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Altrock PM, Brendel C, Renella R, Orkin SH, Williams DA, Michor F. Mathematical modeling of erythrocyte chimerism informs genetic intervention strategies for sickle cell disease. Am J Hematol 2016; 91:931-7. [PMID: 27299299 PMCID: PMC5093908 DOI: 10.1002/ajh.24449] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/11/2016] [Indexed: 01/24/2023]
Abstract
Recent advances in gene therapy and genome-engineering technologies offer the opportunity to correct sickle cell disease (SCD), a heritable disorder caused by a point mutation in the β-globin gene. The developmental switch from fetal γ-globin to adult β-globin is governed in part by the transcription factor (TF) BCL11A. This TF has been proposed as a therapeutic target for reactivation of γ-globin and concomitant reduction of β-sickle globin. In this and other approaches, genetic alteration of a portion of the hematopoietic stem cell (HSC) compartment leads to a mixture of sickling and corrected red blood cells (RBCs) in periphery. To reverse the sickling phenotype, a certain proportion of corrected RBCs is necessary; the degree of HSC alteration required to achieve a desired fraction of corrected RBCs remains unknown. To address this issue, we developed a mathematical model describing aging and survival of sickle-susceptible and normal RBCs; the former can have a selective survival advantage leading to their overrepresentation. We identified the level of bone marrow chimerism required for successful stem cell-based gene therapies in SCD. Our findings were further informed using an experimental mouse model, where we transplanted mixtures of Berkeley SCD and normal murine bone marrow cells to establish chimeric grafts in murine hosts. Our integrative theoretical and experimental approach identifies the target frequency of HSC alterations required for effective treatment of sickling syndromes in humans. Our work replaces episodic observations of such target frequencies with a mathematical modeling framework that covers a large and continuous spectrum of chimerism conditions. Am. J. Hematol. 91:931-937, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Philipp M. Altrock
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA 02215
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115
- Program for Evolutionary Dynamics, Harvard University, Cambridge, MA 02138
| | - Christian Brendel
- Division of Hematology/Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115
| | - Raffaele Renella
- Division of Hematology/Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215
| | - Stuart H. Orkin
- Division of Hematology/Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215
- Howard Hughes Medical Institute, Cambridge, MA 02138
- Harvard Stem Cell Institute, Cambridge, MA 02138
| | - David A. Williams
- Division of Hematology/Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215
- Harvard Stem Cell Institute, Cambridge, MA 02138
- Corresponding Authors: David A. Williams, MD, Boston Children’s Hospital, 300 Longwood Ave., Karp 08125.3, Boston, MA 02115, Phone: 617-919-2697, Fax: 617-730-0868, , Franziska Michor, PhD, Dana-Farber Cancer Institute, Dept of Biostatistics and Computational Biology, Mailstop CLS-11007, 450 Brookline Avenue, Boston, MA 02115, Phone: 617-632-5045,
| | - Franziska Michor
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA 02215
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115
- Corresponding Authors: David A. Williams, MD, Boston Children’s Hospital, 300 Longwood Ave., Karp 08125.3, Boston, MA 02115, Phone: 617-919-2697, Fax: 617-730-0868, , Franziska Michor, PhD, Dana-Farber Cancer Institute, Dept of Biostatistics and Computational Biology, Mailstop CLS-11007, 450 Brookline Avenue, Boston, MA 02115, Phone: 617-632-5045,
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Krzyzanski W. Pharmacodynamic models of age-structured cell populations. J Pharmacokinet Pharmacodyn 2015; 42:573-89. [PMID: 26377617 DOI: 10.1007/s10928-015-9446-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/08/2015] [Indexed: 12/15/2022]
Abstract
The purpose of this work is to review basic pharmacodynamic (PD) models describing drug effects on cell populations and expand them to age-structured models using the theory of physiologically structured populations. The plasma drug concentrations are interpreted as the environment affecting the cell production and mortality rates. An explicit solution to model equations provides the age density distribution that serves to establish a relationship between the cell lifespan distribution and the hazard of cell removal. Given the lifespan distributions, the age distributions for most commonly applied PD models of cell responses including basic cell turnover, transit compartments, and basic lifespan models have been derived both for the baseline conditions and drug treatment. The steady-state age distribution for basic indirect response models is exponential, and it is uniform for the basic lifespan model. As an example of more complex cell population, the age distribution of human red blood cells has been simulated based on a recent model of red blood cell survival. The age distribution for cells in the transit compartment model is the sum of the gamma functions. Means and variances of age distributions for all discussed models were calculated. A brief discussion of numerical challenges and possible future model developments is presented.
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Affiliation(s)
- Wojciech Krzyzanski
- Department of Pharmaceutical Sciences, University at Buffalo, 370 Kapoor Hall, Buffalo, NY, 14214, USA.
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