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B-cell acute lymphoblastic leukaemia (B-ALL) is characterized by the overproduction of lymphoblasts in the bone marrow (BM), and it is the most common cancer in children while being comparatively uncommon in adults. On the other hand, in chronic myeloid leukaemia (CML), 70% of cases are found in patients older than 50 years, making it uncommon in children. All CML cases and up to 3% of paediatric B- ALL (and 25% of adult B-ALL) cases are due to fusion gene BCR-ABL1, which gives rise to the cytoplasmatic, constitutively active oncoprotein, tyrosine kinase BCR-ABL1 through a reciprocal translocation between chromosomes 9 and 22. The constitutively active BCR-ABL tyrosine kinase leads to deregulation of different signal transduction pathways such as cell growth, proliferation and cell survival. The role of the bone marrow microenvironment (BMM) can mediate disease initiation (only in mice), progression, therapy resistance, and relapse, as has been increasingly recognized over the last two decades. In general, the BMM is a very complex arrangement of various cell types such as osteoblasts, osteoclasts, endothelial cells, adipocytes, mesenchymal stromal cells, macrophages and several others. In addition, the BMM is composed of multiple chemical and mechanical factors and extra cellular matrix (ECM) proteins which contribute to the BMM’s features influencing leukaemia behaviour. Considering the incidence of B-ALL and CML in children and in adults respectively, we hypothesized that the young and/or an aged BMM might also play a previously unrecognized role in the aggressiveness of B-ALL and CML. We proposed that BM, transduced with BCR-ABL1-expressing retrovirus in the murine transduction/transplantation model of B-ALL, transplanted into young versus old recipient mice would lead to a more aggressive disease in young mice, and similarly CML would be more aggressive in old recipient mice. In close recapitulation with the human incidence, induction of CML led to a significantly shorted survival in old recipient mice. On the other hand, induction of B-ALL showed a shortened survival in young compared to old syngeneic mice, as well as in a xenotransplantation model. Among the highly heterogenous composition of the BMM, we implicate young BM macrophages as a supportive niche for B-ALL cells. The results were found to be mostly due to potential soluble factors differentially secreted from young and old macrophages. Therefore, we hypothesized that the chemokine CXCL13, which has been demonstrated to play a role in B cell migration and act as a diagnostic marker in the cerebrospinal fluid of patients with neuroborreliosis, might be responsible for the observed phenotype. CXCL13 was found to be more highly expressed in healthy and leukaemic young mice as well as in conditioned medium of young macrophages. Using a variety of in vitro experiments, CXCL13 showed to significantly increase the proliferation and the migration of leukaemia cells when exposed to young macrophages, and the phenotype was rescued while using a CXCL13 neutralizing antibody. The CXCL13 role was also confirmed in vivo, since macrophage ablation led to a prolongation of survival in young mice and a reduction of CXCL13 levels. The use of an additional mouse model, leukaemia cells with CXCR5 deficiency, led to a significant prolongation of survival of young mice, confirming the importance of the CXCL13-CXCR5 axis in B-ALL. In line with our murine results, we found that human macrophages and CXCL13 levels were higher in pediatric B-ALL patients than in adults. Consistent with our murine data, the expression level of CXCR5 may act as a prognostic marker in B-ALL, as well as a predictive marker for central nervous system relapse in human B-ALL. The overall findings show that a young BMM, and in particular macrophages, influences B-ALL progression. We specifically identified CXCL13, secreted by young macrophages, as a promoter of proliferation of B-ALL cells, influencing survival in B-ALL via CXCR5. The CXCR5-CXCL13 axis may be relevant in human B-ALL, and higher CXCR5 expression in human B-ALL may act as a predictive marker.
As one of the most widespread infectious diseases in the world, it is currently estimated that approximately 296 million people globally are chronically infected with Hepatitis B virus (HBV), the consequences of HBV infection cause more than 620,000 deaths each year. Although safe and effective HBV vaccines have reduced the incidence of new HBV infections in most countries, there are still around 1.5 million new infections each year. HBV remains a major health problem because there is no large-scale effective vaccination strategy in many countries with a high burden of disease, many people with chronic HBV infection are not receiving effective and timely treatment, and a complete cure for chronic infection is still far from being achieved.
Since its discovery, HBV has been identified as an enveloped DNA virus with a diameter of 42 nm. For efficient egress from host cells, HBV is thought to acquire the viral envelope by budding into multivesicular bodies (MVBs) and escape from infected cells via the exosome release pathway. It is clear that HBV hijacks the host vesicle system to complete self-assembly and propagation by interacting with factors that mediate exosome formation. Consequently, the overlap with exosome biogenesis, using MVBs as the release platform, raises the possibility for the release of exosomal HBV particles. Currently, virus containing exosomal vesicles have been described for several viruses. In light of this, this study explored whether intact HBV-virions wrapped in exosomes are released by HBV-producing cells.
First, this study established a robust method for efficient separation of exosomes from HBV virions by a combination of differential ultracentrifugation and iodixanol density gradient centrifugation. Fractionation of the density gradient revealed that two populations of infectious viral particles can be separated from the culture fluids of HBV-producing cells. The population present in the low-density peak co-migrates with the exosome markers. Whereas the population that appeared in the high-density fractions was the classical HBV virions, which are rcDNA-containing nucleocapsids encapsulated by the HBV envelope.
Subsequently, the characterization of this low-density population was performed, namely the highly purified exosome fraction was systematically investigated. Relying on the detergent sensitivity of the exosome membrane and the outer envelope of the HBV virus, disruption of the exosome structure by treatment with limited detergent revealed the presence of HBsAg in the exosomes. At the same time, mild and limited NP-40 treatment of highly purified exosomes and a further combination of density gradient centrifugation resulted in the stepwise release of intact HBV virions and naked capsids from the exosomes generated by HBV-producing cells. This implies the presence of intact HBV particles encapsulated by the host membrane.
The presence of exosome-encapsulated HBV particles was consequently also verified by suppressing the morphogenesis of MVBs or exosomes. Impairment of MVB- or exosome-generation with small molecule inhibitors has significantly inhibited the release of host membrane-encapsulated HBV particles as well. Likewise, silencing of exosome-related proteins caused a diminution of exosome output, which compromised the budding efficiency of wrapped HBV.
Moreover, electron microscopy images of ultra-thin sections combined with immunogold staining visualized the hidden virus in the exosomal structure. Additionally, the presence of LHBs on the surface of exosomes derived from HBV-expressing cells was also observed.
As expected, these exosomal membrane-wrapped HBV particles can spread productive infection in differentiated HepaRG cells. In HBV-susceptible cells, as LHBs on the membrane surface, this type of exosomal HBV appeared to be uptaken in an NTCP receptor-dependent manner.
Taken together these data indicate that a fraction of intact HBV virions can be released as exosomes. This reveals a so far not described release pathway for HBV. Exosomes hijacked by HBV act as a transporter impacting the dissemination of the virus.
The majority of B-cell precursor acute leukemias in infants are associated with the chromosomal translocation t(4;11)(q21;q23), resulting in the fusion of the mixed-lineage leukemia (MLL) and ALL1-fused gene of chromosome 4 (AF4) genes. While the fusion protein MLL-AF4 is expressed in all t(4;11) patients and essential for leukemia progression, the distinct role of the reciprocal fusion protein AF4-MLL, that is expressed in only 50-80% of t(4;11) leukemia patients (Meyer et al., 2018), remains unclear. In addition, t(4;11) leukemia could so far exclusively be generated in vivo in the presence of AF4-MLL and independent of the co-expression of MLL-AF4 (Bursen et al., 2010).
In a multifactorial approach inhibiting histone deacetylases (HDACs) and expressing the dominant negative mutation of Taspase1 (dnTASP1), both MLL fusion proteins were targeted simultaneously to evaluate a possible cooperative effect between MLL-AF4 and AF4-MLL during the progression of leukemia. Of note, neither HDACi nor dnTASP1 expression negatively affect endogenous MLL, but rather endorse its function hampered by the MLL fusion proteins (Ahmad et al., 2014; Bursen et al., 2004; Zhao et al., 2019). The mere expression of dnTASP1 failed to induce apoptosis, whereas dnTASP1 could elevate apoptosis levels significantly in HDACi-treated t(4;11) cells underlining the therapeutic potential of co-inhibiting both MLL fusion proteins.
Next, the impact of inhibiting either MLL-AF4 or AF4-MLL in vivo was resolved using whole transcriptome analysis. In PDX cells obtained by the Jeremias Laboratory (Völse, 2020) that co-expressed both t(4;11) fusion proteins, the knock-down of MLL-AF4 revealed the down-regulation of pivotal hemato-malignant factors. The expression of dnTASP1 led to massive deregulation of cell-cycle genes in vivo. Considering that the inhibition of particularly MLL-AF4 but not AF4-MLL impaired leukemic cell growth in vivo (Völse, 2020), the results of this work suggest a cooperative effect between both fusion proteins, while the loss of AF4-MLL during leukemia progression appears not essential.
Thereafter, a possible short-term role of AF4-MLL during the establishment of t(4;11) leukemia was analyzed. For this purpose, an in vitro t(4;11) model was constructed to investigate the transforming potential of transiently expressed AF4-MLL in cells constitutively expressing MLL-AF4, putatively reflecting the situation in vivo. Due to the lack of a leukemic background of the applied cell line, the aim was to investigate the long-term potential of AF4-MLL to significantly alter the epigenome rather than mimicking the development of leukemia. Strikingly, short-term-expressed AF4-MLL in cooperation with MLL-AF4 exerted durable epigenetic effects on gene transcription and chromatin accessibility. The here obtained in vitro data suggest a clonal evolutionary process initiated by AF4-MLL in a cooperative manner with MLL-AF4. Importantly, no long-term changes in chromatin accessibility could be observed by the transient expression of either MLL-AF4 or AF4-MLL alone.
All in all, considering endogenous MLL, MLL-AF4 and AF4-MLL in a targeted treatment is a promising approach for a more tailored therapy against t(4;11) leukemia, and AF4-MLL is suggested to act in a cooperative manner with MLL-AF4 especially during the development of a t(4;11) leukemia.
The Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus that causes high fever, rash, and recurrent arthritis in humans. The majority of symptoms disappear after about one week. However, arthritis can last for months or even years (in about 30% of cases), which makes people unable to work during this period. The virus is endemic in Sub-Saharan Africa, the Indian Ocean islands, India, and Southeast Asia. It has additionally caused several large outbreaks in the last few years, affecting millions of people. The mortality rate is very low (0.1%), but the infection rates are high (sometimes 30%) and the number of asymptomatic cases is rare (about 15%). The first CHIKV outbreak in a country with a moderate climate was detected in Italy in 2007. Furthermore, the virus has spread to the Caribbean in late 2013. Due to climate change, globalization, and vector switching, the virus will most likely continue to cause new worldwide outbreaks. Additionally, more temperate regions of the world like Europe or the USA, which have recently reported their first cases, will likely become targets. Alarmingly, there is no specific treatment or vaccination against CHIKV available so far.
The cell entry process of CHIKV is also not understood in detail, and was thusly the focus of study for this project. The E2 envelope protein is responsible for cell attachment and entry. It consists of the domain C, located close to the viral membrane, domain A, in the center of the protein, and domain B, at the distal end, prominently exposed on the viral surface.
In this work, the important role of cell surface glycosaminoglycans (GAGs) for CHIKV cell attachment was uncovered. GAGs consist of long linear chains of heavily sulfated disaccharide units and can be covalently linked to membrane associated proteins. They play an important role in different cell signaling pathways. So far, solely cell culture passage has revealed an increased GAG-dependency of CHIKV due to mutations in E2 domain A, which was associated with virus attenuation in vivo. However, in this work it could be shown that cell surface GAGs promote CHIKV entry using non-cell culture adapted CHIKV envelope (Env) proteins. Transduction and infection of cell surface GAG-deficient pgsA-745 cells with CHIKV Env pseudotyped vector particles (VPs) and with wild-type CHIKV revealed decreased transduction and replication rates. Furthermore, cell entry and transduction rates of GAG-containing cells were also dose-dependently decreased in the presence of soluble GAGs. In contrast, transduction of pgsA-745 cells with CHIKV Env pseudotyped VPs was enhanced by the addition of soluble GAGs. This data suggests a mechanism by which GAGs activate CHIKV particles for subsequent binding to a cellular receptor. However, at least one GAG-independent entry pathway might exist, as CHIKV entry could not be totally inhibited by soluble GAGs and entry into pgsA-745 was, albeit at a lower rate, still possible. Further binding experiments using recombinant CHIKV E2 domains A, B, and C suggest that domain B is responsible for the GAG binding, domain A possibly for receptor binding, and domain C is not involved in cell binding. These results are in line with the geometry of CHIKV Env on the viral surface. They altogether reveal that GAG binding promotes viral cell entry and that the E2 domain B plays a central role for this mechanism.
As no vaccine against CHIKV has been approved so far, another goal of this project was to test new vaccination approaches. It has been published that a single linear epitope of E2 is the target of the majority of early neutralizing antibodies against CHIKV in patients. Artificial E2-derived proteins were created, expressed in E.coli, and successfully purified. They consisted of 5 repeats of the mentioned linear epitope (L), the surface exposed regions of domain A linked by glycine-serine linkers (sA), the whole domain B plus a part of the β-ribbon connector (B+), or a combination of these 3 modules. Vaccination experiments revealed that B+ was necessary and sufficient to induce a neutralizing immune response in mice, with the protein sAB+ yielding the best results. sAB+, as a protein vaccine, efficiently and significantly reduced viral titers in mice upon CHIKV challenge, which was not the case for recombinant Modified Vaccinia virus Ankara (MVA; MVA-CHIKV-sAB+), as a vaccine platform expressing the same protein. These experiments show that a small rationally designed CHIKV Env derived protein might, after optimization of some vaccination parameters, be sufficient as a safe, easy-to-produce, and cheap CHIKV vaccine.
Epigallocatechin-3-gallate (EGCG) is a catechin found in green tea and was, in this work, found to inhibit the CHIKV life cycle at the entry state in in vitro experiments using CHIKV Env VPs and wild-type virus. EGCG was recently published to inhibit attachment of several viruses to cell surface GAGs, which is in line with the role for GAGs in CHIKV entry revealed in this work. EGCG might serve as a lead compound for the development of a small molecule treatment against CHIKV.
Molecular concepts for pandemic viruses : membrane fusion assays and targeting of reservoir cells
(2024)
In den letzten Jahren haben verschiedene pandemische Viren zu beträchtlichen Krankheits- und Todesfällen geführt. Um dieser ständigen Bedrohung entgegenzuwirken, ist es wichtig diagnostische Testsysteme und Therapien anzupassen oder neu zu etablieren. Diese Arbeit konzentriert sich auf die pandemischen Viren SARS-CoV-2 und HIV.
Der Zelleintritt von SARS-CoV-2 wird durch das Spike-Protein (S) ausgelöst, welches die Fusion der Virushülle mit der zellulären Membran bewirkt. Erste Studien haben gezeigt, dass das S-Protein eine hohe Fusionsaktivität aufweist. Aus diesem Grund sollten in dieser Arbeit neue Fusionstests etabliert werden, um potenzielle Inhibitoren der Zellfusion zu evaluieren. Im ersten Teil dieser Thesis wird die Etablierung von quantitativen Tests zur Evaluierung der Zell-Zell und Partikel-Zell Fusionsaktivität, welche durch S bewirkt wird, demonstriert.
Trotz jahrelanger Forschung können HIV-Patienten nicht geheilt werden und Virusinfektionen treten weiterhin weltweit auf. Das größte Problem bei der Entwicklung eines Heilmittels ist die frühe Bildung von Reservoirzellen während einer Infektion. Um diese Reservoirzellen zu identifizieren, wurde der Oberflächenmarker CD32a vorgeschlagen. Die Nutzung von Cas9-Nukleasen zur Inaktivierung von HIV ist in vitro erfolgreich, aber der effiziente Transfer in Reservoirzellen bleibt weiterhin herausfordernd. Im zweiten Teil dieser Thesis werden Rezeptor-gerichtete Adeno-assoziierte Vektoren (AAVs) für die HIV-Gentherapie präsentiert, die CD4 und CD32a für den Zelleintritt nutzen.
Zur Charakterisierung der Fusionsaktivität von SARS-CoV-2 wurden drei quantitative Fusionstests etabliert, welche Partikel- und Zell-Zell Fusionen berücksichtigen. Für den Partikel-Zell Fusionstest wurden lentivirale Vektoren (LV) verwendet, welche das S-Protein auf ihrer Oberfläche präsentierten. Die Transduktionseffizienz von S-LV erreichte auf Zellen, die den SARS-CoV-2 Rezeptor ACE2 exprimieren, ein Signal-zu-Hintergrund Verhältnis von über 2000. Durch die Präsentation von S auf leeren LV-Partikeln konnte die Fusion von benachbarten Zellen detektiert und quantifiziert werden („fusion-from-without“ (FFWO)). Für die Quantifizierung wurde ein Reporter-Komplementationstest etabliert. Hierbei wurden die Alpha- und Omega-Fragmente der β-Galaktosidase getrennt in zwei Zielzellpopulationen exprimiert, die beide ACE2 exprimierten. Durch die Zugabe von S-Partikeln kam es zur Fusion der Zielzellen und zur Komplementation der Alpha- und Omega-Fragmente. Die resultierende β-Galaktosidase-Aktivität konnte anschließend quantifiziert werden. Unter optimalen Versuchsbedingungen erreichte dieser Assay ein Signal-zu-Hintergrund Verhältnis von 2,7 Größenordnungen. Anschließend wurde der Komplementationstest für die Messung der Zell-Zell Fusion verwendet. In diesem Test exprimierten Effektorzellen S und das Alpha-Fragment, Zielzellen ACE2 und das Omega-Fragment. Obwohl die S-Expression auf den Effektorzellen sehr gering war, konnte dennoch eine signifikante Fusion nachgewiesen werden. Auch hier konnte unter optimalen Versuchsbedingungen ein hohes Signal-zu-Hintergrund Verhältnis von 2,9 Größenordnungen festgestellt werden. Nach der Etablierung der Testsysteme wurden S-spezifische Inhibitoren verwendet. Im Gegensatz zu Partikel-Zell-Fusionen wurde die Fusionsaktivität von S auf Zellen nur mäßig inhibiert. Dies deutet daraufhin, dass das Eindringen von Partikeln in Zellen wirksamer verhindert werden kann als die Ausbreitung durch Zell-Zell Fusionen.
Um AAVs spezifisch an HIV-Reservoirzellen zu binden, wurden CD4- und CD32a-spezifische DARPins („designed ankyrin repeat proteins“) in Rezeptor-verblindete AAVs eingebaut. Ebenso wurden beide DARPins gleichzeitig auf dem Kapsid präsentiert, um eine höhere Spezifität für doppelt-positive Zellen zu erreichen. Wenn diese Partikel einer Zellmischung aus CD4-, CD32a- und CD4/CD32a-exprimierenden Zellen zugesetzt wurden, transduzierten die bispezifischen Vektoren vorzugsweise doppelt-positive Zellen. Diese Präferenz war am höchsten in Zellkulturen, die stark unterrepräsentierte CD4/CD32a-exprimierende Zellen enthielten. Unter diesen Voraussetzungen erreichten bispezifische Vektoren eine bis zu 66-fach höhere Transduktionseffizienz auf CD4/CD32a-positive Zellen im Vergleich zu CD32a-exprimierenden Zellen. Darüber hinaus zeigten bispezifische AAV eine präferentielle Bindung und Transduktion von isolierten Primärzellen und Zellen in Vollblut. Selbst nach systemischer Injektion in humanisierte Mäuse wurden doppelt-positive Zellen effizienter von bispezifischen als von monospezifischen AAVs transduziert. Schließlich zeigten die generierten Vektoren, welche die Cas9 Nuklease transferierten, eine effiziente Inhibition der HIV-Replikation.
Chromosomal translocations (CTs) are a genetic hallmark of cancer. They could be identified as recurrent genetic aberrations in hemato-malignancies and solid tumors. More than 40% of all "cancer genes" were identified in recurrent CTs. Most of these CTs result in the production of oncofusion proteins of which many have been studied over the past decades. They influence signaling pathways and/or alter gene expression. However, a precise mechanism for how these CTs arise and occur in a nearly identical fashion in individuals remains to be elucidated. Here, we performed experiments that explain the onset of CTs: proximity of genes able to produce prematurely terminated transcripts, which leads to the production of transspliced fusion RNAs, and finally, the induction of DNA double-strand breaks which are subsequently repaired via EJ repair pathways. Under these conditions, balanced chromosomal translocations could be specifically induced.
Chronic inflammation is considered to be a cause of the autoimmune diseases such as rheumatoid arthritis, Alzheimer’s disease, multiple sclerosis, etc. The search for effective compounds with anti-inflammatory properties to combat these diseases is still ongoing. Natural compound narciclasine, derived from plants of Narcissus species, demonstrated its anti-inflammatory activity in in vivo arthritis models. Further investigation of narciclasine’s anti-inflammatory activity together with its impact on the interaction between leukocytes and endothelial cells was the main focus of this PhD thesis.
Narciclasine reduced the infiltration of monocytes and neutrophils to the abdomen and the concentration of the pro-inflammatory cytokines TNF, IL-6 and IL-1β. Together with this, it reduced acute visceral pain caused by zymosan injection. Narciclasine interfered with leukocyte-endothelial cell interaction in both in vivo and in vitro models. In vivo microscopy revealed that the compound reduced rolling, adhesion and transmigration of leukocytes in the vessels of an injured murine cremaster muscle. This observation was confirmed in the in vitro models for adhesion and transmigration where narciclasine reduced the level of leukocyte’s interaction with HUVECs. Narciclasine demonstrated profound anti-inflammatory properties based on its interference with leukocyte-endothelium interaction by downregulation of endothelial cell adhesion molecules expression (ICAM-1, VCAM-1, E-selectin, CX3CL1) and shutdown of NF-κB pathway. All these effects were a result of the TNF receptor 1 protein translation blocking by narciclasine.
In this work the ability of the compound to reduce visceral pain, downregulate the expression of the endothelial cell adhesion molecules and to interfere with the interaction between leukocytes and endothelial cells was demonstrated for narciclasine for the first time. Obtained results open a promising insight into the understanding of narciclasine’s anti-inflammatory properties and justify further investigation of its potential for treatment of inflammatory diseases.
Pretubulysin (PT), a biosynthetic precursor of the myxobacterial compound tubulysin D, was recently identified as a novel microtubule-targeting agent (MTA) causing microtubule destabilization. MTAs are the most frequently used chemotherapeutic drugs. They are well studied regarding their direct cytotoxic effects against various tumors as well as for their anti-angiogenic and vascular-disrupting action addressing endothelial cells of the tumor vasculature. However, the impact of MTAs on endothelial cells of the non-tumor vasculature has been largely neglected, although tumor cell interactions with the healthy endothelium play a crucial role in the process of cancer metastasis. Besides their use as potent anti-cancer drugs, some MTAs such as colchicine are traditionally used or recommended for the therapy of inflammatory diseases. Here, too, the role of endothelial cells has been largely neglected, although the endothelium is crucially involved in regulating the process of inflammation.
In the present study, the impact of PT on tumor-endothelial cell interactions was therefore analyzed in vitro to gain insights into the mechanism underlying its anti-metastatic effect that was recently confirmed in vivo. In the second part of this work, the influence of PT and other MTAs, namely the microtubule-destabilizing compounds vincristine (VIN) and colchicine (COL) and the microtubule-stabilizing drug paclitaxel (PAC), on leukocyte-endothelial cell interactions was investigated in vitro and in vivo (only PT). It is important to mention that in all in vitro experiments solely endothelial cells and not tumor cells or leukocytes were treated with the MTAs to strictly focus on the role of the endothelium in the action of these compounds.
The impact of PT on tumor-endothelial cell interactions was analyzed in vitro by cell adhesion and transendothelial migration assays as well as immunocytochemistry using the breast cancer cell line MDA-MB-231 and primary human umbilical vein endothelial cells (HUVECs). The treatment of HUVECs with PT increased the adhesion of MDA cells onto the endothelial monolayer, whereas their transendothelial migration was reduced by the compound. Thereafter, the influence of PT on the endothelial cell adhesion molecules (CAMs) E-selectin, N-cadherin, ICAM-1, VCAM-1 and galectin-3 and on the CXCL12/CXCR4 chemokine system was examined, since they might be involved in the PT-triggered tumor cell adhesion. Interestingly, although PT induced the upregulation of ICAM-1, VCAM-1, N-cadherin and CXCL12, cell adhesion assays using neutralizing antibodies or the CXCL12 inhibitor AMD3100 revealed that all these molecules were dispensable for the PT-evoked tumor cell adhesion. As PT induces the formation of interendothelial gaps and MDA cells might adhere onto components of the underlying extracellular matrix (ECM), the precise location of MDA cells attached to the PT-treated endothelial monolayer was investigated. Instead of a direct interaction between tumor and endothelial cells, this work showed that MDA cells preferred to adhere to the ECM component collagen that was exposed within PT-triggered endothelial gaps. Both the PT-evoked increase in tumor cell adhesion onto and the decrease in trans-endothelial migration were completely abolished when β1-integrins were blocked on MDA cells. Similar results were obtained when endothelial cells were treated with VIN and COL but not PAC, indicating that the observed effects of PT depend on its microtubule-destabilizing activity.
The impact of PT, VIN, COL and PAC on leukocyte-endothelial cell interactions was analyzed in vivo (only PT) by intravital microscopy of the mouse cremaster muscle and in vitro by cell adhesion assays using the monocyte-like cell line THP-1 and TNFα-activated human dermal microvascular endothelial cells (HMEC-1). While PT did not affect the rolling of leukocytes on the endothelium, their firm adhesion onto and transmigration through the activated endothelium was reduced by PT in vivo. In accordance, the treatment of HMEC-1 with PT, VIN and COL decreased the TNFα-induced adhesion of THP-1 cells onto the endothelial monolayer, whereas PAC had no influence on this process. Thereafter, the influence of PT, VIN, COL and PAC on endothelial ICAM-1 and VCAM-1 was examined, since these molecules are substantially involved in the firm adhesion of leukocytes onto the endothelium. The cell surface protein expression of ICAM-1 and VCAM-1 was reduced by PT, VIN and COL in activated endothelial cells, whereas PAC did only slightly affect the TNFα-induced upregulation of VCAM-1. As the pro-inflammatory transcription factor NFκB plays a crucial role in the TNFα-induced expression of these CAMs, the impact of the MTAs on the NFκB promotor activity was investigated. While PT, VIN and COL decreased the activation of NFκB in activated endothelial cells, PAC did not affect this process. However, in contrast to the strong effects regarding the cell surface protein expression of ICAM-1 and VCAM-1, the effects of PT, VIN and COL on the NFκB activity was rather low. Thus, the used MTAs might also affect other relevant signaling pathways and/or the intracellular transport of CAMs might be influenced by the impact of the MTAs on the microtubule network.
Taken together, the current study provides – at least in part – an explanation for the anti-metastatic potential of PT and gives first insights into the use of PT and VIN as anti-inflammatory drugs. Moreover, this work highlights the endothelium as an attractive target for the development of new anti-cancer and anti-inflammatory drugs.
The innate immune system is the first line of host defense that senses invading pathogens by various surveillance mechanisms, involving pattern recognition receptors (PRRs) such as Toll-like receptors (TLRs). Furthermore, in response to stress, tissue injury or ischemia, cells release endogenous danger-associated molecular patterns (DAMPs) which activate PRRs in order to prompt an effective immune response. Activation of PRRs by DAMPs initiates signaling transduction pathways which drive sterile inflammation by the production of pro-inflammatory effector molecules. Biglycan, a class I small leucine-rich proteoglycan (SLRP), is proteolytically released from the extracellular matrix (ECM) in response to tissue stress and injury or de novo synthesized by activated macrophages. In its soluble form, biglycan operates as an ECM-derived DAMP and triggers a potent inflammatory response by engaging TLR2 and TLR4 on immune cells. By selective utilization of TLR2/4 and the TLR adaptor molecules adaptor molecule myeloid differentiation primary response gene 88 (MyD88) or TIR domain-containing adaptor-inducing interferon-β (TRIF) biglycan differentially regulates the production of TLR downstream mediators or inflammatory molecules. In this way, biglycan triggers the activation of mitogen-activated protein kinase (MAPK) p38, extracellular signal-regulated kinase (Erk) and nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB) in a primarily MyD88-dependent manner. In contrast, biglycan induces the expression of (C–C motif) ligand (CCL)5 and chemokine (C-X-C motif) ligand (CXCL)10 over TLR4/TRIF, heat shock protein 70 (HSP70) production over TLR2 and the synthesis of tumor necrosis factor (TNF)-α, CCL2 and CCL20 by utilizing TLR2/4/MyD88. As a consequence, biglycan promotes the recruitment of immune cells such as neutrophils, T cells, B cells and macrophages into the inflamed tissue. Research over the past years showed that biglycan-induced inflammation is involved in the pathogenesis of various inflammatory diseases such as lupus nephritis (LN), sepsis and renal ischemia/reperfusion injury (IRI), whereby genetic deletion of biglycan or TLR2/4 alleviated disease outcome. Unfortunately, the selective interaction of biglycan to TLRs and TLR adaptors complicates the identification of an efficient pharmacological target in biglycan-mediated inflammation. Yet, the necessity of possible co-receptors in biglycan signaling such as cluster of differentiation 14 (CD14) which was found in a high molecular complex with biglycan was not addressed so far.
In the first part of the present study, by utilizing primary peritoneal murine macrophages we demonstrated that the biglycan-induced expression and synthesis of TNF-α and CCL2 via TLR2/4/MyD88, CCL5 through TLR4/TRIF and HSP70 over TLR2 is blunted in CD14 deficient mice, proving that CD14 is essential in TLR2- and TLR4-mediated biglycan signaling. Pre-incubation of macrophages with an anti-CD14 antibody significantly reduced the protein levels of TNF-α, CCL2, CCL5 and HSP70. In line with these data, pharmacological inhibition of CD14 alleviated the transcriptional activation of NF-κB by biglycan in HEK-Blue cells expressing hTLR2/CD14 as well as hTLR4/CD14/MD2 supporting CD14-dependency for biglycan/TLR2/4 signaling. Western blot analysis of phosphorylated p38, p44/42 and NF-κB in WT and CD14 deficient mice revealed that activation of biglycan-mediated TLR downstream signaling is CD14-dependent. Accordingly, biglycan-induced activation and nuclear translocation of p38, p44/42 and NF-κB was blocked in Cd14-/- mice as analyzed by confocal microscopy. Co-immunoprecipitation studies combined with microscale thermophoresis analysis showed that biglycan is in complex with CD14 in macrophages and in vitro binds directly with high affinity to CD14, thereby sustaining the concept that CD14 is a novel co-receptor in biglycan-mediated inflammation. Additionally, we provided proof-of-principle of our concept in an in vivo mouse model of renal IRI. Transient overexpression of biglycan in WT mice exacerbated the expression and production of TNF-α, CCL2, CCL5 and HSP70 in a CD14-dependent manner. Interestingly, pLIVE or pLIVE-hBGN-injected Cd14-/- mice displayed lower chemo- and cytokine levels in reperfused kidneys as compared to respective WT controls during renal IRI (30 h), indicating a renoprotective effect by CD14 deficiency. Flow cytometry analysis of kidney homogenates underlined the pivotal effect of CD14 in biglycan signaling as biglycan-mediated infiltration of CD11b- and F4/80-positive renal macrophages was abolished in Cd14-/- mice. Additionally, pLIVE or pLIVE-hBGN-injected CD14 deficient mice displayed lower numbers of renal CD11b- and F4/80-positive cells during renal IRI compared to WT mice. Analysis of F4/80- and CD38-positive cells isolated from mononuclear cell extracts from kidney homogenates of pLIVE or pLIVE-hBGN-injected WT and Cd14-/- mice revealed that biglycan triggers the polarization of pro-inflammatory M1 macrophages in a CD14-dependent manner. In line with this, Cd14-/- mice, either injected with pLIVE or pLIVE-hBGN, showed less F4/80- and CD38-positive cells during renal IRI than the respective WT control. As a corroboration of our data PAS-stained renal sections of pLIVE- or pLIVE-hBGN-injected WT or Cd14-/- mice uncovered that biglycan worsens tubular damage in IRI-subjected mice via CD14. At the same time, tubular damage was significantly reduced in IRI-subjected Cd14-/- mice as compared to WT mice. In correlation with these data, serum creatine levels were increased in pLIVE-hBGN-injected WT mice during renal IRI. In contrast, serum creatine levels were significantly less increased in pLIVE- or pLIVE-hBGN-injected Cd14-/- mice than in WT littermate controls. In conclusion we demonstrated that CD14 is a new high affinity ligand for biglycan-mediated pro-inflammatory signaling over TLR2 and TLR4 in macrophages. In vivo, soluble biglycan triggers the expression of various inflammatory mediators by utilizing the co-receptor CD14. Ablation of CD14 abolishes biglycan-induced renal macrophage infiltration and M1 macrophage polarization as well as overall kidney function by reduced tubular damage and serum creatinine levels. Therefore, this study identifies CD14 as a promising therapeutic target to ameliorate biglycan-induced inflammation.
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At the beginning of the 1980s, an increased frequency of immune deficiency was discovered in a population of homosexual men, which is nowadays known as the Acquired Immune Deficiency Syndrome (AIDS). A few years later, the retro virus Human Immunodeficiency Virus 1(HIV-1) has been discovered as the cause of AIDS. Since the beginning of the pandemic, more that 74 million people have become infected and more than 32 million people died. In 2018, it was estimated that 38 million people where living with HIV-1 of which 24.5 million had access to Highly Active Antiretroviral Therapy (HAART), which blocks viral replication and prevents the progression towards AIDS. In the most cases an HIV-1 infection leads to the patient’s death within a few years Without HAART.
Taken together, this thesis shows that hematopoietic stem and progenitor cells harbor the prerequisites and characteristics to form an HIV-1 reservoir in vivo. The subsets of HSCs, MPPs and CD34+CD38+ progenitors harbor CD4 & CXCR4 double-positive cells as well as a lower amount of CD4 & CCR5 doublepositive cells. In addition, the susceptibility to X4-tropic HIV-1 is shown in vitro. Susceptibility to R5-tropic HIV-1 is only seen to a very low amount for CD34+CD38+ progenitors. The results also show that transduced HSPCs are capable to pass on integrated viral genomes via proliferation and differentiation during in vitro colony formation. More over the experiments provide evidence that this can take place for long time span as the outcome of the replating assays shows. Ex vivo analysis of HSPCs isolated from PLHIV also suggests that these cells are susceptible to HIV-1. Proviral DNA detection using a nested PCR showed infection of Lin- cells of a single donor with an R5-tropic subtype B HIV-1 clone. However, the assay could not detect infection of CD34+ cells. The
received results of this thesis are in agreement with previously published results. Albeit the obvious susceptibility to HIV-1 and existing reports of viral survival within HSPCs for several years, the low frequency of detected in vivo infected HSPCs could be related to the cytopathic effects of HIV-1 during replication resulting in cell death of potentially infected CD34+ cells. Other reasons could be associated with assay sensitivity or the small number of available patient samples. This makes hematopoietic stem and progenitor cells a target, which can be infected by HIV-1. The role and the clinical relevance of hematopoietic stem and progenitor cells in contribution to the latent viral HIV-1 reservoir within an HIV-1 infected patient needs to be further analyzed.
Der Hirntumor Glioblastom (GBM) ist aufgrund seines infiltrativen Wachstums, der hohen intra- und intertumoralen Heterogenität, der hohen Therapieresistenz als auch aufgrund der sogenannten gliomartigen Stammzellen sehr schwer zu behandeln und führt fast immer zu Rezidiven. Da es in den letzten Jahrzehnten kaum Fortschritte in der Behandlung des GBMs gab, bis auf die Therapie mit Tumortherapiefeldern, wird weiterhin nach alternativen Zelltodtherapien geforscht, wie zum Beispiel dem Autophagie-abhängigen Zelltod. Der Autophagie-abhängige Zelltod ist durch einen erhöhten autophagischen Flux gekennzeichnet und obwohl die Autophagie, als auch selektive Formen wie die Lysophagie und Mitophagie, normalerweise als überlebensfördernde Mechanismen gelten, konnten viele Studien eine duale Rolle in der Tumorentstehung, -progression und -behandlung aufzeigen, die vor allem vom Tumortyp und stadium abhängt. Um die zugrunde liegenden Mechanismen des durch Medikamente induzierten Autophagie-abhängigen Zelltods im GBM weiter zu entschlüsseln, habe ich in meiner Dissertation verschiedene Substanzen untersucht, die einen Autophagie-abhängigen Zelltod induzieren.
In einer zuvor in unserem Labor durchgeführten Studie konnte gezeigt werden, dass das Antipsychotikum Pimozid (PIMO) und der Opioidrezeptor-Antagonist Loperamid (LOP) einen Autophagie-abhängigen Zelltod in GBM Zellen induzieren können. Darauf aufbauend habe ich die Fähigkeit zur Induktion des Autophagie-abhängigen Zelltods in weiteren Zellmodellen validiert. Dies bestätigte einen erhöhten autophagischen Flux nach PIMO und LOP Behandlung, während der Zelltod als auch der autophagische Flux in Autophagie-defizienten Zellen reduziert war. In weiteren Versuchen konnte ich die Involvierung der LC3-assoziierten Phagozytose (LAP), ein Signalweg der auf die Funktion einiger autophagischer Proteine angewiesen ist, ausschließen. Weiterhin konnte ich eine massive Störung des Cholesterin- und Lipidstoffwechsels beobachten. Unter anderem akkumulierte Cholesterin in den Lysosomen gefolgt von massiven Schäden des lysosomalen Kompartiments und der Permeabiliserung der lysosomalen Membran. Dies trug einerseits zur Aktivierung überlebensfördernder Lysophagie als auch der Zell-schädigenden „Bulk“-Autophagie bei. Letztendlich konnte aber die erhöhte Lysophagie die Zellen nicht vor dem Zelltod retten und die Zellen starben einen Autophagie-abhängigen lysosomalen Zelltod. Da die Eignung von LOP als Therapie für das GBM aufgrund der fehlenden Blut-Hirn-Schranken Permeabilität und von dem Antipsychotikum PIMO aufgrund teils schwerer Nebenwirkungen eingeschränkt ist, habe ich mich im weiteren Verlauf meiner Dissertation mit einer Substanz mit einem anderen Wirkmechanismus beschäftigt.
Der Eisenchelator und oxidative Phosphorylierungs (OXPHOS) Inhibitor VLX600 wurde zuvor berichtet mitochondriale Dysfunktion und Zelltod in Kolonkarzinomzellen zu induzieren. Allerdings hat meines Wissens nach bisher noch keine Studie die therapeutische Eignung von VLX600 für das GBM untersucht. Hier zeige ich eine neuartige Autophagie-abhängige Zelltod-induzierende Fähigkeit von VLX600 für GBM Zellen, da der Zelltod signifikant in Autophagie-defizienten Zellen aber nicht durch Caspase-Inhibitoren gehemmt wurde und der autophagische Flux erhöht war. Darüber hinaus konnte ich die Hemmung der OXPHOS und die Induktion von mitochondrialem Stress in GBM Zellen bestätigen und weiterhin aufzeigen, dass VLX600 nicht nur die mitochondriale Homöostase stört, sondern auch zu einer BNIP3-BNIP3L-abhängigen Mitophagie führt, die wahrscheinlich durch HIF1A reguliert wird aber keinen erkennbaren Nettoeffekt auf den von VLX600 induzierten Zelltod hat. Demnach induziert VLX600 letale „Bulk“-Autophagie in den hier verwendeten Zellmodellen. Darüber hinaus konnte ich zeigen, dass die Eisenchelatierung durch VLX600 eine große Rolle für den von VLX600-induzierten Zelltod spielt aber auch für die Mitophagie Induktion, Histon Lysin Methylierung und den ribosomalen Stress. Letztendlich ist es wahrscheinlich ein Zusammenspiel all dieser Faktoren, die zur Zelltodinduktion durch VLX600 führen und interessanterweise werden Eisenchelatoren bereits in präklinischen und klinischen Studien für Krebstherapien untersucht. Dabei könnten gewisse metabolische Eigenschaften verschiedener Tumorzellen die Sensitivität von Wirkstoffen, die auf den Metabolismus wirken wie VLX600, beeinflussen was in zukünftigen Studien beachtet werden sollte um den bestmöglichsten Therapieerfolg zu erzielen. Zusammenfassend unterstützt meine Dissertation die duale Rolle der Autophagie, die stark vom jeweiligen Kontext abhängt und befürwortet die weitere Forschung von Substanzen, die einen Autophagie-abhängigen Zelltod induzieren, für das GBM.
Bei ca. 95% der chronisch myeloischen Leukämie (CML) und 20-30% der akuten lymphatischen Leukämie (ALL) des Erwachsenen liegt eine reziproke Chromosomentranslokation t(9;22)(q34;q11) vor, in deren Rahmen das BCR (Breakpoint Cluster Region) Gen auf Chromosom 22 mit dem ABL (Abelson-Leukämie-Virus) Gen auf Chromosom 9 fusioniert. Auf Chromosom 22 gibt es zwei verschiedene Bruchpunkte, die somit zur Bildung von unterschiedlichen Fusionsgenen führen. Bei der CML findet man den sogenannten „großen“ Bruchpunkt (M-bcr), während bei der Ph+ ALL der sogenannte „kleine“ Bruchpunkt (m-bcr) vorkommt. Das hybride Fusionsgen auf Chromosom 22q+ (Philadelphia-Chromosom) kodiert für das jeweilige BCR/ABL Protein, während das Fusionsgen auf Chromosom 9q+ für das reziproke ABL/BCR Protein kodiert. Das ABL-Protein ist eine Nicht-Rezeptor Tyrosinkinase, die eine wichtige Rolle in der Signaltransduktion und der Regulation des Zellwachstums spielt. Im BCR/ABL Fusionsprotein wird die Kinase-Aktivität von ABL, die im Normalfall streng reguliert ist, durch die Fusion mit BCR konstitutiv aktiv. Dadurch kommt es zur Deregulierung intrazellulärer Signalwege, welche die maligne Transformation hämatopoetischer Zellen verursacht. Eine zielgerichtete Inhibierung von BCR/ABL mittels ABL-Kinase-Inhibitoren induziert Apoptose in BCR/ABL transformierten Zellen, was eine komplette Remission im größten Teil Ph+ Leukämie Patienten zur Folge hat.
Chronische Entzündungen und die daraus resultierenden Morbiditäten gehören zu den häufigsten Ursachen für einen frühen Tod beim Menschen. Einer der Hauptfaktoren für die Verschlechterung des Gesundheitszustands bei Patienten mit chronischen-entzündlichen Erkrankungen ist die pathologische Infiltration von Leukozyten in gesundes Gewebe, die zu Gewebeschäden und dem Fortschreiten der Krankheit führt. Das vaskuläre Endothel, das die Innenseite der Blutgefäße auskleidet, spielt eine entscheidende Rolle bei der Entzündungsreaktion, da es als Schnittstelle für die Interaktion mit Leukozyten fungiert, um die Extravasation von Leukozyten aus dem Blutstrom in das Gewebe zu ermöglichen. Die Adhäsion von Leukozyten an die Zellen des Endothels wird dabei hauptsächlich durch die von Zytokinen ausgelösten pro-inflammatorischen NFκB- und AP-1-Signalkaskaden ermöglicht, die die Hochregulierung der wichtigsten endothelialen Adhäsionsmoleküle – ICAM-1, VCAM-1 und E-Selektin – bewirken. Eine Klasse von Wirkstoffen, die für ihre entzündungshemmenden Eigenschaften und ihren Nutzen bei der Behandlung chronischer Entzündungskrankheiten bekannt sind, sind die Mikrotubuli-bindenden-Substanzen (microtubule-targeting-agents; MTAs), die nachweislich auch den Entzündungszustand in den Zellen des Endothels und die Leukozyten-Adhäsionskaskade beeinflussen können. MTAs lassen sich in Mikrotubuli-Destabilisatoren, die eine Depolymerisation des Mikrotubuli-Zytoskeletts bewirken, und Mikrotubuli-Stabilisatoren, die die Depolymerisation der Mikrotubuli verhindern, unterteilen. Die zugrundeliegenden biomolekularen Vorgänge und Wirkungen, die die MTAs auf die Zellen des Gefäßendothels haben, und wie sie die Adhäsionskaskade der Leukozyten beeinflussen, sind jedoch weitgehend unbekannt.
Ziel dieser Studie war es, die Auswirkungen des neuartigen Mikrotubuli-Destabilisators Prätubulysin, eines Vorläufers der Tubulysine, die ursprünglich in Stämmen des Myxobakteriums Angiococcus disciformis entdeckt wurden, auf die entzündlichen Prozesse zu untersuchen, die die Leukozyten-adhäsion in TNF-aktivierten primären Endothelzellen aus der menschlichen Nabelschnurvene (HUVECs) ermöglichen. Zusätzlich wurden auch die Auswirkungen der bereits klinisch etablierten Mikrotubuli-Destabilisatoren Colchicin und Vincristin sowie des Mikrotubuli-Stabilisators Paclitaxel untersucht.
Das entzündungshemmende Potenzial von Prätubulysin wurde daher zunächst in vivo in einem Imiquimod-induzierten psoriasiformen Dermatitis-Mausmodell getestet, wobei sich zeigte, dass Prätubulysin den Entzündungszustand deutlich verringert. Um zu beweisen, dass der entzündungshemmende Effekt mit einer verringerten Interaktion von Leukozyten mit dem Endothel zusammenhängt, wurde die Wirkung von Prätubulysin in vivo mittels Intravitalmikroskopie des TNF-aktivierten Kremaster-Muskels der Maus untersucht. Dabei zeigte sich, dass die Behandlung mit Prätubulysin zu einer signifikant verringerten Adhäsion von Leukozyten an die Zellen des Gefäßendothels führte. Die verringerte Adhäsion von Leukozyten an Endothelzellen wurde auch in der in vitro Umgebung bestätigt, indem die Adhäsion von Leukozyten unter Flussbedingungen getestet wurde. Mittels Durchflusszytometrie, Western-Blot-Analyse, sowie qRT-PCR-Analyse der jeweiligen mRNA-Level konnte gezeigt werden, dass die verringerten Leukozyten-Interaktionen auf der verringerten Expression der Zelladhäsionsmoleküle ICAM-1 und VCAM-1 sowie teilweise von E-Selektin nach Behandlung mit Prätubulysin, Vincristin und Colchicin beruhen, wobei Paclitaxel keine signifikanten hemmenden Auswirkungen hatte. Weitere Untersuchungen des Einflusses von Prätubulysin auf die NFκB- und AP-1-Signalübertragung zeigten, dass diese intrazellulären Signalkaskaden durch Prätubulysin nicht behindert werden, wobei NFκB und AP-1 weitgehend in den Promotoren der Zelladhäsionsmoleküle angereichert waren, wie durch Chromatin-Immunpräzipitation nachgewiesen wurde. Darüber hinaus induzierte die Behandlung mit Prätubulysin die Aktivität der NFκB-induzierenden Kinase IKK und führte zu einem signifikanten Anstieg der Aktivität der AP-1 Upstream-Kinase JNK, wie eine Western Blot Analyse ergab. Die Prüfung der Transkriptionsaktivität von NFκB und AP-1 in Reportergen Assays zeigte, dass insbesondere die Mikrotubuli-Destabilisatoren die Promotoraktivität dieser Transkriptionsfaktoren in einer konzentrationsabhängigen Weise verringerten. Weitere Tests zur Abhängigkeit der durch Prätubulysin induzierten Hemmung der Zelladhäsionsmoleküle von der Aktivität der JNK zeigten, dass die Hemmung empfindlich auf die Aktivität dieser Kinase reagiert. Es konnte gezeigt werden, dass die Inhibition der Aktivität der JNK die Expression der Zelladhäsionsmoleküle durch die Behandlung mit Prätubulysin auf mRNA und Proteinebene wiederherstellt. Mit Hilfe der Chromatin-Immunpräzipitation konnte weiterhin gezeigt werden, dass die Behandlung mit Prätubulysin zunächst die Assoziation des Bromodomänen-enthaltenden Proteins 4 mit den Promotoren/Genen von ICAM-1 und VCAM-1 erhöhte, aber zu einem behandlungszeitabhängigen Rückgang der Anreicherung führte. Darüber hinaus wurde durch die Behandlung mit Prätubulysin auch der Abbau dieses Proteins leicht erhöht. Durch den Einsatz eines JNK Inhibitors konnte gezeigt werden, dass die Verdrängung des Bromodomänen-enthaltenden Proteins 4 von icam-1 und vcam-1, sowie der erhöhte Abbau dieses Faktors auch von der Aktivität der JNK abhängig sind. Die Verdrängung des Bromodomänen-enthaltenden Proteins 4 induzierte auch das Vorhandensein von repressiven Chromatinmarkierungen in den Genen von ICAM-1 und VCAM-1. Die Prüfung der Anreicherung der RNA-Polymerase II an den Promotoren/Genen von ICAM-1 und VCAM-1 zeigte jedoch auch eine behandlungszeitabhängige differentielle Anreicherung dieser Polymerase, wobei die Anreicherung nach kurzen Behandlungszeiten reduziert war, sich nach mittleren Behandlungszeiten erholte und nach längeren Behandlungszeiten wieder stark reduziert war. Die anschließende Prüfung der Bedeutung des Bromodomänen-enthaltenden Proteins 4 für die Expression von ICAM-1 und VCAM-1 durch Knock-down-Experimente ergab, dass das vcam-1 Gen durch Knock-down dieses Proteins unterdrückt, das icam-1 Gen jedoch induziert wird. Dies deutet auf das Vorhandensein zusätzlicher Faktoren hin, die auch auf die Aktivität der JNK reagieren und neben dem Bromodomänen-enthaltenden Proteins 4 die Transkriptionsverlängerung des icam-1 Gens bewirken.
Leukemia is a cancer of the blood and bone marrow characterized by an uncontrolled proliferation and accumulation of abnormal white blood cells. Leukemia can be classified based on the course of the disease (acute or chronic) and the blood cell type involved (myeloid or lymphocytic), leading to four main subtypes: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Leukemia represents 2.5% of all new cancer cases per year, and survival rates in some leukemias remain low at 40%.
The bone marrow microenvironment (BMM) is a system within the bone marrow comprising cellular and acellular components, all of which play a major role in hematopoiesis, providing the physical space where hematopoietic stem cells (HSCs) reside. The BMM interacts with HSCs, offering a “niche” for those cells and in case of leukemia, the BMM has a supportive role in disease maintenance and progression by supporting Leukemia stem cells (LSCs). One of the components of the BMM are calcium ions. Calcium is the most abundant mineral in the body, a key component of bones and is released by parathyroid hormone (PTH) induced bone remodeling. Calcium ions play a role in the localization, engraftment and adhesion of normal HSC to extracellular matrix (ECM) proteins in the BMM via the calcium sensing receptor (CaSR), thereby maintaining normal hematopoiesis. In addition of a major regulator of calcium homeostasis, CaSR contribute to the development of different cancers, functioning as either tumor suppressor or oncogene, depending on the involved tissue. However, the role of CaSR and its associated pathways in the local BMM for the development of leukemia is poorly understood. We hypothesized that calcium ions released from bone, subject to a fine balance between osteoblasts and osteoclasts, and/or CaSR, contribute to development, progression and response to therapy.
We have shown that the local calcium concentration forms a gradient in the bone marrow niche and in mice with CML is similarly low as in control mice, but significantly higher in mice suffering from BCR ABL1 driven B ALL or MLL AF9 driven AML. Similarly, the calcium concentration in the human BMM was found to be higher in AML than in other leukemias. Regarding the function of calcium in leukemia cells, we found that AML and CML cells respond differently to calcium exposure, with AML cells exhibiting regulation of cellular processes such as adhesion to the ECM protein fibronectin and migration toward CXCL 12, whereas CML cells remained mostly unaltered. Using genetic deletion or overexpression of CaSR in murine models of leukemia, we observed that CaSR acts as tumor suppressor in BCR-ABL1 driven CML and B ALL and as oncogene in AML.
Focusing on AML, our data shows that deficiency of CaSR on LICs leads, on one hand to increased apoptosis, and on the other hand to reduced cell cycle, reactive oxygen species (ROS) production and DNA damage in vivo, which may explain the observed prolongation of survival of mice. Complementary, in vitro experiments demonstrated that cells overexpressing CaSR have a distinct, cancer promoting phenotype compared to wildtype cells. Overexpression of CaSR led to an increase in proliferation, cell cycle, ROS production, DNA damage and reduced apoptosis. We have identified CaSR mediated pathways in AML and shown that CaSR enhances leukemia progression by activating MAPK/ERK and Wnt β catenin signaling. In addition, the CaSR interacting protein filamin A (FLNA) was shown to contribute to aggressive disease in vitro and in vivo. Furthermore, the mechanism underlying the role of CaSR in AML pathogenesis and possible regulation of LSCs was studied. Our findings demonstrated that CaSR ablation reduces myeloid progenitor function and proved that CaSR is required for maintenance of LSC pool by regulating its frequency and function. Further supporting the role of CaSR in LSC maintenance, genes associated with AML stemness and self renewal capacity were upregulated when CaSR was overexpressed and downregulated when CaSR was depleted. Given the role of CaSR in AML, the CaSR antagonist NPS 2143 was tested in vivo. The combination treatment of NPS 2143 with the standard of care, ara C, significantly reduced the tumor burden and prolonged the survival of mice with AML in syngeneic and xenotransplantation experiments. Based on the finding that CaSR functions as a tumor suppressor in CML, treatment of mice with the CaSR agonist cinacalcet in combination with imatinib prolonged survival of mice with CML compared to treatment with the mice given vehicle.
Our results suggest that calcium ions stemming from the calcium-rich BMM via CaSR strongly and differentially influence leukemia progression. As an adjunct to existing treatment therapies, targeting of CaSR with specific pharmacologic antagonists may prolong survival of patients with AML.
Standard cancer therapy research targets tumor cells while not considering the damage on the tumor microenvironment (TME) and its associated implications in impairing therapy response. Employing patients-derived organoids (PDOs) and matched stroma cells or a novel murine preclinical rectal cancer model of local radiotherapy, it was demonstrated that tumor cells-derived IL-1α polarizes cancer-associated fibroblasts towards an inflammatory (iCAFs) phenotype. While numerous studies in different tumor entities highlighted the molecular heterogeneity of CAFs, so far there are no clear findings on their functional heterogeneity and relevance in therapy resistance and response. The present study molecularly characterized iCAFs subpopulation among RCA patients as well as the preclinical mouse model and importantly unraveled the detailed molecular mechanism underlying their contribution to impair therapy response. Mechanistically, iCAFs were demonstrated to be characterized by an upregulation of nitric oxide synthase (iNOS) which triggered accumulation of reactive nitrogen species (RNS) and subsequently an oxidative DNA damage response (DDR). Such a baseline IL-1α-driven DNA damage further sensitized iCAFs to a p53-mediated therapy induced senescence (TIS) causing extensive extracellular matrix (ECM) changes and induction of senescence associated secretory phenotype (SASP) that favored tumor progression and hindered tumor cell death. Moreover, iCAFs reversibility and repolarization into more quiescent like phenotype was demonstrated upon IL-1 signaling inhibition by anakinra, a recombinant IL-1 receptor antagonist (IL1RA). Accordingly, treating mice with anakinra or specific deletion of Il1r1 in CAFs sensitized stroma-rich resistant tumors to chemoradiotherapy (CRT). Similarly, targeting CAFs senescence by senotherapy (venetoclax chemical) or employing Trp53 deficient mice reverted therapy resistance among non-responsive tumors in vivo by reducing ECM deposition and consequently favoring CD8+ T cells intratumoral infiltration posttherapy. Importantly, rectal cancer patients that do not completely respond to neoadjuvant therapy displayed an iCAFs senescence program post-CRT. Moreover, these patients presented a baseline increased CAFs content, a dominant iCAFs signature that correlated with poorer disease-free survival (DFS) and a significantly reduced circulating IL1RA serum levels. While reduced pretherapeutic IL1RN gene expression predicted poor prognosis among RCA patients, IL1RA serum levels were associated with rs4251961 (T/C) single nucleotide polymorphism (SNP) in the IL1RN gene. Finally, functional validation assays revealed that conditioned media of PDOs drove inflammatory polarization of fibroblasts and consequently rendered them sensitive to RNS-mediated DNA damage and TIS. Collectively, the study highlighted a crucial and novel role of a CAFs subset, iCAFs, in therapy resistance among RCA patients, shedding light on their functional relevance by identifying IL-1 signaling as an appealing target for their repolarization and successful targeting. Therefore, it makes sense to combine the newly demonstrated and thoroughly proven therapeutic approach of targeting IL-1 signaling in combination with conventional CRT and possibly immunotherapy. This might have a major impact on RCA therapy and be of immense relevance for other stroma-rich tumors.
The overall survival for patients with acute lymphoblastic leukemia (ALL) often is the function of age, in particular in 2019 analysis revealed that 5-year overall survival for patients older than 20 years remains below 35% (American Cancer Society, Cancer Facts &Figures 2019). Importantly, one of the major issues in ALL therapy is the ability of tumor cells to escape the treatment via the establishment of an immunosuppressive environment. The tumor microenvironment has gained tremendous importance in the past decade. This is largely based on the reasoning that, in order to devise better therapeutic strategies for patients, we need to gain better understanding into how malignant cells transform their microenvironment to promote growth, escape immune control and gain therapeutic resistance.
TAM receptors (TAMRs) are engaged in innate immune cells as a feed-back mechanism to terminate the immune response and promote the return to homeostasis (Rothlin et al. 2007). In the context of cancers, aberrant TAMR signaling was mainly explored concerning its pro-oncogenic function (Paolino and Penninger 2016). There are only limited data available suggesting the modulation of cancer immune response via TAMR signaling in highly immunogenic solid tumor models (Paolino et al. 2014; Ubil et al. 2018). So far, however, little is known about their potential indirect immune-modulatory function in hematological malignancies. Taking into account the pronounced importance of TAMR signaling in immune cells combined with the leukemic immune tolerance, the current study focused on the function of TAMR and their ligands in anti-leukemic immunity.
This work uncovers the mechanism of dampening anti-leukemic immune response via TAMR signaling on macrophages using the syngeneic BCR-ABL1 B-ALL mouse model. Using genetic depletion of GAS6 in the host environment or ablation of AXL and/or MERTK receptors in macrophages the bone marrow microenvironment could be rewired in order to achieve an efficient anti-leukemic immune response. In particular, the GAS6/AXL blockade triggers an effective NKand T- cell-dependent anti-leukemic response that results in prolonged survival. This finding specifically tackles the obstacle of inefficient bridging between innate and adaptive immune response typical for hematological malignancies in contrast to solid tumors (E. K. Curran, Godfrey, and Kline 2017).
Besides establishing the vital function of TAMR signaling in anti-leukemic immunity using murine models, the analysis of human blood plasma revealed that age-related immune dysregulation was manifested by significant GAS6 decrease and PROS1 upregulation among elderly donors (>60 y.o.) compared to controls (<25 y.o.). These data are indicative that TAMR signaling likely favors the age-dependent immune system decline, which in turn is associated with a poor survival rate of elderly patients diagnosed with leukemia.
In conclusion, using a preclinical ALL model here it was identified in vivo, that Axl significantly increases upon B-ALL challenge in Mph and NK cells. Therefore, AXL targeting, using the orally bioavailable selective inhibitor Bemcentinib, could serve as a powerful approach to revert early immunosuppression created by leukemia.
Taken together these data propose the AXL receptor as a novel immune checkpoint and attractive candidate for the development of a new therapeutic approach via unleashing the patient’s own immune system to combat leukemic cells.
In the recent years, myxobacteria have emerged as a novel source of natural compounds with structural diversity and biological activity for drug discovery. In this work, the two myxobacterial compounds archazolid and vioprolide were characterized for their potential pharmacological effects in vascular endothelial cells. Archazolid is a wellestablished v-ATPase inhibitor found in Archangium gephyra and Cystobacter spec. As the v-ATPase represents a promising target in cancer treatment, the effects of archazolid have been intensively studied in cancer cells, but rarely in endothelial cells. Vioprolide is an antifungal and cytotoxic metabolite obtained from Cystobacter violaceus. There are only few studies on vioprolide, most of them focusing on its biosynthesis. Preliminary studies revealed that it inhibited TNF-induced expression of ICAM-1, indicating possible anti-inflammatory properties. As the endothelium plays an important role in cancer and inflammation, it represents an attractive drug target. Therefore, the archazolid and vioprolide were investigated regarding their effects on endothelial cells.
V-ATPase inhibition by archazolid resulted in anti-tumor and anti-metastatic effects in vitro and in vivo. Archazolid was used to study the consequences of v-ATPase inhibition in endothelial cells that might contribute to the anti-metastatic activities observed in vivo. To analyze the impact of archazolid on the interaction endothelial and cancer cells, in vitro cell adhesion and transmigration assays were performed using primary HUVEC or immortalized HMEC-1 and different cancer cell types (MDA-MB-231, PC-3 and Jurkat cells). For these experiments, only the endothelial cells were treated with archazolid. VATPase inhibition by archazolid led to an increased adhesion of the metastatic breast cancer cell line MDA-MB-231 and prostate cancer cell line PC-3 onto endothelial cells whereas the adhesion of Jurkat cells was unaffected. Interestingly, archazolid treatment of HUVECs decreased the transendothelial migration of MDA-MB-231 cells. Endothelial ICAM-1, VCAM-1, E-selectin and N-cadherin are potential ligands of interacting cancer cells. Therefore, the mRNA and surface protein levels of these cell adhesion molecules were measured via qRT-PCR and flow cytometry, respectively. These adhesion molecules were not responsible for the archazolid-induced cancer cell adhesion, as archazolid treatment of HUVECs did not upregulate their mRNA or surface expression. Instead, cell adhesion assays using a monoclonal antibody against integrin subunit β1 showed that β1-integrins expressed on MDA-MB-231 and PC-3 cells mediated the archazolid-induced cancer cell adhesion. Cell adhesion assays onto plastic coated with ECM components which are the major ligands of β1-integrins, revealed that MDA-MB231 and PC-3 cells preferably interact with collagen. So next, we investigated the influence of archazolid on surface collagen levels in HUVECs by immunostaining, which demonstrated an increase of nearly 50 % upon archazolid treatment. We confirmed the hypothesis that the expression and activity of cathepsin B, a lysosomal enzyme that degrades extracellular matrix components including collagen, was inhibited by archazolid in endothelial cells. Finally, overexpression of cathepsin B reduced the cancer cell adhesion on archazolid-treated HUVECs, but also in control cells, indicating a negative correlation between cathepsin B expression and cancer cell adhesion.
The influence of vioprolide on the interaction of endothelial cells with leukocytes was analyzed by in vitro cell adhesion assays using HUVECs and primary monocytes, THP-1 or Jurkat cells. Vioprolide inhibited the adhesion of these cells onto TNF-activated HUVECs. In addition, the endothelial-leukocyte interaction was observed in vivo by intravital microscopy in the mouse cremaster muscle. Vioprolide prevented the TNFinduced firm adhesion and transmigration of leukocytes, while leukocyte rolling was not affected. ICAM-1, VCAM-1 and E-selectin are cell adhesion molecules, which are upregulated by TNF and mediate leukocyte adhesion onto endothelial cells. Therefore, flow cytometric analysis was performed to measure their surface expression. Vioprolide significantly decreased TNF-induced expression of surface ICAM-1, VCAM-1 and E-selectin, which was in line with the in vitro results. In vivo, vioprolide may act in a different way on E-selectin expression, so that leukocyte rolling, which is governed by E-selectin, remained unaffected. qRT-PCR experiments revealed that the mRNA expression of ICAM-1 and VCAM-1 were also reduced by vioprolide, indicating a regulation on transcriptional level. In contrast, the mRNA expression of E-selectin was not decreased at the timepoint when surface protein expression was diminished. The induction of these cell adhesion molecules is mainly mediated by the transcription factor NFκB. A Dual-Luciferase® reporter assay was used to study the impact of vioprolide on the TNF-induced NFκB promotor activity. Vioprolide blocked the TNF-induced NFκB promotor activity while the TNF-induced IκBα degradation and nuclear translocation of the NFκB subunit p65 was not altered by vioprolide. Western blot analysis revealed that vioprolide had no effect on the activation of MAPK (p38, JNK) and AKT by TNF, which could interfere with the NFκB-dependent gene expression.
Taken together, archazolid and vioprolide are interesting myxobacterial compounds with different modes of actions. The study suggests that the v-ATPase inhibitor archazolid impairs the expression and activity of cathepsin B in endothelial cells, which leads to a higher amount of collagen on the endothelial surface. As a result, the adhesion of β1-integrin expressing metastatic cancer cells onto archazolid-treated endothelial cells increased while transendothelial migration was reduced. Further, archazolid represents a promising tool to elucidate the role of v-ATPase in endothelial cells. Vioprolide was able to prevent TNF-induced endothelial-leukocyte interaction in vitro and in vivo by interfering with NFκB-dependent gene expression. Further research is required to enlighten the underlying mechanism and the direct target of vioprolide.
The human Long Interspersed Nuclear Element-1 (LINE-1, L1) is a member of the group of autonomous non-LTR retrotransposons found in almost every eukaryotic genome. L1 elements generate copies of themselves by reverse transcription of an RNA intermediate and integrate into the host genome by a process called Target Primed Reverse Transcription (TPRT). They are responsible for the generation of approximately 35% of the human genome, cover about 17% of the genome and represent the only group of active autonomous transposable elements in humans. L1 activity bears several risks for the integrity of the human genome, since the L1-encoded protein machinery generates DNA double-strand breaks (DSBs) and is capable of conducting numerous genome-destabilizing effects, e.g. causing deletions at insertion sites, disrupting or rearranging coding sequences and deregulating transcription of functional host genes. On the other side, L1 elements have had and still exert a great impact on human genome structure and evolution by increasing the genome size and rearranging and modulating gene expression. Furthermore, due to its endogenous and generally non-pathogenic nature, L1 is a promising candidate as vector for gene delivery in somatic gene therapy. The structure of the flanking regions between de novo L1 integrants and the genomic sequence suggests an involvement of cellular DSB repair pathways in L1 mobilization. To elucidate the role of DSB repair proteins in L1 retrotransposition, I disabled DSB repair factors ATM, ATR, DNA-PK, p53 and Ku70 by knock down (KD) using short hairpin RNA (shRNA) expression constructs. To inhibit the function of DSB repair factors PARP and Rad51, I used dominant negative (DN) PARP and Rad51 mutants. Applying a well established L1-retrotransposition reporter assay in HeLa cells, de novo retrotransposition events were launched in order to test L1 for its retrotransposition activity in the context of altered DSB repair conditions. I could show that L1 retrotransposition frequency after ATM KD had increased by 3-fold, while ATR and p53 KD reduced L1 retrotransposition by approximately one third. Unfortunately, the cytotoxic effects of the DNA-PK and Ku70 shRNA expression constructs were too strong to determine potential effects of DNA-PK and Ku70 KD on L1 retrotransposition. Inhibition of PARP function by expression of the DN mutant and overexpression of wild type PARP were found to increase L1 retrotransposition by 1.8 and 1.5, respectively, while Rad51 DN had no detectable effect. Interestingly, overexpression of wild type Rad51 seemed to roughly double L1 retrotransposition frequencies. Since in my experiments KD or expression of DN mutants was time-delayed to the onset of L1 retrotransposition after transfection into the cells, I developed a temporally controllable, tetracyclin transactivator (tTA)-dependent L1 retrotransposition reporter assay which will be of great value for future L1 retrotransposition studies that rely on temporally controllable retrotransposition. Due to a previously published hypothesis of L1 playing a role in brain development by contributing to somatic mosaicism in neuronal precursor cells, I generated a transgenic mouse (LORFUS) using the tTA-dependent L1 construct to further test this hypothesis. LORFUS harbors a bidirectional cassette driving simultaneous expression of a GFP-tagged L1 retrotransposition reporter and beta-galactosidase. It was bred to another transgenic mouse line expressing tTA in the forebrain. The double transgenic offspring was used to characterize L1 expression and retrotransposition patterns in the brain at postnatal day 15 (P15). General transgene expression indicated by beta-galactosidase activity was found in hippocampus, cortex and striatum, while retrotransposition events revealed by GFP expression were found in hippocampus, cortex, striatum, olfactory bulb and brainstem. These results suggested L1 retrotransposition in the granule layer of the dentate gyrus earlier than P15 and migration of cells carrying these events along the rostral migratory stream into the olfactory bulb. To facilitate the use of L1 as gene delivery tool in gene therapy or genetic engineering, I furthermore intended to manipulate the L1 target site recognition to allow the site-specific integration into defined genomic locations. To this end, I performed crystal structure-guided mutational analysis exchanging single amino acid residues within the endonuclease (EN) domain of L1 to identify residues influencing target site recognition. However, individual point mutations did not change the nicking pattern of L1-EN, but resulted in a reduction of endonucleolytic activity reflected by a reduced retrotransposition frequency. This suggests that additional factors other than the DNA nicking specificity of L1-EN contribute to the targeted integration of non-LTR retrotransposons in the host genomes.
In this research project we aimed to generate genetically modified megakaryocytes and platelets, by targeting protein expression to their secretory alpha-granules to delivery ectopic or therapeutic proteins, to be stored and kept there until an external stimulus triggers platelet activation and platelet secretion takes place. During platelet activation, the therapeutic proteins would then be released to the extracellular space, either as a soluble protein or exposed as a transmembrane protein on the cell surface of platelets. For long-term approaches, genetic modifications must be introduced at the hematopoietic stem cell level.
AIMS: As first approach, we aimed to characterize the lineage-specificity of expression of six different promoter fragments in lentiviral vectors: the murine platelet factor 4 (mPf4) 1222 bp (-1074 to +148), human glycoprotein Ib alpha (hGP1BA) 595 bp (-265 to +330), a short and a longer fragment of the human glycoprotein 6 (hGP6 / hGP6s) 351 bp (-322 to +29) / 726 bp (-697 to +29), as well the human glycoprotein 9 (GP9) promoter 794 bp (-782 to -12). These promoter fragments were included as internal cellular promoters in self-inactivating lentiviral vectors (SIN), using an enhanced green fluorescent protein (eGFP) as gene reporter. GFP detection was evaluated in vitro (in transduced non-megakaryocitc blood cell progenitors and in-vitro differentiated megakaryocytes) and in vivo (Bone marrow cells, blood cells and spleen cells). For targeting of proteins to the secretory alpha granules of megakaryocytes and platelets, we followed two strategies: A) The sorting signal of the cytokine RANTES was fused N-terminally to the destabilized GFP, d2eGFP (RANTES. d2eGFP), to deliver the protein into the granules as soluble cargo. B) The transmembrane granular targeting sequence of P-selectin (the transmembrane domain and cytoplasmic tail (referred as TDCT) was fused to d2eGFP or the B domain deleted codon optimized human coagulation Factor VIII cDNA (referred as BDcohFVIII_TDCT or FVIII_TDCT), to deliver the protein into the membrane of alpha granules. These two strategies were tested in-vitro, from transduced differentiated megakaryocytes in liquid cultures, and in-vivo, by analysis of genetically modified platelets by means of Laser Scanning Confocal Microscopy (LSM) in colocalization analysis (performed at the single cell level) and fluorescence intensity analysis.
RESULTS: GFP expression in blood cells from transplanted mice was significantly higher in platelets, with a smaller background promoter activity in leukocytes and erythrocytes. The highest expression was observed from the mPf4-vector, followed by hGP1BA, hGP6 and hGP6s vectors, identifying the hGP6 vectors as the most restricted to the megakaryocyte and platelet lineage. Analysis in bone marrow cells showed that hGP6-vectors have the lowest activity in the hematopoietic stem and progenitor cells (HSPC) with less than 10% of GFP positive stem cells. Surprisingly, the mPf4 and hGP1BA vectors were both highly active in the HSPC, in a range of 20 to 70% of GFP-positive cells. Polyploidization in later stages of MK-maturation of in-vitro Mks differentiated from Mpl-/- lineage marker negative cells were recovered after gene transfer of the thrombopoietin receptor Mpl, under the control of MK-specific vectors in differentiated into MKs. These results were corroborated in in-vivo analysis, where Mpl-/- mice transplanted with lin-BM cells transduced with the mPf4.Mpl and hGP6.Mpl vectors, showed significantly elevated platelet counts compared to control mice transplanted with a GFP-encoding control vector (PGK-GFP). In the Fluorescent intensity and colocalization analysis of transduced megakaryocytes with the targeting vectors, we observed a significant difference in the GFP targeting compared with those MK transduced with the non-targeting vectors. The median of the WCC values observed from the RANTES.d2eGFP targeting vector was 0.8 (80 % of colocalization) with P-selectin stained granules, and 0.7 (70%) with von Willebrand Factor stained granules. In the case of the non-targeting vector SFFV.d2eGFP the median of the WCC observed were <0.3 (30%) both in P-selectin and von Willebrand Factor stained granules. We observed as well that the GFP signal of MK transduced with the P-selectin.d2eGFP fusion overlapped the signals emitted by P-selectin and von Willebrand factor stained granules, not just in LSM-digitalized images but in the fluorescens intensity analysis as well, indicating a clear signal of GFP colocalization. Likewise, an evident signal overlap between the targeted FVIII (FVIII_TDCT) with the P-selectin / von Willebrand marker was observed. Colocalization and fluorescens intensity analysis performed on activated platelets from transplanted mice with the targeting vectors, corroborated what was previously observed in in-vitro megakaryocytes. The genetic modification of megakaryocyte and platelets will allow in the furture, not just the development of new generation of cells with advanced functions, but it will help us to elucidate new mechanisms and pathways of important cellular processes, by modifying cell function and cell interactions.
KMT2A-rearrangements are causative for 70-80% all infant acute lymphoblastic leukemias (Pieters et al., 2019, 2007). Among these, the translocation t(4;11)(q21;23) generating the oncogenic fusion genes KMT2A::AFF1 and AFF1::KMT2A is the most frequent one, accounting for almost every second case of KMT2A-r infant ALL (Meyer et al., 2018). Despite passing a multimodal chemotherapy, 64% of patients achieve an event including relapse or death within four years from diagnosis, and overall survival three years from relapse remains poor with only 17% (Driessen et al., 2016; Pieters et al., 2019, 2007). Vari-ous studies have shown that relapse and therapy resistance were not mediated by chemotherapy-induced mutagenesis as there was no accumulation of secondary mutations in the dominant leukemic clone between diagnosis and relapse (Agraz-Doblas et al., 2019; Andersson et al., 2015; Bardini et al., 2011; Dobbins et al., 2013; Driessen et al., 2013; Mullighan et al., 2007).
Intriguingly, exclusively infant t(4;11) ALL patients were reported to subdivide in two groups depending on the level of HOXA gene cluster expression (Trentin et al., 2009). The HOXAlo group displayed a high expression of IRX1 and the HOXAhi group a low expression of IRX1 (Symeonidou and Ottersbach, 2021; Trentin et al., 2009). Importantly, the HOXAlo/IRX1hi group was characterized to possess a strongly ele-vated relapse incidence compared to the HOXAhi/IRX1lo group (Kang et al., 2012; Stam et al., 2010). IRX1 was identified to upregulate the Early growth response genes EGR1, EGR2 and EGR3 (Kühn et al., 2016).
The doctoral project “EGR-mediated relapse mechanisms in infant t(4;11) acute lymphoblastic leuke-mia” aimed to investigate a potential correlation between the HOXAlo-IRX1-EGR axis and relapse development in infant t(4;11) ALL. The primary objective was to clarify through which molecular mechanism(s) relapse development despite continuous chemotherapy could be achieved. In this context, the role of the EGR genes has been investigated. In addition, this project aimed to disclose molecular targets which could offer novel therapeutic interventions to interfere with therapy resistance and relapse formation.