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Mayani H, Chávez-González A, Vázquez-Santillan K, Contreras J, Guzman ML. Cancer Stem Cells: Biology and Therapeutic Implications. Arch Med Res 2022; 53:770-784. [PMID: 36462951 DOI: 10.1016/j.arcmed.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
It is well recognized that most cancers derive and progress from transformation and clonal expansion of a single cell that possesses stem cell properties, i.e., self-renewal and multilineage differentiation capacities. Such cancer stem cells (CSCs) are usually present at very low frequencies and possess properties that make them key players in tumor development. Indeed, besides having the ability to initiate tumor growth, CSCs drive tumor progression and metastatic dissemination, are resistant to most cancer drugs, and are responsible for cancer relapse. All of these features make CSCs attractive targets for the development of more effective oncologic treatments. In the present review article, we have summarized recent advances in the biology of CSCs, including their identification through their immunophenotype, and their physiology, both in vivo and in vitro. We have also analyzed some molecular markers that might become targets for developing new therapies aiming at hampering CSCs regeneration and cancer relapse.
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Affiliation(s)
- Hector Mayani
- Unidad de Investigaci..n en Enfermedades Oncol..gicas, Hospital de Oncolog.ía, Centro M..dico Nacional SXXI, Instituto Mexicano del Seguro Social. Ciudad de M..xico, M..xico.
| | - Antonieta Chávez-González
- Unidad de Investigaci..n en Enfermedades Oncol..gicas, Hospital de Oncolog.ía, Centro M..dico Nacional SXXI, Instituto Mexicano del Seguro Social. Ciudad de M..xico, M..xico
| | | | - Jorge Contreras
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY, USA
| | - Monica L Guzman
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY, USA
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Torres-Barrera P, Moreno-Lorenzana D, Alvarado-Moreno JA, García-Ruiz E, Lagunas C, Mayani H, Chávez-González A. Cell Contact with Endothelial Cells Favors the In Vitro Maintenance of Human Chronic Myeloid Leukemia Stem and Progenitor Cells. Int J Mol Sci 2022; 23:ijms231810326. [PMID: 36142235 PMCID: PMC9499491 DOI: 10.3390/ijms231810326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/30/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic Myeloid Leukemia (CML) originates in a leukemic stem cell that resides in the bone marrow microenvironment, where they coexist with cellular and non-cellular elements. The vascular microenvironment has been identified as an important element in CML development since an increase in the vascularization has been suggested to be related with poor prognosis; also, using murine models, it has been reported that bone marrow endothelium can regulate the quiescence and proliferation of leukemic stem and progenitor cells. This observation, however, has not been evaluated in primary human cells. In this report, we used a co-culture of primitive (progenitor and stem) CML cells with endothelial colony forming cells (ECFC) as an in vitro model to evaluate the effects of the vascular microenvironment in the leukemic hematopoiesis. Our results show that this interaction allows the in vitro maintenance of primitive CML cells through an inflammatory microenvironment able to regulate the proliferation of progenitor cells and the permanence in a quiescent state of leukemic stem cells.
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Affiliation(s)
- Patricia Torres-Barrera
- Laboratorio de Células Troncales Leucémicas, Unidad de Investigación Médica en Enfermedades Oncológicas, CMN Siglo XXI, Instituto Mexicano del Seguro Social, CDMX 06725, Mexico
- Posgrado en Ciencias Biológicas, UNAM, CDMX 04510, Mexico
| | | | - José Antonio Alvarado-Moreno
- Unidad de Investigación Médica en Trombosis Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, CDMX 03100, Mexico
| | - Elena García-Ruiz
- Departamento de Hematología, Hospital de Especialidades, CMN La Raza, Instituto Mexicano del Seguro Social, CDMX 02990, Mexico
| | - Cesar Lagunas
- Departamento de Cirugías de Cadera, Hospital General “Villa Coapa” Instituto Mexicano del Seguro Social, CDMX 14310, Mexico
| | - Hector Mayani
- Laboratorio de Células Troncales Hematopoyéticas, Unidad de Investigación Médica en Enfermedades Oncológicas, CMN Siglo XXI, Instituto Mexicano del Seguro Social, CDMX 06725, Mexico
| | - Antonieta Chávez-González
- Laboratorio de Células Troncales Leucémicas, Unidad de Investigación Médica en Enfermedades Oncológicas, CMN Siglo XXI, Instituto Mexicano del Seguro Social, CDMX 06725, Mexico
- Correspondence:
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Bilko DI, Dyagil IS, Chaikovsky YB. Morphofunctional Features of Hematopoietic Bone Marrow Progenitor Cells in Patients with Chronic Myeloid Leukemia in Long-Term Culture of Gel Diffusion Chambers In Vivo. CYTOL GENET+ 2022. [DOI: 10.3103/s0095452722010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Torres-Barrera P, Mayani H, Chávez-González A. Understanding the hematopoietic microenvironment in chronic myeloid leukemia: A concise review. Curr Res Transl Med 2021; 69:103295. [PMID: 33962119 DOI: 10.1016/j.retram.2021.103295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/04/2021] [Accepted: 04/13/2021] [Indexed: 12/01/2022]
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disease that results from the BCR-ABL gene-induced transformation of a primitive hematopoietic cell. This disease has been extensively studied, and, as a result, a very effective therapy has been developed: the tyrosine kinase inhibitors. Although, there is a significant knowledge about the intrinsic biology of CML cells, alterations in their bone marrow microenvironment are not yet completely understood. In this concise review, we summarized recent findings on the composition and function of the bone marrow microenvironment in CML, and their importance in the progression of the disease and treatment resistance.
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Affiliation(s)
- P Torres-Barrera
- Laboratorio de Células Troncales Leucémicas, Unidad de Investigación Médica en Enfermedades Oncológicas, CMN Siglo XXI, Instituto Mexicano del Seguro Social, México; Posgrado en Ciencias Biológicas, UNAM, México
| | - H Mayani
- Laboratorio de Células Troncales Hematopoyéticas, Unidad de Investigación Médica en Enfermedades Oncológicas, CMN Siglo XXI, Instituto Mexicano del Seguro Social, México
| | - A Chávez-González
- Laboratorio de Células Troncales Leucémicas, Unidad de Investigación Médica en Enfermedades Oncológicas, CMN Siglo XXI, Instituto Mexicano del Seguro Social, México.
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5
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Moreno-Lorenzana D, Avilés-Vazquez S, Sandoval Esquivel MA, Alvarado-Moreno A, Ortiz-Navarrete V, Torres-Martínez H, Ayala-Sánchez M, Mayani H, Chavez-Gonzalez A. CDKIs p18(INK4c) and p57(Kip2) are involved in quiescence of CML leukemic stem cells after treatment with TKI. Cell Cycle 2017; 15:1276-87. [PMID: 26985855 PMCID: PMC4889309 DOI: 10.1080/15384101.2016.1160976] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Chronic Myeloid Leukemia (CML) is sustained by a small population of cells with stem cell characteristics known as Leukemic Stem Cells that are positive to BCR-ABL fusion protein, involved with several abnormalities in cell proliferation, expansion, apoptosis and cell cycle regulation. Current treatment options for CML involve the use of Tirosine Kinase Inhibitor (Imatinib, Nilotinib and Dasatinib), that efficiently reduce proliferation proliferative cells but do not kill non proliferating CML primitive cells that remain and contributes to the persistence of the disease. In order to understand the role of Cyclin Dependent Kinase Inhibitors in CML LSC permanence after TKI treatment, in this study we analyzed cell cycle status, the levels of several CDKIs and the subcellular localization of such molecules in different CML cell lines, as well as primary CD34+CD38−lin− LSC and HSC. Our results demonstrate that cellular location of p18INK4c and p57Kip2 seems to be implicated in the antiproliferative activity of Imatinib and Dasatinib in CML cells and also suggest that the permanence of quiescent stem cells after TKI treatment could be associated with a decrease in p18INK4c and p57Kip2 nuclear location. The differences in p18INK4cand p57Kip2activities in CML and normal stem cells suggest a different cell cycle regulation and provide a platform that could be considered in the development of new therapeutic options to eliminate LSC.
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Affiliation(s)
- Dafne Moreno-Lorenzana
- a Oncology Research Unit , Oncology Hospital, National Medical Center , Mexican Institute for Social Security , Mexico City , Mexico.,b Molecular Biomedicine Department , CINVESTAV , Mexico City , Mexico
| | - Sócrates Avilés-Vazquez
- a Oncology Research Unit , Oncology Hospital, National Medical Center , Mexican Institute for Social Security , Mexico City , Mexico
| | - Miguel Angel Sandoval Esquivel
- a Oncology Research Unit , Oncology Hospital, National Medical Center , Mexican Institute for Social Security , Mexico City , Mexico
| | - Antonio Alvarado-Moreno
- c Thrombosis Haemostasia and Atherogenesis Research Unit , Mexican Institute for Social Security , Mexico City , Mexico
| | | | - Héctor Torres-Martínez
- d Department of Hip Surgery , Villa Coapa General Hospital , Mexican Institute for Social Security , Mexico City , Mexico
| | - Manuel Ayala-Sánchez
- e Department of Hematology , La Raza Medical Center , Mexican Institute for Social Security , Mexico City , Mexico
| | - Héctor Mayani
- a Oncology Research Unit , Oncology Hospital, National Medical Center , Mexican Institute for Social Security , Mexico City , Mexico
| | - Antonieta Chavez-Gonzalez
- a Oncology Research Unit , Oncology Hospital, National Medical Center , Mexican Institute for Social Security , Mexico City , Mexico
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Casiopeina III-Ea, a copper-containing small molecule, inhibits the in vitro growth of primitive hematopoietic cells from chronic myeloid leukemia. Leuk Res 2016; 52:8-19. [PMID: 27855286 DOI: 10.1016/j.leukres.2016.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/01/2016] [Accepted: 11/01/2016] [Indexed: 11/21/2022]
Abstract
Several novel compounds have been developed for the treatment of different types of leukemia. In the present study, we have assessed the in vitro effects of Casiopeina III-Ea, a copper-containing small molecule, on cells from patients with Chronic Myeloid Leukemia (CML). We included primary CD34+ Lineage-negative (Lin-) cells selected from CML bone marrow, as well as the K562 and MEG01 cell lines. Bone marrow cells obtained from normal individuals - both total mononuclear cells as well as CD34+ Lin- cells- were used as controls. IC50 corresponded to 0.5μM for K562 cells, 0.63μM for MEG01 cells, 0.38μM for CML CD34+ lin- cells, and 1.0μM for normal CD34+ lin- cells. Proliferation and expansion were also inhibited to significantly higher extents in cultures of CML cells as compared to their normal counterparts. All these effects seemed to occur via a bcr-abl transcription-independent mechanism that involved a delay in cell division, an increase in cell death, generation of Reactive Oxygen Species and changes in cell cycle. Our results demonstrate that Casiopeina III-Ea possesses strong antileukemic activity in vitro, and warrant further preclinical (animal) studies to assess such effects in vivo.
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Alvarado-Moreno JA, Hernandez-Lopez R, Chavez-Gonzalez A, Yoder MC, Rangel-Corona R, Isordia-Salas I, Hernandez-Juarez J, Cerbulo-Vazquez A, Gonzalez-Jimenez MA, Majluf-Cruz A. Endothelial colony-forming cells: Biological and functional abnormalities in patients with recurrent, unprovoked venous thromboembolic disease. Thromb Res 2015; 137:157-168. [PMID: 26597044 DOI: 10.1016/j.thromres.2015.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/27/2015] [Accepted: 11/06/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Endothelial cells (ECs) are an important component of the blood coagulation system because it maintains blood fluid. Because in patients with venous thromboembolic disease (VTD) a thrombophilic condition is not found sometimes, we investigated if endothelial colony-forming cells (ECFCs) from these patients have biological and functional abnormalities. PATIENTS AND METHODS Human mononuclear cells (MNCs) were obtained from peripheral blood from patients with VTD and controls to obtain ECFCs. These cells were assayed for their immunophenotype and electron microscopy characteristics and their ability to form capillary-like structures and to produce pro-inflammatory and pro-angiogenic cytokines and reactive oxygen species (ROS). RESULTS ECFCs appeared at 7 and 21 days of culture in VTD patients and controls, respectively. ECFCs increased 8-fold in patients and emerged 1 week earlier. No differences in the size of the colonies of ECFCs were found. Numbers and time of appearance of ECFCs was different between groups. ECFC-derived ECs (ECFC-ECs) of both groups expressed CD31, CD34, CD146, and CD-309 but none expressed CD45, CD14, or CD90. Interest CD34 was highly expressed in ECFC-ECs from patients. In both groups, ECFC-ECs showed similar capacity to form capillary-like structures but ECFC-ECs from patients had significant abnormalities in the mitochondrial membrane. We found a significant increase in ROS production in ECFC-ECs from patients. There were significant differences in cytokine profiles between VTD patients and controls. CONCLUSIONS We found a dysfunctional state in ECFC from VTD patients resembling some characteristics of dysfunctional ECs. These findings may help to understand some pathophysiological aspects of VTD.
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Affiliation(s)
- Jose Antonio Alvarado-Moreno
- Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, IMSS, Gabriel Mancera 222, Col. Del Valle, CP 03100 Mexico City, Mexico.
| | - Rubicel Hernandez-Lopez
- Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, IMSS, Gabriel Mancera 222, Col. Del Valle, CP 03100 Mexico City, Mexico.
| | - Antonieta Chavez-Gonzalez
- Unidad de Investigacion Medica en Enfermedades Oncologicas, IMSS, Av. Cuauhtemoc 330, Col. Doctores, CP 06700 Mexico City, Mexico.
| | - Mervin C Yoder
- Wells Center for Pediatric Research, Indiana University School of Medicine, 1044 W. Walnut Street, R4-W125, Indianapolis, IN 46202, USA.
| | - Rosalva Rangel-Corona
- Laboratorio de Oncología Celular, L-4P.B, UMIE-Z, FES-Zaragoza, UNAM, Batalla 5 de Mayo s/n Esq. Fuerte de Loreto, Col. Ejercito de Oriente. C.P. 09230 Mexico City, Mexico.
| | - Irma Isordia-Salas
- Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, IMSS, Gabriel Mancera 222, Col. Del Valle, CP 03100 Mexico City, Mexico.
| | - Jesus Hernandez-Juarez
- Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, IMSS, Gabriel Mancera 222, Col. Del Valle, CP 03100 Mexico City, Mexico.
| | - Arturo Cerbulo-Vazquez
- Hospital de la Mujer, Division de Enseñanza e Investigacion, Salvador Diaz Miron 374, Col. Santo Tomas, Delegacion Miguel Hidalgo, CP 11340 Mexico City, Mexico.
| | - Marco Antonio Gonzalez-Jimenez
- Departamento de Biologia Celular, Instituto Nacional de Perinatologia, Torre de Investigacion, Montes Urales #800 Lomas Virreyes, CP11000 Mexico City, Mexico.
| | - Abraham Majluf-Cruz
- Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, IMSS, Gabriel Mancera 222, Col. Del Valle, CP 03100 Mexico City, Mexico.
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Estrada-González PK, Gómez-Ceja L, Montesinos JJ, Mayani H, Chávez-González A, Meillón L, Delgado N, Sánchez-Nava E, Flores-Figueroa E. Decreased frequency, but normal functional integrity of mesenchymal stromal cells derived from untreated and Imatinib-treated chronic myeloid leukemia patients. Leuk Res 2014; 38:594-600. [PMID: 24661629 DOI: 10.1016/j.leukres.2014.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/18/2014] [Accepted: 02/20/2014] [Indexed: 02/07/2023]
Abstract
In vitro, Imatinib inhibits the proliferation and stimulates the osteogenic and adipogenic differentiation of mesenchymal stromal cells (MSC). However, it is unknown whether Imatinib affects the biology of MSC in vivo. We asked whether MSC from long-term Imatinib-treated CML patients were affected by the in vivo treatment. MSC from untreated and Imatinib-treated patients displayed normal functional properties (i.e. proliferation, immunophenotype, differentiation and hematopoietic supportive capacity) - but a decreased frequency. In vitro, Imatinib lost its effect when discontinued; which suggest that it has a reversible effect on MSC. Therefore it might lose its effect on MSC after discontinuation in vivo.
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Affiliation(s)
- P K Estrada-González
- Niche and Microenvironment Laboratory, Oncology Research Unit, Oncology Hospital, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Coyoacán, México City, Mexico
| | - L Gómez-Ceja
- Niche and Microenvironment Laboratory, Oncology Research Unit, Oncology Hospital, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Coyoacán, México City, Mexico
| | - J J Montesinos
- Mesenchymal Stem Cells Laboratory, Oncology Research Unit, Oncology Hospital, Mexico
| | - H Mayani
- Hematopoietic Stem Cells Laboratory, Oncology Research Unit, Oncology Hospital, Mexico
| | - A Chávez-González
- Leukemic Stem Cells Laboratory, Oncology Research Unit, Oncology Hospital, Mexico
| | - L Meillón
- Hematology Service, Bernardo Sepulveda Hospital, National Medical Center, IMSS, México City, Mexico
| | - N Delgado
- Hematology Service, Bernardo Sepulveda Hospital, National Medical Center, IMSS, México City, Mexico
| | - E Sánchez-Nava
- Hematology Service, Bernardo Sepulveda Hospital, National Medical Center, IMSS, México City, Mexico
| | - E Flores-Figueroa
- Niche and Microenvironment Laboratory, Oncology Research Unit, Oncology Hospital, Mexico.
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Vonka V. Immunotherapy of chronic myeloid leukemia: present state and future prospects. Immunotherapy 2010; 2:227-41. [PMID: 20635930 DOI: 10.2217/imt.10.2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In spite of the considerable successes that have been achieved in the treatment of chronic myeloid leukemia (CML), cure for the disease can only be obtained by the present means in a rather small minority of patients. During the past decade, considerable progress has been made in the understanding of the immunology of CML, which has raised hopes that this disease may be curable by supplementing the current targeted chemotherapy with immunotherapeutic approaches. More than ten small-scale clinical trials have been carried out with experimental vaccines predominantly based on the p210bcr-abl fusion protein. Their results suggested beneficial effects in some patients. Recent data obtained in human patients as well as in animal models indicate that the p210bcr-abl protein does not carry the immunodominant epitope(s). These observations, combined with the recognition of an ever increasing number of other immunogenic proteins in CML cells, strongly support the concept that gene-modified, cell-based vaccines containing the full spectrum of tumor antigens might be the most effective immunotherapeutic approach. Recently created mathematical models have provided important leads for the timing of the combination of targeted drug therapy with vaccine administration. A strategy of how targeted drug therapy might be combined with vaccination is outlined.
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Affiliation(s)
- Vladimír Vonka
- Department of Experimental Virology, Institutute of Hematology & Blood Transfusion, Prague, Czech Republic.
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Mayani H, Flores-Figueroa E, Chávez-González A. In vitro biology of human myeloid leukemia. Leuk Res 2009; 33:624-37. [DOI: 10.1016/j.leukres.2008.11.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 11/04/2008] [Accepted: 11/08/2008] [Indexed: 11/27/2022]
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Kobsar A, Heeg S, Krohne K, Opitz A, Walter U, Böck M, Gambaryan S, Eigenthaler M. Cyclic nucleotide-regulated proliferation and differentiation vary in human hematopoietic progenitor cells derived from healthy persons, tumor patients, and chronic myelocytic leukemia patients. Stem Cells Dev 2008; 17:81-91. [PMID: 18208372 DOI: 10.1089/scd.2007.0060] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Although circulating hematopoietic progenitor cells (HPCs) are frequently used in therapeutic approaches, many aspects of their cellular biochemistry are still unclear. In the present study, the effects of cyclic nucleotide-elevating agents on HPC proliferation and differentiation were investigated. HPCs from different sources, including healthy persons, patients with tumors (medulloblastoma, seminoma, or multiple myeloma), and patients with chronic myelocytic leukemia (CML), were compared. HPCs were isolated by standard leukapheresis procedures and analyzed for proliferation and differentiation into the megakaryocytic and granulocytic lineages. HPCs contained high concentrations of cyclic guanosine monophosphate (cGMP)-dependent and cyclic adenosine monophosphate (cAMP)-dependent protein kinases G and A (PKG and PKA, respectively). Whereas PKG was partly down-regulated during culture, the PKA level remained constant. Stimulation of PKG in HPCs isolated from healthy donors or tumor patients resulted in a biphasic reaction: low cGMP concentrations inhibited proliferation and stimulated differentiation into megakaryocytes, whereas high concentrations revealed the opposite effect. In contrast, differentiation into granulocytes was inhibited in a concentration-dependent manner. Stimulation of PKA inhibited HPC differentiation; however, HPC proliferation was inhibited in controls and stimulated in HPCs from tumor patients. HPCs isolated from CML patients showed a nonhomogeneous reaction pattern to both cyclic nucleotides with high variability between the individual donors. We demonstrated the importance of the source of HPCs for the investigation of proliferation and differentiation. Cyclic nucleotide-regulated pathways are clearly involved in HPC proliferation and differentiation. Pharmacological strategies using cyclic nucleotide-elevating substances to influence HPC growth and differentiation in the bone marrow might support current strategies in HPC recovery from the peripheral blood.
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Affiliation(s)
- Anna Kobsar
- Institute of Clinical Biochemistry and Pathobiochemistry, University of Wuerzburg, 97080 Wuerzburg, Germany
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