In this study, we show that combined use of Imatinib (IM) and arsenic sulfide [As4S4 (AS)] exerts more profound therapeutic effects inside a retinoic acid, in the treatment of acute promyelocytic leukemia (APL) (4). involved in protein ubiquitination and proteasomal degradation, which correlated with the catabolism of BCR/ABL and may form the basis for AS synergy with IM in CML treatment. Results AS Potentiates the Effectiveness of IM inside a CML Mouse Model. We compared the effectiveness of combined use of IM (25 mg/kg/d) and AS (6 mg/kg/d) with each monotherapy in the P210 BCR/ABL mouse model. Within 5 weeks of transplantation, 100% of PBS-treated control mice died from a CML-like illness characterized by granulocytosis with an average white blood cell (WBC) count >200 106 cells per milliliter, splenomegaly, and infiltration of bone marrow (BM), liver, and spleen by leukemic cells. In contrast, all drug-treated mice showed a reduction in the leukemic burden with a diminished degree of leukemia cell infiltration in major hematopoietic organs [Fig. 1and assisting info (SI) Fig. S1 and = 0.01; = 0.001; and = 0.005 versus 50 mg/kg/d IM, 25 mg/kg/d IM, and AS, respectively; %GFP, = 0.007; < 0.001; and = 0.005 versus 50 mg/kg/d IM, 161796-78-7 IC50 25 mg/kg/d IM and AS, respectively). Importantly, although all treatment organizations showed prolonged survival compared with PBS control mice (= 0.049 to < 0.001, Fig. 1= 0.011) and 25 mg/kg/d IM- (= 0.009) treated organizations, whereas the 161796-78-7 IC50 variations between 50 mg/kg/d IM group and those with 25 mg/kg/d IM and AS did not reach the statistical significance. These results indicated that low dose (25 mg/kg/d) IM and AS exerted synergistic effects and acquired even better therapeutic effect than the relatively high dose (50 mg/kg/d) IM with this CML mouse model. Furthermore, no treatment organizations including IM (25 and 50 mg/kg/d) or combination therapy exhibited significant cardiomyocyte damage as evaluated by using mouse echocardiography (Fig. S1ideals were labeled within the numbers. (and demonstrates AS substantially down-regulated EIF4E and 2 phosphorylation forms of 4EBP (4EBP-Thr-37/46 and 4EBP-Thr-70) but experienced no obvious effect on additional signaling proteins with this pathway. On the other hand, although significantly down-regulating the manifestation of the main elements with this pathway such as mTOR, PI3K, PS6K, 4EBP-Thr-37/464EBP-Thr-70, and EIF4E, IM significantly induced the manifestation of PP2A, resulting in the inhibition of the activity of PI3K/AKT/mTOR IGLC1 pathway. Cotreatment with AS/IM induced higher changes of some key elements of PI3K/AKT/mTOR pathway (e.g., mTOR and 4EBP) compared with IM monotreatment, suggesting that the activity of IM underlies these effects, whereas 161796-78-7 IC50 While may have a potentiating part. AS promotes the ubiquitinCproteasome pathway and UPR. Analysis of the transcriptome and proteome exposed that many mRNA transcripts and proteins related to the ubiquitinCproteasome pathway, especially the E3 ubiquitin ligase (CUL1, CBL, FBXO16, and and and and and = 3). One-sided combined test is used for statistical analysis (, < 0.05 versus control; , ... MS Characterization of Ubiquitinated BCR/ABL. GFP-tagged BCR/ABL was immunoprecipitated from 293T cells by using anti-GFP antibody, trypsinized, and subjected to LC-MALDI-MS/MS analysis. BCR/ABL/GFP fusion protein was recognized with the highest confidence. Specific signatures corresponding to the C-terminal BCR and N-terminal ABL areas not contained in the fusion protein were not recognized, indicating that the majority of immunoprecipitated material was purified BCR/ABL/GFP. 161796-78-7 IC50 Moreover, unique 1460.8-Da fragments produced by digestion of K48-linked polyubiquitin were detected with >60% relative intensity. Further MS/MS analysis demonstrated that this fragment originated from polyubiquitin (Fig. S3and (18) reported that arsenite could inhibit JNK phosphatase, Luo (19) and our data indicate that AS up-regulates PP2A, 1 of the 4 major Ser/Thr phosphatases. How arsenic functions within the ubiquitinCproteasome pathway remains controversial. Most studies suggest arsenic.