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Hematopoietic stem cells: insights into bone marrow biology QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. Aleksandra Wodnar-Filipowicz Department of Biomedicine University Hospital Basel Switzerland ESH-EBMT 1 Latimer 2009 Stem Cells - Definition: Cells capable • to divide for indefinite period, • to self-renew, and • to give rise to specialized cells 2 Totipotent Stem Cell Zygote Embryonic und adult tissue stem cells Pluripotent Stem Cell Embryonic Stem (ES) Cells QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. T-CELL LYMPHOID STEM CELL B-CELL Multipotent Tissue Stem Cells BFU-E Neural Muscle Liver Epidermis Retina Hematopoietic PLASMA CELL ERYTHROCYTE NEUTROPHIL CFU-GM MONOCYTE MACROPHAGE Cancer Stem Cells MYELOID STEM CELL CFU-Eo EOSINOPHIL CFU-Baso BASOPHIL PLATELETS CFU-Meg 3 MEGAKARYOCYTE Developmental Potential of Stem Cells Zygote Embryonic stem cells Adult tissue stem cells “De-differentiation” QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. “Trans-differentiation” Specialization Developmental potential 4 Embryonic stem cells QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. Adult tissue stem cells Cancer Stem Cells 5 Presentation outline: 1. Characterisation of bone marrow - resident hematopoietic stem cells Phenotype Functional assays Stem cell niche Leukemia stem cells 2. Stem cell research and challenges of regenerative medicine ES cells iPS cells Plasticity of bone marrow - resident stem cells Therapeutic outlook - 2009 6 Hematopoietic stem cells Mouse Human Phenotype Phenotype LSK cells Lin0.007% sca1+ of BM ckit+ tie2+ flk2CXCR4+ Abcg2+ SLAM-Rs: CD150+CD244-CD48TLR4+ c-kit 0.007% R3 BL6 c-kit % 101 102 SCA1-Height 103 sca-1 Hoechst blue Hoechst Blue Side population (SP) (ABCG2+transporter) LSK cells: 100 CD34+CD38- cells Lin0.1% CD34+ (CD34- ?) of BM CD38ckit+ flk2- (flk2+ ?) CD133+ (?) CXCR4+ ABCG2+ ? 0.2% SP 104 Hoechst Far Red Hoechst far red The phenotype of human HSC remains poorly defined 7 Human hematopoietic stem cells Function • In vitro CFU assays • In vivo transplantation: xenografts in immunologically permissive mouse strains (e.g. ..NOD/SCID; NOD/SCID-c-/-; Rag2-/-c-/-) SRC human CD34+cells (i.v. or i.f.) BMT 1º BMT 2º 3º Clinical transplantation 8 In situ analysis of bone marrow “niche” Labeled HSC in the bone marrow niche CFSE/ DAPI/ OPN Cytokine expression in the bone marrow niche CD45/ Flt3 ligand BONE HSC os BM Wilson et al. 2004 ISO CD45 FL CD45 Kenins & Wodnar-Filipowicz 2005 endosteum Cytokine receptor expression in the bone marrow niche Tie2+CD45+ cells (yellow) adhere to the endosteal surface 9 Arai et al. 2004 Bone marrow “niche” 2009 QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. 10 Cellular components of stem cell niches in the adult bone marrow Sinusoid endothelial cells QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. MSC Trabecular bone MSC MSC Endosteal niche HSC Vascular niche Migration Proliferation Differentiation Precursor cells HSC CAR cells Osteoblasts Osteoblasts - osteogenic cells lining the inner surface of the bone Stroma fibroblasts Self-renewal CAR cells - (CXCL12 abundant reticular) cells close to 11 the bone surface and endothelium Molecular interactions in the bone marrow niche Intrinsic Extrinsic mechanisms: mechanisms: • signalling molecules • cytokines • cytoplasmic • chemokines • nuclear, incl. • adhesion molecules transcription factors • negative regulators (osteopontin) • epigenetic mechanisms • proteases (MMP-9, cathepsin K) • DNA/histone modif. HSC • hormones (PTH, PGE2) • microRNAs • sympathetic nerves Gene expression • oxygen status • calcium concentration • circadian rhytm Ang-1 - tie2 quiescence SCF - c-kit self-renewal Flt3-L - Flt3 expansion TPO - mpl Wnt - Frizzled Jagged/Delta - Notch Cadherins VCAM - VLA ICAM - LFA CXCL12 - CXCR4 HA - CD44 cell-cell adhesion migration OSTEOBLAST PTH, PGE2 nerves 12 Leukemia Stem Cells 13 Cancer stem cells Normal stem cells and cancer cells share the ability to self-renew and many signaling pathways involved in the regulaton of normal stem cell development are mutated or epigenetically activated in cancer. Leukemia stem cells: Transformed hematopoietic stem or commited progenitor cells that have amplified or acquired the capacity for self-renewal, albeit in a poorly regulated fashion. HSC HSC LSC Prog. LSC 14 1st Leukemia stem cells: identified cancer stem cells Phenotype CD34+CD38CD34- ? CD33+ ? CD44+ ? CD71+ ? CD96+ ? CD117- ? CD123+ ? CD133+ ? CLL-1+ ? Function SL-IC Human AML peripheral blood NOD/SCID CD34+CD38not CD34+CD38+ (?) 15 Functional analysis of LSCs BM BM FACS: human CD45+ cells iv AML cells 2o 1o if Injected femur Peripheral blood CD33 Non-injected bones 3o Langenkamp & Wodnar-Filipowicz 2008 CD45 AML cells 2 weeks 1o CFU 2o CFU 3o CFU 16 Leukemic stem cells Conventional treatment • resistant to conventional treatment • lead to relapse and fatal outcome Leukemic cell growth Relapse Degeneration Remission Terminal differentiation Remission Elimination of LSC Challenge in stem cell biology/stem cell-based therapies: understanding the molecular and the functional programmes of leukemic vs normal stem cells 17 Cross-talk in the AML niche in the bone marrow ? Bone marrow stromal cells are important for the maintenance of normal HSCs (cell cycle, differentiation, proliferation) and of AML-LSCs (CD44-dependent interactions) CFSE/ DAPI/ OPN bone BM os HSC endosteum Van Etten et al. Nat Med 2006 Wilson et al. Genes & Dev 2004 Bone marrow stromal cells can in turn be influenced by leukemic cells BM stroma HSC or LSC Transition of SDF-1- to SCF - expressing environment, which disrupts the behaviour of normal HSC/progenitors Colmone et al. Science 2008 Is the stem cell niche in leukemia normal or not ? 18 “Seed or soil” or both ? Self-renewal mechanism of stem cells Normal stem cell s. Cancer stem cell stem cell number: as. stable 80% asymmetric increased 80% symmetric Mathematical model: Skipping assymetric division every 4-6 divisions is sufficient for the tumor to grow. 19 Presentation outline: 1. Characterisation of bone marrow - resident hematopoietic stem cells Phenotype Functional assays Stem cell niche Leukemia stem cells 2. Stem cell research and challenges of regenerative medicine ES cells iPS cells Plasticity of bone marrow - resident stem cells Therapeutic outlook - 2009 20 Generation of ES cell lines from human blastocysts Thomson et al. Science 282:1145 (1998) Donated IVF blastocyst Inner cell mass „immortal“ cell lines Somatic differentiation in vitro into various tissue types CFU’s Kaufman et al. PNAS 98:10716 (2001) 21 „Therapeutic Cloning“ (SCNT) Enucleated donor oocyte Fusion Blastocyst Nuclear-transfer From adult cell QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. ES cell lines Human ES cells with patient’s genetic information Immunologically-compatible tissue for transplantation 22 Human iPS cells (induced pluripotent stem cells) from adult dermal fibroblasts Takahashi et al. Cell 131:1 (2007) Yu et al. Science 318:1917 (2007) Zhou et al. Cell Stem Cell 4:381 (2009) Oct3/4 Sox2 c-myc Klf4 Fusionproteins iPS (piPS) ES-like cells fibroblasts ± 20 days Oct4 Sox2 Nanog Lin28 Differentiation into cells of all germ layers: Ectoderm e.g. Mesoderm neural cells, Entoderm heart muscle cells Human ES morphology Normal karyotype Telomerase activity Cell surface markers of ES cells Gene expression profile of ES cells 23 Adult bone marrow - derived stem cells for organ regeneration and repair 24 Bone marrow - resident stem cells Cell type Differentiation potential Hematopoietic stem cells (HSC) blood cells other tissues = plasticity (?) Mesenchymal stem cells (MSC) bone, cartilage adipose tissue, muscle other tissues = plasticity (?) Hemangioblasts (EPC) endothelium blood cells, muscle [Multipotent adult progenitor cells (MAPC)] multilineage 25 Adult stem cell plasticity by “trans-differentiation” Ability of tissue-specific stem cells to acquire, under defined microenvironmental conditions, the fate of cell types different from the tissue of origin and belonging to all three germ layers, i.e. similar to the differentiation ability of ES cells. 26 Muscle (Heart) Neural (CNS) HSC Adipocytes contamination not reproducible not reproducible Hepatocyte (Liver) cell fusion = BM-HSC remained true to their roots Criteria to prove adult stem cell plasticity by “trans-differentiation”: - initiated by single self-renewing stem cell - generation of all functional cell types of tissue of origin and unrelated tissue - robust repopulation of tissue of origin and unrelated tissue in vivo have not been fulfilled in the existing studies. 27 BM tissue regeneration (clinical trials) Diseases G/GM-CSF mobilization BM Cardiac Vascular Lung BM (MNCs, CD34+) Brain stroke, Paraplegia, ALS autologous Breast cancer Retina degeneration Cartillage degeneration MSC-infusions Osteogenesis imperfecta allogeneic GvHD autologous 28 Stem cells: Key words d.0-d.14 w.2-w.8 mo.3-mo.9 Pre-embryo Embryo after birth Fetus Adult Parthenogenesis (chemical treatment) d.1-d.2 Oocyte + Sperm Adult cells 8 cell (blastomeres) Zygote * QuickT im e™ and a T IFF (Uncom pressed) decom pressor are needed to see this picture. d.8-9 32 cell Implantation (blastocyst) in utero ES cells * = ICM animal oocyte (chimerae) Nuclear transfer (SCNT) trophoblast Embryo ES cell lines * Gene transfer (reprogramming) iPS * d.5 Extraembryonic tissue Epiblast * AGM region * EG cells * Yolk sac * Placenta * Amniotic fluid * Natural plasticity of adult cells ?? Cell fusions (adult/adult; adult/ES) All duplicated if starting from diseased cells Fetal Cord Bone Liver * Blood * Marrow * 29 ± Genetic modifications 2009: Prospects for stem cell-based therapy of degenerative diseases ES SCNT iPS MSC CBHSC HSC NSC Stem cell choice: • adult (multipotent) or embryonic (pluripotent) • “off-the-shelf” from master-stocks (= cell banks) or “customized” for ... ... ...individual patients Stem cell number: • increase homing and engraftment in tissue of choice • develop drugs that augment the endogenous stem cell pools Stem cell immunogenicity: • generate isogenic (genetically equivalent) cells: • iPS cells • ES cells after nuclear transfer (“therapeutic cloning”) • parthenogenetic embryos as ES cell source (pES) • overcome the immune response: engineer cells deficient in class I ...and II HLA genes/NK ligands or antagonizing immune responses Stem cell gene therapy: ES/iPS terato/cancerogenicity: 30 • control insertional mutagenesis ? Literature - Reviews: Stem cells - all aspects: Issue of Cell 132; Feb 22 (2008) HSC and niches: Kiel & Morrison, Nature 8:290-301 (2008) Adult stem cell (general) niches: Jones & Wagers, Nature 9:11-21 (2008) Cancer stem cells - targeting Trumpp & Wiestler, Nature Clinical Oncol 5:337 (2008) Leukemia stem cells Chan & Huntly, Seminars in Oncology 35:326 (2008) Plasticity: Scadden DT, J Clin Invest 117:3653-3655 (2007) Deconstructing Stem Cell Tumorigenicity: A Roadmap to Safe Regenerative Medicine. Knoepfler PS, Stem Cells 29:1050-1056 (2009) 31