FLT3LG and IFITM3P6 consolidate T cell activity in the bone marrow microenvironment and are prognostic factors in acute myelocytic leukemia

Acute myelocytic leukemia (AML) is a malignancy of the stem cell precursors of the myeloid lineage. CD4+ and CD8+ T cells play pivotal roles in influencing AML progression but are functionally suppressed in the bone marrow microenvironment. We aimed to find hub genes related to T cell exhaustion and suppression, thereby providing evidence for immunotherapy. In this study, gene transcriptome expression data from TCGA and TARGET databases were utilized to find key genes. Firstly, CIBERSORT immune cell infiltration algorithm and WGCNA method were used to identify CD4+ and CD8+ T cells-related genes. Univariate and multivariate cox regression analyses were then introduced to construct the overall survival prognosis model and included hub genes. The ESTIMATE and ssGSEA scoring methods were used to analyze the correlation between the hub genes and immune activity. Single-cell transcriptome analysis was applied to detect the immune cells expressing hub genes, hence, to detect exact mechanisms. Consequently, FLT3LG and IFITM3P6 were determined to be positively correlated with patients’ overall survival and microenvironment immune activity. Further study suggested FLT3-FLT3LG and IFITM3P6-miR-6748-3p-CBX7 signaling axes were involved in CD4+ and CD8+ T cells activation. This may be one of the mechanisms of T cells suppression in AML.

[Physiopathology and possible clinical use of hematopoietic stem cells. Recent advances]

Studies carried out during these last years have lead to a considerable improvement in the understanding of the biology of hematopoietic stem cells. The development of hematopoietic stem cell transplantation had a considerable impact on the therapy of leukemias. The improvement in transplantation protocols allowed the development of allogenic transplantations in which the graft versus tumor contributes to the anti-tumor effects. In parallel many growth factors acting on hematopoietic cells have been isolated and used in clinic to stimulate hematopoietic recovery and stem cell mobilization. Finally, malignant stem cells have been isolated and characterized in acute and chronic leukemias: these cells are responsible for the development and maintenance of the leukemic process and must be eradicated to obtain an effective treatment of leukemias.

Haemopoietic growth factors: structure and receptor interactions

The proteins which regulate the production of blood cells appear to have overlapping functions. There are several forms of the haemopoietic growth factors (HGFs). Although a few have been purified, the functions of the different growth factors have not yet been clarified. The amino acid sequence of murine granulocyte-macrophage colonystimulating factor (GM-CSF) has been determined from a cDNA clone and several molecular forms of the molecule have been purified. Although there is no extensive homology with other haemopoietic growth factors, the mRNA for GM-CSF suggests two possible functions for this molecule. Radioiodination of GM-CSF to high specific activity has permitted the detection of two classes of specific GM-CSF receptors on myeloid cells. Although the different haemopoietic growth factors do not compete directly for binding to their specific receptors, GM-CSF and interleukin 3 (IL-3) can modulate the availability of other HGF receptors.

The role of haemopoietic cell growth factor (interleukin 3) in the development of haemopoietic cells

Haemopoietic cell development in vivo occurs in restricted sites in association with stromal cells. Haemopoiesis in vitro can be induced in the absence of stromal cells, provided the haemopoietic cells are supplied with appropriate growth stimulatory molecules. Evidence indicates that the same, or functionally similar, growth factors are normally supplied in vivo by the surrounding stromal cells and that the control of haemopoietic cell proliferation and development is regulated locally and is mediated by cell-cell interactions. We have been studying the effects of a growth factor which induces self-renewal and differentiation of multipotential stem cells as well as proliferation and development of lineage-restricted progenitor cells and activation of mature cells. Because of the wide range of activities embraced by this molecule we have termed it haemopoietic cell growth factor (HCGF). It is also known as interleukin 3 and multi-CSF. HCGF allows the survival, proliferation and development of cells and can be used to generate continuously growing, non-leukaemic, factor-dependent cell lines, in vitro (FDC-P). In the absence of HCGF. FDC-P cells die within hours. We have shown that HCGF may exert its primary effects (in terms of cell survival) on ATP generation, via its influence on glucose transport. Studies are also described which indicate that a primary event in differentiation induced by HCGF involves ADP-ribosylation of membrane-associated proteins. The significance of these findings for normal haemopoiesis and in leukaemogenesis is discussed.

Haemopoietic growth factor regulation of protein kinases and genes associated with cell proliferation

Haemopoietic growth factors stimulate a number of common biochemical and molecular events despite the high specificity of individual ligand-receptor interactions. Analysis of three distinct colony-stimulating factors (CSFs), interleukin 3 (IL-3), granulocyte-CSF and granulocyte macrophage-CSF, and the lymphocytotropic growth factor IL-2 revealed remarkably similar distal subcellular biochemical signals, although the mode of initial membrane signal transduction may differ significantly. Both early progenitor cell growth factors, such as IL-3, and late-acting factors, such as CSF-1, stimulate tyrosine and serine/threonine substrate phosphorylations. One substrate (p68) is phosphorylated in response to many CSFs and to IL-2, suggesting that it plays a highly conserved role in the signal transduction processes of many different receptor(s). The proliferative CSFs and IL-2 also stimulate the expression of many of the same genes, including protooncogenes, the ornithine decarboxylase gene, and members of the phylogenetically ancient family of stress response genes. Thus although initial membrane events may differ among the proliferative stimulants, the biochemical and molecular convergence of signalling pathways on highly conserved cellular substrates and on the programme of gene expression is seen.

Haemopoietic growth factors: their relevance in osteoclast formation and function

The major recent advance in our knowledge of the haemopoietic system has been the purification and characterization of a family of haemopoietic growth factors, and their availability in recombinant form. In the bone marrow the sequences of differentiation and proliferation leading to the production of mature cells that these factors regulate may be determined by the relative availability of the factors in microenvironmental domains. The observation that growth factor-producing cells and haemopoietic progenitor cells are not evenly distributed in the bone marrow leads us to expect that the overall effect of growth factors (and other regulatory molecules) on the production and function of macrophages and osteoclasts may differ when in vivo or in vitro assays are used as end-points and, in the latter case, when whole marrow or purified cell populations are tested. The availability of an in vitro assay in which osteoclast-like cells are generated will allow these concepts to be tested.

Erythropoiesis stimulating agents

May not be safe in people with cancer

Familial hemophagocytic lymphohistiocytosis with the MUNC13-4 mutation: a case report

A 44-day-old male infant with familial hemophagocytic lymphohistiocytosis (FHL) associated with the MUNC13-4 mutation is reported. He presented with fever and poor feeding, lymphocytosis with thrombocytopenia and CSF pleocytosis without virological explanation. On the basis of progressive hyperferritinemia (1323 ng/ml), anemia (hemoglobin: 5.2 g/dl), hypertriglyceridemia (547 mg/dl) and increased LDH (1063 IU/l) with hemophagocytosis in the bone marrow, hemophagocytic lymphohistiocytosis was diagnosed. He showed a good response to corticosteroid therapy and the disease was stable for more than 5 months. Thereafter, he suffered from central nervous system complications, and successfully underwent unrelated cord blood stem cell transplantation. A remission was observed for more than 2 years, with mild mental retardation. Genetic analysis revealed that he had a compound heterozygous mutation of MUNC13-4; namely a novel 2163G>A mutation resulting in W721X, and 754-1G>C resulting in a premature stop codon in this gene. Western blot analysis showed the complete loss of the MUNC13-4 protein, whereas other molecules associated with the SNARE systems were detected at normal levels. Conclusion. FHL may have a broad clinical spectrum, and further analysis on its phenotype-genotype association is required to establish an appropriate treatment strategy, including immunochemotherapy and stem cell transplantation in the future.

Erythropoietin: the story of hypoxia and a finely regulated hematopoietic hormone

The dramatic increase in knowledge during the last half century about the hormone erythropoietin is reviewed. The description of these events has been separated into two parts. The first part describes how the rapid changes in response to tissue oxygenation in the kidneys changes the rate of erythropoietin production. The second part describes how changes in erythropoietin concentrations act on erythroid progenitor cells, resulting in prompt changes in rates of erythrocyte production. Together these two aspects of erythropoietin biology provide an explanation for the tight physiological regulation of the numbers of circulating erythrocytes and, in a more general manner, provide a model for the control of the numbers of other specific blood cells by their respective hematopoietic growth factors.

Thrombopoietin, flt3-ligand and c-kit-ligand modulate HOX gene expression in expanding cord blood CD133 cells

Haemopoietic stem/progenitor cell (HSPC) development is regulated by extrinsic and intrinsic stimuli. Extrinsic modulators include growth factors and cell adhesion molecules, whereas intrinsic regulation is achieved with many transcription factor families, of which the HOX gene products are known to be important in haemopoiesis. Umbilical cord blood CD133+ HSPC proliferation potential was tested in liquid culture with 'TPOFLK' (thrombopoietin, flt-3 ligand and c-kit ligand, promoting HSPC survival and self-renewal), in comparison to 'K36EG' (c-kit-ligand, interleukins-3 and -6, erythropoietin and granulocyte colony-stimulating factor, inducing haemopoietic differentiation). TPOFLK induced a higher CD133+ HSPC proliferation (up to 60-fold more, at week 8) and maintained a higher frequency of the primitive colony-forming cells than K36EG. Quantitative polymerase chain reaction analysis revealed opposite expression patterns for specific HOX genes in expanding cord blood CD133+ HSPC. After 8 weeks in liquid culture, TPOFLK increased the expression of HOX B3, B4 and A9 (associated with uncommitted HSPC) and reduced the expression of HOX B8 and A10 (expressed in committed myeloid cells) when compared to K36EG. These results suggest that TPOFLK induces CD133+ HSPC proliferation, self-renewal and maintenance, up-regulation of HOX B3, B4 and A9 and down-regulation of HOX B8 and A10 gene expression.

Ex vivo expansion of neutrophil precursor cells from fresh and cryopreserved cord blood cells

BACKGROUND

Neutropenia following cord blood (CB) transplantation may be abrogated by infusion of granulopoietic progenitor cells. The purpose of this study was to determine whether myeloid progenitors can be obtained by ex vivo expansion of cryopreserved cord blood aliquots, and whether these progenitors present the morphologic, biologic and functional properties of myeloid progenitors at various stages of differentiation.

METHODS

The cells, plated for 7 days in serum-free medium with SCF, IL-3, G-CSF, Flt3-ligand and thrombopoietin in various combinations were assessed for the expression of CD34, CD38 and CD13. Maturation of cells into the myeloid lineage was evaluated by the expression of CD15, CD11b and CD16 and by the presence of primary (myeloperoxidase) and secondary granules (lactoferrin). The capacity of cells to phagocyte latex beads was evaluated to assess their functionality.

RESULTS

We have shown that a). CD34+ cells isolated from thawed samples were able to produce expansions similar to fresh samples. b). The best combination for the expansion of neutrophil precursor cells was S3FG; c). in these conditions, all stages of myeloid progenitors were represented, but few mature cells were observed. d). However, when the cells were plated on a BM stroma to try to reproduce conditions occurring during transplant, they acquired rapidly the characteristics of mature segmented cells. e). The ex vivo generated granulocytes were able to phagocyte latex beads.

DISCUSSION

In conclusion, it seems reasonable to systematically aliquot CB samples before cryopreservation. Some aliquots can then be thawed, enriched in CD34+ cells and ex vivo differentiated into myeloid lineage, while the other aliquots are conserved to be infused without manipulation.

[Pitfalls of hematopoietic growth factors on MR images]

We report the effects of hematopoietic growth factors on MR signal intensity of bone marrow in 2 children undergoing chemotherapy for musculoskeletal malignancies. The two patients with initially fatty marrow had signal intensity changes: diffuse decreased signal of the distal femoral metaphysis and patchy areas in the diaphysis of both tibia and fibula, simulating metastases. These changes coincided with dramatic increase in neutrophil counts. Technetium 99 skeletal scintigraphy was normal. After a three year follow-up the patients are in good health.

Expression of LSLCL, a new C-type lectin, is closely restricted, in bone marrow, to immature neutrophils

In vitro, LSLCL is expressed by numerous myeloid, promyelocytic, and T or B lymphoblastoid cell lines. In vivo, LSLCL is strongly expressed in bone marrow and only faintly in lymphoid organs. We show here that, in bone marrow, LSLCL is detected: (i) concentrated in the cytoplasm of immature neutrophils but not in myeloblasts nor in mature neutrophils, (ii) in extracellular bone marrow fluid. Besides, numerous cDNAs, similar to LSLCL (identity of 93-99%), are found in 'expressed sequence tags' databases from various origins, mostly fetal and undifferentiated tumour tissues. Since LSLCL and various closely related cDNAs are expressed at definite stages of cellular maturation processes, we hypothesize that this class of proteins could play an important role in the control of cellular differentiation.

Serum-free ex vivo expansion of CD34(+) hematopoietic progenitor cells

In an effort to obtain defined culture conditions for ex vivo expansion of hematopoietic stem and progenitor cells which avoid the supplementation of serum, we cultured human CD34(+) hematopoietic progenitor cells in a chemically defined, serum-free medium in the presence of hematopoietic growth factors (HGFs), stem cell factor (SCF), interleukin (IL)-1beta, IL-3, IL-6, and erythropoietin (EPO). A medium, SFM-1, was prepared according to a protocol previously optimized for semisolid progenitor cell assays containing Iscove's Modified Dulbecco's Medium (IMDM) plus cholesterol, bovine serum albumin, transferrin, nucleotides and nucleosides, insulin, and beta-mercaptoethanol. In static cultures seeded with CD34(+)-enriched progenitor cells isolated from human peripheral blood, a mean 76.6-fold expansion of total nucleated cells and a mean 4.6-fold expansion of colony-forming cells (CFC) was recorded after 14 days. Morphological analysis of the expanded cells revealed formation of myeloid, erythroid, and megakaryocytic cells. Flow cytometric analysis indicated that CD34(+) antigen expressing cells were maintained to a limited degree only, and cell populations expressing surface markers for myeloid (CD33, CD14, and CD15) and megakaryocytic (CD41a) lineages predominated. Within SFM-1, bovine serum albumin (BSA), cholesterin, and transferrin represented the most critical components needed for efficient total cell and CFC expansion. Addition of autologous patient plasma (APP) or fetal calf serum (FCS) to SFM-1 resulted in inferior cell amplification and CFC formation compared to controls in SFM-1, indicating that the components used in SFM-1 could replace exogenous serum. Four commercially available serum-free media resulted in either comparable or lower total cell and CFC yields as SFM-1. The transplantation potential of CD34(+) cells after culture in SFM-1 was assayed using limiting dilution analysis on preformed irradiated bone marrow stroma and revealed maintenance of long-term bone marrow culture initiating cell (LTCIC) levels during the culture period. These data indicate that HGF-supported multilineage ex vivo expansion of human CD34(+) hematopoietic progenitor cells is feasible using an IMDM-based culture medium which contains a restricted number of additives, resulting in analogous or improved yields of both primitive and differentiated cells compared to previously established protocols. We suggest that this culture protocol is of advantage when working with pharmaceutical-grade preparations under serum-free conditions.

Mpl: from an acute myeloproliferative virus to the isolation of the long sought thrombopoietin

Mpl, the receptor for thrombopoietin (TPO), was isolated as a cellular sequence transduced by a new acute myeloproliferative virus. Human and murine c-mpl were subsequently cloned and Mpl was identified as a member of the growth factor receptor superfamily. For a time, Mpl remained an orphan receptor. Engineering of cell lines expressing c-mpl provided a sensitive tool for detecting the ligand of Mpl, and led to the molecular cloning of TPO, the long sought proliferation and differentiation factor for the megakaryocytic lineage. Afterwards, signal transduction by Mpl was studied, and the functional elements of the cytoplasmic domain responsible for cell proliferation and differentiation were identified. When studied in various human hematologic malignancies, Mpl expression was shown to be increased in 50% of the patients with acute myeloblastic leukemia (AML). In vitro treatment of AML cells by TPO led to proliferation, suggesting that TPO could contribute, at least in part, to abnormal growth of AML cells. A tremendous number of studies have followed the isolation of TPO, and have shown that TPO is the primary regulator of physiological platelet production. However, roles for Mpl and TPO in other lineages, especially in erythroid and immature hematopoietic progenitors, have also emerged from these studies.

Ex vivo expansion of hematopoietic progenitor cells for clinical use

The development of efficient stem and progenitor cell selection methods in combination with the development of hematopoietic growth factors facilitated the development of ex vivo expansion techniques. Currently, this novel domain of cellular therapy aims to generate stem and progenitor cells, as well as more differentiated post-progenitor cells and antigen-presenting dendritic cells. The feasibility of generating and transplanting hematopoietic progenitor cells ex vivo (using various cytokine combinations) has been successfully shown preclinically as well as clinically. Furthermore, cytokines (eg, Flt-3-ligand; thrombopoietin) have been identified that play important roles with regard to amplification of undifferentiated early hematopoietic cells. The use of lineage-specific cytokines such as granulocyte colony-stimulating factor and thrombopoietin facilitated the generation of large numbers of myeloid and megakaryocytic post-progenitor cells. The clinical usefulness of such ex vivo generated cells, however, has not yet been convincingly shown. Last, ex vivo expansion techniques can be used to generate large numbers of antigen-presenting dendritic cells from CD34+ peripheral blood progenitor cells that might be ideally used for immunotherapeutic approaches.

Molecular cloning of a new secreted sulfated mucin-like protein with a C-type lectin domain that is expressed in lymphoblastic cells

We have previously demonstrated hyposialylation of the two major CD45 and leukosialin (CD43) molecules at the surface of latently human immunodeficiency virus type 1-infected CEM T cells (CEMLAI/NP), (Lefebvre, J. C., Giordanengo, V., Doglio, A., Cagnon, L., Breittmayer, J. P., Peyron, J. F., and Lesimple, J. (1994) Virology 199, 265-274; Lefebvre, J. C., Giordanengo, V., Limouse, M., Doglio, A., Cucchiarini, M., Monpoux, F., Mariani, R., and Peyron, J. F. (1994) J. Exp. Med. 180, 1609-1617). Searching to clarify mechanism(s) of hyposialylation, we observed two sulfated secreted glycoproteins (molecular mass approximately 47 and approximately 40 kDa) (P47 and P40), which were differentially sulfated and/or differentially secreted in the culture supernatants of CEMLAI/NP cells when compared with parental CEM cells. A hybridoma clone (7H1) resulting from the fusion between CEMLAI/NP and human embryonic fibroblasts MRC5 cells produced very large amounts of P47 that was purified using Jacalin lectin (specific for O-glycans) and microsequenced. Cloning of P47 was achieved using a CEMLAI/NP cDNA library screened with a degenerate oligonucleotide probe based on its NH2-terminal amino acid sequence. A single open reading frame encoding a protein of 323 amino acids was deduced from the longest isolated recombinant (1.4 kilobase). P47 is a secreted sulfated protein. It carries an NH2-terminal RGD (Arg-Gly-Asp) triplet, a striking alpha-helical leucine zipper composed of six heptads, and a C-terminal C-type lectin domain. The NH2-terminal portion is rich in glutamic acids with a predicted pI of 3.9. In addition, a hinge region with numerous condensed potential sites for O-glycan side chains, which are also the most likely sulfation sites, is located between the RGD and leucine zipper domains. Transcripts were detected in lymphoid tissues (notably bone marrow) and abundantly in T and B lymphoblastoid but very faintly in monocytoid cell lines.