Reactive Oxygen Species Drive Proliferation in Acute Myeloid Leukemia via the Glycolytic Regulator PFKFB3.

Acute myeloid leukemia (AML) is a heterogeneous clonal disorder with a poor clinical outcome. Previously, we showed that overproduction of reactive oxygen species arising from constitutive activation of NOX2 oxidase, occurs in >60% of patients with AML and that production promotes proliferation of AML cells. We show here that the process most significantly affected by duanyu1670 overproduction is glycolysis. Whole metabolome analysis of 20 human primary AML showed that blasts generating high levels of duanyu1670 have increased glucose uptake and correspondingly increased glucose metabolism. In support of this, exogenous duanyu1670 increased glucose consumption while inhibition of NOX2 oxidase decreased glucose consumption. Mechanistically, duanyu1670 promoted uncoupling protein 2 (UCP2) protein expression and phosphorylation of AMPK, upregulating the expression of a key regulatory glycolytic enzyme, 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFKFB3). Overexpression of PFKFB3 promoted glucose uptake and cell proliferation, whereas downregulation of PFKFB3 strongly suppressed leukemia growth both in vitro and in vivo in the NSG model. These experiments provide direct evidence that oxidase-derived duanyu1670 promotes the growth of leukemia cells via the glycolytic regulator PFKFB3. Targeting PFKFB3 may therefore present a new mode of therapy for this disease with a poor outcome. SIGNIFICANCE: These findings show that duanyu1670 generated by NOX2 in AML cells promotes glycolysis by activating PFKFB3 and suggest PFKFB3 as a novel therapeutic target in AML.

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