MLN4924 promotes the transcriptional activation of BTG2 via the ROS/EGR1-mediated signaling axis to suppress acute myeloid leukemia progression.

Acute myeloid leukemia (AML) is a highly heterogeneous hematological malignancy characterized by a high relapse rate and a low survival rate. Although chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) have improved the prognosis for AML patients, the overall survival rate remains suboptimal. MLN4924 is a neddylation inhibitor and is considered a promising treatment approach for AML. However, the exact molecular mechanism remains elusive and requires further investigation. This study aims to investigate the molecular mechanisms of MLN4924 and novel molecular pathways in AML. RNA sequencing (RNA-seq) reveals that the transcription factor (TF) EGR1 serves as a core regulator of MLN4924 and is upregulated by MLN4924 in AML. Mechanistic studies demonstrate that MLN4924 induces apoptosis by generating reactive oxygen species (ROS) and facilitates the nuclear translocation of EGR1. This translocated EGR1 interacts with the promoter region of BTG2, promoting its transcription and inhibiting the progression of AML. Notably, the ROS generated by MLN4924 influences the expression of both EGR1 and BTG2 and establishes a positive feedback loop between EGR1 and ROS. In vivo, we confirm that MLN4924 reduces the leukemic burden in AML cell-derived xenograft models by increasing the expression of both EGR1 and BTG2. In conclusion, these findings suggest that MLN4924 exerts an anti-tumor effect on AML by inducing apoptosis through the ROS-EGR1-BTG2 signaling axis. Our research provides a novel theoretical basis for the clinical potential of MLN4924 in improving the treatment of AML patients, offers novel strategies for AML treatment, and thereby advances the implementation of precision medicine.