The effects of SG511-BECN and Dox alone, as well as SG511-BECN plus Dox, around the growth of K562 and K562/A02 cells were analyzed. for the treatment of leukemia with chemotherapy resistance. and continuous survival in tumor or leukemia models8,11,12. Malignancy is a complex disorder associated with defects in multiple signaling pathways that confer resistance to apoptosis, suggesting the need for other innovative Hpt strategies12,13. Recent studies have exhibited that autophagic cell death may serve as a novel way to eliminate tumor cells with defective apoptosis14,15,16,17,18. Therefore, we reasoned that arming CRAds with the genes inducing autophagic cell death could effectively kill cancer cells, especially malignancy cells resistant to apoptosis, and represent a stylish prospect. Indeed, in our previous study19, we have demonstrated that combined Beclin-1 gene therapy that induces autophagic cell death and the SG511 vector (a new Ad5/11 fiber chimeric CRAd) showed enhanced anti-leukemia activities. Current therapeutic methods for CML mainly include Bcr-Abl-targeted drug or cytotoxic brokers and stem cell transplantation20. Although the efficacy of Bcr-Abl tyrosine kinase inhibitors (TKIs) is undoubtedly for CML therapy, resistance remains a challenge21. Causes of the drug resistance include P-glycoprotein (P-gp) up-regulation, Abl kinase domain name mutations, and Bcr-Abl overexpression22. Thus, novel approaches must be adopted to reverse drug resistance and enhance the therapeutic efficacy. In this study, we combined the Beclin-1 gene therapy that induces autophagic cell death with the SG511 vector. The results showed that overexpression of Beclin-1 significantly enhanced the killing effect of the computer virus in multidrug-resistant CML cells, in which the cytotoxic activity of the parental computer virus without the Beclin-1 gene was poor overall. Next, we evaluated whether the combination treatment of SG511-BENC plus Dox performed strong synergistic killing in CML cells. We further analyzed the mechanism of enhanced cytotoxicity induced by the combination therapy focusing on the alteration of the computer virus infectious efficiency and autophagy/apoptosis-associated proteins, suggesting targeting the autophagic cell death pathway may be a novel strategy for the treatment of leukemia with chemotherapy resistance. Materials and methods Normal bone marrow samples, cell lines and reagents Normal bone marrow samples from healthy volunteers were obtained after informed consent and with the approval of the Ethics Committee of the First Affiliated Hospital of Zhejiang University or college (Hangzhou, China). Bone marrow mononuclear cells (MNCs) were isolated by gradient centrifugation using lymphocyte cell separation medium. The human CML cell collection K562 was obtained from the American Type Culture Collection (ATCC, Rockville, MD, USA). K562/A02, the doxorubicin-resistant CML cell collection, was kindly provided by the Institute of Hematology, Chinese Academy of Medical Sciences (Tianjin, China). The cell lines were authenticated by comparing the immunophenotype, the karyotype, and molecular markers. All the cell lines were used within 6 months after paperwork and were cultured as previously explained10. Dox was purchased from Sigma (St Louis, MO, USA). All main antibodies used in this study were purchased from Cell Signaling Technology (Beverly, MA, USA), except for anti-Beclin-1 (Novus Biologicals), anti-LC3 (Novus Biologicals), and anti-actin (Santa Cruz Biotechnology, Santa Cruz, CA, USA). Construction of recombinant viruses The complete cDNA sequence of the DDR1-IN-1 dihydrochloride Beclin-1 gene was amplified by quantitative real-time-PCR (qPCR) using the upstream primer (5-CCG GAA TTC ACC ATG GAA GGG TCT AAG ACGTCC AAC-3) and downstream primer (5-ACG CGTCGA CTT ATC ATT TGT TAT AAA ATT GTG AGG-3). The synthetic DNA was released with portion affected, and log10 (CI) <0 indicates synergy; log10 (CI) = 0 indicates an additive effect; and log10 (CI) >0 indicates antagonism. Results Oncolytic computer virus SG511-BECN mediates multidrug-resistant cell killing in an apoptotic-independent manner It has been shown that SG511-BECN could induce leukemia cell death in our previous studies19. We first examined the effect of SG511-BECN on CML cell lines K562 and K562/A02 (a doxorubicin-resistant cell collection). As shown in Physique 1B and Physique 1C, CML cells were exposed to 40 MOI of SG511-BECN computer virus for 48 h, DDR1-IN-1 dihydrochloride and DDR1-IN-1 dihydrochloride the viability of K562 and K562/A02 cells was reduced by 39.33% and 54.67%, respectively, indicating that K562/A02 cells were more sensitive to SG511-BECN. However, the.