Altered miRNA and gene expression in acute myeloid leukemia with complex karyotype identify networks of prognostic relevance.

Recently, the p53-miR-34a network has been identified to have an important role in tumorigenesis. As in acute myeloid leukemia with complex karyotype (CK-AML) TP53 alterations are the most common known molecular lesion, we further analyzed the p53-miR-34a axis in a large cohort of CK-AML with known TP53 status (TP53(altered), n=57; TP53(unaltered), n=31; altered indicates loss and/or mutation of TP53). Profiling microRNA (miRNA) expression delineated TP53 alteration-associated miRNA profiles, and identified miR-34a and miR-100 as the most significantly down- and upregulated miRNA, respectively. Moreover, we found a distinct miR-34a expression-linked gene expression profile enriched for genes belonging to p53-associated pathways, and implicated in cell cycle progression or apoptosis. Clinically, low miR-34a expression and TP53 alterations predicted for chemotherapy resistance and inferior outcome. Notably, in TP53(unaltered) CK-AML, high miR-34a expression predicted for inferior overall survival (OS), whereas in TP53(biallelic altered) CK-AML, high miR-34a expression pointed to better OS. Thus, detailed molecular profiling links impaired p53 to decreased miR-34a expression, but also identifies p53-independent miR-34a induction mechanisms as shown in TP53(biallelic altered) cell lines treated with 15-deoxy-Δ(12,14)-prostaglandin. An improved understanding of this mechanism might provide novel therapeutic options to restore miR-34a function and thereby induce cell cycle arrest and apoptosis in TP53(altered) CK-AML.

Deregulated apoptosis signaling in core-binding factor leukemia differentiates clinically relevant, molecular marker-independent subgroups.

Core-binding factor (CBF) leukemias, characterized by translocations t(8;21) or inv(16)/t(16;16) targeting the CBF, constitute acute myeloid leukemia (AML) subgroups with favorable prognosis. However, about 40% of patients relapse and the current classification system does not fully reflect this clinical heterogeneity. Previously, gene expression profiling (GEP) revealed two distinct CBF leukemia subgroups displaying significant outcome differences and identified apoptotic signaling, MAPKinase signaling and chemotherapy-resistance mechanisms among the most significant differentially regulated pathways. We now tested different inhibitors of the respective pathways in a cell line model (six cell lines reflecting the CBF subgroup-specific gene expression alterations), and found apoptotic signaling to be differentiating between the CBF subgroup models. In accordance, primary samples from newly diagnosed CBF AML patients (n=23) also showed differential sensitivity to in vitro treatment with a Smac mimetic such as BV6, an antagonist of inhibitor of apoptosis (IAP) proteins, and ABT-737, a BCL2 inhibitor. Furthermore, GEP revealed the BV6-resistant cases to resemble the previously identified unfavorable CBF subgroup. Thus, our current findings show deregulated IAP expression and apoptotic signaling to differentiate clinically relevant CBF subgroups, which were independent of known molecular markers, thereby providing a starting point for novel therapeutic approaches.

Identification of acquired copy number alterations and uniparental disomies in cytogenetically normal acute myeloid leukemia using high-resolution single-nucleotide polymorphism analysis.

Recent advances in genome-wide single-nucleotide polymorphism (SNP) analyses have revealed previously unrecognized microdeletions and uniparental disomy (UPD) in a broad spectrum of human cancers. As acute myeloid leukemia (AML) represents a genetically heterogeneous disease, this technology might prove helpful, especially for cytogenetically normal AML (CN-AML) cases. Thus, we performed high-resolution SNP analyses in 157 adult cases of CN-AML. Regions of acquired UPDs were identified in 12% of cases and in the most frequently affected chromosomes, 6p, 11p and 13q. Notably, acquired UPD was invariably associated with mutations in nucleophosmin 1 (NPM1) or CCAAT/enhancer binding protein-alpha (CEBPA) that impair hematopoietic differentiation (P=0.008), suggesting that UPDs may preferentially target genes that are essential for proliferation and survival of hematopoietic progenitors. Acquired copy number alterations (CNAs) were detected in 49% of cases with losses found in two or more cases affecting, for example, chromosome bands 3p13-p14.1 and 12p13. Furthermore, we identified two cases with a cryptic t(6;11) as well as several non-recurrent aberrations pointing to leukemia-relevant regions. With regard to clinical outcome, there seemed to be an association between UPD 11p and UPD 13q cases with overall survival. These data show the potential of high-resolution SNP analysis for identifying genomic regions of potential pathogenic and clinical relevance in AML.

Increased helper cell activity of NZB mice against H-2-identical allogeneic cells.

The T cells of NZB mice become hyperreactive after stimulation with minor histocompatibility (MIH) antigens. This hyperreactivity has previously been demonstrated only for cytotoxic T cells of NZB, although there was some evidence for an increase of their T-helper cell activity facilitating the response. Here we report a quantitative analysis of T-cell help and help of T-cell subpopulations against autologous, MIH, and H-2 antigens in a limiting dilution assay. After stimulation of NZB T cells with autologous and H-2 antigens, the T-helper cell frequencies did not differ from that of normal mice. After stimulation with MIH antigens however, Lyt 1+2+ T-cells of NZB showed a higher response than those of BALB/c origin. The same difference was seen after prestimulation with ConA or the specific antigen. This demonstrates that NZB-helper cells are more easily activated by weak antigenic differences, and it is possible that this contributes to the prevalence of autoimmune disease in this strain.

Primary cytotoxic T-cell response in vitro against Mls antigens in NZB-mice.

NZB-mice have a T cell hyperreactivity based on a primary response to minor histocompatibility antigens (MIH) on target cells identical to NZB on the H-2 complex (MHC). We tested the idea that a single MIH difference on MHC identical target cells is sufficient to elicit such a primary response in vitro. Cytotoxic T lymphocyte (CTL) response and activated T-helper cell (THC) frequencies were evaluated. NZB x CBA/J (Mls a/d) and NZB x CBA/Ca (Mls a/b) hybrids, which differ only at the M-locus, were raised. A primary cytotoxic response in the direction Mls b anti Mls d, but not vice versa was observed in vitro. In the assay used no unusual THC frequencies against Mls d could be demonstrated. The results favour cellular hyperreactivity in NZB which can be elicited by a single MIH antigen alone.

Lymphocyte subpopulations in solvent-exposed workers.

To estimate the cellular immune response of workers highly exposed to mixtures of organic solvents, subpopulations of peripheral blood lymphocytes (PBLs) were analyzed. For this, the PBLs of nine floorers (aged 25-58 years, exposure time 8-35 years) were subsequently labelled with monoclonal antibodies OKT4, OKT8, OKT11, anti-Leu 7 and anti-Leu 12. Analysis was made by a FACS IV cell sorter (Becton-Dickinson, USA). The control group consisted of matched pairs of healthy donors. In the exposed group we found a decrease in the OKT11 (all) T cell fraction, a decrease in the OKT4 helper cells, an increase in the anti-Leu 7 positive cells, mostly natural killer cells, an important increase in anti-Leu 12 labelled T cells, i.e., human B-lymphocytes, and no differences in the OKT8 suppressor cells. Total fluorescence intensity profiles between the exposed and the unexposed group did not differ, i.e., the marker density on the cell surfaces remained unchanged. Similar changes in lymphocyte subpopulations are found in states of immunodeficiency and immunogenetic forms of aplastic anemia, a disease whose etiological relationship may be due to long-term exposure to organic solvents.

Equal distribution of T-lymphocyte subpopulations in thymus and spleen cells of NZB and BALB/c mice.

NZB mice develop an autoimmune disease of unknown etiology. Since the detection of immunoregulatory T-cells it has been speculated that disbalances of these cells may be important in the course of the NZB disease. By utilization of monoclonal antibody defining immunoregulatory Lyt subsets and a FACS IV system we investigated whether differences in the number and/or marker densities of given subsets exist between NZB and the normal reference strain BALB/c. Newborn animals and animals up to 60 weeks of age were tested. No significant difference in the percentages nor in the marker densities of theta+, Lyt 1+, and Lyt 2+ cells was observed at any age or sex, neither in spleen nor in thymus. It is concluded the autoimmune disease of NZB is not influenced by the parameters investigated.

Primary in vivo T cell reactivity of NZB grafts in H-2 identical allogenic hosts.

By means of the Simonson GVH-assay and the popliteal lymph node (PLN) assay, the T-cell reactivity of NZB mice against H-2 identical allogenic cells was investigated in vivo and compared to that of normal mice. None of the normal mice did react, but a highly significant NZB response could be demonstrated, which did not depend on differences in Mls antigens. These in vivo results extend previous findings of a T-cell hyperreactivity of NZB mice in primary in vitro reactions. They favour the possibility that the T-cell hyperreactivity might be relevant in vivo in facilitating autoimmune responses.

Studies on the mechanism of PMN activation III. by lymphokines.

The influence of a guinea pig lymphokine preparation on the oxidative metabolism of human and guinea pig granulocytes of various sources was investigated. A dose-dependent increase of the oxidative burst following lymphokine challenge was observed. It occurred in unstimulated guinea pig peripheral polymorphonuclear leukocytes (PMN) and in prestimulated PMN obtained from the peritoneal cavity after glycogen injection as well. The lymphokine effect on the oxidative metabolism is not species-restricted because the guinea pig lymphokine preparation elicits an oxidative burst in human PMN, too. The increase caused by lymphokines is nearly of the same order of magnitude as that obtained with zymosan.

T-cell hyperreactivity of NZB mice against H-2 identical cells. Equal cytotoxic T lymphocyte precursor frequency against H-2 allogeneic and H-2 syngeneic target cells in NZB.

NZB mice serve as a model for human systemic lupus erythematodes. T-cell abnormalities in this strain have previously been described. In this paper the cytotoxic T lymphocyte precursor (CTL-p) frequencies of NZB mice against H-2 allogeneic and H-2 syngeneic cells are investigated and compared with those of the normal strain BALB/c. The CTL-p frequency in NZB lymphocytes against H-2 allogeneic cells equals that in normal mouse strains (i.e. 1/7500). The NZB anti BALB/c response is in the same order of magnitude. No corresponding BALB/c anti NZB response was elicited. The results suggest abnormally high sensitivity of NZB CTL-p to helper signals.

Studies on the mechanism of PMN activation. II. By triggering the alternative pathway of complement activation.

By means of cobra venom factor (CVF) it is demonstrated that the stimulation of hexosemonophosphate shunt (HMPS) of human polymorphonuclear leukocytes (PMN) by zymosan (Z) and dextran sulfate (DS) is caused by at least two models of activation: (a) via activation caused by phagocytosis, (b) via activated alternative pathway of complement activation (APC). Active factors of APC presented with phagocytizable objects strongly enhance activation of PMN. The effect of APC can be observed in serum-containing as well as in serum-free cultures. It can be demonstrated that in serum-free cultures the factors of APC participating in the activation of PMN are supplied by monocytes. By use of synthetic hexapeptide (HP) representing the COOH-terminal sequence of human C3 further evidence is provided that factors of APC are able to activate the PMN.

On the T cell hyperreactivity of NZB mice against H-2-identical cells. Evidence for primary response characteristics and an increased helper potential.

Experimental evidence presented in this paper suggests that the T cell hyperreactivity of NZB mice against H-2 identical target cells is a true primary response and not the consequence of an in vivo T cell autoimmune priming event. Based on additional data, we believe an elevated potential of T cell help to be present in NZB mice, which facilitates the observed hyperreactivity F1 hybrids of NZB and normal strains of mice inherited the capacity to hyperreact against H-2 identical cells in an H-2-unrestricted fashion. Because the hybrids tested possess both Qa-1 alleles--Qa-1b and Qa-1a--our experiments either indicate the existence of heterogeneity within the Qa-1b system or of an H-2-unrestricted response against additional target antigens. The T cell hyperreactivity might prove to be a valuable tool in further investigations of the pathomechanism of autoimmune disease.

On the feedback regulation of humoral immune response. I. Evidence for 'B suppressor cells'.

Evidence has been presented that complete and antigen-specific immune inhibition can be obtained by 'B suppressor cells'. Transfer of spleen cells from twice-immunized (SRBC) donors to untreated syngeneic recipients resulted in antigen-specific inhibition of the hosts' immune response. The cell responsible for this phenomenon could be shown to be the 7S-producing B cell; participation of T cells and macrophages could be excluded. After a second immunization of the donors, these B cells remained inhibitory for more than 20 weeks in the donors as well as in the recipients after transfer. Passively administered specific IgG antibody caused a similar inhibition of the hosts' immune response, which, however, lasted for less than 9 weeks only. The extent of inhibition caused by transfer of hyperimmune cells was parallel to the number of transferred 7S producing cells. Since it could be demonstrated that memory cells were present at times when the transferred cell material had lost its inhibitory potency, we concluded that inhibition is not caused by the mere presence of these cells. Since the transferred cells regained their inhibitory capacity after non-specific activation with LPS, we concluded that a product of such activated cells--most likely the specific 7S antibody--was responsible for the observed inhibition. Thus, it is demonstrated that B cells may serve as 'suppressor cells' in appropriate transfer experiments. It is, however, concluded that this effect is basically mediated by produced IgG and may in its mechanism be identical to the phenomenon of antibody-mediated regulation of humoral immune response.

Primary in vitro cell-mediated lympholysis reaction of NZB mice against unmodified targets syngeneic at the major histocompatibility complex.

T-cell cytotoxicity of NZV mice was tested after in vitro sensitization against a group of H-2 identical strains (BALB/c, B10.D2, DBA/2, HW19). A highly significant and unexpected unidirectional cell-mediated lympholysis (CML) reaction by the sensitized NZB effector cells on these targets was found. After sensitization in vitro with stimulator cells of one H-2d strain, NZB effector cells (H-2d) lysed all other H-2d targets and to a lesser degree, some non-H-2d targets (C57BL/10, DBA/1, B10.Q, CBA, B10.S, A.SW). NZB targets were not lysed. Differences in the major histocompatibility region between NZB and other H-2d strains could be excluded as a possible explanation for the observed reaction of NZB (H-2d) against other H-2d strains. These results consequently represent the first description of a primary in vitro CML directed against determinants not coded for in the major histocompatibility complex. The responsible effector cells are demonstrated to be T cells. The CML of NZB against H-2 identiical targets appears best explained by a reaction against minor histocompatibility antigens. This, and the observed cross-reactions, would indicate that the cytotoxic T-cell system in NZB mice is not subjected to restrictions found in all normal mouse strains tested until now under similar conditions. It is suggested that this hyperreactivity is related to the autoimmune responsiveness of the NZB strain.

Comparison of the immunosuppressive efficacy of 6-mercaptopurine, azathioprine, cyclophosphamide and 036.5122 (Asta) on the primary and secondary immune response of mice to sheep erythrocytes.

Two alkylating (cyclophosphamide and 036.5122 Asta) and two antiproliferative agents (6-mercaptopurine and azathioprine) have been compared for their immuno-suppressive potency on the primary and secondary humoral immune response of mice. If equitoxic dosages of the respective drugs are compared, the alkylating agents proved to be of much higher immunosuppressive potency than the antiproliferative agents. In non toxic dosages alkylating agents were able to completely inhibit a primary or secondary immune response, whilst a similar effect with antiproliferative drugs could not be obtained even within toxic dose ranges. Induction of immunological tolerance was possible only by use of the alkylating agents. The significance of these comparative studies is discussed in view of the frequent use of the tested drugs in clinical immunosuppression.