Curcumin combined with arsenic trioxide enhances autophagy and immune surveillance to inhibit immune escape in acute myeloid leukemia. (PubMed, Int Immunopharmacol)
In the AML mouse model, the combination of CUR and ATO exerted a synergistic anti-tumor effect during the progression of AML. In the in vitro KG-1a cell model, it was demonstrated that CUR combined with ATO promoted apoptosis and inhibited proliferation in KG-1a cells through upregulation of the pro-apoptotic protein Caspase3 and downregulation of the anti-apoptotic protein Bcl-2, which was accompanied by a significant increase in autophagosomes in KG-1a cells. In both the co-culture and in vivo models, CUR combined with ATO enhanced the immunotoxic effects of NK cells on KG-1a cells by improving the immunosuppressive microenvironment. The in vivo and in vitro mechanistic studies revealed that CUR combined with ATO primarily upregulated the expression of LC3 protein to promote the formation of autophagosomes in AML cells, downregulated the expression of the hypoxia-inducible factor HIF-1α protein to ameliorate the immunosuppressive microenvironment of AML, and upregulated the expression of MICA protein to activate the NKG2D-NKG2D-L axis. These actions collectively enhanced the immunotoxic and immunosurveillance capabilities of NK cells, thereby inhibiting AML immune evasion. These findings provide novel insights into the mechanisms underlying the synergistic anti-AML effects of CUR combined with ATO and their potential role in inhibiting AML immune evasion.