regulate gene transcriptional programs in MLL-r
leukemia (the intact and partially fused SEC/
DotCom complex is highlighted in red in Fig). The
ENL protein binds to both complexes while the
complex is fused to MLL in cells, and ENL interacts
both with unfused SEC/ DotCom and with fused
SEC/ DotCom. ENL contains a YEATS domain that
can recognize a specific acetyl group (Ac) on the
histone H3. Erb and Wan et al confirmed that the
YEATS domain of ENL protein helps stabilize the
binding of SEC and DotCom to DNA, promoting
gene expression in the driving leukemic manner.
This pathway of action presents a way: using a
small molecule inhibitor targeting the ENL protein
YEATS domain as a drug molecule can selectively
kill leukemia MLL-r cells and then treat leukemia.
Other cell types seem to largely tolerate ENL loss,
but both SEC, DotCom and ENL are expressed in
multiple cells, so it is important that when
developing such drugs is to understand this
difference in tolerance.
In MLL-r leukemia, the importance of ENL is
consistent with multiple studies. These studies show
that poor regulation of DOT1L viability is required
for the survival and proliferation of MLL-r cells.
H3K79 methylation has long been associated with
gene transcriptional viability and is a regulatory
mechanism controlling DOT1L activity. A key
unanswered question is how these histone
modifications can directly affect transcription.
Methyl-lysine signaling is often coupled to
downstream processes by a similar mechanism to the
methylation modification of the YEATS domain
read. All the reader domains of the major histone
methylation sites have been identified except for
H3K79. Furthermore, methylated lysine can be
dynamically regulated by demethylases, but
demethylases that remove methyl groups at H3K79
remain to be characterized. The study by Erb and he
Wan et al further encouraged researchers to identify
and identify "readers" and demethylases for H3K79
methylation because these enzymes cross with ENL-
mediated signaling pathways and may also become
therapeutic targets for MLL-r leukemia.
There is currently a new theory that epigenetic
regulators can play an important role in disease.
Driven by this awareness, a growing number of
academics and businesses are working to develop
inhibitors of these mechanisms to treat cancer.
Clinical trials of MLL-r leukemia have evaluated
DOT1L inhibitors, and Erb et al. found that in
cellular models, using DOT1L inhibitors, plus
knockin of ENL mutant genes that do not recognize
acetylated lysine, was more effective than inhibiting
gene expression programs that drive leukemenesis in
both methods alone. This suggests that there is a
synergy between the two therapies.
Wan et al. also investigated the potential of
combinatorial therapies for MLL-r leukemia by
targeting the ENL YEATS domain with the bromine
domain of another reader of lysine acetylation, BET
family proteins. BET proteins typically interact with
SEC. And also promotes transcriptional elongation.
BET inhibitors disrupt the binding of the BET
protein to the acetyl-lysine fraction, and there are
about 20 clinical trials testing the efficacy of these
drugs in cancer treatment. Moreover, the
combination of the YEATS domain inhibitor of ENL
with the BET inhibitor JQ1 is highly toxic to MLL-r
leukemia cells.
The effects of these combinatorial therapies
suggest that multiple histone modification signals
act together to form a characteristic epigenetic state
of MLL-r leukemia. Therefore, multiple targeted
therapies are more effective and can reduce the
emergence of-with resistance, which is one of the
risks of monotherapy.
Drug developers have long focused mainly on
targeting enzymatic activity, rather than protein –
protein interactions. However, the development of
"reader" therapies targeting multiple apparent
modification groups has become increasingly
popular, thanks in part to the success of BET
inhibitors. The binding site of the YEATS domain is
also a very attractive target for drug development.
TCM treatment has made progress in the
treatment of leukemia for many years, and has
developed continuously, while the treatment of
leukemia is not limited to western medicine
technology. At present, the application of TCM has
become an important treatment means of leukemia.
According to researchers, there are six TCM that
have a good anti-leukemia effect, and specifically
list the relevant active ingredients.
Computer-aided Drug Design (CADD), is a
computer chemistry based approach to predicting
testing and computing the relationship between
ligand and receptor biological macromolecules
through computer simulations, enabling optimization
and design of lead compounds (Xie 2019). At
present, CADD method has gradually mature and
plays an increasingly important role in drug
development, which can greatly shorten the
development cycle of new drugs and reduce
development costs.
Molecular docking is the most widely used and
successful method in structure-based drug design.
Molecular docking generally refers to the process in