Induction of the differentiation of HL-60 promyelocytic leukemia cells by nonsteroidal anti-inflammatory agents in combination with low levels of vitamin D3.

Previous experiments have shown that a variety of agents that interfere with the activity of the transcription factor NF-kB significantly enhanced the differentiation of HL-60 leukemia cells when combined with low levels of the monocytic/macrophagic differentiating agent vitamin D3. These include an antisense phosphorothioate oligonucleotide to the Rel A subunit of NF-kB, vitamin E and other antioxidants, and curcumin. Acetylsalicylic acid and other nonsteroidal anti-inflammatory agents represent another group of agents that have been reported to inhibit NF-kB at serum levels approximating those obtained during long-term therapy of chronic inflammatory states. To determine whether nonsteroidal anti-inflammatory agents also were capable of enhancing the differentiation of HL-60 leukemia cells produced by vitamin D3, we measured the effects of a variety of nonsteroidal anti-inflammatory agents on the maturation of HL-60 cells produced by low levels of vitamin D3. Acetylsalicylic acid by itself had no significant effect on the differentiation of HL-60 cells; however, this agent markedly increased the degree of differentiation produced by low levels of vitamin D3. Furthermore, a variety of other nonsteroidal anti-inflammatory agents of different chemical classes exhibited similar enhancements of the maturation of HL-60 cells when combined with vitamin D3. An analogous increase in the differentiation of HL-60 cells was also obtained by combination of several nonsteroidal anti-inflammatory agents with the granulocytic inducing agent, retinoic acid, but not with dimethylsulfoxide. The nonsteroidal anti-inflammatory agents also enhanced the differentiation of HL-60 cells when combined with vitamin D analogs which share the receptor binding properties of vitamin D3; however, a vitamin D analog which caused significant calcium mobilization, but was less effective in receptor binding than vitamin D3, did not induce the differentiation of HL-60 cells in the presence or absence of anti-inflammatory agents. The findings suggest that the nonsteroidal anti-inflammatory agents may have utility in the treatment of acute promyelocytic leukemia when used with the D vitamins or retinoic acid.