Review Article

Targeting Mitochondrial Bioenergetics as a Therapeutic Strategy for Chronic Lymphocytic Leukemia

Table 1

List of compounds targeting mitochondrial metabolism in CLL.

CompoundTargetPossible mechanismReferences

Ellagic acid (EA, 2,3,7,8-tetrahydroxy-chromeno[5,4,3-cde]chromene-5,10-dione)Antioxidant and antiproliferative properties (inhibition of DNA binding of certain carcinogens)↓ MMP, ↑ cytochrome c release, caspase 3 activation, and apoptosis[43]
Sodium dichloroacetatePyruvate dehydrogenase kinaseP53 activity[46]
Acacetin (4-methoxy-5,7-dihydroxyflavone)Unknown↓ MMP, ↑ cytochrome c release, caspase 3 activation, and apoptosis[47]
Metformin (1,1-dimethylbiguanide hydrochloride)Energetic metabolism, cell proliferation through AMPK-dependent and independent mechanismApoptosis, inhibition of cell cycle entry[54]
2-Methoxiestradiol (2-ME)Superoxide dismutase inhibitionApoptosis[55]
β-phenylethyl isothiocyanate (PEITC)Glutathione antioxidant system↓ Glutathione, ↑ ROS, oxidation of cardiolipin[56]
FK866/APO866NAMPT inhibitionNAD depletion, ↓ cell viability, ↑ ROS[57, 58]
Valproic acid (VPA)Histone deacetylase inhibition↓ AKT and ATM activation
↑ ROS, ↑ Cytochrome c release, activation of caspases
[59]
Venetoclax (ABT-199)BH3 mimetic, BCL-2-selective inhibitorApoptosis[61]
ZGDHu-1 [N,N-di-(m-methylphenyi)-3,6-dimethyl-1,4-dihydro-1,2,4,5-tetrazine-1,4-dicarboamide]Proteasome inhibitorApoptosis[66]
MCNA, metal-containing nucleoside analoguesPARP-mediated cell death↓ OCR, rapid membrane depolarization[67]
ROS inducible DNA crosslinking agentsDNA crosslinking coupled with H2O2Cytotoxic, tumor-specific damage[69]

↓: decreased; ↑: increased; MMP: mitochondrial membrane potential; ROS: reactive oxygen species; NAMPT: nicotinamide phosphoribosyl transferase; AMPK: 5 adenosine monophosphate-activated protein kinase; AKT: RAC-alpha serine/threonine-protein kinase; ATM: ataxia telangiectasia mutated; BCL2: B-cell lymphoma gene 2; BH3: BCL2 homology domain 3; PARP: poly (ADP-ribose) polymerase; OCR: oxygen consumption rate.