de Beauchamp, Lucie and Kalkman, Eric and Rattigan, Kevin and Himonas, Ekaterini and Jones, Joe and James, Daniel and Shokry, Engy Shokry Abd and Scott, Mary T. and Dunn, Karen and Tardito, Saverio and Copland, Mhairi and Sumpton, David and Shanks, Emma and Helgason, Vignir (2024) Nutrient-sensitizing drug repurposing screen identifies lomerizine as a mitochondrial metabolism inhibitor of chronic myeloid leukemia. Science Translational Medicine, 16 (751): eadi5336. ISSN 1946-6234
AI Summary:
Lomerizine, a voltage-gated Ca2 channel blocker, was identified as a top hit in a high-throughput drug repurposing screen designed to identify mitochondrial metabolism inhibitors in myeloid leukemia cells. Lomerizine treatment inhibited mitochondrial isocitrate dehydrogenase activity and mitochondrial oxidative metabolism, selectively sensitizing CML LSCs to imatinib treatment.AI Topics:
In chronic myeloid leukemia (CML), the persistence of leukemic stem cells (LSCs) after treatment with tyrosine kinase inhibitors (TKIs), such as imatinib, can lead to disease relapse. It is known that therapy-resistant LSCs rely on oxidative phosphorylation (OXPHOS) for their survival and that targeting mitochondrial respiration sensitizes CML LSCs to imatinib treatment. However, current OXPHOS inhibitors have demonstrated limited efficacy or have shown adverse effects in clinical trials, highlighting that identification of clinically safe oxidative pathway inhibitors is warranted. We performed a high-throughput drug repurposing screen designed to identify mitochondrial metabolism inhibitors in myeloid leukemia cells. This identified lomerizine, a US Food and Drug Administration (FDA)–approved voltage-gated Ca2+ channel blocker now used for the treatment of migraines, as one of the top hits. Transcriptome analysis revealed increased expression of voltage-gated CACNA1D and receptor-activated TRPC6 Ca2+ channels in CML LSCs (CD34+CD38−) compared with normal counterparts. This correlated with increased endoplasmic reticulum (ER) mass and increased ER and mitochondrial Ca2+ content in CML stem/progenitor cells. We demonstrate that lomerizine-mediated inhibition of Ca2+ uptake leads to ER and mitochondrial Ca2+ depletion, with similar effects seen after CACNA1D and TRPC6 knockdown. Through stable isotope-assisted metabolomics and functional assays, we observe that lomerizine treatment inhibits mitochondrial isocitrate dehydrogenase activity and mitochondrial oxidative metabolism and selectively sensitizes CML LSCs to imatinib treatment. In addition, combination treatment with imatinib and lomerizine reduced CML tumor burden, targeted CML LSCs, and extended survival in xenotransplantation model of human CML, suggesting this as a potential therapeutic strategy to prevent disease relapse in patients.
Title | Nutrient-sensitizing drug repurposing screen identifies lomerizine as a mitochondrial metabolism inhibitor of chronic myeloid leukemia |
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Creators | Khalaf, Ahmed and de Beauchamp, Lucie and Kalkman, Eric and Rattigan, Kevin and Himonas, Ekaterini and Jones, Joe and James, Daniel and Shokry, Engy Shokry Abd and Scott, Mary T. and Dunn, Karen and Tardito, Saverio and Copland, Mhairi and Sumpton, David and Shanks, Emma and Helgason, Vignir |
Identification Number | 10.1126/scitranslmed.adi5336 |
Date | 12 June 2024 |
Divisions | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
Publisher | American Association for the Advancement of Science |
Additional Information | This work was supported by Newton-Mosharafa Fund Scholarship (awarded to A.K.). Cancer Research UK (A29754, to G.V.H.), University of Glasgow PhD Studentship (to L.B), Chief Scientist Office (CGA/18/02, to L.B and G.V.H), Blood Cancer UK (formerly Bloodwise; Ref 18006, to G.V.H), The Howat Foundation (to G.V.H.) and Friends of Paul O’Gorman Leukaemia Research Centre (o G.V.H.). Cancer Research UK (A23982) to S.T. and D.S. |
URI | https://pub.demo35.eprints-hosting.org/id/eprint/233 |
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Item Type | Article |
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Depositing User | Unnamed user with email ejo1f20@soton.ac.uk |
Date Deposited | 11 Jun 2025 16:36 |
Revision | 42 |
Last Modified | 12 Jun 2025 11:09 |
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