Mechanism action of Bortezomib
Bortezomib is a reversible inhibitor of the chymotrypsin-like activity
of the 26S proteasome in mammalian cells. The 26S proteasome is a large
protein complex that degrades ubiquitinated proteins. The active site of
the proteasome has chymotrypsin-like, trypsin-like, and postglutamyl
peptide hydrolysis activity. The 26S proteasome degrades various
proteins critical to cancer cell survival, such as cyclins, tumor
suppressors, BCL-2, and cyclin-dependent kinase inhibitors. Inhibition
of these degradations sensitizes cells to apoptosis. Bortezomib is a
potent inhibitor of 26S proteasome, which sensitizes activity in
dividing multiple myeloma and leukemic cells, thus inducing apoptosis.
In addition, bortezomib appears to increase the sensitivity of cancer
cells to traditional anticancer agents (e.g., gemcitabine, cisplatin,
paclitaxel, irinotecan, and radiation).
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