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MAHDAVI MR, POURFARZAD F, KOSARYAN M, AKBARI MT. In Vitro Hb Production in B-thalassemia Patients Is Not a Predictor of Clinical Responsiveness to Hydroxyurea. IRANIAN JOURNAL OF PUBLIC HEALTH 2017; 46:948-956. [PMID: 28845406 PMCID: PMC5563877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The hematologic response to hydroxyurea (HU) is varied among β-thalassemia (BT) patients. The BCL11A and SOX6 genes are involved in response to HU. This study aimed to investigate the in-vitro responsiveness of HU among BT major patients homozygote for IVSII-1G>A mutation and XmnI single nucleotide polymorphism (SNP) in order to find whether the in-vitro Hb concentration is a predictor of clinical (HU) responsiveness. METHODS In this case-control study, twenty BT patients homozygote for IVSII-1G>A mutation and XmnI SNP from Thalassemia Research Center, Sari, Iran in 2015 were selected and categorized into two groups of 10 Responder (R) and 10 Non-Responder (NR) according to their clinical HU response. Ten healthy individuals as a control group were also selected. Hematopoietic erythroid progenitors were expanded from peripheral blood. Hb concentration was measured using photometry method. The flow cytometry and real-time PCR methods were applied for the analysis of cell surface markers (CD71 and CD235a) and gene expression (BCL11A and SOX6), respectively. RESULTS R and NR groups produced higher amount of Basic Hb than C group in cell culture medium at day 14 (P<0.05). After HU treatment, in R group, Hb levels was significantly elevated in comparison to NR and C group (P<0.05). BCL11A expression was decreased after exposure to HU in all groups while SOX6 expression was only down-regulated in C group, and its expression was increased in R and NR groups after HU treatment. CONCLUSION Since different factors including wide networks of intracellular factors and individual differences between patients can affect response to HU in patients, the increasing Hemoglobin on culture medium alone cannot predict clinical responsiveness to that drug.
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Dulmovits BM, Hom J, Narla A, Mohandas N, Blanc L. Characterization, regulation, and targeting of erythroid progenitors in normal and disordered human erythropoiesis. Curr Opin Hematol 2017; 24:159-166. [PMID: 28099275 PMCID: PMC5518670 DOI: 10.1097/moh.0000000000000328] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW The erythroid progenitors burst-forming unit-erythroid and colony-forming unit-erythroid have a critical role in erythropoiesis. These cells represent a heterogeneous and poorly characterized population with modifiable self-renewal, proliferation and differentiation capabilities. This review focuses on the current state of erythroid progenitor biology with regard to immunophenotypic identification and regulatory programs. In addition, we will discuss the therapeutic implications of using these erythroid progenitors as pharmacologic targets. RECENT FINDINGS Erythroid progenitors are classically characterized by the appearance of morphologically defined colonies in semisolid cultures. However, these prior systems preclude a more thorough understanding of the composite nature of progenitor populations. Recent studies employing novel flow cytometric and cell-based assays have helped to redefine hematopoiesis, and suggest that erythroid progenitors may arise from different levels of the hematopoietic tree. Moreover, the identification of cell surface marker patterns in human burst-forming unit-erythroid and colony-forming unit-erythroid enhance our ability to perform downstream functional and molecular analyses at the population and single cell level. Advances in these techniques have already revealed novel subpopulations with increased self-renewing capacity, roles for erythroid progenitors in globin gene expression, and insights into pharmacologic mechanisms of glucocorticoids and pomalidomide. SUMMARY Immunophenotypic and molecular characterization resolves the diversity of erythroid progenitors, and may ultimately lead to the ability to target these progenitors to ameliorate diseases of dyserythropoiesis.
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Affiliation(s)
- Brian M. Dulmovits
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Manhasset, NY
- Hofstra Northwell School of Medicine, Department of Molecular Medicine and Pediatrics, Hempstead, NY
| | - Jimmy Hom
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Manhasset, NY
- Hofstra Northwell School of Medicine, Department of Molecular Medicine and Pediatrics, Hempstead, NY
| | - Anupama Narla
- Stanford University School of Medicine, Department of Pediatric Hematology/Oncology, Stanford, CA
| | - Narla Mohandas
- Red Cell Physiology laboratory, New York Blood Center, New York, NY
| | - Lionel Blanc
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Manhasset, NY
- Hofstra Northwell School of Medicine, Department of Molecular Medicine and Pediatrics, Hempstead, NY
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Vathipadiekal V, Farrell JJ, Wang S, Edward HL, Shappell H, Al-Rubaish A, Al-Muhanna F, Naserullah Z, Alsuliman A, Qutub HO, Simkin I, Farrer LA, Jiang Z, Luo HY, Huang S, Mostoslavsky G, Murphy GJ, Patra PK, Chui DH, Alsultan A, Al-Ali AK, Sebastiani P, Steinberg MH. A candidate transacting modulator of fetal hemoglobin gene expression in the Arab-Indian haplotype of sickle cell anemia. Am J Hematol 2016; 91:1118-1122. [PMID: 27501013 DOI: 10.1002/ajh.24527] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 08/02/2016] [Accepted: 08/03/2016] [Indexed: 12/30/2022]
Abstract
Fetal hemoglobin (HbF) levels are higher in the Arab-Indian (AI) β-globin gene haplotype of sickle cell anemia compared with African-origin haplotypes. To study genetic elements that effect HbF expression in the AI haplotype we completed whole genome sequencing in 14 Saudi AI haplotype sickle hemoglobin homozygotes-seven selected for low HbF (8.2% ± 1.3%) and seven selected for high HbF (23.5% ± 2.6%). An intronic single nucleotide polymorphism (SNP) in ANTXR1, an anthrax toxin receptor (chromosome 2p13), was associated with HbF. These results were replicated in two independent Saudi AI haplotype cohorts of 120 and 139 patients, but not in 76 Saudi Benin haplotype, 894 African origin haplotype and 44 AI haplotype patients of Indian origin, suggesting that this association is effective only in the Saudi AI haplotype background. ANTXR1 variants explained 10% of the HbF variability compared with 8% for BCL11A. These two genes had independent, additive effects on HbF and together explained about 15% of HbF variability in Saudi AI sickle cell anemia patients. ANTXR1 was expressed at mRNA and protein levels in erythroid progenitors derived from induced pluripotent stem cells (iPSCs) and CD34+ cells. As CD34+ cells matured and their HbF decreased ANTXR1 expression increased; as iPSCs differentiated and their HbF increased, ANTXR1 expression decreased. Along with elements in cis to the HbF genes, ANTXR1 contributes to the variation in HbF in Saudi AI haplotype sickle cell anemia and is the first gene in trans to HBB that is associated with HbF only in carriers of the Saudi AI haplotype. Am. J. Hematol. 91:1118-1122, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Vinod Vathipadiekal
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - John J. Farrell
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Shuai Wang
- Department of Biostatistics; Boston University School of Public Health; Boston Massachusetts
| | - Heather L. Edward
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Heather Shappell
- Department of Biostatistics; Boston University School of Public Health; Boston Massachusetts
| | - A.M. Al-Rubaish
- Department of Internal Medicine; College of Medicine, University of Dammam; Dammam Kingdom of Saudi Arabia
| | - Fahad Al-Muhanna
- Department of Internal Medicine; College of Medicine, University of Dammam; Dammam Kingdom of Saudi Arabia
| | - Z. Naserullah
- Al-Omran Scientific Chair for Hematological Diseases; King Faisal University; Al-Ahsa Kingdom of Saudi Arabia
- Department of Pediatrics; Maternity and Child Hospital; Dammam Kingdom of Saudi Arabia
| | - A. Alsuliman
- Alomran Scientific Chair; King Faisal University, King Fahd Hospital; Hafof Al-Ahsa Kingdom of Saudi Arabia
| | - Hatem Othman Qutub
- Alomran Scientific Chair; King Faisal University; Al-Ahsa Kingdom of Saudi Arabia
| | - Irene Simkin
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Lindsay A. Farrer
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Zhihua Jiang
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Hong-Yuan Luo
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Shengwen Huang
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Gustavo Mostoslavsky
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - George J. Murphy
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Pradeep K. Patra
- Department of Biochemistry; Pt. J. N. M. Medical College; Raipur Chattisgarh India
| | - David H.K. Chui
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
| | - Abdulrahman Alsultan
- Sickle Cell Disease Research Center and Department of Pediatrics; College of Medicine, King Saud University; Riyadh Saudi Arabia
| | - Amein K. Al-Ali
- Center for Research and Medical Consultation; University of Dammam; Dammam Kingdom of Saudi Arabia
| | - Paola Sebastiani
- Department of Biostatistics; Boston University School of Public Health; Boston Massachusetts
| | - Martin H. Steinberg
- Department of Medicine; Boston University School of Medicine; Boston Massachusetts
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Koury MJ. Tracking erythroid progenitor cells in times of need and times of plenty. Exp Hematol 2016; 44:653-63. [DOI: 10.1016/j.exphem.2015.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/22/2015] [Accepted: 10/28/2015] [Indexed: 01/01/2023]
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Rowe RG, Wang LD, Coma S, Han A, Mathieu R, Pearson DS, Ross S, Sousa P, Nguyen PT, Rodriguez A, Wagers AJ, Daley GQ. Developmental regulation of myeloerythroid progenitor function by the Lin28b-let-7-Hmga2 axis. J Exp Med 2016; 213:1497-512. [PMID: 27401346 PMCID: PMC4986532 DOI: 10.1084/jem.20151912] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 05/18/2016] [Indexed: 01/01/2023] Open
Abstract
Daley and collaborators show that endogenous Lin28b drives erythroid-dominant fetal hematopoiesis and that decreases in Lin28b activate adult granulocyte-predominant hematopoiesis. For appropriate development, tissue and organ system morphogenesis and maturation must occur in synchrony with the overall developmental requirements of the host. Mistiming of such developmental events often results in disease. The hematopoietic system matures from the fetal state, characterized by robust erythrocytic output that supports prenatal growth in the hypoxic intrauterine environment, to the postnatal state wherein granulocytes predominate to provide innate immunity. Regulation of the developmental timing of these myeloerythroid states is not well understood. In this study, we find that expression of the heterochronic factor Lin28b decreases in common myeloid progenitors during hematopoietic maturation to adulthood in mice. This decrease in Lin28b coincides with accumulation of mature let-7 microRNAs, whose biogenesis is regulated by Lin28 proteins. We find that inhibition of let-7 in the adult hematopoietic system recapitulates fetal erythroid-dominant hematopoiesis. Conversely, deletion of Lin28b or ectopic activation of let-7 microRNAs in the fetal state induces a shift toward adult-like myeloid-dominant output. Furthermore, we identify Hmga2 as an effector of this genetic switch. These studies provide the first detailed analysis of the roles of endogenous Lin28b and let-7 in the timing of hematopoietic states during development.
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Affiliation(s)
- R Grant Rowe
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215
| | - Leo D Wang
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215 Harvard Stem Cell Institute, Cambridge, MA 02138 Joslin Diabetes Center, Boston, MA 02215
| | - Silvia Coma
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215
| | - Areum Han
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215 Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115
| | - Ronald Mathieu
- Harvard Stem Cell Institute, Cambridge, MA 02138 Flow Cytometry Laboratory, Boston Children's Hospital, Boston, MA 02115
| | - Daniel S Pearson
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215
| | - Samantha Ross
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215
| | - Patricia Sousa
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215
| | - Phi T Nguyen
- Harvard Stem Cell Institute, Cambridge, MA 02138 Joslin Diabetes Center, Boston, MA 02215
| | - Antony Rodriguez
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030
| | - Amy J Wagers
- Harvard Stem Cell Institute, Cambridge, MA 02138 Joslin Diabetes Center, Boston, MA 02215 Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA 02138
| | - George Q Daley
- Stem Cell Transplantation Program, Stem Cell Program, Division of Pediatric Hematology/Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215 Harvard Stem Cell Institute, Cambridge, MA 02138 Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115 Howard Hughes Medical Institute, Boston, MA 02115 Division of Hematology, Brigham and Women's Hospital, Boston, MA 02115 Manton Center for Orphan Disease Research, Boston, MA 02115
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Bouchnita A, Eymard N, Moyo TK, Koury MJ, Volpert V. Bone marrow infiltration by multiple myeloma causes anemia by reversible disruption of erythropoiesis. Am J Hematol 2016; 91:371-8. [PMID: 26749142 DOI: 10.1002/ajh.24291] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 12/29/2015] [Indexed: 12/20/2022]
Abstract
Multiple myeloma (MM) infiltrates bone marrow and causes anemia by disrupting erythropoiesis, but the effects of marrow infiltration on anemia are difficult to quantify. Marrow biopsies of newly diagnosed MM patients were analyzed before and after four 28-day cycles of non-erythrotoxic remission induction chemotherapy. Complete blood cell counts and serum paraprotein concentrations were measured at diagnosis and before each chemotherapy cycle. At diagnosis, marrow area infiltrated by myeloma correlated negatively with hemoglobin, erythrocytes, and marrow erythroid cells. After successful chemotherapy, patients with less than 30% myeloma infiltration at diagnosis had no change in these parameters, whereas patients with more than 30% myeloma infiltration at diagnosis increased all three parameters. Clinical data were used to develop mathematical models of the effects of myeloma infiltration on the marrow niches of terminal erythropoiesis, the erythroblastic islands (EBIs). A hybrid discrete-continuous model of erythropoiesis based on EBI structure/function was extended to sections of marrow containing multiple EBIs. In the model, myeloma cells can kill erythroid cells by physically destroying EBIs and by producing proapoptotic cytokines. Following chemotherapy, changes in serum paraproteins as measures of myeloma cells and changes in erythrocyte numbers as measures of marrow erythroid cells allowed modeling of myeloma cell death and erythroid cell recovery, respectively. Simulations of marrow infiltration by myeloma and treatment with non-erythrotoxic chemotherapy demonstrate that myeloma-mediated destruction and subsequent reestablishment of EBIs and expansion of erythroid cell populations in EBIs following chemotherapy provide explanations for anemia development and its therapy-mediated recovery in MM patients.
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Affiliation(s)
- Anass Bouchnita
- Institut Camille Jordan, UMR 5208 CNRS, University Lyon 1; Villeurbanne 69622 France
| | - Nathalie Eymard
- Institut Camille Jordan, UMR 5208 CNRS, University Lyon 1; Villeurbanne 69622 France
| | - Tamara K. Moyo
- Division of Hematology/Oncology; Department of Medicine; Vanderbilt University Medical Center; Nashville Tennessee
| | - Mark J. Koury
- Division of Hematology/Oncology; Department of Medicine; Vanderbilt University Medical Center; Nashville Tennessee
| | - Vitaly Volpert
- Institut Camille Jordan, UMR 5208 CNRS, University Lyon 1; Villeurbanne 69622 France
- INRIA Team Dracula, INRIA Antenne Lyon La Doua, Villeurbanne 69603, France, and European Institute of Systems Biology and Medicine; Lyon 69007 France
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Suzuki N, Sasaki Y, Kato K, Yamazaki S, Kurasawa M, Yorozu K, Shimonaka Y, Yamamoto M. Efficacy estimation of erythropoiesis-stimulating agents using erythropoietin-deficient anemic mice. Haematologica 2016; 101:e356-60. [PMID: 27247319 DOI: 10.3324/haematol.2015.140814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Norio Suzuki
- Division of Oxygen Biology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yusuke Sasaki
- Product Research Department, Chugai Pharmaceutical Co. Ltd., Kamakura, Japan
| | - Koichiro Kato
- Division of Oxygen Biology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shun Yamazaki
- Division of Oxygen Biology, Tohoku University Graduate School of Medicine, Sendai, Japan Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mitsue Kurasawa
- Product Research Department, Chugai Pharmaceutical Co. Ltd., Kamakura, Japan
| | - Keigo Yorozu
- Product Research Department, Chugai Pharmaceutical Co. Ltd., Kamakura, Japan
| | - Yasushi Shimonaka
- Product Research Department, Chugai Pharmaceutical Co. Ltd., Kamakura, Japan
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan
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Abstract
Sickle cell disease and β thalassemia are common severe diseases with little effective pathophysiologically-based treatment. Their phenotypic heterogeneity prompted genomic approaches to identify modifiers that ultimately might be exploited therapeutically. Fetal hemoglobin (HbF) is the major modulator of the phenotype of the β hemoglobinopathies. HbF inhibits deoxyHbS polymerization and in β thalassemia compensates for the reduction of HbA. The major success of genomics has been a better understanding the genetic regulation of HbF by identifying the major quantitative trait loci for this trait. If the targets identified can lead to means of increasing HbF to therapeutic levels in sufficient numbers of sickle or β-thalassemia erythrocytes, the pathophysiology of these diseases would be reversed. The availability of new target loci, high-throughput drug screening, and recent advances in genome editing provide the opportunity for new approaches to therapeutically increasing HbF production.
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Affiliation(s)
- Duyen A Ngo
- Department of Medicine, Boston University School of Medicine, 820 Harrison Ave., FGH 1st Floor, Boston, MA, 02118, USA.
| | - Martin H Steinberg
- Departments of Medicine, Pediatrics, Pathology and Laboratory Medicine, Boston University School of Medicine, 72 E. Concord Street, Boston, MA, 02118, USA.
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