INTRODUCTION
Valrubicin (N-trifluoroacetyladriamycin-14-valerate) is a semisynthetic anthracycline originally developed from doxorubicin as an anti-cancer drug and currently approved as Valstarâ„¢ (Endo Pharmaceuticals, Lexington, MA) for the treatment of bladder cancer.1,2 Valrubicin is a drug with a favorable safety profile shown as limited induction of resistant cancer cells, lack of toxicity in healthy tissue, and decreased incidence of severe heart insufficiency.1,3-6 The absence of skin toxicity and the lipophilic characteristic of the molecule permit the use of valrubicin as topical treatment with focus on hyper-proliferative skin diseases. Recently, we showed that valrubicin has a beneficial effect in treating psoriasis and non-melanoma skin cancer (NMSC) by topical application in animal models. The effect was suggested to be partly due to an inhibition of proliferation
and an induction of apoptosis in the keratinocytes.1,4,5,7-9
Nevertheless, valrubicin cellular activity is still unknown. Elucidation
of valrubicin mode of action aims at optimizing the use of valrubicin as treatment, and unravels new and useful steps in valrubicin signaling pathway that may have potential as targets for future treatments of hyper-proliferative skin diseases.
Hyper-proliferation and abnormal differentiation are part of the pathogenesis of several common skin disorders such as psoriasis, NMSC, actinic keratosis, and acne. Consequently a compound which targets this aspect of the pathogenesis of the diseases may offer a future novel treatment.
Valrubicin localizes in the cytoplasm,8,10,11 implicating a mode of action distinct from the former anthracyclines that explicate their effects in the nucleus. The valerate moiety of valrubicin structurally resembles diacyglycerol (DAG), a natural ligand of protein kinase C (PKC), thus binding of valrubicin to PKC is suggested. Moreover, valrubicin has been demonstrated to inhibit TPA induced PKC activity12 and AD198, an analog to valrubicin also possessing a valerate chain, has been described to activate PKCα.13
PKC is a family of cytoplasmic serine/threonine protein kinases that take part in a variety of cellular processes by playing a crucial role in the initial events of signal transduction.14,15 The PKC family consists of nine isoenzymes that, in a concerted manner, regulate cell function upon differential activation by phosphatidylserine (PS) alone or in association with Ca2+ and/or DAG.16 Five isoforms