Normal Stem Cell Populations Research Articles

CNSC-29. INVESTIGATING THE INFLUENCE OF DOPAMINERGIC ACTIVITY ON THE GLIOBLASTOMA NICHE

Abstract Glioblastoma (GBM) is an incurable disease of adults and children and the deadliest form of central nervous system (CNS) malignancy. Despite major advances in our understanding of GBM biology in recent years, the prognosis for patients who develop this disease has not improved. If we hope to find new treatments for GBM that are safe and effective, we desperately need to reform our thinking. The brain’s chemical milieu is rich with neurotransmitters, and our lab’s screen of 680 neuroactive compounds on patient-derived glioblastoma stem cells (GSCs) in vitro strongly implicates neurotransmitter pathways as critical regulators of the GSC niche. More specifically, disrupting dopamine signaling by inhibiting its receptor D4 on GSCs causes substantial GSC apoptosis in vitro and attenuates GBM growth in vivo (Dolma et al., Cancer Cell, 2016). Dopamine (DA) is a catecholamine neurotransmitter that is essential for reward learning and movement and has numerous roles in cognition. Consequentially, dysregulation of DA signaling is associated with a diversity of brain diseases ranging from drug addiction to schizophrenia to Parkinson’s. Our research aims to determine how DA signaling affects normal neural stem cell (NSC) and tumorigenic GSC populations, as we hypothesize that GSCs arising/residing in DA projection zones exploit dopaminergic (DAergic) activity for GBM growth. Toward these aims, we have developed in vivo model systems and harnessed them to study NSC and GSC niches in the context of either controlled activation or depletion of DAergic neurons. These manipulations of the brain's DAergic neurons are achieved using optogenetic stimulation, genetic depletion, and neurotoxin-mediated ablation in mice. Ultimately, unraveling the dopaminergic influence on GBM may contribute to a redeployment of existing treatments—that modulate DA signaling and are already approved to treat CNS disorders—to patients with this deadly brain cancer.

Characterization of normal and cancer stem-like cell populations in murine lingual epithelial organoids using single-cell RNA sequencing

The advances in oral cancer research and therapies have not improved the prognosis of patients with tongue cancer. The poor treatment response of tongue cancer may be attributed to the presence of heterogeneous tumor cells exhibiting stem cell characteristics. Therefore, there is a need to develop effective molecular-targeted therapies based on the specific gene expression profiles of these cancer stem-like cell populations. In this study, the characteristics of normal and cancerous organoids, which are convenient tools for screening anti-cancer drugs, were analyzed comparatively. As organoids are generally generated by single progenitors, they enable the exclusion of normal cell contamination from the analyses. Single-cell RNA sequencing analysis revealed that p53 signaling activation and negative regulation of cell cycle were enriched characteristics in normal stem-like cells whereas hypoxia-related pathways, such as HIF-1 signaling and glycolysis, were upregulated in cancer stem-like cells. The findings of this study improved our understanding of the common features of heterogeneous cell populations with stem cell properties in tongue cancers, that are different from those of normal stem cell populations; this will enable the development of novel molecular-targeted therapies for tongue cancer.

Integrated Transcriptomics and Proteomics Identifies Therapeutic Targets in Pediatric Acute Myeloid Leukemia

Acute myeloid leukemia (AML) remains a therapeutic challenge with high mortality rates despite intensive and myeloablative therapies. While immunotherapies targeting CD19 have yielded remarkable outcomes in acute lymphoblastic leukemia, identifying similar antigen therapeutic targets in AML remains a challenge due to inherent heterogeneity associated with AML and overlapping immunophenotypes with normal hematopoietic stem and myeloid cell populations. Transcriptional heterogeneity within pediatric AML has primarily been linked to underlying fusion. Therefore, we integrated large transcriptomics and proteomics datasets from AML and normal tissues to identify potential targets expressed in leukemias, but not in normal bone marrow or other normal tissue types.To identify candidate therapeutic targets in pediatric AML, we leveraged transcriptome sequencing data from bone marrow aspirates or peripheral blood collected from 1,481 children, adolescents, and young adults with AML at the time of diagnosis. Patients were enrolled on one of four Children's Oncology Group trials spanning the past three decades: CCG-2961, AAML03P1, AAML0531, and AAML1031. We also leveraged transcriptome sequencing from normal bone marrow (NBM) and normal CD34+ hematopoietic stem and progenitor cells (HSPCs) in order to exclude targets that are highly expressed during normal hematopoiesis. Finally, we performed additional filtering based on proteomic databases to exclude targets that lack membrane localization (Human Protein Atlas, UniProt, and Ensembl) or that are highly expressed on normal tissue types (Human Proteome Map, Human Protein Atlas, and Proteomics DB databases) (Figure 1A).First, we computed the log expression ratio between AMLs and NBM/HSCPs for all protein coding genes. We next selected genes expressed greater than a threshold of two standard deviations above the mean in 50% or more of AMLs (Figure 1B). Additionally, we further selected genes on the basis of differential gene expression and absolute expression thresholds. This analysis was repeated for our entire pediatric AML cohort and the following AML subtypes: RUNX1-RUNX1T1, CBFB-MYH11, KMT2A-MLLT3, KMT2A-MLLT10, KMT2A-MLLT4, KMT2A-ELL, KMT2A-MLLT1, KMT2A-MLLT11, NUP98-NSD1, NUP98-KDM5A, and CBFA2T3-GLIS2. Candidate therapeutic targets were filtered based on membrane localization and normal tissue expression using the aforementioned proteomics databases (Figure 1C and 1D). Based on this algorithm, we identified a nonzero number of candidate therapeutic targets for each of our pediatric AML subtypes (Figure 1D). Intriguingly, we found no overlap between targets identified in our pediatric, adolescent, and young adult cohort and a previous similar analysis performed in AMLs diagnosed in older patients (PMID 29017060).This study demonstrates that by combining our large transcriptomics dataset with pre-existing proteomics datasets, we are able to identify a collection of candidate therapeutic targets in pediatric AML. Importantly, zero targets were identified that were inclusive to all pediatric AMLs within our cohort, which underscores the transcriptional heterogeneity that our group and others have previously identified in pediatric AML. Future preclinical and clinical studies will need to account for this heterogeneity by prioritizing targets on the basis of underlying molecular alteration. Our study comprises a platform and dataset of candidate targets for further functional validation and/or immunotherapy targeting studies in pediatric AML. [Display omitted] DisclosuresShaw: T-Cell and/or Gene Therapy for Cancer: Patents & Royalties.

The role of high mobility group protein B3 (HMGB3) in tumor proliferation and drug resistance.

The high mobility group protein B (HMGB) family (including HMGB1, HMGB2, HMGB3, and HMGB4) can regulate the mechanisms of DNA replication, transcription, recombination, and repair, and act as cytokines to mediate responses to infection, injury, and inflammation. HMGB1/2/3 has a high similarity in sequence and structure, while HMGB4 has no acidic C-terminal tail. Among them, HMGB3 can regulate the self-renewal and differentiation of normal hematopoietic stem cell population, but the decrease of its expression is easy to induce leukemia. Up-regulation of its expression promotes tumor development and chemotherapy resistance through a variety of mechanisms, and non-coding RNA can regulate to promote tumor cell proliferation, invasion, and migration and inhibit cancer cell apoptosis.

The Role of β-Arrestins in Regulating Stem Cell Phenotypes in Normal and Tumorigenic Cells.

β-Arrestins (ARRBs) are ubiquitously expressed scaffold proteins that mediate inactivation of G-protein-coupled receptor signaling, and in certain circumstances, G-protein independent pathways. Intriguingly, the two known ARRBs, β-arrestin1 (ARRB1) and β-Arrestin2 (ARRB2), seem to have opposing functions in regulating signaling cascades in several models in health and disease. Recent evidence suggests that ARRBs are implicated in regulating stem cell maintenance; however, their role, although crucial, is complex, and there is no universal model for ARRB-mediated regulation of stem cell characteristics. For the first time, this review compiles information on the function of ARRBs in stem cell biology and will discuss the role of ARRBs in regulating cell signaling pathways implicated in stem cell maintenance in normal and malignant stem cell populations. Although promising targets for cancer therapy, the ubiquitous nature of ARRBs and the plethora of functions in normal cell biology brings challenges for treatment selectivity. However, recent studies show promising evidence for specifically targeting ARRBs in myeloproliferative neoplasms.

Inhibition of the Wnt Signalling Pathway: An Avenue to Control Breast Cancer Aggressiveness.

Breast cancer (BC) is the most common tumour in women. Although the introduction of novel therapeutic approaches in clinical practice has dramatically improved the clinical outcome of BC patients, this malignant disease remains the second leading cause of cancer-related death worldwide. The wingless/integrated (Wnt) signalling pathway represents a crucial molecular node relevantly implicated in the regulation of normal somatic stem cells as well as cancer stem cell (CSC) traits and the epithelial–mesenchymal transition cell program. Accordingly, Wnt signalling is heavily dysregulated in BC, and the altered expression of different Wnt genes is significantly associated with cancer-related aggressive behaviours. For all these reasons, Wnt signalling represents a promising therapeutic target currently under clinical investigation to achieve cancer eradication by eliminating CSCs, considered by most to be responsible for tumour initiation, relapse, and drug resistance. In this review, we summarized the current knowledge on the Wnt signalling pathway in BC and have presented evidence implicating the suitability of Wnt targeting in an attempt to improve the outcome of patients without affecting the normal somatic stem cell population.

A Phase 1/1b Safety Study of Prgn-3006 Ultracar-T™ in Patients with Relapsed or Refractory CD33-Positive Acute Myeloid Leukemia and Higher Risk Myelodysplastic Syndrome

A Phase 1/1b Safety Study of Prgn-3006 Ultracar-T™ in Patients with Relapsed or Refractory CD33-Positive Acute Myeloid Leukemia and Higher Risk Myelodysplastic Syndrome

Abstract 3829: Dclk1 expressing crypt epithelial cells become tumor initiating stem cells in an inflammation associated environment

Abstract Background: Chronic intestinal inflammation is a major risk factor for the development of CRC and consequently individuals suffering from inflammatory bowel diseases (IBD) are at increased risk. However, the molecular mechanism by which inflammation initiates colonic tumorigenesis in the cell type is unclear and the regulatory factors that mediate the complex interplay between inflammation and the colonic tumor initiation are unknown. Doublecortin-like kinase 1 (Dclk1) is a microtubule-associated kinase, which marks TSCs in colon cancer, and is predominantly expressed in a unique intestinal epithelial cell type termed the tuft cells. Tuft cells are chemosensory cells that regulate host immunity and inflammation and is highly increased in CRC and, ablation of Dclk1 expressing cells in the ApcMin/+ mice completely regressed the tumors without affecting the normal stem cell population. Our aim is to elucidate the molecular mechanism that is responsible for inflammation-associated colon cancer and to determine the role of Dclk1 expressing tuft cells in this process. Experimental Procedure: YMCA non-malignant colonic epithelial cells were used. Loss and gain of Dclk1 expression in the YMCA cells were carried with siRNA transfection and lentivirus overexpression vector infection respectively. Dclk1 expressing cells were selected for stable cell generation. DSS and LPS were used. Cell self-renewal, secondary and tertiary organoid generation, survival, DNA damage, DNA damage response (DDR) and apoptosis were assessed. Protein and mRNA expressions by western-blot and RT-PCR. Results: Here, we report that increased expression of Dclk1 is the key to the generation of tumor-initiating cells under the influence of an inflammatory environment. We observed increased self-renewal of Dclk1+ YMCA cells treated with DSS and further increase in self-renewal was observed with DSS+LPS treatment. Silencing Dclk1 failed to initiate self-renewal under the influence of DSS and LPS treatment. Dclk1+ YMCA cells displayed enhanced inflammatory mediators, survival with colony formation and increased survival pathways (AKT/mTOR/Beta-catenin/NFkB pathways) and DDR (ATM/ATR) with DSS or LPS treatment. However, the DNA damage and cell apoptosis were not increased in vector control cells and significantly increased in Dclk1 knockdown cells after DSS or LPS treatment. Conclusion: Our data demonstrate that the increased expression of Dclk1 is associated with tumor-initiating features, and survival ability in an inflammatory environment, which is important to understand the cell type and inflammation associated mechanisms in tumor initiation. Based on these findings we proposed that specific targeting of Dclk1-expressing colonic crypt epithelial cells has the potential to result in ablation of tumor initiation. Citation Format: Parthasarathy Chandrakesan, Janani Panneerselvam, Dongfeng Qu, Chinthalapally Rao, Michael Bronze, Courtney Houchen. Dclk1 expressing crypt epithelial cells become tumor initiating stem cells in an inflammation associated environment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3829.

Enhanced Kat3A/Catenin transcription: a common mechanism of therapeutic resistance.

Cancers are heterogeneous at the cellular level. Cancer stem cells/tumor initiating cells (CSC/TIC) both initiate tumorigenesis and are responsible for therapeutic resistance and disease relapse. Elimination of CSC/TIC should therefore be able to reverse therapy resistance. In principle, this could be accomplished by either targeting cancer stem cell surface markers or “stemness” pathways. Although the successful therapeutic elimination of “cancer stemness” is a critical goal, it is complex in that it should be achieved without depletion of or increases in somatic mutations in normal tissue stem cell populations. In this perspective, we will discuss the prospects for this goal via pharmacologically targeting differential Kat3 coactivator/Catenin usage, a fundamental transcriptional control mechanism in stem cell biology.

Cell Cycle Dynamics in Glioma Cancer Stem Cells.

Cancer stem cells, sometimes referred to as tumor initiating cells, play pivotal roles in tumor initiation, progression, metastasis, resistance to therapy, and relapse. Understanding how these populations of cells expand in response to a host of conditions is critical in determining effective cancer therapeutics. A defining feature of cancer stem cells is the ability to switch between modes of quiescence and symmetric/asymmetric division to protect and conserve the population, this feature is traditionally reserved for normal adult stem cell populations. Understanding how the core cell cycle machinery responds to external cues to drive symmetric/asymmetric division vs. quiescence will reveal fundamental information about how cancer stem cell populations survive and expand. This chapter will describe methods to study the cell cycle dynamics in brain cancer stem cell populations and how they compare to the other populations in a tumor.

A Human Adult Stem Cell Signature Marks Aggressive Variants across Epithelial Cancers

Cancer progression to an aggressive phenotype often co-opts aspects of stem cell biology. Here, we developed gene signatures for normal human stem cell populations to understand the relationship between epithelial cancers and stem cell transcriptional programs. Using a pan-cancer approach, we reveal that aggressive epithelial cancers are enriched for a transcriptional signature shared by epithelial adult stem cells. The adult stem cell signature selected for epithelial cancers with worse overall survival and alterations of oncogenic drivers. Lethal small cell neuroendocrine lung, prostate, and bladder cancers transcriptionally converged onto the adult stem cell signature and not other stem cell signatures tested. We found that DNA methyltransferase expression correlated with adult stem cell signature status and was enriched in small cell neuroendocrine cancers. DNA methylation analysis uncovered a shared epigenomic profile between small cell neuroendocrine cancers. These pan-cancerfindings establish a molecular link between human adult stem cells and aggressive epithelial cancers.

Issue Highlight - July 2018.

Issue Highlight - July 2018.

Soluble HLA-associated peptide from PSF1 has a cancer vaccine potency

Partner of sld five 1 (PSF1) is an evolutionary conserved DNA replication factor involved in DNA replication in lower species, which is strongly expressed in normal stem cell populations and progenitor cell populations. Recently, we have investigated PSF1 functions in cancer cells and found that PSF1 plays a significant role in tumour growth. These findings provide initial evidence for the potential of PSF1 as a therapeutic target. Here, we reveal that PSF1 contains an immunogenic epitope suitable for an antitumour vaccine. We analysed PSF1 peptides eluted from affinity-purified human leukocyte antigen (HLA) by mass spectrometry and identified PSF179–87 peptide (YLYDRLLRI) that has the highest prediction score using an in silico algorithm. PSF179–87 peptide induced PSF1-specific cytotoxic T lymphocyte responses such as the production of interferon-γ and cytotoxicity. Because PSF1 is expressed in cancer cell populations and highly expressed in cancer stem cell populations, these data suggest that vaccination with PSF179–87 peptide may be a novel therapeutic strategy for cancer treatment.

Abstract 939: Single cell mRNA expression profiling reveals heterogeneity of normal and malignant breast stem cell populations

Abstract The normal breast contains epithelial populations which are hierarchically organized, a profile recapitulated in breast cancer. At the apex of these hierarchies are "stem like" cells defined by their capacity to self-renew as well as to generate more differentiated progeny. In breast cancer these "cancer stem cells" (CSCs) have been shown to be important mediators of tumor metastasis and treatment resistance. Although the phenotypes of normal rodent and human mammary stem cells have been characterized, CSC populations are operationally defined by their capacity for tumor initiation. In addition, putative breast CSC markers such as CD44+/CD24low/- and or ALDH+ have proven useful in enriching for cells capable of tumor initiation and previous studies have suggested that these markers identify alternative mesenchymal and epithelial stem cell states, respectively. However, it remains unclear whether CSCs exist in discrete states or whether these cells actually represent a continuum reflected in heterogeneity of cell populations defined by expression of these markers. To address this question we utilized single cell mRNA expression profiling of normal and malignant breast stem cells. We first generated a panel of 96 genes representing stem cell and developmental pathways and analyzed expression of these 96 genes utilizing Fluidigm’s C1 and BioMark HD technologies and TaqMan gene expression assays. We also utilized Fluidigm’s Polaris to selectively isolate single cells that were then analyzed by illumina RNA-Seq method. Utilizing these advanced technologies, we demonstrated that both normal and malignant breast stem cells characterized by CD44+/CD24low/- and or ALDH+ expression are highly heterogeneous. For example, the ALDH isoforms ALDH1A1 and ALDH1A3 were each expressed in some single cells and co-expressed in others. ALDH1A1 expressing single cells appeared to express a unique gene pattern characterized by SLIT/ROBO, PLXNA2, RHOU and HNF1a. These results suggest that at the level of mRNA expression, normal and malignant breast stem cells display a greater heterogeneity than has previously been reported. These results have important implications for breast carcinogenesis as well as for the development of therapeutic strategies designed to target CSCs in breast cancer. Citation Format: Shamileh Fouladdel, Justin Colacino, Ebrahim Azizi, Max S. Wicha. Single cell mRNA expression profiling reveals heterogeneity of normal and malignant breast stem cell populations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 939. doi:10.1158/1538-7445.AM2017-939

Abstract 1898: microRNA-137/DCLK1 axis: A novel mechanism regulating tumorigenicity of colon cancer stem cell

Abstract Background: The understanding of colon cancer stem cell (CSC) biology is essential to developing new treatments, however, little is known about the molecular mechanisms underlying the acquisition of colon CSC properties. Furthermore, the similarity of the predisposition, including the surface markers, between colon CSCs and normal colon stem cells makes it difficult to develop a practical approach that targets colon CSCs. MicroRNA (miRNA) is one of the important factors regulating CSC properties. In addition, doublecortine-like kinase 1 (DCLK1), a microtubule-associated kinase, has been proposed to be a distinctive marker for colon CSCs. In the present study, we aimed to identify miRNAs that potentially target DCLK1 and unveil the role of the miRNA/DCLK1 axis in colon CSC properties. Material and Methods: Human colon cancer and normal colon specimens were dissociated into single cells and sorted by flow cytometry to separate the stem cell enriched population (EpCAM+/CD44+/CD66a-) and stained with anti-DCLK1 antibody. The expression profile of 384 miRNAs and the expression of DCLK1 in the colon CSC and normal colon stem cell populations were determined using a qRT-PCR. A luciferase activity assay and Western blotting were performed to evaluate the relationship between the miRNA and DCLK1. A lentiviral expression system was designed to investigate the miRNA phenotypes. We adopted an organoid assay and in vivo tumorigenicity assay to examine the influence of the miRNA on CSCs. Results: MiRNA-137 was highly expressed in the normal colon stem cell population whereas the DCLK1 mRNA expression was significantly upregulated in the colon CSC population. Actually, DCLK1-positive colon cancer cells were widely distributed in the colon cancer specimens, while DCLK1-positive epithelial cells were rarely detected in normal colon tissues, including the crypt bottoms. We confirmed that the activity of the luciferase gene linked to the 3’UTR of DCLK1 was decreased and that the protein level of DCLK1 was suppressed in the miRNA-137 transduced SW480 cells. The transduction of exogenous miRNA-137 suppressed the organoid development of colon cancer cells as well as shRNAs against DCLK1. The defect in organoid development by the transduction of miR-137 or shRNAs were substantially rescued by co-expression of the exsogenous DCLK1. Although miRNA-137 overexpression did not affect the organoid development of the normal intestine, miRNA-137 knockdown promoted the organoid development of normal colon cells. Xenograft tumor formation and growth were markedly suppressed in the miRNA-137-transduced SW480 cell-injected mice. Conclusion: These results suggest that miRNA-137 has the potential to suppress the tumorigenicity of colon CSCs through the inhibition of DCLK1 and that the dysregulation of the miRNA-137/DCLK1 axis plays an important role in colon CSCs. Citation Format: Masazumi Sakaguchi, Shigeo Hisamori, Nobu Oshima, Yoshiharu Sakai. microRNA-137/DCLK1 axis: A novel mechanism regulating tumorigenicity of colon cancer stem cell. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1898.

Unique epigenetic influence of H2AX phosphorylation and H3K56 acetylation on normal stem cell radioresponses.

Normal tissue injury resulting from cancer radiotherapy is often associated with diminished regenerative capacity. We examined the relative radiosensitivity of normal stem cell populations compared with non-stem cells within several radiosensitive tissue niches and culture models. We found that these stem cells are highly radiosensitive, in contrast to their isogenic differentiated progeny. Of interest, they also exhibited a uniquely attenuated DNA damage response (DDR) and muted DNA repair. Whereas stem cells exhibit reduced ATM activation and ionizing radiation-induced foci, they display apoptotic pannuclear H2AX-S139 phosphorylation (γH2AX), indicating unique radioresponses. We also observed persistent phosphorylation of H2AX-Y142 along the DNA breaks in stem cells, which promotes apoptosis while inhibiting DDR signaling. In addition, down-regulation of constitutively elevated histone-3 lysine-56 acetylation (H3K56ac) in stem cells significantly decreased their radiosensitivity, restored DDR function, and increased survival, signifying its role as a key contributor to stem cell radiosensitivity. These results establish that unique epigenetic landscapes affect cellular heterogeneity in radiosensitivity and demonstrate the nonubiquitous nature of radiation responses. We thus elucidate novel epigenetic rheostats that promote ionizing radiation hypersensitivity in various normal stem cell populations, identifying potential molecular targets for pharmacological radioprotection of stem cells and hopefully improving the efficacy of future cancer treatment.

CBP/catenin antagonist safely eliminates drug-resistant leukemia-initiating cells.

CBP and p300 are highly homologous transcriptional coactivators with unique, non-redundant roles that bind a wide array of proteins, including catenins – β and γ. ICG-001 is a small molecule inhibitor that specifically inhibits the CBP/catenin interaction. Importantly, ICG-001 does not inhibit the p300/catenin interaction. We demonstrate that specifically inhibiting the interaction between CBP and catenin with ICG-001, results in the differentiation of quiescent drug resistant chronic myelogenous leukemia initiating cells (CML-LICs), thereby sensitizing them to BCR-ABL tyrosine kinase inhibitors, e.g. Imatinib. Using ICG-001 in a NOD/SCID/IL2Rγ−/− mouse model of engrafted human chronic myelogenous leukemia, we now demonstrate the complete elimination of engrafted leukemia after only one course of combined chemotherapy. Combination-treated animals live as long as their non-engrafted littermates. Results from these studies demonstrate that specifically antagonizing the CBP/catenin interaction with ICG-001 can eliminate drug resistant CML-LICs without deleterious effects to the normal endogenous hematopoietic stem cell population.

Replicator dynamics of cancer stem cell: Selection in the presence of differentiation and plasticity

The cancer stem cell hypothesis has evolved into one of the most important paradigms in cancer research. According to cancer stem cell hypothesis, somatic mutations in a subpopulation of cells can transform them into cancer stem cells with the unique potential of tumour initiation. Stem cells have the potential to produce lineages of non-stem cell populations (differentiated cells) via a ubiquitous hierarchal division scheme. Differentiation of a stem cell into (partially) differentiated cells can happen either symmetrically or asymmetrically. The selection dynamics of a mutant cancer stem cell should be investigated in the light of a stem cell proliferation hierarchy and presence of a non-stem cell population. By constructing a three-compartment Moran-type model composed of normal stem cells, mutant (cancer) stem cells and differentiated cells, we derive the replicator dynamics of stem cell frequencies where asymmetric differentiation and differentiated cell death rates are included in the model. We determine how these new factors change the conditions for a successful mutant invasion and discuss the variation on the steady state fraction of the population as different model parameters are changed. By including the phenotypic plasticity/dedifferentiation, in which a progenitor/differentiated cell can transform back into a cancer stem cell, we show that the effective fitness of mutant stem cells is not only determined by their proliferation and death rates but also according to their dedifferentiation potential. By numerically solving the model we derive the phase diagram of the advantageous and disadvantageous phases of cancer stem cells in the space of proliferation and dedifferentiation potentials. The result shows that at high enough dedifferentiation rates even a previously disadvantageous mutant can take over the population of normal stem cells. This observation has implications in different areas of cancer research including experimental observations that imply metastatic cancer stem cell types might have lower proliferation potential than other stem cell phenotypes while showing much more phenotypic plasticity and can undergo clonal expansion.

Characterization and Targeting of Myelodysplastic Syndrome Stem Cells

Abstract Myelodysplastic syndrome (MDS) is a malignant disorder of myeloid hematopoietic cells, resulting in ineffective hematopoiesis leading to bone marrow dysfunction and failure, and frequently evolves to acute myelogenous leukemia (AML). While chemotherapy can on occasion induce transient remissions, the disease is typically progressive, with the vast majority dying of MDS complications or AML. While MDS is thought to arise from a malignant stem cell population, the properties of such cells are not well understood. Thus, we performed studies to better characterize candidate MDS stem cells and allow insights into the development of novel stem cell directed targeted therapies. One line of investigation examined the cytokine receptor CD123, which we have previously shown to be a marker of AML stem cells. Analysis of primary human specimens demonstrates that CD123 is not expressed in the normal stem cell population (phenotypically identified as CD34+/CD38-) or in stem cells(CD34+/CD38-) from low risk (<5% blasts and/or ≤ intermediate risk IPSS-R) MDS patients, but is readily detected in high-risk patients (>5% blasts and/or ≥ high risk IPSS-R) as shown in figure 1. These data suggest that up-regulation of CD123 may be a hallmark of pathogenesis as MDS progresses toward AML. To better understand the properties of CD123+ vs. CD123- stem cells, we performed global expression studies (RNA-seq) on sorted primary cell populations derived from high-risk MDS patients. The data indicate strong up-regulation of protein synthesis machinery, which indicates a major change in underlying cellular physiology and metabolism. Increased protein synthesis in CD123+ MDS stem cells was verified using the fluorescent protein substrate OP-puro, which identifies newly synthesized polypeptides. We found a ~13 fold difference in OP-puro staining of the CD123+ MDS stem cells versus CD123- cells. Based on these findings, we pursued two related lines of investigation to develop targeted therapies against MDS stem cells. First, we tested the protein synthesis inhibitors anisomycin and homoharringtonine for their ability to target the candidate MDS stem cell population; both agents demonstrated highly selective eradication of CD123+ stem cells, with a significant differential toxicity observed in multiple samples (up to an 80-fold difference in viability after treatment) as shown in figure 2. Second, because protein synthesis inhibition is known to rapidly down-regulate Bcl-2, we tested a selective Bcl-2 inhibitor. This agent also selectively eradicated CD123+ MDS stem cells in 4 of 10 patient samples tested. Finally, analysis of protein synthesis inhibitors or a Bcl-2 inhibitor in combination with the hypomethylating agent 5-azacytidine demonstrated potent efficacy in targeting the CD123+ stem cell population with greater then additive toxicity when compared to single agent treatment. We found significant differential sensitivity in the CD123+ population to the Bcl-2 inhibitor + 5-azacytidine in 9 out of 10 in samples tested and found significant toxicity to the combination of anisomycin or homoharringtonine with 5-azacytidine in 4 out of 4 samples. Taken together, these data show that we have identified two novel pharmacological approaches that may effectively target the MDS stem cell population. Further, these agents may function well in conjunction with commonly used agents used in the treatment of MDS. Disclosures Pollyea: GlycoMimetics: Other: Member of data safety monitoring board; Pfizer: Consultancy; Ariad: Consultancy; Agios: Consultancy, Membership on an entity's Board of Directors or advisory committees; Karyopharm: Consultancy; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding.

A Role for IL1RAP in Acute Myelogenous Leukemia Stem Cells Following Treatment and Progression

BackgroundAcute Myelogenous Leukemia (AML) evolves as many patients who are responsive to therapy upfront are resistant to the same agents when applied at relapse. We previously reported the results of our prospective efforts to formally assess the evolution of the leukemia stem cell (LSC) population(s) during patients' clinical courses. We identified a 9-90 fold increase in LSC activity and greatly increased phenotypic diversity of the LSC population. To identify the potential mechanisms underlying these changes we further characterized functionally-defined LSC populations from paired diagnosis and relapse samples.MethodsPrimary bone marrow and peripheral blood samples were collected on IRB approved protocols from patients with newly diagnosed AML undergoing induction therapy as well as normal donors. Twenty-five patients who relapsed after achieving a complete remission were selected for further study. Screening studies identified seven patients whose pre-therapy samples demonstrated sustained engraftment of NSG mice following transplantation. Transcriptional profiling of highly enriched LSC populations from seven patients was performed using ABI TaqMan® Low Density Array (TLDA) qPCR analyses following pre-amplification using a novel 153 gene expression platform. Protein expression levels of interleukin-1 receptor accessory protein (IL1RAP) on bulk leukemia cells and LSC populations from 25 patients were assessed by flow cytometry. The impact of loss of IL1RAP was assessed using lentiviral based shRNA targeting all IL1RAP isoforms followed by assessment of proliferation, apoptosis, colony forming unit (CFU) activity and NSG engraftment capacity in human cell lines as well as in primary patient samples. Downstream signaling events for IL1RAP were probed using a small molecule inhibitor approach.ResultsWhile the majority of the LSC populations' gene expression profile remained stable, twelve genes were differentially expressed between pre-treatment and relapsed LSC populations including IL1RAP. Flow cytometric analyses confirmed that IL1RAP is overexpressed on both bulk leukemia populations as well as LSC populations at diagnosis and relapse in comparison to normal hematopoietic stem cell (HSC) populations. Targeting ILRAP1 using shRNA in both cell lines and primary AML samples resulted in impaired proliferation, increased apoptosis, a marked loss of CFU capacity and impaired NSG engraftment. IL1 signaling is known to involve both the MAPkinase and NFKappB pathways. To determine which pathways are involved in IL1RAP mediated LSC survival, we performed a small molecule inhibitor screen targeting elements in both signaling cascades. Established inhibitors of the NFKappaB pathway resulted in loss in loss of leukemic cell function while MAPK signaling inhibition had minimal to no effect.ConclusionsWe identified IL1RAP as being overexpressed in both bulk leukemia and functionally defined LSC populations from pre-treatment and relapsed AML samples. Loss of IL1RAP was associated with a marked decline in LSC function. Preliminary studies support a primary role for the NF Kappa B pathway in LSC function. Our findings support a critical role for IL1RAP in LSC function and support its development as a target for AML therapy in both the upfront and relapse setting. DisclosuresWang:Immunogen: Research Funding. Calvi:Fate Therapeutics: Patents & Royalties. Becker:Millenium: Research Funding.