Levels Of Telomerase Activity Research Articles

Novel protective effect of the FOXO3 longevity genotype on mechanisms of cellular aging in Okinawans

The genetic association of FOXO3 genotypes with human longevity is well established, although the mechanism is not fully understood. We now report on the relationship of the FOXO3 longevity variant rs2802292 with telomere length, telomerase activity, FOXO3 expression, and inflammatory cytokine levels in men and women. In agreement with earlier work, the FOXO3 longevity variant conferred protection against telomere shortening of peripheral blood mononuclear cells from adults aged 55 years and older. This was accompanied by higher levels of telomerase activity in mononuclear cells for carriers of the longevity-associated FOXO3 G-allele of SNP rs2802292 (P = 0.015). FOXO3 mRNA expression increased slightly with age in both young (P = 0.02) and old (P = 0.08) G-allele carriers. Older female G-allele carriers displayed a modest decline in levels of pro-inflammatory cytokine IL-6 with age (P = 0.07). In contrast, older male G-allele carriers displayed an age-dependent increase in levels of anti-inflammatory cytokine IL-10 with age (P = 0.04). Thus, FOXO3 may act through several different pro-longevity mechanisms, which may differ by age and sex.

Arabidopsis telomerase takes off by uncoupling enzyme activity from telomere length maintenance in space

Spaceflight-induced changes in astronaut telomeres have garnered significant attention in recent years. While plants represent an essential component of future long-duration space travel, the impacts of spaceflight on plant telomeres and telomerase have not been examined. Here we report on the telomere dynamics of Arabidopsis thaliana grown aboard the International Space Station. We observe no changes in telomere length in space-flown Arabidopsis seedlings, despite a dramatic increase in telomerase activity (up to 150-fold in roots), as well as elevated genome oxidation. Ground-based follow up studies provide further evidence that telomerase is induced by different environmental stressors, but its activity is uncoupled from telomere length. Supporting this conclusion, genetically engineered super-telomerase lines with enhanced telomerase activity maintain wildtype telomere length. Finally, genome oxidation is inversely correlated with telomerase activity levels. We propose a redox protective capacity for Arabidopsis telomerase that may promote survivability in harsh environments.

Seasonal variation in telomerase activity and telomere dynamics in a hibernating rodent, the garden dormouse (Eliomys quercinus)

Telomere dynamics in hibernating species are known to reflect seasonal changes in somatic maintenance. Throughout hibernation, the periodic states of rewarming, known as inter-bout euthermia or arousals, are associated with high metabolic costs including shortening of telomeres. In the active season, if high energetic resources are available, telomere length can be restored in preparation for the upcoming winter. The mechanism for telomere elongation has not been clearly demonstrated, although the action of the ribonucleoprotein complex, telomerase, has been implicated in many species. Here we tested for levels of telomerase activity in the garden dormouse (Eliomys quercinus) at different seasonal time points throughout the year and across ages from liver tissues of male juveniles to adults. We found that telomerase is active at high levels across seasons (during torpor and inter-bout euthermia, plus in the active season) but that there was a substantial decrease in activity in the month prior to hibernation. Telomerase levels were consistent across age groups and were independent of feeding regime and time of birth (early or late born). The changes in activity levels that we detected were broadly associated with changes in telomere lengths measured in the same tissues. We hypothesise that i) telomerase is the mechanism used by garden dormice for maintenance of telomeres and that ii) activity is kept at high levels throughout the year until pre-hibernation when resources are diverted to increasing fat reserves for overwintering. We found no evidence for a decrease in telomerase activity with age or a final increase in telomere length which has been detected in other hibernating rodents.

THE FOXO3 LONGEVITY GENOTYPE PROTECTS AGAINST MECHANISMS OF CELLULAR AGING IN OKINAWANS

Abstract The genetic association of FOXO3 genotypes with human longevity is well established, although the mechanism is not fully understood. We now report on the relationship of the FOXO3 longevity variant rs2802292 with telomere length, telomerase activity, FOXO3 expression and inflammatory cytokine levels in men and women. In agreement with earlier work, the FOXO3 longevity variant conferred protection against telomere shortening of peripheral blood mononuclear cells from adults aged 55 and older. This was accompanied by higher levels of telomerase activity in carriers of the longevity-associated FOXO3 G-allele (P=0.015). FOXO3 mRNA expression increased slightly with age in both young (P=0.02) and old (P=0.08) G-allele carriers. Older female G-allele carriers displayed a modest decline in levels of pro-inflammatory cytokine IL-6 with age (P=0.07). In contrast, older male G-allele carriers displayed an age-dependent increase in levels of anti-inflammatory cytokine IL-10 with age (P=0.04). Thus, FOXO3 may act through several different pro-longevity mechanisms, which may differ by age and sex.

Abstract A09: Telomerase activity as a biomarker to predict outcomes of CAR T-cell therapy

Abstract Introduction: Chimeric antigen receptor T-cells (CAR T-cells) and T-cells in general, remain in a quiescent state when unstimulated, showing no proliferative activity. In contrast, upon specific antigenic stimulation, CAR T-cells rapidly divide and kill their target cancer cells. However, one of the immunologic changes with aging is the progressive impairment of T-cell responses. This physiologic immunosenescence is associated with the shortening of telomeres. The telomerase enzyme is transiently upregulated in stimulated CAR T-cells preventing dramatic telomere shortening during rapid CAR T-cell division. Our previous study showed that during T-cell expansion, the period during which telomerase is active and the magnitude of its activity correlates with the donor’s age and overall health status (“healthy aging”) [1]. The aim of this study is to investigate whether the magnitude of telomerase activity in stimulated CAR T-cells is a predictive biomarker of outcomes in patients receiving CAR T-cell therapy.Methods: The study population comprises of older adult patients (age range: 50-84 years) receiving autologous anti-CD19 CAR T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma, mantle cell lymphoma or follicular lymphoma. Peripheral blood samples are collected from patients pre-lymphodepletion and T-cells isolated from PBMCs (peripheral blood mononuclear cells). CAR T-cells are then generated from patient T-cells in the lab and telomerase activity analyzed over 2 weeks in culture. For each patient’s CAR T-cells, absolute values of telomerase activity are plotted to calculate the area under the curve (AUC). We are investigating the potential correlation of AUC of telomerase activity to disease response at 30- and 90-days post CAR T-cell infusion. Results: Preliminary data from eight patients is showing a clear correlation between telomerase activity and patient outcomes. Robust telomerase activity shows a positive correlation with complete responses on day 30 PET-CT scans and sustained clinical remission, while poor telomerase activity correlates with no response or progressive disease. We are expanding our study sample to 30-50 patients and updated data will be presented at the meeting. Conclusions: CAR T-cell therapy has been a game-changer for hematological malignancies; however therapeutic resistance and disease relapse remains a major concern. Understanding the mechanisms of resistance to CAR T-cell therapy is critical for advancing the field. Telomerase activity levels could be a potential predictive biomarker for CAR T-cell therapy outcomes and aid in personalizing treatment choices. Furthermore, future research on increasing telomerase activity may enhance CAR T-cell therapy function and ultimately patient outcomes. [1] Tedone et.al, Telomere length and telomerase activity in T cells are biomarkers of high-performing centenarians, Aging Cell, 2019 Citation Format: Mohammed E Sayed, Enzo Tedone, Emily Zhang, Helen Stephens, Farrukh T Awan, Jerry Shay, Praveen Ramakrishnan Geethakumari. Telomerase activity as a biomarker to predict outcomes of CAR T-cell therapy [abstract]. In: Proceedings of the Third AACR International Meeting: Advances in Malignant Lymphoma: Maximizing the Basic-Translational Interface for Clinical Application; 2022 Jun 23-26; Boston, MA. Philadelphia (PA): AACR; Blood Cancer Discov 2022;3(5_Suppl):Abstract nr A09.

Comparison of urinary telomerase, CD44, and NMP22 assays for detection of bladder squamous cell carcinoma.

BackgroundSquamous cell carcinoma (SCC) of the bladder is common in many regions around the world. Prognosis is very poor, as most cases are diagnosed at an advanced stage due to a lack of affordable and valid screening markers for this type of cancer. The diagnostic accuracy of urinary nuclear matrix protein-22 (NMP22), telomerase activity, and CD44 were evaluated in urine samples of patients with bladder SCC.Materials and methodsWe conducted a case-control study comprised of 60 consecutive newly diagnosed bladder SCC patients diagnosed by cystoscopy and histopathological examination, and controls were 60 outpatients with benign urologic conditions and healthy clinic visitors. Urine samples collected from each subject underwent testing for NMP22, telomerase activity, and CD44. Descriptive and correlational statistical analysis of cases and controls were carried out and receiver operating characteristic curve analysis was used to determine optimal cut-off points for the three assays.ResultsArea under the curve was calculated at 0.96, 0.93, and 0.62 for NMP22, telomerase, and CD44, respectively. Urine levels of NMP22 and telomerase activity were significantly higher in the SCC group compared to controls (p < 0.001). Urine CD44 levels were not significantly higher in the SCC group compared to controls (p = 0.111). The overall sensitivity of NMP22, telomerase, and CD44 was 96.7%, 87%, and 45%, respectively, while the specificity was 85%, 88.6%, and 86.7%, respectively.ConclusionsUrinary telomerase activity, followed by NMP22 urine levels, showed high diagnostic yield and could hold potential promise as urinary biomarkers for the diagnosis of bladder SCC.

Short and Long-Term Interval Effects of High-Intensity Interval Training on Pathways Related to Telomere Homeostasis in Rat Skeletal Muscle

Background: Exercise training through various mechanisms leads to correct telomere homeostasis. The potential role of high-intensity interval training (HIIT) to keep up the telomere length has not been recognized in skeletal muscle. Objectives: This study investigated the influence of eight weeks of HIIT with short-term interval (HIITSh) and long-term interval (HIITL), and four weeks of detraining on the regulation of some pathways maintaining telomere length in skeletal muscle. Methods: Fifty-four male Wistar rats were randomly assigned into HIITSh, HIITL, and control groups. Rats were sacrificed after the end of the intervention (eight weeks of training and four weeks of detraining). Gastrocnemius muscle was collected, and telomerase activity, p53 protein, total oxidative status (TOS), and total antioxidant capacity (TAC) levels were measured. Results: We found no change in telomerase activity, p53, TOS, and TAC levels in both HIIT groups compared to the control group (P &gt; 0.05). In addition, the p53 level was higher in the detrained HIITSh group than the control group (P = 0.004), and the TOS level was higher in the detrained HIITSh group than both HIIT groups. Conclusions: Short-term HIIT does not improve telomere length and some pathways contributing to maintaining telomere length in skeletal muscle. The training protocol’s duration is an essential factor in activating telomerase as a mechanism to keep up telomere length in skeletal muscle.

Investigating the Long-Term Effect of an Interdisciplinary Multimodal Rehabilitation Program on Levels of Bioactive Lipids and Telomerase Activity in Blood from Patients with Chronic Pain.

Mechanism-based diagnosis and therapies for chronic pain are lacking. However, bio-psycho-social interventions such as interdisciplinary multimodal rehabilitation programs (IPRPs) have shown to be relatively effective treatments. In this context we aim to investigate the effects of IPRP on the changes in levels of bioactive lipids and telomerase activity in plasma, and if these changes are associated with changes in pain intensity and psychological distress. This exploratory study involves 18 patients with complex chronic pain participating in an IPRP. Self-reports of pain, psychological distress, physical activity, and blood samples were collected before the IPRP and at a six-month follow-up. Levels of arachidonoylethanolamide (AEA) and 2-arachidonoylglycerol (2-AG), palmitoylethanolamide (PEA), oleoylethanolamide (OEA), stearoylethanolamide (SEA), and telomerase activity were measured. Pain intensity was decreased, and SEA levels were increased at the six-month follow up. A significant correlation existed between changes in SEA levels and pain intensity. AEA levels, were inversely correlated with physical activity. Furthermore, 2-AG and telomerase activity was significantly correlated at the six-month follow-up. This study confirms that IPRP is relatively effective for reduction in chronic pain. Changes in SEA were correlated with changes in pain intensity, which might indicate that SEA changes reflect the pain reduction effects of IPRP.

Effects of FOXO3 on Markers of Aging in Blood : An Okinawan Longevity Cohort Study

FOXO3 is among only a few genes that demonstrate a consistently reproducible genetic association with human longevity. We previously demonstrated, in a cross-sectional study of Okinawan Japanese, that the principal longevity variant of FOXO3 (rs 2802292 “G allele”) protects against age-associated attrition of telomere length. We now expand upon this initial observation in a more detailed cross-sectional analysis of the effect of FOXO3 on telomerase activity, FOXO3 expression and inflammatory cytokine levels in both men and women. In agreement with our initial study, we found the FOXO3 longevity variant conferred significant protection against telomere shortening to roughly the same degree in elderly (ages 55 and older) men and women. Carriers of the G - allele also had slightly higher levels of blood telomerase activity in young (ages 20 – 54) and elderly participants (P≤0.1). The expression (mRNA) of FOXO3 increased steadily with age in young and old G – allele carriers (borderline P≤0.08), in contrast to a lack of association with age in non-carriers. The FOXO3 G - allele was also observed to significantly impact levels of both interleukin 6 (IL 6) and IL10, but in a sex dependent manner (P<0.05). These sex-specific effects may point to different mechanisms by which FOXO3 exerts its effect on longevity in men and women.

Reciprocal impacts of telomerase activity and ADRN/MES differentiation state in neuroblastoma tumor biology

Telomere maintenance and tumor cell differentiation have been separately implicated in neuroblastoma malignancy. Their mechanistic connection is unclear. We analyzed neuroblastoma cell lines and morphologic subclones representing the adrenergic (ADRN) and mesenchymal (MES) differentiation states and uncovered sharp differences in their telomere protein and telomerase activity levels. Pharmacologic conversion of ADRN into MES cells elicited consistent and robust changes in the expression of telomere-related proteins. Conversely, stringent down-regulation of telomerase activity triggers the differentiation of ADRN into MES cells, which was reversible upon telomerase up-regulation. Interestingly, the MES differentiation state is associated with elevated levels of innate immunity factors, including key components of the DNA-sensing pathway. Accordingly, MES but not ADRN cells can mount a robust response to viral infections in vitro. A gene expression signature based on telomere and cell lineage-related factors can cluster neuroblastoma tumor samples into predominantly ADRN or MES-like groups, with distinct clinical outcomes. Our findings establish a strong mechanistic connection between telomere and differentiation and suggest that manipulating telomeres may suppress malignancy not only by limiting the tumor growth potential but also by inducing tumor cell differentiation and altering its immunogenicity.

Efficacy of decitabine in malignant meningioma cells: relation to promoter demethylation of distinct tumor suppressor and oncogenes and independence from TERT.

Chemotherapeutic options for meningiomas refractory to surgery or irradiation are largely unknown. Human telomerase reverse transcriptase (hTERT) promoter methylation with subsequent TERT expression and telomerase activity, key features in oncogenesis, are found in most high-grade meningiomas. Therefore, the authors investigated the impact of the demethylating agent decitabine (5-aza-2'-deoxycytidine) on survival and DNA methylation in meningioma cells. hTERT promoter methylation, telomerase activity, TERT expression, and cell viability and proliferation were investigated prior to and after incubation with decitabine in two benign (HBL-52 and Ben-Men 1) and one malignant (IOMM-Lee) meningioma cell line. The global effects of decitabine on DNA methylation were additionally explored with DNA methylation profiling. High levels of TERT expression, telomerase activity, and hTERT promoter methylation were found in IOMM-Lee and Ben-Men 1 but not in HBL-52 cells. Decitabine induced a dose-dependent significant decrease of proliferation and viability after incubation with doses from 1 to 10 μM in IOMM-Lee but not in HBL-52 or Ben-Men 1 cells. However, effects in IOMM-Lee cells were not related to TERT expression, telomerase activity, or hTERT promoter methylation. Genome-wide methylation analyses revealed distinct demethylation of 14 DNA regions after drug administration in the decitabine-sensitive IOMM-Lee but not in the decitabine-resistant HBL-52 cells. Differentially methylated regions covered promoter regions of 11 genes, including several oncogenes and tumor suppressor genes that to the authors' knowledge have not yet been described in meningiomas. Decitabine decreases proliferation and viability in high-grade but not in benign meningioma cell lines. The effects of decitabine are TERT independent but related to DNA methylation changes of promoters of distinct tumor suppressor genes and oncogenes.

Potential of Naturally Derived Compounds in Telomerase and Telomere Modulation in Skin Senescence and Aging.

Proper functioning of cells—their ability to divide, differentiate, and regenerate—is dictated by genomic stability. The main factors contributing to this stability are the telomeric ends that cap chromosomes. Telomere biology and telomerase activity have been of interest to scientists in various medical science fields for years, including the study of both cancer and of senescence and aging. All these processes are accompanied by telomere-length modulation. Maintaining the key levels of telomerase component (hTERT) expression and telomerase activity that provide optimal telomere length as well as some nontelomeric functions represents a promising step in advanced anti-aging strategies, especially in dermocosmetics. Some known naturally derived compounds contribute significantly to telomere and telomerase metabolism. However, before they can be safely used, it is necessary to assess their mechanisms of action and potential side effects. This paper focuses on the metabolic potential of natural compounds to modulate telomerase and telomere biology and thus prevent senescence and skin aging.

Intron 4\u20135 hTERT DNA Hypermethylation in Merkel Cell Carcinoma: Frequency, Association with Other Clinico-pathological Features and Prognostic Relevance

Merkel cell carcinoma (MCC) is an aggressive skin tumor with neuroendocrine differentiation, mainly affecting elderly population or immunocompromised individuals. As methylation of the human telomerase reverse transcriptase (mhTERT) has been shown to be a prognostic factor in different tumors, we investigated its role in MCC, in particular in intron 4–5 where rs10069690 has been mapped and recognized as a cancer susceptibility locus. DNA methylation analysis of hTERT gene was assessed retrospectively in a cohort of 69 MCC patients from the University of Bologna, University of Turin and University of Insubria. Overall mortality was evaluated with Kaplan-Meier curves and multivariable Royston-Parmar models. High levels of mhTERT (mhTERThigh) (HR = 2.500, p = 0.015) and p63 (HR = 2.659, p = 0.016) were the only two clinico-pathological features significantly associated with a higher overall mortality at the multivariate analysis. We did not find different levels of mhTERT between MCPyV (+) and (−) cases (21 vs 14, p = 0.554); furthermore, mhTERThigh was strongly associated with older age (80.5 vs 72 years, p = 0.026), no angioinvasion (40.7% vs 71.0%, p = 0.015), lower Ki67 (50 vs 70%, p = 0.005), and PD-L1 expressions in both tumor (0 vs 3%, p = 0.021) and immune cells (0 vs 10%, p = 0.002). mhTERT is a frequently involved epigenetic mechanism and a relevant prognostic factor in MCC. In addition, it belongs to the shared oncogenic pathways of MCC (MCPyV and UV-radiations) and it could be crucial, together with other epigenetic and genetic mechanisms as gene amplification, in determining the final levels of hTERT mRNA and telomerase activity in these patients.

Detection of Urothelial Bladder Cancer Based on Urine and Tissue Telomerase Activity Measured by Novel RT-TRAP-2PCR Method.

Purpose: To assess the diagnostic performance of urine telomerase activity (TA) in detecting bladder cancer (BCa) using the modified Telomeric Repeat Amplification Protocol (TRAP) and the Real Time Telomeric Repeat Amplification Protocol with double Polymerase Chain Reaction (RT-TRAP-2PCR). Methods: In this case-control study, matching urine (in the pre- and post-surgical period) and tissue samples from 68 patients with BCa were assessed for TA. As a control, 45 urine samples were examined from non-BCa patients. TA levels were measured using TRAP and RT-TRAP-2 PCR methods. Results: Preoperative urinary TA was elevated in 64 (94.1%) of the 68 BCa patients. Urine TA was undetectable in 44 control patients, while TA was detected in one patient with histologically verified cystitis. Sensitivity for BCa detection of 94.1% and specificity of 97.8% were observed for urinary TA, while tissue TA had 100% sensitivity and 97.8% specificity. Both urine and tissue TA levels were not significantly higher in patients with muscle-invasive disease compared to those with non-muscle invasive BCa (p > 0.05). Urine and tissue TA levels were not associated with higher tumor grade, stage, and number of tumors (p > 0.05). However, the association was found between higher urinary and tissue TA levels with tumor size ≥ 3 cm (p = 0.02 and p = 0.01, respectively). During the first postoperative year, 17 BCa patients experienced disease recurrence, and urinary TA was present in 14 (82.4%) of these patients. The sensitivity and specificity of urinary TA levels for BCa recurrence in patients with non-muscle invasive bladder cancer (NMIBC) during follow-up were 82% and 94.4%, respectively. Conclusions: This pilot study demonstrates a high diagnostic performance of urinary and tissue TA levels measured by a new RT-TRAP-2PCR method for detecting and monitoring BCa. Additionally, the association was found between higher urinary and tissue TA levels with tumor size ≥ 3 cm; however, higher TA levels failed for significant correlation with advanced tumor stage and grade. Our study could serve as a benchmark for the evaluation of novel biomarkers using the RT-TRAP-2PCR method.

Telomerase Level: A Useful Tool to Predict Longevity

In the context of the global elderly population increase, due to the rise of average life span, many researches try to explain the molecular bases of ageing and age-related diseases. In the headlines, there are the telomere-telomerase based studies, which support the idea that telomere length dynamics and telomerase activity level are involved in cellular senescence, immortalization and tumorigenesis. Here, no statistical difference is shown between hTERT content in the plasma of young and elderly groups, Nevertheless the higher level of telomerase increases with age in the older age group. A good balance between telomerase level and telomere shortening seems to be a useful machinery to maintain health and prolong lifespan. In this scientific concept, further progress has to be made in order to explain the origin of increasing life span and the lack of pathology during ageing.

Endometriosis Is Associated with a Significant Increase in hTERC and Altered Telomere/Telomerase Associated Genes in the Eutopic Endometrium, an Ex-Vivo and In Silico Study.

Telomeres protect chromosomal ends and they are maintained by the specialised enzyme, telomerase. Endometriosis is a common gynaecological disease and high telomerase activity and higher hTERT levels associated with longer endometrial telomere lengths are characteristics of eutopic secretory endometrial aberrations of women with endometriosis. Our ex-vivo study examined the levels of hTERC and DKC1 RNA and dyskerin protein levels in the endometrium from healthy women and those with endometriosis (n = 117). The in silico study examined endometriosis-specific telomere- and telomerase-associated gene (TTAG) transcriptional aberrations of secretory phase eutopic endometrium utilising publicly available microarray datasets. Eutopic secretory endometrial hTERC levels were significantly increased in women with endometriosis compared to healthy endometrium, yet dyskerin mRNA and protein levels were unperturbed. Our in silico study identified 10 TTAGs (CDKN2A, PML, ZNHIT2, UBE3A, MCCC2, HSPC159, FGFR2, PIK3C2A, RALGAPA1, and HNRNPA2B1) to be altered in mid-secretory endometrium of women with endometriosis. High levels of hTERC and the identified other TTAGs might be part of the established alteration in the eutopic endometrial telomerase biology in women with endometriosis in the secretory phase of the endometrium and our data informs future research to unravel the fundamental involvement of telomerase in the pathogenesis of endometriosis.

β-galactosidase and Annexin V/PI Assays as QC Tests for Manufacturing cGMP-Grade Wharton Jelly Derived Mesenchymal Stem Cells

Background: According to the guidelines for cGMP, strictly regulated procedures and quality control (QC) tests are required. However, none of the regulations by authorities suggested have β galactosidase and Annexin V/PI assays as QC tests. In this study, we aimed to demonstrate the feasibility of Annexin V and β galactosidase assays as valid cGMP compliant QC tests. Methods: Wharton’s Jelly derived mesenchymal stem cells (WJ MSCs) were isolated, characterized and screened as valid QC tests. In this study, in addition to routine QC tests, β gal assays were performed to confirm telomerase activity and Annexin V methods were used to confirm cell viability assays. Results: It was concluded that one donor (WJ MSC 3) has higher telomerase activity and it has lowest β gal activity at the same time (p<0,001). Only one donor showed significant difference in annexin V viability tests, indicating the importance of using automatic devices and Annexin V to manual tests for cell viability analysis (Muse: 92,48 ± 0,487% Flow Cytometry: 90,76 ± 1,116% p<0,01). Conclusion: With these existing data, telomerase activity and senescence levels may correlate and affect MSC quality in cell based therapy. In order to determine the viability values by adding Annexin V based automated methods could give more guaranteed results. Key words: Good Manufacturing Practice, SA b galactosidase, cell senescence, telomerase activity, Annexin V, cell based medicinal products. DOI: 10.7176/JSTR/6-12-07

Potential Disease-Modifying Activity of Imetelstat Demonstrated By Reduction in Cytogenetically Abnormal Clones and Mutation Burden Leads to Clinical Benefits in Relapsed/Refractory Myelofibrosis Patients

Background: Myelofibrosis (MF) is a clonal stem cell disease characterized by marrow fibrosis and a heterogeneous disease phenotype with a variable degree of splenomegaly, cytopenias, and constitutional symptoms that significantly impact quality of life and survival. Both cytogenetic abnormalities and gene mutations in MF carry prognostic significance. Development of novel agents for treatment of MF to target the underlying malignant clones remains a significant area of unmet need. IMbark (MYF2001; NCT02426086) is a randomized Phase 2 study of imetelstat (9.4 mg/kg or 4.7 mg/kg) in intermediate-2/high-risk MF relapsed/refractory to prior Janus kinase inhibitor treatment. Comparing the 9.4 mg/kg arm to the 4.7 mg/kg arm, the rate of symptom response (total symptom score [TSS] reduction ≥50%) was 32.2% and 6.3%, respectively (Mascarenhas et al ASH 2018 #685), and median overall survival (OS) was 28.1 months (mos) (95% confidence interval [CI]: 22.8, 31.6) and 19.9 mos (95% CI: 17.1, 33.9) with an overall study follow up of 42 mos (Mascarenhas et al, EHA 2020, EP1107). Dose-dependent target inhibition as evaluated by reduction of telomerase activity and human telomerase reverse transcriptase level correlated with clinical responses and longer OS; also, reduction in variant allele frequency (VAF) of driver mutations by imetelstat was reported (Mascarenhas et al EHA 2020 #EP1098). Aims: To evaluate imetelstat activity on depletion of malignant cells (cytogenetically abnormal clones and mutation burden); to assess the relationships between baseline cytogenetic status and change in mutation VAF with clinical benefits such as spleen volume reduction, symptom response, bone marrow fibrosis improvement, and OS. Methods: Cytogenetic analyses were performed on bone marrow aspirates. Peripheral blood samples pre and post imetelstat administration were collected and granulocytes were isolated to analyze mutations and VAF by next-generation sequencing (NGS) using the Illumina TruSight Myeloid Sequencing Panel. Bone marrow fibrosis was assessed by a central pathologist. Results: 83 patients (pts) had baseline cytogenetic results available; 45 (54.2%) had an abnormal karyotype, including 32 (71.1%) with a sole abnormality, the most prevalent being deletions 13q- (24.4%) and 20q- (8.8%), and 5 (11.1%) with a complex karyotype. Spleen and symptom responses were observed in pts with or without abnormal karyotype. Of the 24 pts that had identified cytogenetic abnormalities at baseline and with matched post-treatment cytogenetic results available, 5 (20.8%) achieved ≥50% reduction in their cytogenetically abnormal clones, and interestingly they all had sole deletion 13q-. 49 pts had matched pre- and post-imetelstat treatment (3-14 mos) NGS data and had at least one mutation at baseline. 46.2% of pts (12/26) in the 9.4 mg/kg vs 17.4% (4/23) in the 4.7 mg/kg arm (p=0.0321) achieved ≥20% VAF reduction in any of the mutated genes present at baseline. In addition, pts who achieved ≥20% VAF reduction had higher rates of spleen response (12.5% vs 3%), symptom response (31.3% vs 24.2%) or bone marrow fibrosis improvement (54.4% vs 25%) compared to pts who did not have VAF reduction regardless of dose level (Fig. 1A). Furthermore, a prolonged median OS was seen (Fig. 1B) in pts who achieved ≥20% VAF reduction (31.6 mos, 95% CI: 21.5, NE) vs those with no VAF reduction (22.8 mos, 95% CI: 17.1, 31.6). The 3-year survival rate was 45.5% for pts who achieved ≥20% VAF reduction vs 14.9% for pts with no VAF reduction. Conclusions: Clinical responses to imetelstat treatment were observed regardless of baseline cytogenetic status, and a subset of pts achieved ≥50% reduction in cytogenetically abnormal clones. Significant dose-dependent reductions of mutation burden by imetelstat were noted and correlated with improved overall clinical benefits including higher rates of spleen and symptom responses, bone marrow fibrosis improvement, and prolonged OS. Together with the clinical data that suggest improvement in median OS in these pts, the data presented here further demonstrate that imetelstat has disease-modifying activity by targeting malignant cells, as evidenced by depletion of cytogenetically abnormal clones and reduction in mutation burden. These results will be confirmed in the planned Phase 3 study in refractory MF. Figure Disclosures Mascarenhas: Celgene, Prelude, Galecto, Promedior, Geron, Constellation, and Incyte: Consultancy; Incyte, Kartos, Roche, Promedior, Merck, Merus, Arog, CTI Biopharma, Janssen, and PharmaEssentia: Other: Research funding (institution). Komrokji:Novartis: Honoraria; BMS: Honoraria, Speakers Bureau; Agios: Honoraria, Speakers Bureau; JAZZ: Honoraria, Speakers Bureau; Acceleron: Honoraria; AbbVie: Honoraria; Geron: Honoraria; Incyte: Honoraria. Cavo:Jannsen, BMS, Celgene, Sanofi, GlaxoSmithKline, Takeda, Amgen, Oncopeptides, AbbVie, Karyopharm, Adaptive: Consultancy, Honoraria. Niederwieser:Novartis: Speakers Bureau; Cellectis: Membership on an entity's Board of Directors or advisory committees; Amgen: Speakers Bureau; Daiichi: Research Funding. Reiter:Gilead: Other: travel support ; Incyte: Consultancy, Other: travel support ; AOP: Consultancy, Other: travel support ; Celgene,: Consultancy, Other: travel support ; Abbvie: Consultancy, Other: travel support ; Deciphera: Consultancy, Other: travel support ; Blueprint: Consultancy, Other: travel support ; Novartis: Consultancy, Honoraria, Other: travel support , Research Funding. Scott:Alexion, Incyte, Novartis, Regeneron: Consultancy; BMS, Novartis: Research Funding; Agios, BMS: Honoraria. Baer:Astellas: Other: Institutional research funding; Forma: Other: Institutional research funding; Incyte: Other: Institutional research funding; Kite: Other: Institutional research funding; Oscotec: Other: Institutional research funding; Takeda: Other: Institutional research funding; AbbVie: Other: Institutional research funding. Hoffman:Protagonist: Consultancy; Forbius: Consultancy; Novartis: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; Dompe: Research Funding. Odenike:Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Astex Pharmaceuticals, NS Pharma, Gilead Sciences, Janssen Oncology, Oncotherapy, Agios, CTI/Baxalta, Aprea: Other: Institutional research funding; Astra Zeneca: Research Funding; Impact Biomedicines: Consultancy, Membership on an entity's Board of Directors or advisory committees; Incyte: Other: Institutional research funding; AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Sherman:Geron Corp: Current Employment, Current equity holder in publicly-traded company. Dougherty:Geron Corp: Current Employment, Current equity holder in publicly-traded company. Feller:Geron Corp: Current Employment, Current equity holder in private company. Berry:Geron Corp: Current Employment, Current equity holder in publicly-traded company. Sun:Geron Corp: Current Employment, Current equity holder in publicly-traded company. Wan:Geron Corp: Current Employment, Current equity holder in publicly-traded company. Rizo:Geron Corp: Current Employment, Current equity holder in publicly-traded company. Huang:Geron Corp: Current Employment, Current equity holder in publicly-traded company.

Extracellular vesicles from deciduous pulp stem cells recover bone loss by regulating telomerase activity in an osteoporosis mouse model

BackgroundSystemic transplantation of stem cells from human exfoliated deciduous teeth (SHED) recovers bone loss in animal models of osteoporosis; however, the mechanisms underlying this remain unclear. Here, we hypothesized that trophic factors within SHED-releasing extracellular vesicles (SHED-EVs) rescue osteoporotic phenotype.MethodsEVs were isolated from culture supernatant of SHED. SHED-EVs were treated with or without ribonuclease and systemically administrated into ovariectomized mice, followed by the function of recipient bone marrow mesenchymal stem cells (BMMSCs) including telomerase activity, osteoblast differentiation, and sepmaphorine-3A (SEMA3A) secretion. Subsequently, human BMMSCs were stimulated by SHED-EVs with or without ribonuclease treatment, and then human BMMSCs were examined regarding the function of telomerase activity, osteoblast differentiation, and SEMA3A secretion. Furthermore, SHED-EV-treated human BMMSCs were subcutaneously transplanted into the dorsal skin of immunocompromised mice with hydroxyapatite tricalcium phosphate (HA/TCP) careers and analyzed the de novo bone-forming ability.ResultsWe revealed that systemic SHED-EV-infusion recovered bone volume in ovariectomized mice and improved the function of recipient BMMSCs by rescuing the mRNA levels of Tert and telomerase activity, osteoblast differentiation, and SEMA3A secretion. Ribonuclease treatment depleted RNAs, including microRNAs, within SHED-EVs, and these RNA-depleted SHED-EVs attenuated SHED-EV-rescued function of recipient BMMSCs in the ovariectomized mice. These findings were supported by in vitro assays using human BMMSCs incubated with SHED-EVs.ConclusionCollectively, our findings suggest that SHED-secreted RNAs, such as microRNAs, play a crucial role in treating postmenopausal osteoporosis by targeting the telomerase activity of recipient BMMSCs.

Beneficial Effects of Fermented Papaya Preparation (FPP®) Supplementation on Redox Balance and Aging in a Mouse Model.

In recent decades much attention has been paid to how dietary antioxidants may positively affect the human health, including the beneficial effects of fermented foods and beverages. Fermented Papaya Preparation (FPP®) has been shown to represent a valuable approach to obtain systemic antioxidants effect. In this study, we wanted to verify whether FPP® had a clear and scientifically supported in vivo anti-aging effect together with the induction of a systemic antioxidant reaction. To this purpose we daily treated a mouse model suitable for aging studies (C57BL/6J) with FPP®-supplemented water from either the 6th weeks (early treatment) or the 51th weeks (late treatment) of age as compared to mice receiving only tap water. After 10 months of FPP® treatment, we evaluated the telomerase activity, antioxidants and Reactive Oxygen Species ROS plasmatic levels and the telomeres length in the bone marrow and ovaries in both mice groups. The results showed that the daily FPP® assumption induced increase in telomeres length in bone marrow and ovary, together with an increase in the plasmatic levels of telomerase activity, and antioxidant levels, with a decrease of ROS. Early treatment resulted to be more effective, suggesting a potential key role of FPP® in preventing the age-related molecular damages.