The therapeutic potential of opioid agonists in human leukemia (Cheap OTC loperamide “remarkably suppressed” leukemia)

Medical Xpress / Zhejiang University / Cell Reports ^ | Feb. 22, 2022 | Huanhuan Zhao et al

[ConservativeMind]

Leukemia, the blood cancer, is a group of hematopoietic malignancies. Many types of leukemia are associated with poor outcome. Unfortunately, during the past few decades, the first-line leukemia therapy has long been traditional chemotherapy with high cytotoxicity and low selectivity, such as the "7+3" strategy, i.e., a combination of cytarabine and doxorubicin. Side effects of such intensive chemotherapies are often severe, especially in older patients. Therefore, it is an urgent need to understand the mechanisms of leukemia, and develop novel targeted therapy based on such comprehension.

In this work, Jiang's group first found through drug screening that opioid receptor agonists, especially loperamide (OPA1), an FDA-approved anti-diarrhea drug, remarkably suppressed the viability of AML cells. The therapeutic effect of OPA1 was then verified in mouse models representing different AML subtypes, as well as in a patient-derived model (patient-derived xenotransplantation, or PDX) in which AML patient bone marrow cells were transplanted into immunodeficient mice.

Through an integration of genome-wide RNA-seq, 5hmC-seq, chromosome immunoprecipitation (ChIP)-seq and other mechanism studies, the researchers show that OPA1 activated opioid receptor signaling and recruited transcription factors, e.g. EGR1, to the promoter of the TET2 gene, and upregulated TET2 expression. TET2, as a key factor of DNA epigenetic modification, then functioned in both activity dependent and independent ways. On the one hand, it mediated the 5hmC modification of its target genes, e.g. TRAF2; on the other hand, it recruited OGT to their shared targets, e.g. DNMT. Thus, the OPA1/opioid signaling/TET2 axis plays an important role in regulating the expression of the target genes, and curing leukemia.

This work unveils the regulatory mechanism of opioid signaling in TET-mediated epigenetic modification, reveals the previously unappreciated opioid-TET2 regulatory axis in leukemia, and suggests the therapeutic potential of opioid agonists, particularly OPA1, in leukemia and in other cancers with similar molecular mechanisms.

[ConservativeMind]

You might know this substance as “Imodium A-D Diarrhea Relief with Loperamide HCI.”

I think leukemia patients have a reason to look forward to diarrhea…

[ConservativeMind]

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[noiseman]

Low cost and effective? Well, we know for sure that one will be getting added to the Hydroxychloroquine/Ivermectin “naughty list.”

[metmom]

They’ll be pulling that from the shelves soon.

Can’t have anything that really works, now can we?

[matthew fuller]

This medication sells for about $0.10 per 2 milligram pill. It will NEVER be approved, as is, for use in leukemia patients. Not unless we make a bunch of attitude adjustments at CDC and FDA...

[UnwashedPeasant]

"You might know this substance as 'Imodium A-D Diarrhea Relief with Loperamide HCI.'"

Thanks for the interpretation! The medical lingo was very thick.

I will add this to my list of cures.

[Trillian]

Interesting ping