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and also the pharmacologic inhibitor CC 10 mM decreased kinase phosphorylation, as expected 37,40 . The inhibitory response was not qualitatively affected by variations in culture ALK Inhibitor medium conditions, as detailed in Section 2 results not shown . Time course analysis revealed that AMPK inactivation was a fast response, already detected at around 1 h of therapy, and maintained thereafter Inhibitor 7C and D . When analyzed, 2 DG also decreased phosphorylation in the AMPK upstream effector LKB 1, despite the fact that the reduce was generally of reduced intensity than in the case of AMPK Inhibitor 7D . Concerning ATO, this agent either did not modify or slightly down regulated AMPK phosphorylation, and did not normally affect the reduce produced by 2 DG Inhibitor 7D .
Lastly, therapy for 4 h with 2 DG did not affect AMPK phosphorylation in NB4 and THP 1 cells Inhibitor 7E , which in the case of NB4 cells is consistent with earlier observations 39 . Of note, therapy with lonidamine did not minimize, but rather stimulated LKB ALK Inhibitor 1 and AMPK phosphorylation Inhibitor 7A and B . This could be a consequence of elevated ROS production Supplementary Inhibitor 1 , because AMPK was characterized as an oxidative stress inducible kinase, even in the absence of ATP depletion 28,40,41 . Prolonged remedies 16 24 h with lonidamine plus ATO, and also to some extent with 2 DG plus ATO, normally decreased total and phosphorylated AMPK levels, possibly due to kinase degradation see double bands in Inhibitor 7B and D . AMPK could play pro apoptotic or pro survival roles 37,42 .
To investigate the functional consequence of 2 DG provoked AMPK inactivation in HL60 cells, we examined the effect in the kinase inhibitor CC. The results in Inhibitor 7F indicate that AG-1478 co therapy with 10 mM CC potentiated apoptosis generation by ATO albeit with reduced efficacy than 2 DG , and slightly augmented apoptosis by 2 DG plus ATO. The former observation was qualitatively corroborated working with an AMPKa directed siRNA Inhibitor 7G , despite the fact that this method was limited by the low efficacy and also the toxicity in the transfection procedure. This suggests that AMPK plays a defensive role in this experimental model, and hence its inactivation by 2 DG could in part explain the elevated apoptotic efficacy of 2 DG plus ATO in HL60 cells. Of note, CC did not increase but rather slightly attenuated apoptosis generation by ATO plus lonidamine.
Digestion Nevertheless, as indicated above lonidamine stimulated AMPK phosphorylation, AG-1478 in contrast to 2 DG. In this regard, a protective action of CC was previously observed by us working with ATO plus the phenolic agent genistein, which activated AMPK by way of ROS production 28 Akt and ERK modulation, and effect of Akt and ERK inhibitors It was reported that 2 DG could either stimulate 43,11 or inhibit 44,45 Akt and ERK pro survival kinases. Hence, we examined the phosphorylation activation of these kinases in HL60 cells treated with 2 DG and ATO, alone and in combination. Therapy with 2 DG alone caused a fast stimulation 30 min of Akt and ERK phosphorylation Inhibitor 8A , to later reduce at prolonged time periods 16 or 24 h Inhibitor 8B .
When examined, 2 DG also stimulated the phosphorylation of mTOR and p70S6K downstream Akt kinases , also as of MEK1 2 upstream ERK kinases Inhibitor 8A . Interestingly, ALK Inhibitor ATO alone exerted small if any effect on Akt and ERK phosphorylation, but attenuated their stimulation by 2 DG Inhibitor 8B . Lastly, 2 DG also stimulated Akt and ERK phosphorylation in NB4 and THP 1 cells, despite the fact that with reduced intensity than in HL60 cells Inhibitor 8C . Numerous reports indicate the existence of mutual inhibitory interactions among Akt and AMPK 42,46,47 . For this reason, we examined the effects of Akt and ERK inhibitors on AMPK activation. It was observed that co therapy using the PI3K inhibitor LY294002 LY, 30 mM or and also the MEK ERK inhibitor U0126 U, 5 mM not only prevented 2 DG provoked Akt or ERK phosphorylation, as expected but additionally attenuated to some extent the reduce in AMPK phosphorylation Inhibitor 8D .
Therefore, AMPK inhibition by 2 DG could be in part a consequence in the elevated Akt and ERK activation. To understand the relevance for apoptosis of Akt and ERK activation by 2 DG and its inhibition by ATO, we examined the effects of LY294002, U0126, and also the Akt inhibitor AG-1478 triciribine AktiV, 10 mM , on 2 DG toxicity. As indicated in Inhibitor 8E, co therapy with all inhibitors elevated apoptosis generation by 2 DG alone, hence mimicking the pro apoptotic effect of ATO. Taken with each other, these results indicate that Akt and ERK activation by 2 DG operates as a restrain for apoptosis, and hence their inhibition by ATO could in part explain the elevated apoptotic ALK Inhibitor efficacy of 2 DG plus ATO combination. We earlier reported that protein kinase activities could modulate ATO transport uptake or export mechanisms in leukemia cells AG-1478 26 . Hence, we asked whether or not co therapy with 2 DG could result in elevated intracellular ATO accumulation