Thesis fullx 1 - FreiDok plus
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Thesis fullx 1 - FreiDok plus
Biological effects of NF-E2 overexpression in hematopoietic stem cells Dissertation zur Erlangung des akademischen Grades Doktor der Naturwissenschaften Dr.rer.nat der Biologischen Fakultät Der Albert-Ludwigs-Universität Freiburg vorgelegt im März 2012 von Ruzhica Bogeska geboren in Prilep, Mazedonien 1 Declaration I herewith declare that I have prepared the present work without any unallowed help from third parties and without the use of any aids beyond those given. All data and concepts taken either directly or indirectly from other sources are so indicated along with a notation of the source. In particular I have not made use of any paid assistance from exchange or consulting services (doctoral degree advisors or other persons). No one has received remuneration from me either directly or indirectly for work which is related to the content of the present dissertation. The work has not been submitted in this country or abroad to any other examination board in this or similar form. The provisions of the doctoral degree examination procedure of the faculty of Biology of the University of Freiburg are known to me. In particular I am aware that before the awarding of the final doctoral degree I am not entitled to use the title of Dr. The work presented in this thesis was carried out in the Centre for Clinical Research, Department of Experimental Anaesthesiology, University Clinic Freiburg from June 2008 to March 2012 under the supervision of Prof. Dr. Heike Pahl. Dekan der Fakultät: Prof. Dr. Gunther Neuhaus Promotionsvorsitzender: Prof. Dr. Samuel Rossel Betreuer der Arbeit: Prof. Dr. Heike Pahl Referent: Prof. Dr. Heike Pahl Koreferent: Prof. Dr. Christoph Borner 3. Prüfer: Prof. Dr. Thomas Brabletz Tag der mündlichen Prüfung: 04.05.2012 Ruzhica Bogeska 2 1. Index 1. Index……………………………………………………………………………………… 1 2. Introduction……………………………………………………………………….......... 4 2. 1 Myeloproliferative Neoplasms (MPN)……………………….……………………… 4 2.2 MPN clinical symptoms ……………………………………………………….…….... 5 2.3 Molecular lesions and mutations in MPN ………………………………………….. 6 2.3.1 JAK2 (Janus kinase 2)……………………………………………………………... 7 2.3.2 MPL (Myeloproliferative leukemia protein)………………………………………. 7 2.3.3 LNK (lymphocyte adaptor protein)…………………………………………………8 2.3.4 SOCS 1,2,3 (Suppressor of cytokine signaling)………………………………… 8 2.3.5 TET2 (ten eleven translocation)…………………………………………………... 8 2.3.6 EZH2 (Enhancer of zeste homolog 2)……………………………………………. 9 2.3.7 BCL-XL……………………………………………………………………………….. 9 2.3.8 PRV-1 (Polycythemia rubra vera protein -1)…………………………………….. 9 2.3.9 NF-E2 (nuclear factor – erythroid 2)……………………………………………... 9 2.3.9.1 NF-E2 gene structure and expression………………………………..... 10 2.3.9.2 NF-E2 protein structure, interactions and posttranslational modifications……………………………………... 11 2.3.9.3 NF-E2 function…………………………………………………………… 15 2.4 Hematopoiesis…………………………………………………………………………… 16 2.4.1 The myeloid lineage………………………………………………………………… 20 2.4.1.1 Erythropoiesis……………………………………………………………...21 2.4.1.2 Megakaryopoiesis………………………………………………………… 24 2.4.1.3 Myelopoiesis………………………………………………………………. 25 2.4.2 Altered hematopoiesis in MPNs…………………………………………………... 28 2.4.2.1 Altered NF-E2 expression during hematopoiesis……………………... 29 2.5 Experimental setup……………………………………………………………………… 29 3. Materials and Methods………………………………………………………………… 31 3.1 Isolation of primary human CD34+ cells…………………………………………….. 31 3.1.1 Peripheral blood processing……………………………………………………….. 31 3.1.2 Density gradient centrifugation and MNCs isolation…………………………….. 31 3.1.3 MNC freezing and thawing…………………………………………………………. 32 3.1.4 CD34+ labeling and purification…………………………………………………….33 3.2 Culture of primary human CD34+ cells……………………………………………… 35 3.2.1 Thawing of CD34+ cell……………………………………………………………… 35 3.2.2 Culture media and conditions……………………………………………………… 36 3.2.3 Cytokine reconstitution……………………………………………………………… 37 3 3.3 Culture of stable cell lines…………………………………………………………… 38 3.3.1 Adherent cell lines…………………………………………………………………… 39 3.4 Isolation of murine bone marrow cells………………………………………………. 39 3.5 Virus mediated gene transfer ………………………………………………………….40 3.5.1 Virus production……………………………………………………………………... 40 3.5.2 Virus titration…………………………………………………………………………. 44 3.5.3 Virus mediated gene transfer in human CD34+ cells ……………………………45 3.6 Fluorescence activated cell sorting (FACS) ……………………………………….. 47 3.7 Apoptosis assays………………………………………………………………………...48 3.7.1 Apoptosis in human CD34+ cells………………………………………………….. 48 3.7.2 Apoptosis in KSL (c-kit+, sca-1+, lin-) and KL (c-kit+, sca-1-, lin-) murine bone marrow cells…………………………………………………………. 49 3.8 Proliferation assays……………………………………………………………………...52 3.8.1 AlamarBlue assay…………………………………………………………………… 52 3.8.2 Hoechst based proliferation/cell cycle assay…………………………………….. 53 3.8.3 ClickItEdu assay……………………………………………………………………...56 3.9 Differentiation assays…………………………………………………………………... 57 3.9.1 Human hematopoietic progenitor and hematopoietic stem cells assay……….. 57 3.9.2 Human terminal differentiation assays……………………………………………. 58 3.9.3 Human megakaryocytic ploidy assays……………………………………………. 59 3.9.4 Murine megakaryocytic ploidy assays…………………………………………….. 60 3.9.5 Cytospins……………………………………………………………………………...61 3.9.5.1 May-Grünwald Geimsa (MGG) staining………………………………………. 62 3.10 RNA processing…………………………………………………………………….. 62 3.10.1 RNA isolation……………………………………………………………………. 62 3.10.2 cDNA synthesis………………………………………………………………… 62 3.10.3 qRT-PCR ……………………………………………………………………….. 63 3.11 Protein processing…………………………………………………………………. 66 3.11.1 Protein isolation………………………………………………………………… 66 3.11.2 Protein quantification ………………………………………………………….. 67 3.11.3 Protein reduction and alkylation ……………………………………………… 67 3.11.4 SDS Polyacrylamide Gel Electophoresis (SDS-PAGE) …………………… 68 3.11.5 Western Blot…………………………………………………………………….. 69 3.11.6 Detection of Immunocomplexes………………………………………………. 70 3.11.7 Removal of immunocomplexes……………………………………………….. 71 3.12 Statistical analysis…………………………………………………………………. 71 4. Results…………………………………………………………………………………… 72 4 4. 1 NF-E2 is overexpressed in CD34+ cells derived from PV patients’ peripheral blood………………………………………………………………... 72 4.2 NF-E2 overexpression in CD34+ cells promotes HSC, MPP, CMP and GMP expansion while decreasing MEP cell counts.…………………...... 73 4.3 NF-E2 overexpression elevates the number of CD13+CD36+ double positive cells – common myeloid- erythroid progenitors ……………………. 79 4.4 Effect of NF-E2 overexpression on terminal differentiation along the myeloid lineage ………………………………………………………………. 81 4.5 Cytokine dependent effect of NF-E2 overexpression and silencing on erythroid and megakaryocytic differentiation. …………………………………….. 83 4.6 Cytokine dependent NF-E2 expression………………………………………………... 90 4.7 Effect of NF-E2 overexpression on apoptosis and proliferation in CD34+ cells……………………………………………………………… 91 4.8 NF-E2 overexpression in-vivo influences cell cycle in murine HSC and progenitor cells, but not apoptosis………………………………………………… 93 5. Discussion………………………………………………………………………………. 96 5.1 NF-E2 expression is 2 fold higher in CD34+ cells derived from PV patient’s peripheral blood. …………………………………………... 96 5.2 NF-E2 overexpression in HC CD34+ cells promotes HSC, MPP, CMP and GMP expansion. ……………………………………………….97 5.3 NF-E2 overexpression in HC CD34+ cells promotes Epo-independent erythroid maturation. ……………………………………………….. 100 5.4 Epo-independent erythroid maturation most likely occurs through another progenitor cell type independently of MEP…………………………………... 101 5.5 NF-E2 overexpression does not affect apoptosis and proliferation in HC CD34+ cells, but most likely it influences proliferation and cell cycle in murine HSC and HPC populations. ……………………………………... 103 5.6 Megakaryocytic differentiation is delayed in CD34+ cells overexpressing NF-E2, as in PV CD34+ cells cultured in-vitro. ……………………. 105 5.7 EPO enhances NF-E2 expression, while TPO has an antagonistic effect. ………. 106 5.8 The endogenous overexpression of NF-E2 in PV CD34+ cells is not dependent on EPO and TPO signaling cascades. …………………………… 108 6. Appendix………………………………………………………………………………... 110 6.1 List of abbreviations………………………………………………………………………. 110 6.2 References………………………………………………………………………………… 113 5 2. Introduction 2. 1 Myeloproliferative Neoplasms (MPN) Myeloproliferative Neoplasms (MPN) are hematopoietic disorders developing due to the clonal expansion of a mutant hematopoietic stem cell 3 resulting in overproduction of terminally differentiated cells belonging to the myeloid lineage. According to a recent classification there are three different subtypes of MPN: polycytemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) 4. Although the diagnostic hallmarks and symptoms differ between the three subtypes, they share some common features 5: all three MPN develop due to the clonal expansion of a mutant hematopoietic stem cell 3, 6, 7 . Furthermore they all display common markers like the JAK2 kinase point mutation (JAK2V617F) and the formation of erythropoietin (Epo) independent colonies (endogenous erythroid colonies - EEC) 8-11 . The major clinical symptom of PV patients is the elevated red blood cell mass; thrombocytosis is an ET hallmark, while PMF demonstrates pancytopenia. Often the erythrocytosis in PV is accompanied with elevated white blood cells and/or platelet counts 12. Historically, the description of the different MPN subtypes started during the late 19th century. In 1892 Louis Henry Vaques set the first diagnosis of PV was followed by the description of a patient with PMF by Gustav Hueck documented case of ET emerged in 1934 13 , which 14 . The first 15 . During 1951 William Damashek proposed an interconnection between PV, ET, PMF, Chronic Myelogenous Leukemia (CML) and erythroleukemia separate entity 16 . Over the years erythroleukemia was defined as a 17 . After the discovery of the Philadelphia (Ph) chromosome in CML patients during 1960 18 , the definition of the Ph chromosome as a product of translocation between chromosome 9 and 22 in 1973 ABL fusion gene 19 and description of the BCR- 20 , the classification of MPNs was redefined. ET, PV and PMF are now part of a separate group of Philadelphia (Ph) chromosome (BCR-ABL) negative Myeloproliferative Disorders21. 6 Fig.2.1 Interconnection between the different MPN subtypes and their ability to progress to another MPN subtype or to AML. The figure was adapted from Passamonti F et al. (2011) 22 Classifying PV, ET and PMF in one group emerged not only because all three diseases share common clinical symptoms, but also because during follow up patients show an increased risk of transforming to the other MPN subtypes with the worse clinical outcome - transformation to acute myeloid leukemia (AML). Clinically ET can progress to PV where ET patients carrying the JAK2V617F mutation show a 23, 24 higher risk for transforming into PV . Both PV and ET patients can transform into PMF (secondary myelofibrosis) 25, 26. All three MPN can progress to AML (Fig.2.1) 22. Although all three MPN develop due to the clonal expansion of a mutant hematopoietic stem cell 6, 7 a subset of MPN patients progressing to AML no longer display the JAK2V617F mutation 27 . This finding suggests that there could be an activating mutation preceding JAK2V617F. 2.2 MPN clinical symptoms The classification and diagnosis of BCR-ABL negative MPNs has been revised in 2008 by the World Health Organization (WHO). The diagnosis criteria are summarized in Table 2.1 28 . Diagnosis of PV patients requires the determination of 2 major criteria plus one minor, or meeting 1 major criterion with 2 minor. ET diagnosis is set when all 4 diagnostic criteria are present. In the case of PMF diagnosis meeting all 3 major criteria and 2 of the minor is required. 7 Table 2.1 MPN diagnostic criteria established by WHO 2008. Reviewed in Tefferi et al. (2008) 28 2.3 Molecular lesions and mutations in MPN During the last 5-6 decades a lot of research has been done in order to dissect the molecular defects occurring in MPN. A very recent review 29 (2011) has summarized most of the molecular lesions and mutations found in the chronic and acute phase of MPNs up to date (Table 2.2). However disrupted expression of several molecules like PRV-1, NF-E2 and BCL-XL are not being discussed there. The following sections in this thesis introduction will shortly describe the main factors being influenced during the chronic MPN phase with emphasis on NF-E2. 8 Table 2.2. Mutations and alterations in genes involved in MPNs pathogenesis. Reviewed in Vainchenker et al. (2011) 29 2.3.1 JAK2 (Janus kinase 2) JAK2 is a protein tyrosine kinase functioning in signal transduction through type II cytokine receptor family. Members of this family include: EPOR; TPOR (MPL); GM-CSFR; interferon receptors for IFN-α, IFN-β, IFN-γ; IL-3R; IL-5R and others. Upon cytokine stimulation receptor bound JAK2 gets phosphorylated and sequentially transfers RAS/RAF/MEK/ERK; the signal through PI3K/AKT/mTOR; various signaling cascades like: JAK2/STAT thereby regulating the transcription of genes involved in cell proliferation and cycling 30 . Recently a novel function of JAK2 as a histone modifier has been reported 31. During 2005 the presence of a JAK2V617F mutation in MPNs was described by several groups 32-35 . The frequency of this mutation is more than 90% in PV, around 50% in ET and PMF 36 . Additional mutations of JAK2 in exon 12 have been detected in less than 2% JAK2V617F negative MPNs 37 . Both JAK2V617F and exon 12 mutations render JAK2 constitutively active, thus deregulating physiological cytokine signaling 37, 38 . 2.3.2 MPL (Myeloproliferative leukemia protein) MPL is a transmembrane protein that functions as a receptor for thrombopoietin (TPO). TPO signaling has a well established role on megakaryocyte and platelet development, as well as HSC and early progenitors physiology 39 . In PV patients, MPL was reported to be down regulated on megakaryocytes and platelets 9 and signaling through JAK2-STAT5 was not detectable 40 . Furthermore a W515L/K mutation in MPL protein was detected in 3-5% of ET and 8-10% of PMF patients 41, 42 . This mutation constitutively activates the JAK-STAT pathway. 2.3.3 LNK (Lymphocyte adaptor protein) The main role of LNK in hematopoietic cells is to inhibit cytokine signaling through the EPOR, TPOR, c-KIT and FMS (Flt3) by negatively regulating JAK2 43-45 . In ET and PMF two separate loss of function mutations within exon 2 have been described, thereby resulting in unphysiological amplification of the cytokine signaling 46 . The frequency of these mutations in pathways activated by phosphorylated JAK2 the chronic phase of MPN is low (detected only in 2 out of 33 investigated JAK2V617F negative MPN patients), but the frequency of other LNK mutations in MPN patients that have undergone leukemic transformation was reported to be around 13% 47. 2.3.4 SOCS 1,2,3 (Suppressor of cytokine signaling) Apart from LNK, other loss of function mutations in proteins acting as negative regulators of JAK2 signaling 48 have been detected, namely in SOCS 3 49 . However the frequency of the single mutation described in a PV patient was not studied in detail and most likely is not very prominent 2 and 3 transcriptional regulation 49 . On the other hand defects in SOCS 1, and function have been described. Hypermethylated promoter regions resulting in lower transcription were found in ET and PV patients 50-52 . The molecular function of SOCS in MPNs remains to be further elucidated. A function of SOCS in proteasomal degradation of JAK2 was proposed as well 53. 2.3.5 TET2 (Ten eleven translocation) TET2 is a tumor suppressor protein that acts in nucleotide metabolism. It has a methylcytosine dioxygenase enzymatic activity and catalyses the conversion of methylcytosine to 5-hydroxymethylcytosine, believed to have an impact on epigenetic regulation 54-56. TET2 frameshift, nonsense, missense mutations and deletions have been detected in all 3 MPN subtypes 57, 58. The frequency is 16% in PV, 5% in ET and 17% in PMF 59. 10 2.3.6 EZH2 (Enhancer of zeste homolog 2) EZH2 is an integral part of a larger protein complex the polycomb repressive complex 2 (PRC2) methyltransferase 60 , where it exerts its catalytic function as histone H3 lysine 27 61 . It has been shown to influence stem cell renewal by repressing 62 genes acting in induction of apoptosis and block of differentiation mutations have been detected in 3% PV and 13% PMF patients . Loss of function 63 . 2.3.7 BCL-XL Bcl-x is a member of the evolutionary conserved bcl-2 gene family. Bcl-x is an apoptosis regulatory gene that encodes two protein isoforms due to alternative splicing: Bcl-XL and Bcl-Xs promotes apoptosis 64 . Bcl-XL has an antiapoptotic function, while Bcl-Xs 64 . Exogenous expression of Bcl-XL in a cell line resulted with Epo independent colony growth 65 , which is a MPN diagnostic marker. Moreover overexpression of Bcl-XL mRNA and protein was detected in erythroid cells of PV patients 66 . It is believed that Bcl-XL is upregulated upon EPO signaling during erythroid differentiation 67. 2.3.8 PRV-1 (Polycythemia rubra vera protein -1) The function of PRV-1 is not yet fully discovered. A role in epithelial adhesion and transmigration processes was suggested. Platelet Endothelial Adhesion Molecule (PECAM-1) was identified as its binding partner 68 . PRV-1 (CD177, NB1 or HNA-2a) is a glycosyl-phosphatidyl-inositol (GPI)-anchored protein expressed on the cell surface of megakaryocytes neutrophils, neutrophilic metamyelocytes, 69 myelocytes , as in some epithelial tissues (normal and tumor derived) and 70 . Its expression is elevated during severe infection and inflammation, pregnancy and in MPN patients. The overexpression of PRV-1 in PV patients and other MPNs was detected in Prof. Pahl’s lab and since then it has been routinely used as a diagnostic tool 9, 71. 2.3.9 NF-E2 (Nuclear factor – erythroid 2) Recently, NF-E2 has been shown to play a role in MPN. Data obtained in Prof. Pahl’s lab by microarray analysis, quantitative RT-PCR, Northern and Western blotting revealed an elevated expression of NF-E2 in PV patients. The 11 overexpression of NF-E2 in PV was detected in granulocyte, erythroid and myeloid precursors as well as in megakaryocytes by immunohistochemistry 72. 2.3.9.1 NF-E2 gene structure and expression The DNA sequence encoding NF-E2 is located on human chromosome 12q13.13 and mouse chromosome 15F3. The gene for both human and mouse NFE2 is composed of three exons. There are two distinct isoforms detected: the adult αNF-E2 and the fetal - fNF-E2. The two isoforms were first distinguished on the cDNA level when a cDNA library from human fetal liver cells was screened and compared to the previously reported cDNA sequence of NF-E2 derived from adult bone marrow cells 73 . Exon 2 and 3 of the two isoforms were identical, but the difference was detected in the sequence for exon 1. There are two alternative first exons of NF-E2 the 1a and 1f (1b) exon (Fig.2.2). The promoter sequence of each exon was reported to differ, which suggests a tissue specific expression of each isoform. Indeed the 1f promoter contained binding sequences for transcriptional factors like GATA-1, EKLF, SSP and YY-1 that are involved in erythroid differentiation processes, while the 1a promoter contained TF binding sites resembling ones found in housekeeping genes. Other studies have detected tissue specific utilisation of the 1a and 1f promoters 74, 75 . In a mouse model the expression of NF-E2 through the 1a promoter was detected in eyrthoid, myeloid cells and megakaryocytes, while the 1f promoter was highly utilized in erythroid and megakaryocytic cells, but not in myeloid cells 75 . Another study using human cord blood CD34+ cells reported the preferential utilization of the 1f promoter during erythroid differentiation and its abrogation during megakaryocytic differentiation 76 . The first NF-E2 exon does not contain translation initiation site, but most likely has regulatory elements coordinating translation. The NF-E2 transcript has three ATGs at nucleotide position 112, 181 and 205 (Fig.2.3). The initial paper describing the ATGs claims that by Kozaks sequence prediction only the ATGs located at nucleotide 181 and 205 can be used as translational start sites 77 . However, the ATG at position 112 is the first translational site generating a 373aa long protein. The alternative translation site has never been studied in detail, but in any case the two alternative translation initiation sites (ATG) located in exon 2, generate two protein variants with a different size 77. 12 Fig. 2.2 Gene structure of mouse and human NF-E2. Boxes represent exons and connecting lines are intronic regions. Grey areas in the boxes depict the translated NF-E2 sequence. Arrowheads indicate a tandem GATA motif. The figure was adapted from Takayama et al. 75 NF-E2 is expressed mainly in hematopoietic precursors and erythrocytic, granulocytic and megakaryocytic cells in colon and testis 78 . In lower amounts NF-E2 is also expressed 77 . In the same publication NF-E2 transcripts were detected in lung, placenta and liver, but the authors argue that this observation could be biased because of blood infiltration in the samples. Previously NF-E2 was defined as a lineage specific factor coordinating terminal differentiation, but there is growing evidence that its expression starts from the HSC 79 and it plays an important role during various stages of lineage commitment along the myeloid lineage 80-83 (Fig.5.4.1). 2.3.9.2 NF-E2 protein structure, interactions and posttranslational modifications NF-E2 is a 45kDa transcription factor composed of 373 AA residues. It belongs to the bZIP (basic leucine zipper) family, shares homology with the cap’n’collar subfamily of transcription factors heterodimer with the small Maf oncogene) proteins 77 and is active when it forms a p18 (avian musculoaponeurotic fibrosarcoma 84 . While Mafs are ubiquitously expressed, NF-E2 expression is tissue specific. There are few well described functional domains of the NF-E2 protein. The largest is the transactivation domain (aa1-206) that contains several functional subdomains ensuring interactions with other proteins or cofactors like heme. Within the proline rich domain (aa1-79) there are two CP (cysteine/proline sites) that bind to heme 85. After the proline rich domain follows the PY (proline/tyrosine) domain (aa7913 83). Through the PY domain NF-E2 interacts with other proteins that contain a WW 86 . Some of the identified interactors are WW-1 (tryprtophan/tryptophan) domains domain of ITCH (or NAPP1) 87, 88 , WW-2 domain of NEDD4 and WW-1 of YAP Other proteins binding to the transactivation domain of NF-E2 are NAPP2 phosphorylated JNK 90 , CBP 91 and TAF II 130 86 . 89 , 92 . Fig. 2.3 Nucleotide sequence and predicted amino acid sequence of NF-E2. The DNA binding domain is in a box and the heptad repeats of leucine or hydrophobic residues comprising the leucine zipper are in circles. The three potential translation initiation sites (ATGs) are underlined. The figure was adapted from Chan et al.(1993) 77. 14 The proteins interacting with NF-E2 execute variety of functions. NEDD4 was identified as an E3 ubiquitin ligase catalyzing the ubiquitination of PTEN 93 and RNA Polymerase II (Pol II) thus leading to Pol II degradation and transcriptional arrest 94 . Another function of NEDD4 is to mediate transcriptional activation guided by progesterone and glucocorticoid signaling 95 . Up to my knowledge NF-E2 has not been yet identified as a NEDD4 ubiquitination substrate. Another ubiquitin ligase interacting with NF-E2 is the NEDD4 like ligase ITCH. ITCH catalyzes the addition of a Lys63 ubiquitin chain to NF-E2, leading to translocation of NF-E2 to the cytoplasm 87 , that most likely is the mechanism by which ITCH acts as transcriptional corepressor of NF-E2 88. NAPP2 interaction with NF-E2 also results in transcriptional repression of NFE2 specific genes most likely by recruiting HDAC1 to the NF-E2 – NAPP2 complex leading to histone deacetylation and repression of transcription TAF II 89 . Binding of YAP, 130 and CBP on the other hand leads to activation of NF-E2 target gene transcription. The mechanism by which YAP assist NF-E2 target gene transcription is possibly due to its interaction with RNA polymerase CTD (C-terminal domain) 86. TAF II 130 is a subunit of the general transcription factor TFIID and its interaction with NF- E2 was reported to be important in regulating globin gene expression in erythroid cell lines 92 . CREB is another transcriptional factor that binds to TAF II 130 96 . The mechanism by which CREB activates transcription is dependent on the elevation of cAMP concentration in the cell. Elevated amount of cAMP stimulate PKA in the cytoplasm which leads to its translocation to the nucleus where it phosphorylates CREB 97 thereby activating the transcription of genes containing cAMP-response elements (CRE) sequence in their promoter. However, CREB mediated transcription requires the assembly of a multiprotein complex in which NF-E2 may also be involved. This assumption is based on a paper published in 1994 reporting that PKA is necessary for increased NF-E2 – DNA complex formation during erythroid differentiation of the MEL cell line 98. The phosphorylation of NF-E2 by PKA has been detected 98, 99 , but this did not affect the NF-E2 – DNA complex formation suggesting that PKA regulates the complex formation indirectly. Possibly the formation of a multiprotein transcription complex containing PKA phosphorylated CREB, CBP, NFE2, general transcription factors (like TFIID or TFIIB) and Pol II augments cAMP induced transcription. Moreover CBP has been identified as a binding partner of both NF-E2 91 and PKA phosphorylated CREB 100. 15 Other important functional domains of NF-E2 are the DNA binding and beta zipper domain. Within the DNA binding domain (aa268-287) lays the nucleus locating sequence (NLS). Experimentally the NLS was reported to be from aa271 to aa273 101 . The bZip domain (aa287-297) functions mainly in dimerisation with the small Mafs (MafK and MafG) which enables DNA binding to the specific MARE sequence (TGCTGAC(G)TCAGCA) and transcriptional activation of the complex. The function and activity, as localization and stability of the NF-E2 protein are regulated by posttranslational modifications like: • Phosphorylation – NF-E2 contains 3 phosphorylation sites reported up to date. Serine157 (S157) gets phosphorylated by pJNK in undifferentiated MEL cells which leads to poly-ubiquitination on several lysine (K) residues and subsequent proteasomal degradation of NF-E2 pJNK did not influence proteasomal 90 . Phosphorylation of S346 by degradation 90 . S169 gets phosphorylated upon cAMP dependent protein kinase A (PKA-kinase) activation, however the phosphorylation did not have an effect on DNA binding or transcriptional ability 99. • Ubiquination – there are several ubiquitination sites detected within the NF-E2 protein: K108, K137, K245, K234, K241 and K368 90 . Besides poly- ubiqitination of these lysine residues leading to proteasomal degradation, NFE2 gets modified by addition of a Lys63 chain by the E3 ubiquitine ligase ITCH. ITCH dependent Lys63 ubiquitination led to translocation of NF-E2 from the nucleus to the cytoplasm 87. • Sumoylation – only one sumoylation site has been detected up to date: the K368 which is an ubiquitination site as well. The study investigating the sumoylation of NF-E2 102 raises few questions. While the data presented in the study is very clear on the indispensable role of K368 on the transactivation activity and DNA binding ability of NF-E2 (K368R mutants could not bind DNA and transactivate the expression of a reporter construct), the sumoylation of NF-E2 in general and specifically at position K368 was more difficult to prove. The proposed size of the sumoylated NF-E2 protein was not always consistent and in general the presented Western Blots were not of best quality. Immunofluorescence experiments within the same paper show that sumoylation of NF-E2 is necessary for its co-localization with SUMO-1 within the POD type nuclear bodies 102. 16 A schematic representation of NF-E2 protein’s functional domains and groups as posttranslational modification is represented on Fig. 2.4 Fig. 2.4 NF-E2 protein domains, post-translational modifications and protein-protein interactions. CNC - Cap’n’collar domain 2.3.9.3 NF-E2 function The known function of NF-E2 is to regulate the expression of genes acting in erythropoiesis 103 , megakaryopoiesis and thrombopoiesis iron and heme metabolism 104 , globin production 92, 105 , 106-109 . In a new publication (2010) a novel function of NF- E2 was described. The authors report down regulation of cytoprotective genes and accumulation of reactive oxygen species (ROS) in megakaryocytes, as a result of competitive displacement of Nrf2 (NF-E2 related factor 2) from the regulatory DNA 110 sequences by NF-E2 been described . The role of NF-E2 as an epigenetic modulator has also 111, 112 . Up to date a direct enzymatic function of NF-E2 as a histone modifier has not yet been reported. But by recruiting histone methyltransferases like MLL2 111 and G9a 113 to the β-globin enhancer HS2 region, NF-E2 is able to induce activating histone modifications leading to initiation of transcription. Another important feature in activation of transcription by NF-E2 is its ability to recruit RNA polymerase II to promoter regions by cooperating with other transcriptional factors like USF 114 17 and GATA-1 115 . By staying attached to the highly condensed chromosomes at the mouse globin gene cluster during mitosis 116 , NF-E2 acts in gene bookmarking thereby maintaining cellular memory during erythroid lineage commitment. By definition gene bookmarking is “a mechanism of epigenetic memory that functions to transmit through mitosis the pattern of active genes and/or genes that can be activated to daughter cells. It is thought that, at a point before mitosis, genes that exist in an open, transcriptionally competent state are bound by proteins or marked by some kind of modification event. This is thought to facilitate the assembly of transcription complexes on the promoters in early G1, thereby ensuring that daughter cells have the same pattern of gene expression as the cell from which they derived.”117 One way to study the systematic effect of NF-E2 is by generating the NF-E2 knock-out mice (NF-E2-/-). This was done in the laboratory of Stuart Orkin during 1995. Previous research implicated that NF-E2 is indispensable for erythroid differentiation. Surprisingly the NF-E2-/- mice displayed only mild defects in erythropoiesis like: anemia with compensatory reticulocytosis and splenomegaly, slightly decreased haemoglobin synthesis, dysmorphic erythrocytes118. However, the major systematic defect in the NF-E2-/- mice was the inability to form platelets due to a block in late stages of megakaryopoiesis leading to perinatal mortality due to hemorrhage 119. 2.4 Hematopoiesis The process of generating mature cellular elements in blood is called hematopoiesis. The etymology of the word comes from ancient Greek “αἷµα“ meaning blood and “ποιεῖν“ – to make. However during the times when the term emerged, no one could even assume that all blood components are created by a single pluripotent hematopoietic stem cell (HSC). Only during 1945 the possibility was acknowledged and experimentally proven in 1961120. In this pioneer study bone marrow cells were irradiated and transplanted in sublethally irradiated host mice. Ten days after transplantation the spleens or the recipient mice were investigated and the formation of CFU (colony forming units) was detected. The amount of CFU correlated one to one with the number of transplanted cells where 1 in 1x104 transplanted cells could give rise to a single CFU. This finding and the fact that most of the bone marrow cells died during increasing doses of radiation suggested that there is a small 18 subfraction of undifferentiated cells surviving higher doses of radiation that can give rise to CFUs. Histological examination of the CFUs revealed that it is composed of differentiated cells with mature blood cell phenotype. The major idea of this paper was that each colony is derived from a single progenitor cell. Later on the clonality of all the cells in the CFU was proven by several studies 121-123 . All these studies gave evidence to the existence of hematopoietic stem cells which were phenotyped and isolated from mice in 1988 124. Fig. 2.5 The classical model of hematopoiesis and differential expression of specific surface markers during different stages of mouse (left) and human (right) hematopoiesis. The definition of the progenitor populations for mouse and human cells are different. This is not only because of the different research strategies used for detecting surface marker expression, but also because of differences in the expression of the molecules themselves. For example Flt3 during human hematopoiesis is expressed on HSC, MPP and oligopotent progenitors 125, 126, while in murine hematopiesis its expression is limited to MPPs. The expression of Slam markers like CD150 (Slamf1), CD48 and CD144 on HSC is used for HSC phenotyping of mouse, but not human cells. Mouse cells positive for CD150 and negative for CD48 and CD144 are defined as LT-HSC. The figure was adapted from Chao et al. (2008) 127 Since then a lot of research was done on characterizing HSCs and other adult tissue specific stem cells. But still the HSC and the generation of its progeny stays the best studied system of stem cell development. The effort of many researchers led to the creation of the most accepted “classical” model of hematopoiesis that follows a 19 linear scheme: Long term HSC differentiates to short term HSC and thereafter to multipotent progenitor (MPP) progenitors (CMPs) 82 128, 129 , which can generate common myeloid and common lymphoid progenitors (CLP) 130 . The CMP then commits to megakaryocyte-erythroid progenitors (MEPs) or granulocyte-monocyte progenitors (GMPs) that generate granulocytic, monocytic cells 82 erythroid and megakaryocytic and DC (dendritic cells) 131 cells, or respectively. The CLP however has a potential to generate B, T, NK (natural killer) 130 and DC 131 committed progenitors. Each committed progenitor can generate only specific cell types. Each defined cell type has a distinct phenotype detected mostly by specific surface marker expression. The “classical” model of hematopoiesis and the surface markers typically expressed on each cell type in mouse and human hematopoiesis are depicted on Fig. 2.5 132 . However the “classical” model has been disputed recently, mostly by research done on the lymphoid branch of hematopoiesis. Either a complete new model – the myeloid model was proposed or the classical model was modified by including novel progenitors that have a mixed potential 133, 134 (Fig. 2.6) Fig. 2.6 Suggested models of hematopoiesis. a) Classical model b) Myeloid-based model c) Modified classical model 83. In this scheme the megakaryocytic lineage for simplicity was combined with the erythroid and both together are marked with E. Each letter represents the differentiation potential the cell has where: M – myeloid, E – erythroid, T – T-cell, B – B-cell potential. Combination of letters represents the mixed potential of a progenitor cell. CMEP stands for common myeloid-erythroid progenitor where in this case CMEP is equivalent to CMP. CLP – common lymphoid progenitor, CMLP - common myeloid-lymphoid progenitor, MTP –myeloid – T cell progenitor, MBP –myeloid – B cell progenitor. The figure was adapted from Kawamoto and Katsura (2009) 134 20 HSCs in human adult hematopoiesis reside in the bone marrow surrounded by other cell types of the bone marrow stroma like osteblasts and endothelial cells comprising the stem cell niche 135, 136 . Within this niche the HSC remains dormant until receiving a signal causing the HSC to go through a process of asymmetric cell division, thus generating another HSC (self-renewal) and a more committed progenitor cell 137 . Depending on the physiological requirements different cytokine signals influence the fate of the progenitor cell and coordinate its differentiation towards a certain hematopoietic lineage. During the process of lineage commitment, the cell losses its ability to self-renew and its plasticity (pluripotency), while increasing the rate of cell cycling 82, 128, 130, 138. The expression of several lineage specific transcription factors (TF) was detected in HSC and it was proposed that their activation and effect during/on fate decision and differentiation is coordinated by combination of cytokine signals 139, 140 . There is also a model suggesting that the expression of lineage specific TFs in HSC has a role in suppressing the execution of a specific differentiation program, thus keeping the HSCs in an undifferentiated state. However, induction of a specific combination of TF and regulation of their dosage upon cytokine stimulation or other exogenous and endogenous signals is crucial for lineage commitment. Some TFs essential for lineage commitment are listed in table 2.3. As previously mentioned MPN demonstrate trilineage hyperplasia within the myeloid lineage. An overview of the major cytokines and TFs involved in myeloid differentiation will be given in the upcoming sections. Table 2.3 Transcriptional regulators of hematopoiesis. Orkin (2000) 141 21 2.4.1 The myeloid lineage The most general division within the hematopoietic system is between the lymphoid and the myeloid lineage. Initially, the separation between the two lineages was based on anatomical grounds: myeloid were all cells present in the bone marrow and lymphoid were cells originating from the lymphatic organs. With time this classification was anatomically and functionally redefined. While terminally differentiated cells of the lymphoid lineage are functioning mainly in immunity, the myeloid lineage is more divergent which creates a discrepancy in the terminology used. While both erythroid and megakaryocytic cells belong to the myeloid lineage, frequently the terminally differentiated granulocytes and monocytes and their progenitors are referred as myeloid. In summary the myeloid lineage includes all cells derived from the CMP – erythroid, megakaryocytic and granulo/monocytic cells, but the term myeloid cells includes only granulocytes, monocytes and macrophages. The generation of granulocytes, monocytes and macrophages in this work will be termed as myelopoiesis. Within the myeloid lineage divergent lineage commitment is regulated by a complex network of cytokine signals, cell to cell interactions, spatio-temporal regulation of TF expression. Crucial for lineage commitment is the dosage of TFs during a specific stage of hematopoiesis. For example both GATA-1 and PU-1 are expressed in low amounts in the MPP 142 . During this stage of maturation the cells get primed, meaning they could execute both the myeloid and the lymphoid program. However, when PU-1 concentration increases lymphoid differentiation occurs while the myeloid program is switched off 142 . On the other hand increase of GATA-1 concentration leads to myeloid commitment by the generation of CMPs from the multipotent MPPs 142 . The CMPs expresses lower amounts of PU-1 than the MPP, but PU-1 expression is abolished in the MEPs, which show high expression of GATA1. PU-1 up-regulation and GATA-1 downregulation in the CMPs leads to generation of GMPs. What is crucial in this model of lineage commitment is the threshold point of TF concentration. Once the threshold concentration is reached the cells lose their multipotency/oligopotency and get specialized to differentiate only throughout one lineage (Fig. 2.7) 2. 22 Fig.2.7 GATA-1 and PU-1 dependent priming and how their concentration determines lineage commitment. See text for explanation. Figure adapted from Iwasaki et al (2007) 2. 2.4.1.1 Erythropoiesis The process of creating mature circulating erythrocytes is called erythropoiesis. The main function of erythrocytes is to deliver oxygen to all tissues in the body. The production of erythrocytes is regulated by the amount of O2 in blood 143 . O2 sensors in the kidney cortex can detect the decrease in the partial pressure of O2 which leads to the release of erythropoietin (EPO) in the blood stream 143 . EPO than stimulates erythroid precursors in the bone marrow (BM) leading to elevated erythrocyte production. However the expression of the EPO receptor starts only in later erythroid precursors: from late BFU-E up to orthochromatic erythroblasts 144 . The different stages of erythroid differentiation have been detected by two methods: histological staining enabling morphological distinction of the precursors and the colony forming ability in semi-solid medium. Later on the expression of different precursor specific surface marker was described. The most immature erythroid precursor identified is the BFU-E (burst forming unit-erythroid) still having high proliferative capacity and being independent of EPO signaling 144 . The expression of the EPOR gets upregulated in the more mature CFU-E (colony forming unit-erythroid) and later erythroid differentiation is highly dependent on EPO 103 . The CFU-E generates proerythroblasts which are the first recognizable eyrthroid precursors in the BM detected by histological staining. The proerythroblast sequentially differentiates into few morphologically distinct cell types which are: basophilic, polychromatic, and orthochromatic erythroblasts. During differentiation the 23 erythroblasts decrease their size. The orthochromatic erythroblast by extruding the nucleus creates the retuculocyte, which can then leave the BM and form functional circulating erythrocytes 145. The expression of different surface markers gets differentially regulated during erythropoiesis (Fig.2.8). Markers most commonly used in phenotyping human erythroid cells are CD71 (transferrin receptor), CD36 (thrombospondin receptor), CD235a (Glycophorin A). CD71 is expressed starting from the BFU-E up to reticulocytes. CD36 expression starts at CFU-E and diminishes at the stage of orthchromatic erythroblast 144. CD235a expression starts at proerythroblast stage and gets gradually up regulated through erythroid maturation reaching maximal expression on terminally differentiated erythrocytes 144. Fig. 2.8 Schematic representation of human erythropoiesis indicating the surface expression of specific molecules during differentiation. CD34, an adhesive protein that is expressed by primitive haematopoietic progenitor cells; CD36, an adhesive protein expressed by erythroid progenitor cells; 24 CD41, a membrane protein expressed by early erythroid progenitor cells and megakaryocytic progenitor cells, megakaryocytes and endothelial cells; CD71, the transferrin receptor; CXCR4, the stromal-cell-derived factor-1α receptor; CXCR5, the macrophage inflammatory protein-1α receptor; glycophorin A (GPA), a member of a family of erythrocyte-specific integral membrane proteins; and KIT, the stem cell factor receptor. Several members of the tumour-necrosis factor (TNF) receptor superfamily and of the TNF family of cytokines are also shown: TNF-related apoptosis-inducing ligand (TRAIL), the membrane bound and soluble cytokine receptor ligand for TRAIL-R1 and TRAIL-R2; TNFR1, the p55 TNF receptor; TNFR2, the p75 TNF receptor; TRAIL-R1, the TRAIL receptor DR4; TRAIL-R2, the TRAIL receptor DR5; FAS, a membrane-bound and soluble death receptor; and FASL, the membrane-bound and soluble ligand for FAS. The interferon-γ receptor (IFNγR) is also expressed during the early stages of differentiation. CFU-e, colony-forming unit-erythroid; EPOR, erythropoietin receptor. The figure and parts of the figure legend were adapted from Spivak (2005)144 These complex processes of erythroid differentiation are coordinated by a mix of cytokines acting in an endocrine way (like EPO) or in a paracrine way within the erythroblastic islands. The erythroblastic islands are comprised by a central macrophage surrounded with developing erythroblasts 146 . In addition to EPO other cytokines indispensable in erythroid differentiation are SCF, IGF-1, IL-3, IL-6. Many of these cytokines activate downstream signaling cascades acing through JAK2. Other signaling molecules recruited during erythropoiesis are depicted on Fig.2.9. Fig. 2.9 Schematic representation of human erythropoiesis indicating the cytokines, TFs and signaling molecules important during erythroid maturation. Deregulated expression or defective function of a molecule in erythroleukemia is highlighted in red. The expression of hemoglobin starting in the polychromatic erythroblast is also indicated. Wickema and Crispino (2007) 103 The execution of the erythroid program of differentiation is regulated by a controlled equilibrium of TF expression and dosage. Some of the factors reported to be important in determining erythroid commitment are PU-1, GATA-2, GATA-1, TAL1, STATs, GFI-1B, EKLF, FOXO, NF-E2 147 . These TFs interact with each other, 25 up-regulate genes acting in erythroid cell function or down-regulate genes important in other hematopoietic lineages. 2.4.1.2 Megakaryopoiesis Eryhtropoiesis and megakaryopoiesis share common progenitors up to the MEP where bifurcation to two distinct lineages occurs 148 . The first distinct megakaryocytic progenitor is the BFU-Mk identified by the colony forming ability of cells having megakaryocytic potential 149 . Later in differentiation the CFU-Mk forms, which has an ability to develop to promegakaryoblast. The promegakryoblast can undergo cell division thus generating more promegakaryoblasts or it can differentiate to a megakaryoblast that executes a unique program typical for megakaryopoiesis which includes the process of endomitosis. During endomitosis the amount of DNA and the cell size duplicate, but cytokinesis does not occur. Thereby a mature polyploid megakaryocyte is formed. The megakaryocyte can undergo several rounds of endomitosis reaching up to 256N 150 number of chromosomes. The level of polyploidy however is not related to megakaryocytic maturity 151 . Only proplatelet forming megakaryocytes have reached the terminal stage of differentiation and can produce platelets. Proplatelet formation can occur in megakaryocytes from all ploidy classes 151. Megakaryopoiesis occurs in a specialized niche within the bone marrow which is spatially separated from the erythroblastic islands. This separation could partially explain the diverse cell fate of the common MEP cells although both MEPs and more mature erythroid and megakaryocytic cells show overlapping TF profiles. Some of the TF that show overlapping expression are GATA-1, GATA-2, FOG-1, SCL/TAL, STATs and NF-E2. The cytokines necessary for early erythroid and megakaryocytic differentiation also show an overlap (like IL-6 and IL-3). However thrombopoietin (TPO) is the major cytokine that leads megakaryocytic differentiation. TPO signaling has a well established role on megakaryocyte and platelet development, as well as HSC and early progenitors physiology 39 and can act in an endocrine or paracrine fashion. One mechanism explaining the diverse linage outcomes (lineage bifurcation) on a very similar background is the antagonistic action of “lineage specific” TFs. An example demonstrating how important the dosage and activity of TFs on a megakaryocyte vs. erythroid bifurcation point is that of EKLF and FLI-1. Elevated 26 expression of EKLF promotes erythroid, while blocking megakaryocytic differentiation. The opposite is true for FLI-1; enhanced expression of FLI-1 promotes megakaryocytic differentiation, while suppressing the erythroid differentiation program 152, 153. The process of megakaryopoiesis, the TF and cytokines/chemokines crucial in for megakaryocytic differentiation and maturation are depicted on Fig 2.10 Fig.2.10 Transcription factors, cytokines and chemokines acting in different stages of megakaryopoiesis. The middle scheme depicts the classical megakaryocytic differentiation. Violet arrows on the left side describe TFs acting during different stages of megakaryopoiesis, while the green arrows on the right side indicate the cytokines and chemokines important during different stages of megakaryopoiesis. Dashed arrow lines indicate stages during which the expression of a TFs or the action of a certain cytokine has not been detected. The figure was adapted from Pang et al. (2005) 104. 2.4.1.3 Myelopoiesis The formation of mature granulocytes (neutrophils, eosinophils, basophils), mast cells, monocytes and macrophages starting in BM and completing in the blood stream and peripheral tissues is referred as myelopoiesis. The myeloid cells function mainly in immune response. Neutrophils act in host defense against microorganisms 154, 155 , eosinophils attack parasites inflammatory response 156, 157 , while basophils act in infection and 158 . Monocytes/macrophages and granulocytes act in immunity by antigen presentation 159 , cytokine production 160, 161 and phagocytosis of microbes. All myeloid cells act in innate immunity by recognizing the complement proteins and antigen presentation or recognition of immunoglobins. 27 Fig.2.10 Cytokine guided intermediate and terminal stages of myelopoiesis. The figure represents the separate differentiation stages distinguished on the bases of the cells ability to form morphologically different colonies in semisolid media. The formation of the intermediate CFUs and their differentiation towards terminally differentiated cells is guided by a combination of various cytokines which are depicted for each progenitors transition. CFU-GEMM is a type of colony that contains progenitor cells able to give rise to all lineages of the hematopoietic system 1. Cells that have mixed granulocyte-macrophage potential form CFU-GMs. Progenitor cells committed to form neutrophils generate CFU-Gs, while cells with potential to form monocytes /macrophages form GFU-Ms. According to this scheme cells that have eosinophilic or basophilic potential do not share a common intermediate progenitor that can be identified by the colony assays. Different types of assays have enabled a more precise description of common myeloid progenitors, emphasized the complexity of myelopoiesis and made possible to detect the ability of granulocytemacrophage and basophil-mast cell progenitors to shift lineage commitment (see Fig.2.11 and text). All myeloid cells are derived from the GMP. Sorted and plated in semi-solid medium GMPs give rise to three distinct types of colony forming units: CFU-GM (granulocyte-monocyte), CFU-G (granulocyte) and CFU-M (monocyte) 82, 162 . Several intermediate stages of myeloid differentiation have been identified by histological staining of BM where the promyelocyte is the most undifferentiated progenitor identified by this method. The promyelocyte differentiates into committed basophilic, neutrophilic or eosinophilic myelocytes and later on in metamyelocytes that can mature into basophils, eosinophils or neutrophils having very distinct morphology. Another way to detect the stage of the differentiation and maturation of myeloid cells is by identifying a unique profile of surface markers for each progenitor and terminally differentiated cell. For example CD13 is specific myeloid marker expressed on 28 myeloid progenitors, granulocytes and monocytes. While CD11b (Mac-1) is expressed later in differentiation on granulocytes and monocytes. Some of the cytokines important for coordinating myeloid maturation are: granulocyte colony stimulating factor (G-CSF) 163, 164 , granulocyte-macrophage CSF (GM-CSF), macrophage CSF (M-CSF) and IL-3 165 (Fig.2.10). The action of these cytokines is to maintain survival, proliferation, maturation and functional activation in their target cells. One of the many molecular events occurring upon cytokine stimulation is the regulation of the expression and activity of TFs important for myeloid lineage commitment 166. Some of the TFs involved in myeloid lineage specification are: PU-1, GATA-1, GATA-2, NF-κB, Gfi-1, C/EBP α, β and ε 167 . An example of how TF dosage and regulation of TF expression at different time points affect lineage commitment in myelopoiesis is that of C/EBP α and GATA-2. When the uncommitted CMP upregulates C/EBPα it goes through an intermediate stage – the GMP to form the neutrophile-monocyte progenitor (NMP). The NMP can that generate monocytes and neutrophils. If during the GMP stage GATA-2 gets upregulated an eosinophilic progenitor (EoP) is formed. Upregulation of GATA-2 in the CMP or in the GMP accompanied with downregulation of C/EBPα leads to the generation of a common basophil-mast cell progenitor (BMCP). If on this stage GATA-2 stays upregulated a mast cell progenitor (MCP) is generated, but if C/EBPα expression gets higher than a basophilic progenitor is formed (BaP) 2 (Fig. 2.11). Fig. 2.11 TF regulated lineage diversification during myelopoiesis. Uncommitted stands for CMP where there are comparable amounts of both C/EBPα and GATA-2. Upregulation of C/EBPα leads to the formation of GMP. Further upregulation of C/EBPα and diminishing of GATA-2 expression results with the formation of neutrophile-monocyte progenitor (NMP). The NMP can that generate monocytes and neutrophils. GATA-2 upregulation results in eosinophilic progenitor (EoP) formation. On the other hand increased GATA-2 concentrations in the CMP or in the GMP accompanied with downregulation of C/EBPα leads to the generation of a common basophil-mast cell progenitor (BMCP). If on this stage GATA-2 stays upregulated a mast cell progenitor (MCP) is generated, but if C/EBPα expression gets higher than a basophilic progenitor is formed (BaP). Iwasaki and Akashi (2007) 2 29 2.4.2 Altered hematopoiesis in MPNs For several years now researchers are dissecting the hematopoietic system to understand the defects occurring at different differentiation stages during MPN development. Do the molecular defects acquired by the clonally expanding HSC exert their effect at early or later stages of hematopoiesis? Is there a predominant lesion and which one acts first? After the discovery of JAK2V617F much research was done connecting this mutation to the MPN phenotype. In a study done by Jamieson et al.168 focusing on JAK2V617F effect in PV, elevated counts of circulating hematopoietic stem cells (HSC), common myeloid (CMP) and megakaryocytic – erythroid progenitors (MEP) were described in peripheral blood (PB) from PV patients. The transmission of the mutant JAK2V617F allele from HSC was detected in all three progenitor populations (CMP, MEP and GMP), although the data represented shows heterozygosity of JAK2V617F allele in HSC and progenitors. Interestingly when these populations were sorted and grown in semi-solid medium for colony formation, not all colonies carried the mutant allele. This could mean that either the sorted PV HSC and progenitor populations had both JAK2V617F and JAK2wt cells, or some of the cells heterozygous for JAK2V617F had lost the mutant allele during the process of colony formation. In any case the amount of erythroid colonies was higher in PV patients when compared to healthy controls (HC). Here two questions arise: When JAK2V617F is absent which are the factors promoting an increase of HSC and progenitor counts and could these factors cause the erythroid bent observed in PV? Another study published in 2011 169 investigates the JAK2V617F allele burden in hematopoietic progenitor compartments and terminally differentiated erythroid and granulocytic cells. While in bone marrow derived cells from ET patients there was no increase in JAK2V617F allele burden in all populations, in PV JAK2V617F allele burden increased only in erythroid and granulocytic cells. In PMF the authors observed an increase in all compartments. This data suggest that the expansion of HSC and HPC compartments in MPN are most likely affected by other factors rather than JAK2. Most likely JAK2V617F exerts its major effect during later stages of differentiation. 30 2.4.2.1 Altered NF-E2 expression during hematopoiesis Since NF-E2 is expressed starting from the HSC 79 up to the terminally differentiated cells of the myeloid lineage its function must have an important role in hematopoiesis. As discussed in the previous sections the concentration of TFs during lineage commitment is crucial for fate decision and maintenance of HSC, HPC and terminally differentiated hematopoietic cells. Being up-regulated in MPNs NF-E2 is a worth candidate to be studied in elucidating the pathogenesis of MPNs. The major questions addressed in this thesis are: How the overexpression of NF-E2 in HSC and early progenitor cells affects hematopoiesis and can it be connected to the pathognomic PV phenotype? Weather its overexpression keeps the cells in a less differentiated state and/or promotes terminal differentiation towards a certain lineage? Is NF-E2 overexpression itself sufficient to alter hematopoiesis or are these changes cytokine dependent? 2.5 Experimental setup Fig. 2.12 Experimental setup. The major outline of the experiments done in this thesis is summarized in this scheme. To study the effect of NF-E2 overexpression the experimental design represented on figure 2.12 was used. CD34+ cells were isolated from peripheral blood of PV patients and HC and put in liquid culture. The CD34+ population is a heterogeneous mix of hematopoietic stem cells (HSC) and early hematopoietic progenitors (HPC). Three major sets of experiments were done: lenti/retroviral overexpression of NF-E2 in HC CD34+ cells, liquid culture of PV and HC CD34+ cells and silencing of NF-E2 in PV by transduction with vectors containing shNF-E2 or scrambled NF-E2 sequence as control. 31 Depending on the addressed question in each experiment the cells were stimulated with different combinations of cytokines. The cells were cultured in expansion medium when HSC and progenitor populations were investigated. This medium keeps the cells in a less differentiated state longer and later on promotes myeloid differentiation (Fig.4.4.3). The goal of this study was to observe the effects of NF-E2 overexpression starting from very early stages of hematopoiesis (HSC and HPC) up to the terminally differentiated progeny. Moreover PV affects the myeloid linage. Therefore the expansion medium is very well suited for these experiments, since the cells get transduced at the HSC and early progenitor stage and then generate most of the terminally differentiated cells from the myeloid lineage (erythroid, megakaryocytic cells, granulocytes and monocytes). 32 3. Materials and Methods 3.1 Isolation of primary human CD34+ cells 3.1.1 Peripheral blood processing Reagents/Instruments Company Cat.No. Dextran 500 Fluka 31392 PBS Biochrom AG L182-10 0,9% NaCl VWR 278102-95 Neubauer chamber Brand 717805 50ml Falcon tubes Greiner 227261 *all centrifugation steps were performed at room temperature in Heraeus Megafuge 1.0 centrifuge Phosphate buffered saline without Ca2+ and Mg2+, ready to PBS: use powder for final volume of 10L. Contents: 130mM NaCl, 2.5mM KCl, 1.5 mM KH4PO4, 8mM Na2HPO2x2H2O Dextran solution: 3%Dextran in 0.9% NaCl Anticoagulant-treated peripheral blood (PB) or buffy coats were mixed at a 1:1 ratio with 3% Dextran in 0, 9% NaCl in order to sediment erythrocytes. The supernatant was transferred to 50 ml Falcon tubes after 20 minutes of incubation at room temperature (RT) and centrifuged for 10 minutes, 1600 rpm in a Heraeus Megafuge 1.0. Two or three cell pellets were pooled together in 35ml PBS and applied slowly (without intermixing) to the top of 15 ml Ficoll-Paque (density gradient medium). 3.1.2 Density gradient centrifugation and MNCs isolation Reagents/Instruments Company Cat.No. Ficoll-PaqueTM Plus GE Healthcare 17-1440-03 CliniMACS® PBS/EDTA buffer Miltenyi Biotec 700-25 20% Immuno Human Serum Albumin Octapharma 10542a/96 PBS Biochrom AG L182-10 Neubauer chamber Brand 717805 50ml Falcon tubes Greiner 227261 *all centrifugation steps were performed at room temperature in Heraeus Megafuge 1.0 centrifuge 33 The 50ml Falcons containing the Ficoll-Paque and PB cells in PBS were then centrifuged for 45min, RT at 1800rpm without break to differentially separate the blood cells. After centrifugation there are three distinct layers formed. The top layer contains blood plasma and platelets, the interphase layer mononuclear cells (MNCs) and under the Ficoll-Paque layer are the sedimented erythrocytes and granulocytes. The CD34+ cells settle at the interphase between the top layer and the FicollPaque with the MNCs. To isolate the CD34+, cells the interphase was collected and washed once with 50ml 0,5% HSA in PBS and twice with 50ml 0,5% HSA in CliniMacs. The centrifugation was done at 1200rpm, 10 minutes, RT. Then the pellet was resuspended in 10 ml 0,5% HSA in CliniMacs and the cells were counted. Either the MNCs were frozen in 10%DMSO, 90% FCS or they were immediately used for CD34+ isolation. 3.1.3 MNC freezing and thawing Reagents/Instruments DMSO FCS (Fetal calf serum) IMDM (Iscove's Modified Dulbecco's Medium) DNase I 50ml Falcon tubes 15ml Falcon tubes 1,8 ml Cryo tubes Freezing container Neubauer chamber Megafuge 1.0 Thawing medium: Company Sigma Aldrich Gibco Gibco Roche Greiner Greiner Nunc Nalgene Brand Heraeus Cat.No. D2438 10270-106 21980 11 284 932 001 227261 188271 377267 5100-0001 717805 IMDM (with L-Glutamine, 25 mM HEPES, Phenol Red, Sodium Pyruvate), 2%FCS and 0,25 mg/ml DNaseI Freezing medium: 10%DMSO in FCS 34 Up to 1x108 MNCs were frozen in 1ml 10%DMSO in 90% FCS, in a freezing container filled with isopropanol at -80°C overnight. The cooling rate of the unit is 1°C per minute. When the MNCs were stored for a longer time period the freezing tubes were transferred to liquid nitrogen. The thawing was done at 37°C and the cells were immediately transferred to Falcon tubes containing thawing medium with the following formulation: 2%FCS in IMDM medium and DNaseI at final concentration of 0,25 mg/ml. For each vial of MNCs 10-15ml of thawing medium was used. The cells were then counted with a Neubauer Chamber. After counting the cells were centrifuged once at 1000rpm, 6 min, RT. The thawing medium was discarded and the MNCs were used in the desired assay. An additional (second wash in a medium of buffer without DNaseI) was avoided, because of clump formation. 3.1.4 CD34+ labeling and purification Reagents/Instruments CliniMACS® PBS/EDTA buffer 20% Immuno Human Serum Albumin Direct CD34 Progenitor Cell Isolation Kit, human Company Miltenyi Biotec Octapharma Cat.No. 700-25 10542a/96 Miltenyi Biotec 130-046-703 Magnetic cell separator Macs column adaptor Miltenyi Biotec 130-042-302 Miltenyi Biotec 130-041-407 Nylon membrane filter with Midi LS-column Miltenyi Biotec 130-042-401 antiCD34 PE conjugated antibody Pharmingen 34375X FACS Flow BD Biosciences 340398 PBS Biochrom AG L182-10 50ml Falcon tubes Greiner 227261 15ml Falcon tubes Greiner 188271 Neubauer chamber Brand 717805 FACSCalibur BD Biosciences *all centrifugation steps were performed at room temperature in Heraeus Megafuge 1.0 centrifuge After isolation or thawing the MNCs were pelleted (1000rpm, 6 min.) and then suspended in 300µl 0,5% HSA in CliniMacs per 1x108 cells. To label the CD34+cells, 100µL blocking reagent and 100µL CD34+microbeads (from Direct CD34 Progenitor Cell Isolation Kit) were added per 1x108 cells. The cells were incubated for 30 min on 35 a low speed shaker at 4°C in a 15ml Falcon tube. 0,5% HSA in CliniMacs was added to the tube to a total of 15mL and then centrifuged at 1000rpm for 10 min. The pellet was usually suspended in 15 ml 0,5% HSA in CliniMacs and applied to a previously equilibrated LS-column standing in a midi magnet column adaptor. The capacity of the LS column is up to 1x108 magnetically labeled cells and 2×109 total cells with the cell density not exceeding 2x108cells/mL. A previously moisturized filter was also used to remove clumps and prevent clogging of the column. After the cell suspension has passed through the LS column by gravity flow, three rounds of washing were done each with 3ml 0,5% HSA in CliniMacs. Then the LS column was removed from the adaptor and the cells were eluted by pressing the plunger using 3mL 0,5% HSA. A second elution with 3mL 0,5% HSA in CliniMacs was additionally done to make sure that all labeled cells are removed from the column. To increase the purity of the isolated cells an additional LS column was used. Since usually four buffy coats were purified simultaneously and pooled for performing experiments the MNCs were mixed after the CD34+ magnetic labeling and the number of columns to be used was determined by taking into consideration the capacity of the LS column. Since the amount of labeled CD34+ cells derived from one buffy coat is not more than 3X106, when pooling together four buffy coats only one additional column was used and the cells were eluted twice with 5ml 0,5% HSA in CliniMacs. Fig.3.1.4 Quality of CD34+ purifications. The top two panels represent a good quality purification, while the two bottom panels depict a low quality CD34+ purification. The red gate in the forward/sideward scatter plots defines the CD34+ population. The green and yellow gates for the bad quality purification describe an unspecific (CD34 negative cells) copurification. The specificity of the purification was asses by staining with PE labeled antibody against CD34 cell surface marker. 36 To determine the purity of the isolation 100µl were taken out from the 10 mL eluate, stained with 4µL antiCD34-PE antibody for 20 min at room temperature and washed once with PBS. The cells were then FACSed (Fig.3.1.4). When the CD34+ cells were isolated directly on the same day from a buffy coat they were frozen in 10% DMSO in FCS. But when isolated from MNCs they were immediately put in culture. 3.2 Culture of primary human CD34+ cells Reagents/Instruments Company FCS Gibco IMDM (Iscove's Modified Dulbecco's Medium) Gibco StemSpan Serum Free Expansion Medium (SFEM) Stem Cell Technologies Penicillin/Streptomycin Lonza Primocin (50mg/ml) Amaxa Biosystems L-Glutamin (200mM) Gibco rhFlt3-Ligand PeproTech rhSCF PeproTech rhTPO PeproTech rhIL-6 PeproTech rhIL-3 PeproTech rh EPO (Erypo FS 2000) Ortho Biotech Human LDL Harbor Bio-Products 96 well culture dishes Greiner 12 well culture dishes Greiner 24 well culture dishes Greiner 15ml Falcon tubes Greiner Function Line Incubator Hereaus Cat.No. 10270 – 106 41966 9650 DE17-602E VZA-1021 25030 300-19 300-07 300-18 200-06 200-03 AG55700 C8-D0160 655180 665180 662160 188271 3.2.1 Thawing of CD34+ cells After thawing at 37°C, CD34+ cells from one vial (regardless the count) was added to 10 ml 20%FCS in IMDM in a 15ml Falcon tube and centrifuged at 1100 rpm (Heraeus Megafuge 1.0) for 6 minutes. The supernatant was discarded under the cell culture hood using a suction pump. The pelleted cells were resuspended in an adequate medium and cultured at standard culture conditions – 5%CO2, 37°C, humidified atmosphere. 37 3.2.2 Culture media and conditions The CD34+ cells after thawing or isolation from MNCs were plated in sterile tissue culture plates. The plates used had different sizes, determined according to the starting cell number. From 2x104 to 2x105 cells were plated per one well on a 96 well plate in 200µL medium. When the total cell number ranged from 2x105 to 2x106, a 24 well plate was used and 500µL to 1ml medium per well was added to culture the cells. More that 2x106 cells were cultured in a 12 well plate in 1 to 2 mL of medium. Depending on the type of experiment, different types of media were used for culture. The recipes for their preparation are listed below: • Expansion medium component final concentration StemSpan Serum Free Expansion Medium (SFEM) Penicillin/Streptomycin Primocin L-Glutamin (200mM) rhFlt3-Ligand rhSCF rhTPO rhIL-6 • Modified expansion medium 1% 2 µL/mL (100µg/ml) 1% (2mM) 100 ng/mL 100 ng/mL 20 ng/mL 20 ng/mL component final concentration StemSpan Serum Free Expansion Medium (SFEM) Penicillin/Streptomycin 1% Primocin 2 µL/mL (100µg/ml) L-Glutamin (200mM) 1% (2mM) rhFlt3-Ligand 100 ng/mL rhSCF 20 ng/mL rhTPO 200 ng/mL rhIL-6 20 ng/mL • Thrombopoietin (TPO) response media component final concentration StemSpan Serum Free Expansion Medium (SFEM) Penicillin/Streptomycin 1% Primocin 2 µL/mL (100µg/ml) L-Glutamin (200mM) 1% (2mM) rhSCF 25 ng/mL rhTPO 20 ng/mL, 50 ng/mL, or 200 ng/mL 38 • Vainchenker (erythroid differentiation) medium component final concentration StemSpan Serum Free Expansion Medium (SFEM) Penicillin/Streptomycin 1% Primocin 2 µL/mL (100µg/ml) L-Glutamin 1% (2mM) rhIL-3 5 ng/mL (50IU/mL) rhSCF 50 ng/mL rhEPO 1 IU/mL LDL 40 ng/mL All media were kept at +4°C and used up within 3 weeks of preparation. 3.2.3 Cytokine reconstitution Cytokine Initial amount Reconstitution Solvent for Aliquot concentration reconstruction size rhSCF rhTPO rhIL-6 rhIL3 EPO 10µg 10µg 10µg 10µg 2000 U / 0.5ml 0,1 µg/µl 0,5µg/µl 0,1 µg/µl 0,5 µg/ µl 4 IU/µL 100 µl H2O 20µl H2O 100µl PBS 20µl H2O 10µl 2µl 2µl 1µl 0,5 mL Prior to reconstitution, the tubes containing the lyophilized cytokines were shortly spun down in a table top centrifuge and the appropriate volume of solvent was added. The table above describes the most common cytokine reconstitution. The recommended solvent sometimes varies from lot to lot, but is always indicated on the lot specific data sheet. The cytokines were aliquoted in previously autoclaved PCR tubes and stored at -20°C, except for EPO which was kept on +4°C. The reconstituted cytokines are stable for at least 3 months. 39 3.3 Culture of stable cell lines 3.3.1 Adherent cell lines Component TrypLE Express Serum Supreme FCS DMEM (Dulbecco's Modified Eagle Medium) PBS Penicillin/Streptomycin L-Glutamin (200mM) 10 cm culture plate 15 cm culture plate 24 well culture dishes 75 cm2 culture flask 175 cm2 culture flask Function Line Incubator Culture medium: Company Gibco Biological industries Gibco Gibco Biochrom AG Lonza Gibco Greiner CellStar Greiner Greiner Greiner Hereaus Cat.No. 12604 04-004-1A 10270 - 106 41966 L182-10 DE17-602E 25030 664160 639160 662160 658975 661175 DMEM (with L-Glutamine, 4500 mg/L D-Glucose, 110 mg/L Sodium Pyruvate), 1% Pen/Str, 10%FCS, 1% LGlutamine Production medium: DMEM (with L-Glutamine, 4500 mg/L D-Glucose, 110 mg/L Sodium Pyruvate), 1% Pen/Str, 10%SerumSupreme, 1% L-Glutamine Information regarding the cell line used like cell type, morphology, culture media, optimal cell density etc. can be found at the web page of the “German Collection of Microorganisms and Cell Cultures (DSMZ)” (http://www.dsmz.de/human_and_animal_cell_lines/main.php?menu_id=2) Three adherent cell lines were used in the work done in this thesis: • HEK293T • Phoenix gp • TE-671 The culture medium used for all three of them is composed of DMEM, 10%FCS, 1% Penicillin/Streptomycin and 1% L-Glutamine. When Phoenix gp cells were used for retrovirus production the medium contained 10%Serum Supreme instead of FCS. The cell density was maintained as recommended by DSMZ and the cells were split 40 when necessary. To detach the cells and get them in to a single cell suspension trypsin (TrypLE Express) was added. The volume used was just enough to cover the cell layer. For example 3 ml trypsin is enough to cover the surface of 175cm2 culture flask. The culture plate or flask was placed in the cell culture incubator on 37°C, 5% CO2 for about 2-3 minutes, until the cells detached from the surface. It is better to keep the trypsinisation time as short as possible, since the cells are sensitive to it and may lose their survival and proliferation ability. This is especially important for Phoenix gp and 293T cells when producing virus. To inactivate the trypsin DMEM culture medium was added, at a ratio trypsin:medium = 1:2. The cells were pipetted up and down few times and split to get an appropriate splitting ratio or counted in a Neubauer chamber. The required volume of cell suspension was plated and fresh pre-warmed DMEM culture medium was supplemented to reach the desired cell density. 3.4 Isolation of murine bone marrow cells Component Red Blood Cell Lysis Buffer 26G syringe 1mL IMDM (Iscove's Modified Dulbecco's Medium) 15ml Falcon tubes Company Sigma BD Gibco Greiner Cat.No. R7757 305501 41966 188271 After sacrificing a mouse, one femur was dissected. The head and the lower extremity of the femur were cut off with a scalpel to make the medullary channel accessible. A syringe was filled with IMDM medium and when the medullary channel was reached the underlying bone marrow cells were flushed into a 15mL Falcon tube filled with 7mL IMDM medium. The flushing was repeated several times. After centrifugation (5 min, 1200rpm, RT) the IMDM was discarded and erythrocyte lysis was performed by adding 1mL lysis buffer for 30s, RT. By adding 9mL IMDM the lysis buffer was deactivated. Afterwards the cells were spun down (1200rpm, 5min., RT), resuspended in 1mL IMDM and counted. 41 3.5 Virus mediated gene transfer 3.5.1 Virus production • Retrovirus production Component TrypLE Express DMEM culture medium DMEM production medium Phoenix gp cells PBS Profection Mammalian transfection system CaCl2 (2M) HEPES buffer (2X) 10 cm tissue culture dishes Function Line Incubator Company Gibco see 3.3.1 see 3.3.1 Cat.No. 12604 Biochrom AG Promega Promega Promega Greiner Hereaus L182-10 E1200 E1200 E1200 664160 The packaging cell line Phoenix gp was used for retroviral production. This cell line is based on 293T cells, only that it has been modified to express the retroviral gag-pol genes. Gag-pol is a polyprotein with an acronym derived from Group Antigens (gag) and polymerase (pol). Gag functions as nucleoprotein, capsid and matrix protein. Pol has several enzymatic functions: protease, reverse transcriptase and integrase activity. An envelope (env) protein encoding plasmid, as well as a plasmid carrying the gene of interest, inserted into a retroviral backbone has to be introduced to the producer cells in order to generate a fully functional virus (Fig 3.1). The function of the envelope proteins is to recognize the surface of the host cell making its infection feasible. For more detailed information about the principle of retroviral gene delivery system visit this web page: http://www.stanford.edu/group/nolan/retroviral_systems/retsys.html The retroviral backbone used in the experiments performed in this thesis was pMYsIG (Fig. 3.2) in which the NF-E2 coding sequence was inserted in front of the IRES-GFP sequence. The transcription of the NF-E2-IRES-GFP transcript was controlled by the MPSV promoter. 3.2 General structure of pMYsIG. ψ-packaging signal; Δgag - truncated gag sequence, White box MMLV LTR; gray box - PCMV LTR; hatched box - myeloproliferative sarcoma virus (MPSV) promoter , LTR – Long Terminal Repeat, MCS - multi-cloning site. After the MCS come IRES (Internal Ribosomal Entry Site) and a GFP (Green Fluorescent Protein) coding sequence. 42 Fig. 3.1 Retroviral structure and protein distribution The Phoenix gp cells were thawed and put in culture approximately one week before starting the virus production. During this time the cells were regularly split to maintain the optimal cell density and keep them in the log phase of growth. On the first day of retrovirus production around 5X106 cells were seeded on a 10 cm tissue culture dish in 10ml culture medium. The cells were transfected approximately 8 hours later using the Profection Mammalian transfection system kit, when the plate reached about 80% confluency. Prior to transfection the medium was exchanged with 10ml prewarmed culture medium. The amounts or reagents used for one transfection are listed in the table below. Component pMYsIG-NF-E2 or pMYsIG Empty vector pGag/Pol (SVgp=SBG-MLV=SV40gagpol) pEnv (human feline envelope) CaCl2 (2M) H2O Amount 5µg 10µg 3µg 62,5µL up to 500µL The components were pipetted in to a 1,5mL eppendorf tube in the following order water, plasmids, CaCl2 and vortexed briefly. This solution was added drop-wise while vortexing to 500µL 2xHEPES. When CaPO4 crystals were formed, the suspension became cloudy. After 15min of incubation at room temperature, the CaPO4-DNA crystal suspension was vortexed shortly and added drop-wise to the cells, while swirling the plate gently. The cells were then incubated for 14-16 hours at 37°C, 5% CO2, after which the medium was exchanged with 10mL culture medium. 8 to 10 hours later the culture medium was replaced by 7mL production medium (with 43 SerumSupreme). HEPES buffer was added drop-wise at a final concentration of 20mM. The first viral harvest was done 12 hours after. The production medium was collected with a syringe, filtered through a 20µm filter unit and flush frozen in liquid nitrogen. Up to 5 harvests were done every 12 hours. After the last harvest the transfection efficiency was checked by FACS. (The recipes of the culture and the production medium are described in Chapter 3.3.1) • Lentivirus production Component TrypLE Express DMEM culture medium PBS CaCl2 (2.5M) BES-sodium salt Na2HPO4x2H2O NaOH 15 cm tissue culture dishes Stericup GV PVDF filter units Millex gv 0.22µm PVDF filter Polyalomere Ultracentrifugation Tubes Function Line Incubator L90 ultracentrifuge SW28 rotor 2x BES 50mM Company Gibco see 3.3.1 Biochrom AG Roth Sigma-Aldrich Roth Roth Greiner Millipore Millipore Beckman Coulter Hereaus Beckmann Beckmann Cat.No. 12604 L182-10 5239.1 B2831-25G 4984.1 6771.1 664160 SCGV U01 RE SLGV033RS 326823 N,N-bis(2-hydroxyethyl)-2-aminoethanesulfonic acid), 280mM NaCl, 1.5mM Na2HPO4x2H2O, pH=6,96 by adding NaOH. After pH adjustment the solution was sterile filtered. 2.5M CaCl2 prepared in sterile H2O and sterile filtered before use For lenti virus packaging the HEK293T cell line was used. The cells were placed in culture one week prior to transfection. The Lentiviral "gene ontology" (LeGO) vectors were used for gene expression. The sequence encoding NF-E2 was cloned 3’ of the SFFV (spleen focus-forming virus) promoter, followed by an IRES site and a GFP coding region. In this case the transcription of one transcript encoding NF-E2IRES-GFP is driven by a single promoter. The expression of NF-E2 correlated with the amount of GFP expressed. In the experiments where NF-E2 was silenced a LeGO-G vector containing a human U6 promoter but lacking the IRES site was used (cloned by Roland Roelz) 170 . In this case the transcription of the shNF-E2 sequence 44 was driven by the hU6 promoter and GFP transcription was driven separately by the SFFV promoter. Compared to the LeGO-IG vector the intensity of the GFP signal in LeGO-G vectors was much higher. LeGO-IG LeGO-G Fig.3.3 Structure of LeGO vectors. Self Inactivating Long Terminal Repeat (SIN- LTR), ψ-packaging signal, Rev-responsive element (RRE), central polypurine tract (cPPT), woodchuck hepatitis virus regulatory element (wPRE), multi-cloning site (MCS). The marker used GFP. For transfection of HEK293T the CaPO4 method was used. On the day of transfection a 100% confluent 15cm plate was split 1:2 in the morning. After 8-10h, when the confluence of the plate was around 60-80%, the transfection was done. The amounts used for one 15cm plate are: Component pLeGO gag/pol (pCMV-dR8.74) env (pMD2 vsvG) H2O CaCl2 (2.5M) 2xBES Total volume Amount 22.5µg 14.625µg 7.87µg up to 420µl 105µl 420µl 840µl First the plasmids and H2O were mixed, then CaCl2 was added and the mix was applied drop-wise onto the 2x BES solution while vortexing. After 20 minutes of incubation at room temperature, the CaPO4-DNA crystals were formed and the solution was placed drop-wise onto the cells while swirling the plate gently. 12 to 16 hours later the medium was exchanged with 15ml prewarmed DMEM culture medium. The first viral harvest was done approximately 24h later. One to two additional harvests were pooled together with the first one and stored on +4°C. The medium containing the virus was ultracentrifuged to pellet the viral particles. Prior to ultracentrifugation the medium was filtered through a SteriCup filter unit or a PVDF filter to avoid cross contamination with HEK293T cells. Around 35ml of virus containing medium were transferred into ultracentrifugation tubes and centrifuged at 19500rpm, 2,5 hours, +4°C in a SW28 rotor. After centrifugation in a Beckmann xL90 ultracentrifuge, the supernatant was completely discarded and the virus was 45 reconstituted in 100-300µL SFEM medium or 0,1% BSA in IMDM. BSA stabilizes the virus when frozen and thawed. After making 20-50µL aliquots the virus was frozen and stored on -80°C. One smaller aliquot (5-10µL) was kept for virus titration. 3.5.2 Virus titration Reagents/Instruments HEK293T or TE671 cells TrypLE Express FCS DMEM (Dulbecco's Modified Eagle Medium) PBS Penicillin/Streptomycin L-Glutamine (200mM) 24 well culture dishes FACS Calibur Culture medium: Company Cat.No. Gibco Gibco Gibco Biochrom AG Lonza Gibco Greiner BD 12604 10270 - 106 41966 L182-10 DE17-602E 25030 662160 DMEM (with L-Glutamine, 4500 mg/L D-Glucose, 110 mg/L Sodium Pyruvate), 1% Pen/Str, 10%FCS, 1% LGlutamine Determining the virus titer is important in order to have an approximation of the amount of virus to be used in a certain experiment, thus controlling the amount of infected cells and the amount of gene copies integrated into the genome of the host cell. The virus titer actually describes how many viral particles there are in a defined volume. This determination is largely dependent on the cell line used and the protocol employed. For titrating retroviruses the TE671 cell line was used and for lentivirus titration the HEK293T cell line. In both cases 5x104 cell per well were seeded in a 24-well plate in a volume of 400µL per well. Approximately 8h after seeding 2, 10, 20 and 50µL of virus containing medium was added to the cells. In the case of lentivirus titration the virus medium was diluted 1 to 10 prior to adding it to the cells. 24h after infection the culture medium was exchanged with 500µl fresh prewarmed medium. After one day (day 4 after seeding and infection) the cells were trypsinised (the trypsin was inactivated with PBS) and collected for FACS analysis (FACS Calibur). The percentage of GFP positive cells was used to calculate the virus titer by the following formula: 46 TV (IU/mL) = N x (%GFP / 100%) x (1mL / Vv) TV – viral titer, IU/mL – Infectious units per mL, N – cell count at time of infection (5x104), %GFP – v positive cells, V – volume viral supernatant used for infection in mL Using the %GFP value of the lowest volume viral supernatant used for infection (that had a detectable GFP signal) gives the closes approximation of the virus titer (Fig.3.5.2). Fig. 3.5.2 Lentivirus titration. Different volumes (1 to 30µL) of 1 to 10 diluted virus containing medium was applied to HEK293T cells to test the potency of the produced virus. The amount of infected cells (GFP positive) was detected by FACS on day 4 after virus supplementation. The lowest volume (1µL in this example) was used to calculate the viral titer. 3.5.3 Virus mediated gene transfer in human CD34+ cells After CD34+ isolation or thawing the cells were cultured for one day prior to viral transduction in the appropriate medium. Then, the cells were retrovirally or lentivirally transduced. Fig. 3.5.3 Timeline of retroviral and lentiviral gene transfer in CD34+ cells. 47 • Retroviral gene transfer Component IMDM (Iscove's Modified Dulbecco's Medium) FCS non-tissue culture-treated sterile 6-well plates Retronectin® BSA (Bovine Serum Albumin) PBS Dulbecco without Ca2+ / Mg2+ HBSS (+ CaCl2 + MgCl2) HEPES Reconstitution of retronectin Company Gibco Gibco Greiner TaKaRA Sigma Biochrom Gibco Gibco Cat.No. 41966 10270 - 106 657185 T100B A-1595 L 182-10 14025-050 15630-056 the retronectin powder was dissolved at final concentration 1mg/mL in H2O and stored at -20°C Coating solution reconstituted retronectin diluted in PBS at a final concentration of 50µg /mL Blocking solution 2%BSA in PBS Washing buffer 2,5% 1M HEPES in HBSS One day after placing the CD34+ cells in culture, 2 to 4 wells of a 6-well plate were covered with 2mL coating solution and incubated overnight at 4°C. The next day, the coating solution was removed and the plates were blocked by applying 2mL blocking solution and incubating for 30min, RT. The blocking solution was removed and the plates were washed with 3mL washing buffer. The plates prepared for the second round of infection were covered with an additional 3mL of washing buffer and stored at +4°C overnight. It was then proceeded to the first viral infection cycle. 1mL virus containing medium was applied per well and centrifuged for 20min, 840g (2000rpm Heraeus Megafuge 1.0), RT. This step was repeated twice with two additional aliquots of virus. After each centrifugation the virus containing medium was discarded in a separate glass flask by pipetting it out of the wells. The flask was autoclaved to destroy any viral particles left in the medium. After the last centrifugation step the supernatant was completely aspirated and the CD34+ cells were put on top of the virus coating in 1.5mL medium. The following day a second round of viral transduction was done the same way as performed the previous day. On day 6 of culture the CD34+ cells were FACS sorted. In the work done in this thesis the retroviral gene transfer 48 system was used only for NF-E2 overexpression, but not for shRNA silencing in human CD34+ cells. • Lentiviral gene transfer Lentiviral transduction was used in NF-E2 overexpression and NF-E2 silencing experiments in human CD34+ cells. The procedure for leniviral transduction is less time consuming, acquires less material and in general is simpler than the retroviral transduction. Before infection the CD34+ cells were counted and the amount of viral particles to be used was calculated. A parameter defining the ratio of infectious agents (virions) per cell is called Multiplicity of Infection (MOI). In these experiments the MOI used was around 10 for each round of infection. The calculation was done as described: Vv=Nx10 / TV (IU/µL) v V V – volume viral supernatant used for infection in µL, T – viral titer in IU/µL, IU/µL – Infectious units per µL, N – cell count at time of infection, 10 is the MOI The calculated Vv was added to the cells one day after putting them in culture. The medium was mixed by pipetting up and down few times and the cells were cultured for the next 24h at 37°C, 5% CO2, when the second transduction was done. The GFP positive cells were sorted on day 5 or 6 of culture. Meanwhile the medium was exchanged or supplemented when necessary. 3.6 Fluorescence activated cell sorting (FACS) When the separation of virally transduced cells was necessary, the GFP positive cells were sorted with MoFlo high speed cell sorter (Beckman Coulter). Prior to sorting, the cells were collected in an 1,5 ml eppendorf tube and spun down (13.000rpm, 15s, RT). After discarding the medium they were resuspended in a minimum of 200µL PBS and stored on ice. The cell density was usually in the range of 0,5 x106 to 6x106 cell/mL. The maximum density recommended for the MoFlo sorter is 2,5x107 cell/mL. Obtaining higher cell densities is favorable, because the rate of event acquisition is higher and the sorting time then is much shorter. To avoid nozzle clogs while sorting, the cells were passed through a 40µm cell strainer (Falcon, CatNo.2340). The sorted cells were collected into a 1,5 mL eppendorf tube containing the appropriate medium. Again the cells were spun down (13.000rpm, 49 15s, RT), resuspended in suitable culture medium and put back in culture (37°C, 5% CO2). 3.7 Apoptosis assays Annexin-V is an early apoptotic marker that recognises the exposure of phosphatidylserine (PS) on the outer leaflet of the plasma membrane, a process that occurs during apoptosis 171 . However, this assay does not unequivocally distinguish between apoptotic and necrotic cells, because due to membrane perforation, annexin-V can enter necrotic cells and stain PS at the inner side of the plasma membrane 171 . Therefore in these assays the nuclear dye SytoxOrange was used as a necrotic marker, since it enters the cell only when the plasma membrane is disrupted. The fluorescent signals of Annexin-V-AlexaFluor 647, SytoxOrange, GFP or other surface markers were detected by FACS. 3.7.1 Apoptosis in human CD34+ cells Reagents/Instruments SYTOX Orange nucleic acid stain Annexin-V-AlexaFluor647 Puromycin Dimethyl sulfoxide (DMSO) FACS Calibur Company Molecular Probes BioLegend Sigma Aldrich Sigma Aldrich BD Cat.No. S11368 640911 P8833 D2438 Sytox staining solution: the 5 mM stock solution was diluted 1:100 (to 50 µM) in DMSO, aliquoted and stored at –20°C protected from light until use. Annexin V Binding Buffer (pH=7,4) Final concentration Molecular weight 10 mM Hepes 238.3012 g/mol 140 mM NaCl2 58.44277 g/mol 2,5 mM CaCl2 110.9 g/mol H2O pH was adjusted with NaOH Amounts for 500ml 1.192 g 4.1 g 0.14 g Fill up to 500ml Cultured CD34+ cells were collected daily and the amount of apoptotic and necrotic cells were determined by staining with Annexin-V- AlexaFluor647 and SytoxOrange. Depending on how many cells were available in each experiment from 3000 to 10.000 cells were taken out of culture and washed once with 1,5 mL Annexin-V-binding buffer. 100µL annexin-V-binding buffer were added together with 50 4µL Annexin-V-AlexaFluor647 and 3 µM (1,5µl SytoxOrange staining solution) Sytox orange. The staining was done while incubating the cells for 20min., RT. The cells were washed once with 1,5mL Annexin-V-binding buffer and resuspended in 200µL Annexin-V-binding buffer. The cells were never fixed and fluorescent signals were detected immediately after staining with the FACSCalibur. Apoptosis was detected in NF-E2 overexpression experiments and PV or HC derived CD34+ cells cultured in modified expansion medium. Fig. 3.7.1 Gating strategy for detecting the amount of apoptotic and necrotic cells in virally transduced CD34+cells. All acquired events in the forward /sideward scatter plot were plotted to define the GFP+ (transduced cells). Optionally a gate distinguishing intact cells against cell particles can be defined, but this does not influence much the later readout, since only intact cells will give a GFP signal. Afterwards the percentage of viable (double negative), apoptotic (single positive for AnnexinV) and necrotic (double positive) was detected by staining with SytoxOrange and AnnexinVAlexaFluor647. 3.7.2 Apoptosis in KSL (c-kit+, sca-1+, lin-) and KL (c-kit+, sca-1-, lin-) murine bone marrow cells Reagents/Instruments SYTOX Orange nucleic acid stain Annexin-V-AlexaFluor647 anti lineage cocktail –FITC conjugated anti sca-1 PacificBlue anti c-kit APC-eFluor780 conjugated Dimethyl sulfoxide (DMSO) FACS tubes FACS Canto Company Molecular Probes BioLegend Biolegend Biolegend eBioScience Sigma Aldrich BD Falcon BD Cat.No. S11368 640911 78022 108120 471171-82 D2438 352052 Sytox staining solution: the 5 mM stock solution was diluted 1:100 (to 50 µM) in DMSO, aliquoted and stored at –20°C protected from light until use. 51 Annexin V Binding Buffer (pH=7,4) Final concentration Molecular weight 10 mM Hepes 238.3012 g/mol 140 mM NaCl2 58.44277 g/mol 2,5 mM CaCl2 110.9 g/mol H2O pH was adjusted with NaOH Amounts for 500ml 1.192 g 4.1 g 0.14 g Fill up to 500ml After bone marrow aspiration or flushing of a femur, the total cell count was determined by counting in a Neubauer chamber. The volume containing 5X105 cells was transferred into a 1,5mL eppendorf tube and centrifuged (13.000 rpm, 15s, in a table top centrifuge). The medium was discarded and the cell pellet was washed with 1,5 mL annexin-V-binding buffer. The supernatant was aspirated and the cells were resuspended in 100µL annexin-V-binding buffer. Then 4µl of Annexin-V- AlexaFluor647, 3 µM (1,5µl SytoxOrange staining solution) Sytox orange were pipetted into the eppendorf tube. To detect apoptosis in the KSL and KL bone marrow population 1µL of each antibody were added (anti lineage cocktail –FITC conjugated, anti sca-1 PacificBlue, anti c-kit APC-eFluor780 conjugated), gently vortexed and incubated 20-30 min, RT in the dark. The cells were washed once with annexin-V-binding buffer. After washing 250 µl annexin-V-binding buffer were added and the cells were FACSed as soon as possible (within the next few hours). Fixation was never done because it damages the plasma membrane and Sytox dyes can enter freely through the plasma membrane and stain nucleic acid in each cell. This is why Sytox dyes cannot be used as a necrotic marker when the cells are fixed. When using tandem dyes for surface marker staining fixation is not recommended since it destroys the fluorescent properties of the dye. For detection of the fluorescent signals the FACS Canto was used. 52 Fig. 3.7.2.1 FACS settings used for detection of apoptotic and necrotic cells within the KL and KSL populations in murine bone marrow. Fig. 3.7.2.1 Gating strategy for detection of apoptotic/necrotic cells in the KL and KSL populations in murine bone marrow. 3.8 Proliferation assays 53 3.8.1 AlamarBlue assay Reagents/Instruments Company AlamarBlue AbD Serotec SPECTRAmax®GEMINI XS DualScanning Microplate Spectrofluorometer Flat bottom transparent cell culture plates Greiner Cat.No. BUF012A Alamar Blue is a reagent which contains an oxidation-reduction (REDOX) indicator called resazurin. When exposed to reducing agents it changes its initial oxidized state (non-fluorescent and blue) to its reduced form (fluorescent and red). resazurin resorufin When resazurin enters the cytosol the innate metabolic cell activity is able to reduce it, but not to such extend as in growing and proliferating cells. This is why detecting the difference in absorbance or fluorescence, gives information about the cell’s proliferation status. Before starting the experiment the optimal cell number, cell density and interval of fluorescence measurements were determined. Depending on the cell number used and on the proliferation rate of the cell line, the time period for fluorescence measurements may differ (few days up to one week). Too high cell numbers can saturate the reaction too fast in which case the eventual difference in proliferation rates won’t be detected. When optimizing the experiment 1000, 2000, 5000 cells were used per well (for a 96 well plate) in 100µl final volume. When a larger format was used the volume and cell number were scaled up. Using a larger format can help if the purpose of the experiment is to follow cell proliferation during a longer period of time. To precisely determine the optimal amounts a standard curve was created where a cell range was tested to get the best cell density and time interval of measurements. After this the optimal cell number was plated (96-, 24-, 12-, 6-well plates can be used for measurements in the SPECTRAmax®GEMINI) in appropriate volume (100µl per 96 well; 500µl per 24well, 1ml per 12well or 2ml per 6well). AlamarBlue 54 was added to 10% of the final volume (for example: 10µl AlamarBlue for 100µl final volume). Usually a control was Included (for example: 100µl medium + 10 µl AlamarBlue) to detect possible contamination since bacteria and yeast are also able to reduce AlamarBlue. The fluorometer was set at these specifications (SoftMax Pro software): - Excitation wavelength=560nm, - Emission wavelength=585nm, - CutOff filter=570nm, - PMT(Photo-multiplier Tube)=Medium - Sensitivity=8 There was condensation on the lid of the tissue culture plate, since this changes signal detection the lid was removed while measuring. Fluorescence was measured in Relative Fluorescent Units (RFU) starting from 0h after adding AlamarBlue. The measurements were repeated after a desired period of time (1h, 6h, 12h or more). The plate was kept in culture without exchanging or adding new medium for up to 1 week if the cells were viable and the reaction did not get saturated quickly – during the first days of the experiment. After the end of the experiment a diagram was crated were the x axis was time and y axis was RFU (See Fig. 4.7.2). 3.8.2 Hoechst based proliferation/cell cycle assay Reagents/Instruments LIVE/DEAD Fixable Dead cell stain – near IR Hoechst DNA stain (powder) Verapamil anti lineage cocktail –FITC conjugated anti sca-1 PE conjugated anti c-kit APC conjugated PBS FACS tubes FACS Canto LIVE/DEAD stain reconstitution Company Molecular Probes Molecular Probes Sigma Aldrich Biolegend eBioscience eBioscience Biochrom AG BD Falcon BD Cat.No. L10119 H1399 V-106 5MG 78022 12-5981-81 17-1172-82 L182-10 352052 50µl DMSO were added per vial and stored at –20°C protected from light and moisture. LIVE/DEAD stain working solution reconstituted LIVE/DEAD Fixable Dead cell stain was diluted 1:50 in DMSO 55 Hoechst working solution [5µg/µl] in PBS stored at +4°C Verapamil stock solution 5mg Verapamil were suspended in 1mL 95% ethanol to reach a concentration of 50µM. 1X106 bone marrow cells aspirated or flushed from a femur were put in an 1,5mL eppendorf tube. IMDM medium was added up to 1mL, bringing the cell density to 1X106cells/mL. The tubes were put in a table top heater at 37°C for 10-15min. 1µL Hoechst working solution was pipetted in to each tube to reach a final concentration of 5µg/mL and incubated for 90min at 37°C protected from light. During the incubation the cells were mixed within the heater 2-3 times. The cells were spun down at 13.000rpm, 4°C for 15 seconds. After staining with Hoechst, the cell suspension was always kept on ice and washed once with cold PBS. When working with many samples simultaneously a staining master mix containing the other staining components was prepared. For one staining in final volume of 100µL the amounts used are: Reagent PBS LIVE/DEAD Fixable Dead cell stain working solution anti lineage cocktail –FITC conjugated anti sca-1 PE conjugated anti c-kit APC conjugated Volume 90µL 5µL 2µL 2µL 2µL After adding 100µL to each tube, the cells were kept on ice 30-40 min. and subsequently washed once with cold PBS (13.000rpm, 15s,4°C). The PBS was aspirated and the cells were resuspended in 250µL PBS. The cells were transferred to FACS tubes and acquired on medium flow speed with the FACSCanto. In order to have enough cells to make cell cycle/proliferation analysis 2000 to 5000 events were acquired in the KSL gate. When analyzing the acquired data in some samples a subG1 peak was observed. To test the origin of this peak, whether it is an artifact or cells analogous to the ones defined as the side population (SP), Verapamil was used. The SP (bone marrow stem cells mostly) has the propensity to efflux Hoechst more that the other cell types in the bone marrow 172. Since Verapamil blocks the drug efflux channels 173 and this way enables staining of DNA even in the SP cells, its treatment was used as a control to confirm the stem cell origin of the cells in the subG1 peak. 56 Fig. 3.8.2.1 FACS settings for detection of the amount of cycling cells within the KL and KSL populations in murine bone marrow. Fig. 3.8.2.1 Gating strategy used for detection of the amount of cycling cells within the KL and KSL populations in murine bone marrow. 3.8.3 ClickItEdu assay Reagents/Instruments Company Cat.No. 57 ClickIt Edu Alexa Fluor 594 imaging kit 12 reaction field adherent slides Cover glasess 24x50 mm, No. 1.5H ProLong gold antifade reagent ScanR screening station microscope Invitrogen Marienfeld Marienfeld Invitrogen Olympus C10084 09 000 00 0102222 P36934 The ClickÍt Edu kits provided by Invitrogen offer an alternative to BrdU based detection of proliferation. The principle behind the ClickIt Edu kits is based on the fact that proliferating cells, synthesizing DNA will incorporate the thymidine analog Edu (5-ethynyl-2´-deoxyuridine). Detection of the amount of incorporated Edu is based on the so called ClickIt chemistry. The ClickIT reaction creates a covalent bond between an azide group bound to AlexaFluor dyes and an alkyne group present in Edu. The reaction is catalyzed by copper. The protocol contains several steps: 1) ClickIt Edu labeling – CD34+ cells after being infected with NF-E2 or Empty control virus were counted and mixed with Edu at 10µM concentration. 2x104 cells were then plated per field on a 12 reaction field adherent slide. The final volume added per field was 20µL. The slides with the cells were incubated for 4h at 37°C, 5% CO2 in humidified atmosphere. During this incubation time the cells adhere to the slide. 2) Cell fixation – after the medium was removed from the cells they were fixed by using 20µl 3,7% formaldehyde in PBS per field. The cells were incubated for 15 min and subsequently washed twice with 40µL 3% BSA in PBS. 3) Permeabilisation – cells were permeabilasied by adding 20µL of 0,5% Triton X-100 in PBS per field and incubating for 20 min, RT. 4) EdU detection – after removing the permeabilisation solution the cells were washed twice with 40µL 3%BSA in PBS. Then 20µL of the Click-It reaction cocktail was added per field and incubated for 30min, RT, protected from light. The cells were then washed once with 3%BSA in PBS. The Click-It reaction cocktail was prepared as recommended by the manufacturer: Amount per reaction field Amount for a 12 field slide Reaction component (µL) (µL) 1X Click-iT reaction buffer 17.20 206.40 CuSO4 (Component H) 0.80 9.60 AlexaFluor azide 0.05 0.58 Reaction buffer additive 2.00 24.00 Total volume 20µL 240µL * 1X Click-iT reaction buffer, AlexaFluor azide and reaction buffer additive stock solutions were prepared upon opening the kit as recommended in the manufacturers manual (http://tools.invitrogen.com/content/sfs/manuals/mp10338.pdf) 58 5) DNA staining – after washing once more with 3% BSA in PBS and once with PBS only, 20µL of 5µg/mL Hoechst solution was added, incubated for 30 min. at RT, protected from light. Finally cells were washed twice with PBS, air dried overnight and covered with a cover slip after adding the mounting solution. 6) Imaging – the Edu –AlexaFluor signal was detected by using the ScanR screening microscope (part of the ZKF Core Facility). For analysis only the GFP+ cells were taken. EdU positive cells were defined as proliferating. 3.9 Differentiation assays 3.9.1 Human hematopoietic progenitor and hematopoietic stem cells assay Progenitor and HSC populations were determined by FACS staining using the following antibodies: anti-CD34 PacificBlue (Biolegend, Cat: 343511), anti- CD38 AlexaFluor700 (Biolegend Cat: 303523), anti- CD45RA APC (Abnova Cat: MAB4624), CD123 PE (BD Cat: 555644), Flt3R (CD135) – biotin (Biolegend Cat: 313312) revealed with Streptavidin-PE/Cy7 (Biolegend Cat: 405206) and Thy-1 CD90) PerCP-Cy5. The staining was done on CD34+ cultured cells in expansion medium. Two days after the first lentiviral transduction the cells were collected from culture in an eppendorf tube and the volume was adjusted to 100µL. [C] for 1x106 µl for 1x106 Stock [C] cells cells CD34 PacificBlue 0,5 mg/ml ≤1µg 2 µl CD38 AlexaFluor700 0,5 mg/ml ≤1µg 2 µl CD45RA APC 10µl CD123 PE 0,2 mg/ml ≤0,4µg 2µl Flt3R (CD135) 0,5 mg/ml ≤2 µg 2µl Streptavidin-PE/Cy7 0.2 mg/ml ≤0.125 µg 4µl Thy-1 (CD90) PerCP-Cy5.5 5µl isotype Mouse IgG1, κ Mouse IgG1, κ Mouse IgG2b Mouse IgG1, κ Mouse IgG1, κ Mouse IgG1, κ Mouse IgG1, κ The amounts of Ab listed in the table above were adjusted according to the cell number used per a staining. First Flt3R (CD135) – biotin Ab was added and the cells were incubated on ice for 20min. Thereafter the cells were washed once with PBS. The other Abs including Streptavidin-PE/Cy7 were mixed in 100µL PBS and added to the cells. The mixture was incubated on ice for 30min., washed once with 59 PBS and resuspended in 200µL PBS. The handling and all centrifugation steps were done at +4°C. Fluorescence was detected with FACSCanto II (BD Biosciencies). 3.9.2 Human terminal differentiation assays Component anti CD11b PE conjugated CD13 PE conjugated anti CD13 PE-Cy7 conjugated anti CD19 PE conjugated anti CD235a PE conjugated anti CD36 APC conjugated anti CD41a PE conjugated anti CD42b APC conjugated Company BD BD BD BD BD BD BD BD Cat.No. 30455 555394 338432 30665x 555570 550956 555467 551061 Terminal differentiation of cultured CD34+ cells was detected by staining for specific surface markers. Detection of cells from the erythroid lineage was done by a combination of CD36-APC and CD235a-PE specific antibodies. While megakaryocytic cells were detected by staining with CD41a-PE and CD42b-APC fluorophore conjugated antibodies. Double staining with CD13 PE-Cy7 and CD11b enables the distinction between terminally differentiated granulocytes, monocytes (CD13+CD11b+) and intermediate myeloid progenitors (CD13+CD11b-). CD19 is a B-cell marker and it was used as a proof of principle that differentiation in expansion medium occurs only along the myeloid lineage. The samples were collected at different time points and stained with the desired combination of antibodies. For all mentioned antibodies the staining was done the same way. In a final volume of 100µL, 2µL of each antibody was added to the cell suspension and incubated for 20 min. on RT. When the cell count was low the staining was performed directly in culture medium, without washing with PBS prior to antibody addition. On the other hand, washing once with PBS after staining is recommended, since it reduces the background signal. After the wash the cells were suspended in 200µL PBS and analyzed on a FACS Calibur or a FACSCanto. 3.9.3 Human megakaryocytic ploidy assays 60 Reagents/Instruments Hoechst DNA stain (powder) Verapamil PBS FACS tubes IMDM (Iscove's Modified Dulbecco's Medium) anti human CD41a PE conjugated anti human CD42b APC conjugated FACS Canto Company Molecular Probes Sigma Aldrich Biochrom AG BD Falcon Gibco BD BD BD Cat.No. H1399 V-106 5MG L182-10 352052 21980 555467 551061 Hoechst working solution [5µg/µl] in PBS stored on +4°C Verapamil stock solution 5mg Verapamil were suspended in 1mL 95% ethanol to reach a concentration of 50µM. Previously cultured CD34+ cells with appropriate cytokines were collected and counted. 5X104 cells or more when available were added to 1,5mL eppendorf tube containing enough culture medium to reach a final volume of 1mL. The eppendorf tubes were placed in a table top heater on 37°C for 10-15min. Afterwards 1µL of Hoechst working solution was added per tube to reach final concentration of 5µg/mL. The cells were incubated for 90 to 120min at 37°C protected from light. Verapamil could be added during the incubation to increase the efficiency of the Hoechst staining, but is not absolutely necessary. However, if used, the final concentration of Verapamil should be 0,25µM (diluting the stock solution 1 to 200) and added directly into the medium together with Hoechst. The tubes were shaken 2 to 3 times in the heater during the incubation. After the Hoechst staining was finished the cells were pelleted (13.000rpm, 4°C, 15s), resuspended in cold PBS and stained with CD41aPE and CD42b-APC antibodies (30min, on ice, protected from light). After washing with PBS once the cells were resuspended in 200µL PBS, transferred into FACS tubes, and kept on ice until acquired on FACSCanto on medium flow speed. 3.9.4 Murine megakaryocytic ploidy assays 61 Reagents/Instruments Hoechst DNA stain (powder) Verapamil PBS FACS tubes IMDM (Iscove's Modified Dulbecco's Medium) anti mouse/rat CD41 PE conjugated anti mouse CD42d APC conjugated FACS Canto Company Molecular Probes Sigma Aldrich Biochrom AG BD Falcon Gibco Biolegend eBioScience BD Cat.No. H1399 V-106 5MG L182-10 352052 21980 133905 17-0421-80 The principle and the protocol of this assay is exactly the same as described in 3.9.3. The difference is that the bone marrow cells were not cultured, but stained directly after isolation and the antibodies used are mouse specific. In general, 1x106 bone marrow cells were suspended in IMDM medium in final volume of 1mL. Hoechst staining was done for 90min., at 37°C where Verapamil was optionally added to the mixture. After one wash with PBS the cells were labeled with CD41 and CD42 fluorescent antibodies, washed one more time with PBS and acquired with a FACSCanto. It is important to keep the flow speed on medium and never on high, so that a better resolution is obtained. When using lower flow speeds the diameter of the flow stream is lower and the cells flow through the flow cell in a single cell suspension. Excluding cell clumps is important since this would give a false signal. For example a doublet would be detected as a 4n cell. Fig. 3.9.4.1 FACS settings for detection of the distinct ploidy classes in populations single or double positive for two megakaryocytic markers (CD41 and CD42) in murine bone marrow. 62 Fig. 3.9.4.2 Gating strategy used to detect the distinct ploidy classes in populations single or double positive for two megakaryocytic markers (CD41 and CD42) in murine bone marrow. Note that there are only few polyploid cells within the CD41+CD42- cell population, which means that CD41 alone is not only expressed on megakaryocytic cells in mBM. The granularity and the size of the megakaryocytic cells can vary, where many of the CD41+CD42+ cells are big and granular. This is why a gate defining a population with defined forward/sideward properties was not used for the analysis. 3.9.5 Cytospins Component Slides (SuperFrost 76x26mm) Filter cards (Shandon Filter Cards) Cytospin Clips (CytoClip-Slide Clips) Cytospin Funnels (TPX Sample Chambers) Cytospin centrifuge (Shandon CytoSpin 3) Company Roth Thermo Electron Corp. Thermo Electron Corp. Cat.No. 1879 5991022 59920063 Thermo Electron Corp. A78710018 Thermo Electron Corp. For histological evaluation of differentiation cytospins combined with MayGrünwald Geimsa staining were used. The number of cells used per cytospin was 2x104, while the cell density was always adjusted to 1x105 cells/mL. After counting the cells were suspended in a final volume of 200µL PBS and applied to the assembled cytospin device. A 3min. long centrifugation at 800rpm at low speed acceleration in the cytospin centrifuge was done. The slides were then dried shortly for 15 min or left to dry overnight. Thereafter the cells were stained. 63 3.9.5.1 May-Grünwald Geimsa (MGG) staining Component May-Grünwald eosine-methylene blue solution Geimsa azur methyleneblue solution Buffer tablets (pH=6.8) Entellan Cover slip (24x24mm) thickness 1 ddH2O Company Merck Merck Merck Merck Marienfeld Cat.No. Hx107432 Hx000080 TP1077274113 Hx 624397 0101060 Geimsa staining solution 1 to 20 diluted stock Geimsa solution in H2O Buffered water 1 buffer tablet dissolved in 1L of ddH2O After spinning the cells down and drying the slide they were stained with undiluted May-Grünwald for 5 min., washed twice in buffered water and transferred to a staining container with Geimsa staining solution for 20 min. Afterwards the slides were washed few times until the excess stain was completely dissolved and let to dry overnight. For microscopy the cells were embedded in entellan and covered with a cover slip. 3.10 RNA processing 3.10.1 RNA isolation The RNeasy® mini kit (QIAGEN, CatNo. 74104) was used for RNA purification, because when working with CD34+ cells the amount of available cells is usually low. The kit is suitable for not more than 1x107 cells and the lower range is 5x104 cells to get high quality RNA. The isolation was done as recommended in the producer’s manual. The RNA’s quantity and quality was detected by using the NanoDrop (PeqLab) spectrophotometer. The absorption of the solution was acquired at three wave lengths: 230, 260 and 280nm. Nucleic acids absorb at 260 nm. Proteins and phenol absorb light strongly at 280nm. Other contaminants left from the purification buffers may absorb light at 230nm. This is why the ratios 260/280 and 260/230 are used as a quality control. The 260/280 ratio for pure RNA is from 1,8 to 2,0 and 260/230 is 1,8 to 2,2. 3.10.2 cDNA synthesis The One Step TaqMan reverse kit (Applied biosystems, Cat.No. N808_0234) was used to perform the reverse transcription of total RNA to complementary DNA (cDNA). The amounts used for a single reaction are listed below: 64 Component RT buffer MgCl2 dNTPs Random Hexsamer Primers RNAse Inhibitor Multiscribe Reverse Transcriptase RNA H2O and RNA Total volume Concentration 10X 25mM 2,5mM each 50µM 20U/µL 5U/µL Amount 5µL 11µL 10µL 2.5µL 1µL 1.25µL 50ng 19.25µL 50µL After the RNA and the reverse transcription mix were pipetted into RNAse free PCR tubes, the cDNA synthesis was done in a thermocycler with the following program: 25°C 10min 48°C 30min 95°C 5min 8°C ∞ The samples were stored at -20°C until used for qRT-PCR. 3.10.3 qRT-PCR (quantitative Reverse Transcription-Polymerase Chain Reaction) Reagents/Instruments 2x TaqMAn Universal master mix 20x Gene expression mix 96 well TaqMan Amplification Plates ABI Prism 7000 Sequence Detection System Company Cat.No. Applied Biosystems 4324020 Thermo AB110 Applied Biosystems A singleplex (detection of one gene per one tube) TaqMan system was used for all gene expression quantifications done in this thesis. This system is based on a fluorescent reporter probe method. The probe is designed to be complementary to a specific DNA sequence and has a reporter fluorophore (FAM) attached to its 5’end and a quencher at its 3’ end. As in every PCR reaction the sequence specific primers anneal to the cDNA and the polymerase starts catalyzing the reaction. The TaqMan polymerase also has a 5’ to 3’ exonuclease activity and degrades the probe during the process of amplification. This leads to the separation of the fluorophore from its quencher making the detection of a florescent signal possible upon excitation. The intensity of the signal directly correlates to the number of RNA transcripts within the sample that was reverse transcribed. 65 • qRT-PCR reaction Component 2x TaqMan Universal master mix 20x Gene expression mix cDNA H2O Amount for 1 reaction 12,5µL 1,25µL 5ng=5µL 6,25µL A 53 fold master mix was prepared for the gene of interest and the housekeeping gene, which was B2M in all experiments. 25µL of the master mix were added per well, where 5µL cDNA solution were pipetted in addition. When there was not enough cDNA available, 2.5ng (2,5µL) cDNA per well were used. The PCR reaction and the fluorescent signals detection were done with the ABI Prism 7000 Sequence Detection System using the following program: Initial denaturation: 95°C, 10min Denaturation: 95°C, 15s Annealing and elongation: 60°C, 1min The 20x Gene expression mixes specific for the gene of interest were ordered directly for the company or previously designed. 66 Assay-On-Demand Human NF-E2 Human β-globin Human B2M Company Applied Biosystems Applied Biosystems Applied Biosystems Cat.No. Hs00232351_m1 Hs00758889_s1 Hs00187842_m1 The distinction between JAK2wt and JAK2V617F and their quantification in patient samples was done by using the primers and probe listed in the table below. The detection of JAK2V617F was possible by modifying the reverse primer. The other components of the reaction were equal for both WT and mutant JAK2. Nucleotides JAK2 forward primer JAK2 reverse primer JAK2V617F reverse primer Probe • Sequence 5'-CAGCAAGTATGATGAGCAAGCTTT-3' 5'-TGAACCAGAATATTCTCGTCTCCAC-3' 5'-CCAGAATATTCTCGTCTCCACTGAA-3' 5'-FAM-TCACAAGCATTTGGTTTT-MGB-3' qRT-PCR data analysis The intensity of the fluorescent signal increases with each PCR cycle until the availability of the reaction components becomes limiting. On a plot presenting the number of PCR cycles on the x-axis and the normalized reporter fluorescence (∆Rn) as a Log function of X at the y-axis, four different phases of amplification can be distinguished: linear ground phase, early exponential phase, log-linear and plateau phase. To evaluate the expression of a gene, a threshold line is set within the exponential phase of amplification. The cycle number where the threshold is set is called the threshold cycle (Ct) and its value is used for estimating the amount of gene expression. Fig. 3.4 qRT-PCR amplification plot. The figure was adapted from Ahmed (2005) 174 (http://www.cgpjournal.com/2005%20issue%206/Quantitative%20Real-time.html) There are two ways to evaluate the data acquired by qRT-PCR: by creating a standard curve or by the ∆∆Ct method. The advantage of the standard curve 67 method is the possibility of determining the exact copy number of the gene of interest, while the ∆∆Ct method gives only relative changes in gene expression. To create a standard curve linearized pCR 2.1 or pCRII TOPO plasmids carrying the specific sequence recognized by the primers and probe were used. The exact copy number of the standard was determined and by creating serial dilutions within the range of the sample’s gene expression a standard curve was plotted. The x-axis represented the copy number and the y-axis was the Ct value at a certain threshold. The copy numbers of the samples were calculated by using a linear equation and the data was normalized to the copy number of the housekeeping gene. When using the ∆∆Ct method, the difference between the Ct values of the gene of interest and the housekeeping gene was calculated. Then a Ct value of the gene of interest was chosen as a calibrator to which the other samples were compared to. The formula used to calculate the relative expression of a certain gene compared to a calibrator sample is: 2- ∆∆Ct. 3.11 Protein processing 3.11.1 Protein isolation To prepare whole cells extracts the RIPA buffer supplemented with protease inhibitors was used. RIPA buffer: Reagent NaCl NP-40 Sodium deoxycholic acid SDS Tris pH 8.0 ddH2O Lysis buffer Final concentration 150mM 1% 0.50% 0.10% 50mM Company VWR Roche Sigma-Aldrich Roth Roth Cat.No. 278102-95 11332473001 D6750 4360.2 4855.3 RIPA supplemented with 2xComplete (Roche, Cat.No.04693116001) CD34+ or other tissue cultured cells were collected, counted, washed once with PBS and lysed. The volume of the lysis buffer was 50µL for up to 1x105 cells, 60µL for 1x105 to 1x106 and 90µL for more that 3x106 cells. The samples were kept for 20min. on ice. Thereafter they were either frozen at -80°C or it was proceeded 68 directly to protein isolation. To disrupt all cellular membranes the samples were sonicated with an ultrasonic probe (SonoPulse, Bandelin) with power of 40% for 10s and 2x10% cycles. After sonication samples were centrifuged 13.000rpm, 15 min., 4°C and the protein containing supernatant was collected for protein reduction and alkylation and for protein quantification. 3.11.2 Protein quantification Reagent Lowry assay BSA 96-well microtiter plates Company BioRad Fermentas Greiner Cat.No. 500-0116 B9001S 655160 A small amount of the protein supernatant was taken out and diluted 1 to 10 (1,2µL protein+10,8µL H2O). In a 96 well microtiter plate 5µL of the diluted protein supernatant and the standard solutions was added per well. Standard protein solutions were prepared by diluting BSA to get concentrations of [0,05];[ 0,1]; [0,25]; [0,5]; [0,75] and [1] µg/mL. All samples were pipetted in duplicates. The protein concentration was detected as described in the Lowry assay manual (BioRad, Cat.No. 500-0116). According to the measured absorbance normalized automatically by the software to the blank (including only water instead of protein) a standard curve was ploted. The x axis was the concentration of the BSA protein solutions and the y axis was absorbance. The protein concentration of the samples was calculated as a linear function of the standard curve y=mx+b. 3.11.3 Protein reduction and alkylation 5XSDS sample buffer: Reagent Final concentration 1M Tris (pH=6,8) 0.25M SDS 0.1 g/mL Bromphenol-blue 5mg/mL 100% Glycerol 1/2 of final volume ddH2O up to desired volume Company Roth Roth Roth Fluka Cat.No. 4855.3 4360.1 A512.1 49780 Iodoacetamide (IAA) 1M in H2O (SigmaAldrich Cat.No. I1149), stored on -20°C Dithiothreitol (DTT) 1M in H2O (SigmaAldrich Cat.No. 43817), stored on -20°C 69 To denature and negatively charge the proteins, the protein sample was boiled in 1XSDS sample buffer (Lämmli buffer) 10min, 95°C. Prior to boiling, 50mM DTT was added to the protein sample to obtain reduction of the disulfide bonds within the proteins. The samples were cooled down to RT and IAA at a final concentration of 120mM was added. The samples were incubated for 20min. in the dark. To quench the excess IAA additional 20mM DTT was added and the samples were kept for 20min in the dark at RT. IAA alkalizes the sulphide residues within the protein, which makes the folding of the protein unlikely. The samples were stored on -80°C. 3.11.4 SDS Polyacrylamide Gel Electophoresis (SDS-PAGE) Reagents/Instruments Tris SDS Glycin Rotiphorese TEMED APS Isopropanol Byotinylated Protein ladder Precision Plus Protein Standard (Kaleidoscope) Mini PROTEAN II Cell Company Roth Roth Roth Roth Roth Fluka Roth Cell Signaling BioRad BioRad Cat.No. 4855.3 4360.2 3908.2 3029.1 2367.3 9913 6752.3 7727 161-0375 165-2926 4x separating gel buffer 1,5M Tris (pH=8,8) and 0,4% SDS 4xStacking gel buffer 0,5M Tris (pH=6,8) and 0,4% SDS 5xSDS running buffer 0,125M Tris (pH=8,7), 1M Glycin and 0,5% SDS Rotiphorese 30% Acrylamide and NN Methylenbisacrylamide solution APS solution 10% APS in H2O The separating SDS-PAGE gel was cast between two clean glass plates using the Mini PROTEAN assembling system. The concentration of the gel was prepared according to the size of the proteins to be detected. To achieve a better resolution at the range between 10 and 60kDa a 12% gel was prepared. For separating 30 to 120kDa proteins a 10% gel was used and for proteins ranging between 50 and 200kDa an 8% gel was run. After the gel was poured 0,5 to 1mL isopropanol were put on top to ensure a horizontal and flat distribution of the gel’s top border. When the separation gel was polymerized the isopropanol was poured off and the stacking gel was cast on top. The concentration of the stacking gel was always 3,9%. The gel 70 cassette was then placed into the electrophoresis tank in 1xSDS running buffer. The samples were loaded and ran with 100V and 65mA electrical current. When the separation of the proteins was sufficient (visible by the Kaleidoscope marker) electrophoresis was stopped and the separating gel was blotted. 3.11.5 Western Blot Reagents/Instruments Tris Methanol Glycin Ponceau S Trichloracetic acid Gel Blotting Paper Immobilion PVDF membrane Mini-Trans Blot Module Transfer buffer Company Roth VWR Roth Fluka Roth Schleicher and Schuell Millipore BioRad Cat.No. 4855.3 20.847.295 3908.2 81460 7437.1 10426694 IPVH00010 170-3935 25mMTris, 192mM Glycine, 20%Methanol, H2O to desired volume Ponceau S solution 2% Ponceau S, 3% Trichloracetic acid, H2O up to desired volume To make the detection of specific proteins possible by using antibodies, the sample proteins are transferred to a PVDF membrane. The membrane was previously swelled by putting it in Methanol for 15s, 2 min. in H2O and 5min in Transfer buffer. Also, the separating gel was incubated for 2min. in transfer buffer prior assembling the gel sandwich into the blotting device. It is important to pay attention to the order of putting the gel and the membrane. Since the negatively charged proteins will move towards the anode the membrane has to be on the anode side and the gel on the cathode side. The order of assembly from cathode to anode is as follows: fiber pad, gel blotting (filter) paper, separating gel, PVDF membrane, gel blotting paper, fiber pad. The transfer of proteins to the PVDF membrane was done by using 100V, 350mA electrical current for 3h. The efficiency of the transfer was confirmed by soaking the membrane into Ponceau S solution. By washing few times with ddH2O the staining was removed from the membrane. 71 3.11.6 Detection of Immunocomplexes Reagents/Instruments Tris NaCl Tween-20 Non fat dry milk BSA ECL Western Blot Analytical System ECL Plus Western Blot Detection system Chemiluminescence Detection System Company Roth VWR Roth Fluka Sigma Aldrich GE GE INTAS Cat.No. 4855.3 278102-95 9127.1 70166 A-9647 RPN2109 RPN2132 TBS(10X) 0,2M Tris (ph=7,5); 150mM NaCl Wash buffer 0,1%-0,15%(v/v) Tween-20 in 1xTBS Blocking buffer A 0,1%(v/v) Tween-20, 5%(w/v) dry milk in 1XTBS Blocking buffer B 0,1%(v/v) Tween-20, 5%(w/v) BSA in 1XTBS Primary antibody anti- Biotin anti-JAK2 anti-NF-E2 anti-NF-E2 β-actin Company Cell Signaling Cell Signaling generated in Pahl lab Sigma Aldrich (ATLAS) Sigma Aldrich Secondary antibody anti- Rabbit IgG HRP linked anti- mouse IgG HRP linked Company GE GE CatNo 7075 3230 1089 HPA001914 A5441 LotNo R00723 CatNo NA934V NA931V Usually after Western blotting the membranes were blocked for 1h at RT, by adding around 20mL blocking buffer A in a 50mL Falcon tube. The incubation with the primary antibody was done over night at +4°C (or 1h, RT when applicable) in 10mL blocking buffer with the recommended Ab dilution. The membrane was washed 3 times with washing buffer to get rid of the unbound Ab. Thereafter, the membrane was incubated for 1h, RT with 1 to 4000 diluted secondary Ab in 10mL blocking buffer A or B. Again the membrane was washed twice with wash buffer and once with 1XTBS alone. The detection of the immunocomplexes was done by detecting the chemiluminescent signal. 72 3.11.7 Removal of immunocomplexes Stripping buffer Reagent Tris (pH=6,8) SDS β -mercaptoethanol ddH2O Final concentration 50mM 2% (w/v) 100mM up to desired volume Company Roth Roth Sigma Aldrich Cat.No. 4855.3 4360.2 M7522 When it was necessary to detect several immunocomplexes the PVDF membrane was incubated at 50°C in 40mL stripping buffer for 20-30min within a water bath. Afterwards, the membrane was washed several times with 1xTBS until the smell of β –mercaptoethanol was gone. Then the membrane was used for detection of other immunocomplexes as described before. 3.12 Statistical analysis For statistical data analysis and plotting graphs either the GraphPadPrism 5 (http://www.graphpad.com) or the SigmaPlot 11.0 (Systat Software Inc.) software was used. Paired t-test was used when the same sample received different treatments. For example, when comparing the phenotype of CD34+ cells originating from same donors transduced with ether Empty or NF-E2 vector. When two unrelated groups were compared like PV and HC, unpaired t-test was used. One way ANOVA was applied to compare multiple parameters simultaneously. 73 4. Results 4. 1 NF-E2 is overexpressed in CD34+ cells derived from PV patients’ peripheral blood. To determine the amount of NF-E2 in CD34+ cells originating from PV or HC, the cells were cultured in modified expansion medium and RNA samples were collected daily (from day 4 to day 8 of culture). The level of expression was detected by qRT-PCR. PV cells expressed 1,5 to 2 fold more NF-E2 than the HC from day 4 up to day 8 of differentiation in-vitro (Fig.4.1.1, b). The expression of CD34 was confirmed by FACS daily. On the starting day of culture (day 1) the amount of CD34+ cells was from 90-100% depending on the efficiency of CD34 isolation. After 4 days in modified expansion medium the percentage of CD34 positive cells dropped by only 10-20% and was gradually reduced to 40% on day8 of culture. Both PV and HC CD34+ cells showed the same pattern of CD34 expression (Fig.4.1.1, a). Fig.4.1.1 CD34+ cell surface expression and NF-E2 overexpression in in-vitro differentiating PV and HC CD34+ cells. a) CD34 surface expression was detected daily (from day4 to day8) by FACS in peripheral blood isolated CD34+ cells from healthy controls (HC) and PV patients cultured in modified expansion medium. The data is represented as % positive cells within the viable cell population. b) An RNA sample was collected daily form day4 to day8 of culture and the amount of NF-E2 transcripts in PV and HC cells was detected by qRT-PCR. Evaluation of qRT-PCR data was done by the ΔΔCt method. Statistical analysis was performed by using unpaired two-sided t-test, where * p≤0.05. To investigate the effect of NF-E2 overexpression on hematopoiesis, CD34+ cells isolated from HC were transduced with virus where an equal amount of NF-E2 overexpression as in PV patients was achieved ranging from 1.5 to 2.5 fold (Fig 4.1.2, c). The amount of NF-E2 expression in HC or empty vector transduced cells was taken as a reference value. The expression levels in HC and PV cells on day 8 of culture were detected by qRT-PCR for HC and PV cells (Fig.4.1.2,a) and for NFE2 or empty vector transduced cells (Fig.4.1.2,b).This overexpression was also 74 detectable on protein level (Fig.4.1.2, d). Thus, the experimentally achieved exogenous NF-E2 expression reflected the levels of expression observed in PV patients. Fig.4.1.2 NF-E2 expression in in-vitro differentiating CD34+ cells. The expression of NF-E2 was detected as number of mRNA transcripts per 100.000 B2M. After cDNA synthesis the amount of NFE2 transcripts was detected by qRT- PCR and analysed by the standard curve method in a) healthy control (HC) or PV cells and b) HC cells transduced with pLeGO-iG-NF-E2 (NF-E2) or empty pLeGO-iG (Empty) on day 8 of culture in modified expansion medium. c) Fold exogenous NF-E2 expression in retrovirally transduced HC CD34+ compared to the endogenous levels of NF-E2 expression in CD34+ cells differentiated for 8 days in modified expansion medium. The amount of NF-E2 transcripts in HC cells or cells transduced with the empty vector were taken as reference value. d) Western blot from NF-E2 transduced and control cells on day 14. Statistical analysis was performed by using unpaired a) or paired b) two-sided t-test. 4.2 NF-E2 overexpression in CD34+ cells promotes HSC, MPP, CMP and GMP expansion while decreasing MEP cell counts. After isolation, the CD34+ cells were lentivirally transduced on day 2 and 3 of culture with pLeGO-iG-NF-E2 (NF-E2) or empty pLeGO-iG (Empty). On day 4 and 5 of culture the cells were collected and stained with a combination of fluorescently labeled antibodies to detect HSC and progenitor populations. Only the viable and transduced (GFP+) cells were included in the analysis. The combination of surface specific markers was chosen as previously described 125, 175 . The FACS gating strategy used to distinguish the different populations is described in Fig.4.2.1. The 75 surface marker expression typical for HSC and progenitor populations is summarized in Table.4.2.1. Population Phenotype HSC CD34+CD38-CD45RA- CD90+Flt3+ MPP CD34+CD38-CD45RA- CD90-Flt3+ CMP CD34+CD38+CD45RA- IL-3Ra+ (orFlt3+) MEP CD34+CD38+CD45RA- IL-3Ra- (or Flt3-) GMP CD34+CD38+CD45RA+ IL-3Ra+ Table 4.2.1 Phenotypic characterization of HSC and hematopoietic progenitor cells Fig.4.2.1 Human HSC and progenitor analysis in NF-E2 overexpressing and control PB derived CD34+ cells differentiated in-vitro. The cells were collected on day 4 and 5 of culture labeled for surface specific markers and analyzed by FACS. The gating strategy is depicted in a). b) Represents the initial gating for CD34+CD38- and CD34+CD38+ populations. Representative measurements for HSC and MPP determination are shown in c) and for progenitor distinction in d). The upper panels in c) show CD45RA depletion and the lower ones MPP and HSC population distribution as percentages of CD34+CD38-CD45RA- population. On the upper two and the lower two panels in d) two alternative strategies are depicted for CMP, MEP and GMP analysis as a percent of CD34+CD38+ cells. FACS measurements showing the percentage of HSC and MPP of the CD34+CD38-CD45RA- population are presented in Fig.4.2.1 c) (two bottom plots). NF-E2 overexpression caused an increase in the percentage of HSC and MPP populations. Representative FACS data for progenitor distinction is depicted in 76 Fig.4.2.1 d). The upper two dot plots represent the most commonly used way of CMP, MEP and GMP distinction, while the bottom dot plots show a gating strategy by an alternative progenitor definition. In both cases, an increase of the percentage of CMP and GMP population in the NF-E2 overexpressing cells was observed, at the expense of MEPs that became less. To confirm that these observations are genuine and do not reflect changes in the CD34+CD38- or CD34+CD38+ population due to NF-E2 overexpression their percentage within the GFP+ cells was compared. There was no significant difference detected between NF-E2 and empty transduced cells for neither CD34+CD38(Fig.4.2.2 a and c) or CD34+CD38+ population (Fig.4.2.2 b and d) on day4 and 5 of culture. Around two fold decrease in the percentage of CD34+/CD38- population was detected from day4 to day5 of culture in both NF-E2 and empty transduced cells (Fig. 4.2.2 a and c). On the other hand the frequency of CD34+/CD38+ cells stayed constant reaching a mean value of around 50% of all viably transduced cells. Fig.4.2.2 Frequency of CD34+CD38- and CD34+CD38+ populations among the viable virus transduced (GFP+) CD34+ cells. The percentage distribution with mean and SEM values of CD34+CD38- population are depicted on panel a) day4 of culture and c) day 5 of culture. Panels b) and d) represent the CD34+CD38+ population for day 4 and day5 of in-vitro culture respectively. Paired t-test was used for statistical analysis where no statistical difference was detected between 77 the Empty control and NF-E2 vector transduced cells. n is the number of independent experiments included in the analysis. To evaluate the ability of NF-E2 overexpressing CD34+ cell to generate and/or maintain cells with HSC phenotype the percentage of HSC within the CD34+/CD38population on day4 and day5 was compared to the empty control transduced cells. On day 4 of culture there was not a significant difference in the amount of HSC (Fig. 4.2.3 a), but on day 5 there were significantly more cells with HSC phenotype in the NF-E2 overexpressing cells (Fig.4.2.3 b). The absolute number of HSC on day 5 of culture was also elevated when NF-E2 was overexpressed (Fig.4.2.3 c). Fig.4.2.3 Increase of HSC frequency in NF-E2 overexpressing CD34+ cells. Graphs a) and b) show the percentage HSC within the CD34+CD38-CD45RA- population on day 4 and day 5. The absolute number of HSCs existing within 100.000 transduced (GFP+) CD34+ cells is depicted in c). Statistically significant difference between the groups was determined by paired t-test. NF-E2 overexpression also caused expansion of the MPP pool (Fig.4.2.4). The increase in percentage MPPs within the CD34+/CD38+ population was detected on both day 4 (Fig.4.2.4 a) and 5 (Fig.4.2.4 b) of culture. The same observation was valid when the absolute numbers MPPs were compared (Fig.4.2.4 c). 78 Fig.4.2.4 Increase in MPP frequency in NF-E2 overexpressing CD34+ cells. The expansion of MPP population represented as percentage of CD34+CD38-CD45RA- population was measured on day 4 a) and day 5 b). The total number of MPPs generated within 100.000 transduced (GFP+) cells was calculated for each experiment and is depicted in c). The data distribution with mean of n=4 independent experiments is plotted. Statistically significant difference between the groups was determined by paired t-test. NF-E2 overexpression also affected the later progenitor compartments. The percentage of CMP and GMP compartments were significantly elevated, while MEPs counts were lower (Fig.4.2.5 a and b), reflecting the changes observed as absolute cell numbers (Fig.4.2.5 c). The shift in later progenitor population distribution was present on day 4 and day 5 of culture and was detected by two different gating strategies. Fig. 4.2.5 a represents the most commonly used way (classical definition) of CMP, GMP and MEP distinction, while Fig. 4.2.5 b represents an alternative way of progenitor distinction. The classical definition uses the expression of IL-3Rα and CD45RA expression on CD34+ CD38+ cells, while the alternative definition utilizes the expression of Flt3 and CD45RA. The difference between the two gating strategies was that on day5 the percentage of CMPs in both NF-E2 and Empty vector transduced cells was higher than the percentage detected by the classical definition, while the percentage of MEPs was in general lower. However the increase within the 79 CMP and GMP compartments on the expense of MEPs was also confirmed by determining the absolute numbers of cells within each population (Fig.4.2.5 c). Fig.4.2.5 Effect of NF-E2 overexpression in CD34+ cells on hematopoietic progenitor compartments. The amount of CMP, MEP and GMP as percentage of CD38+CD34+ population was detected by two alternative strategies. a) Gating strategy using IL-3Rα and CD45RA expression. b) gating strategy based on Flt3 and CD45RA expression. c) Absolute cell number of CMP,MEP and GMP in 100.000 GFP+ cells on day 5 of culture in expansion medium. Statistical significance was determined by using paired t-test. N is the number of experiments used in the analysis. * p=0.01 to 0.05, ** p= 0.001 to 0.01, ***p≤0.001. 80 4.3 NF-E2 overexpression elevates the number of CD13+CD36+ double positive cells – common myeloiderythroid progenitors A single study done by Chen et al. 176 describes a cell type positive for both CD36 and CD13 that has a combined myeloid and erythroid potential. By definition, CD36 is expressed during earlier stages of erythroid differentiation, while CD13 is expressed on myeloid cells (from myeloid precursors to terminally differentiated cells). The sorted, double positive population was able to generate both erythroid and myeloid colonies when cultured in semisolid medium. Unfortunately, the dual nature of the progenitor was not assed in-vivo and only the effect of cytokines acting predominantly in erythroid and granulocytic differentiation was tested. When NF-E2 is overexpressed the frequency of CD36+CD13+ cells is significantly elevated (Fig.4.3.1 a and b). This difference however was present only in 2 (UPN:10166 and 2388) out of 5 PV patients (Fig.4.3.1 c and d). The increase in the CD13+CD36+ population was not dependent on the JAK2V617F presence, since one of the patients showing the increase (UPN2388) was negative, while the other patient (UPN 10166) was positive for the JAK2V617F mutation. The PV patients that had comparable amount of CD13+CD36+ to healthy controls had more CD36 single positive cells, while the amount of CD13 single positive cells was reduced. In total the amount of cells expressing CD36 was always more in CD34+ cells derived from PV patients and differentiated for 8 days (Fig.4.3.1 e). The UPN numbers of all patients tested for both CD13+CD36+ and CD36+ population frequency with PRV-1 and JAK2V617F status is included in Fig. 4.3.1 d. 81 p=0,03 b) NF-E2 n=3 50 CD13 %CD13+CD36+ Empty control CD13 a) 40 30 20 10 day 8 c) CD36 PV patients Healthy control p=ns d) UPN:10166 PV n=5 HC n=6 50 %CD13+CD36+ CD13 NF - Em pt CD36 E2 y 0 40 30 20 10 day 8 UPN:10174 PV C CD36 H CD13 0 UPN Age PRV-1 JAK2 V617F 10166 51 (+) 2388 49 (+) (+) (-) 10174 50 (+) (+) 2710 72 (+) (+) 1820 66 (+) (+) CD36 e) P=0,038 100 %CD36+ 80 60 40 20 day8 PV H C 0 Fig.4.3.1 Proposed human common myeloid-erythroid progenitor in NF-E2 overexpressing and control PB derived CD34+ cells differentiated in-vitro. A representative FACS measurement of CD34+ cells differentiated in-vitro for 8 days either for a) NF-E2 or Empty control vector transduced cells or for c) HC and PV cells. A significant increase in the CD13+CD36+ double positive population in NF-E2 overexpressing CD34+ cells of n=3 independent experiments is represented in b). The percentage of double positive cells in PV compared to HC as well as details for the cohort of PV patients investigated is depicted in d). Plot e) represents the percentage of cells expressing CD36. Bars represent mean with standard error. Paired two sided t-test in b) and unpaired two sided t-test in d) were used for statistical evaluation. 82 4.4 Effect of NF-E2 overexpression on differentiation along the myeloid lineage terminal To investigate how the delay of maturation observed during earlier days of culture in expansion medium (section 4.2), affects fate decision and terminal differentiation in NF-E2 overexpressing cells; the expression of several lineage specific markers was measured. Cells expressing CD36 and CD235a were defined as erythroid, while CD41 and CD42 double positive cells as megakaryocytic. CD13 is a marker expressed on early myeloid progenitors, granulocytes and monocytes, while CD11b (Mac-1) is only expressed on terminally differentiated granulocytes and monocytes. After 8 days in culture the cells were stained with fluorochrome labeled antibodies against the markers mentioned above. NF-E2 overexpression promoted Epo-independent erythroid differentiation (Fig.4.4.1 a), while delaying megakaryocytic differentiation (Fig.4.4.1 b). Fig.4.4.1 Ectopic NF-E2 expression in CD34+ cells promotes EPO-independent erythroid differentiation and delays megakaryocytic differentiation during culture in expansion medium. a) The dot plot represents a CD36 and CD235a (GpA) staining on day 8 of culture, where the double positive population contains terminally differentiated erythroid cells. The lower panel describes the percentage of CD36+CD235a+ measured in n=4 independent experiments. b) Top - representative FACS staining with two megakaryocytic markers and bottom – graphical representation of percentage double positive cells for CD41a and CD42b measured in n=5 independent experiments on day 8 of culture. Statistical analysis was done by using paired t-test. 83 The number of cells expressing markers specific for other myeloid cell types, apart from erythroid and megakaryocytic, was slightly elevated when NF-E2 was overexpressed (Fig.4.4.2 a and b). Statistically, the surface expression (detected as mean fluorescent intensity MFI) of both CD13 and CD11b was not significantly different (Fig. 4.4.2 c), which may be due to the low number of experiments included in the analysis (n=3). Fig.4.4.2 Increase in myeloid and granulocytic surface marker expression in NF-E2 overexpressing CD34+ cells. a) Histogram overlays of cells transduced with NF-E2 or Empty vector stained for CD13 respectively CD11b and unstained controls. b) Statistical evaluation of percentage CD13 (left panel) or CD11b (right panel) positive cells. c) Intensity of CD13 (left) or CD11b (right) surface expression per cell represented as MFI. Paired one tailed t-test was used for statistical analysis of n=3 independent experiments. 84 To confirm the differentiation status detected by FACS, cytospins were prepared and stained with May-Grünwald-Geimsa (Fig.4.4.3) Indeed on day 5 of culture the cells had an immature/progenitor phenotype (Fig.4.4.3 a) as confirmed in section 4.2) and on day 8 the cells had already differentiated towards a certain myeloid type – megakaryocytic, erythroid, granulocytic or monocytic (Fig.4.4.3 b). The presence of cells belonging to the lymphoid lineage was not detected, since IL-7 is not part of the expansion medium and therefore lymphoid cells which are highly IL7 dependent could not be generated 177, 178. Fig.4.4.3 Histological evaluation of in-vitro differentiating CD34+ cells. 2x104 CD34+ cells cultured in expansion medium were collected on day 5 a) or day 8 b), cytospined and stained with MayGrünwald Geimsa. Dark blue arrow lines in a) mark early progenitor cells, while purple arrows mark later myeloid progenitors (myelocytes). Pictures were acquired with an Axiovert microscope. 4.5 Cytokine dependent effect of NF-E2 overexpression and silencing on erythroid and megakaryocytic differentiation. Since NF-E2 has an important role in HSC and progenitor physiology, as well as in terminal differentiation processes its regulation must be under a tight control of cytokine signals. Also, PV cells are known to be hypersensitive to certain cytokines 179-182 . The rationale for performing the experiments described bellow was: to see if NF-E2 overexpression in PV happens because of abnormal cytokine stimulation, whether the level of NF-E2 expression can be regulated by adjusting the concentration of cytokine stimulation and what will be the effect of NF-E2 overexpression when the cells are stimulated (and therefore programmed) with a lineage specific cytokine. The interest was put mainly on erythroid and megakaryocytic differentiation, since as previously described PV patients carry 85 lesions in both Epo and Tpo signalling. Epo and Tpo are two very potent cytokines that guide terminal erythroid and megakaryocytic differentiation respectively. To see how changes in Tpo and SCF concentrations affect terminal differentiation, CD34+ cells were cultured in modified expansion medium. The modified expansion medium contains 10 times more Tpo and 5 times less SCF than the expansion medium. This change in cytokine concentration elevated the amount of erythroid cells generated in culture. Cells overexpressing NF-E2 responded by promoting Epo – independent erythroid differentiation by increasing the numbers of cells with erythroid phenotype around 2 fold (Fig.4.5.1 a). This observation was present in CD34+ cells from PV patients that also had a 2 fold increase in Epo – independently generated erythroid cells (Fig.4.5.1 b). Details regarding the PV patients studied in Fig. 4.5.1 are summarized in Table 4.5.1. Judging by the amount of JAK2V617F allele burden in the total cell population on day 8 of culture (Table 4.5.1) it seems that the JAK2V617F mutation does not correlate to the amount of erythroid cells generated independently of EPO in the PV patients investigated here. Fig.4.5.1 Increased TPO and decreased SCF concentrations enhance EPO-independent erythroid differentiation. CD34+ cells were differentiated in-vitro in expansion (20T) and modified expansion medium (200T) for 8 days, labeled with CD36 and CD235a markers and analyzed by FACS. The percentage of double positive cells transduced with pLeGO-iG-NF-E2 (NF-E2) or empty pLeGO-iG (Empty) differentiated in both media is presented in a). In b) is Epo independent erythroid differentiation of PV PB derived CD34+ cells compared to HC differentiated in modified expansion medium. c) Effect of NF-E2 silencing in PV CD34+ cells on erythroid differentiation in modified expansion medium. The cells were transduced with pLeGO-G-shNF-E2 or pLeGO-G-scrambled (scr) 86 control vector. Paired t-test analysis was performed in a) and c) while unpaired t-test was used to detect differences between healthy control (HC) and PV cells in b). Silencing of NF-E2 in PV cells decreased erythroid cell number (Fig.4.5.1 c). It is worth to notice that the scrambled control never exceeds 10% of CD36/CD235a double positive cells while both untreated PV and HC cells overexpressing NF-E2 reach 40% and respectively 20% of double positive cells. This observation, however, could be due to altered differentiation caused by the lentiviral transduction itself, since transduction with LeGO-G vectors lacking the IRES site leads to accumulation of high amounts of GFP. Moreover, the amount of cells double positive for CD36 and CD235a was very variable in the experiments performed (Table 4.5.2). To see whether the overexpression of NF-E2 in PV derived CD34+ cells differentiating in-vitro is functional on transcriptional level, the amount of β-globin transcripts was detected on day 8 of culture. β-globin is a well proven NF-E2 target gene 92, 105, 183 and its expression is crucial for erythroid cell function, since the protein it encodes is a subunit of hemoglobin. In PV cells the expression of β-globin was around 4 fold higher than in HC derived cells (Fig. 4.5.2). The PV patients with the following UPN numbers were included in for the analysis: 2710, 10166 and 1891. Fig.4.5.2 β-globin expression is elevated in CD34+ cells from PV patients differentiating in-vitro. CD34+ cells differentiated for 8 days in modified expansion medium were collected to extract mRNA. After cDNA synthesis the amount of β-globin transcripts was detected by qRT-PCR. Data analysis was performed with the ΔΔCt method. Statistical significance was calculated with unpaired t-test. Megakaryocytic differentiation was also affected by changes of TPO and SCF concentrations. In expansion medium (20ng/mL TPO, 100ng/mL SCF, Flt3L, IL-6) NF-E2 overexpression delayed megakaryocytic differentiation, while in modified expansion medium (200ng/mL TPO, 20ng/mL SCF, Flt3L, IL-6) the effect was reversed - there were more megakaryocytic cells when NF-E2 was overexpressed (Fig. 4.5.3 a). There was no difference between the number of megakaryocytic cells generated from HC or PV CD34+ cells cultured in modified expansion medium (Fig. 87 4.5.3 b). Silencing of NF-E2 in PV cells had no statistically significant effect on megakaryocytic differentiation (Fig. 4.5.2 c). Details about the PV patients included in these experiments are summarized in Table 4.5.1 and Table 4.5.2. UPN: 2710 Age: PRV-1 72 (+) %CD36+CD235+ 37 %CD41+CD42+ 24 hNF-E2/ 100.000 B2M 60841 V617F % JAK2 allele burden 41 10166 10174 51 50 (+) (+) 48 68 14 6 98329 63209 83 3 1820 66 (+) 32 7 38439 22 Table.4.5.1 PV patients analyzed for erythroid and megakaryocytic marker expression in modified expansion medium. Fig.4.5.3 Increased TPO and decreased SCF concentrations exert an effect on megakaryocytic differentiation of CD34+ cells. CD34+ cells differentiated in-vitro in expansion (20T) or modified expansion medium (200T) for 8 days, were labeled with CD41a and CD42b markers and analyzed by FACS. a) Depicts the percentage of double positive cells (CD41+CD42+) transduced with pLeGO-iGNF-E2 (NF-E2) or empty pLeGO-iG (Empty) differentiated in both media. b) Megakaryocytic surface marker expression in PV and HC CD34+ cells differentiated in modified expansion medium for 8 days. c) The effect of NF-E2 silencing in PV CD34+ cells on megakaryocytic differentiation. Statistical analysis in a) and c) was done with paired t-test, while unpaired t-test was used to analyze the data in b). * p=0.01 to 0.05, ** p= 0.001 to 0.01. UPN: 1971 10166 1647 1728 Age: 65 51 68 76 PRV-1 (+) (+) NA NA V617F JAK2 status (+) (+) (+) (+) %CD36+CD235+ shNF-E2/scrambled 4.6 / 5.5 10.7 / 16.5 5.9 / 10 8.2 / 4.3 %CD41+CD42+ shNF-E2/scrambled 7.3 / 5.3 4.6 / 9.2 3.9 / 8.9 1.7 / 2.15 Table.4.5.2 PV patients analyzed for shNF-E2 effect on erythroid and megakaryocytic marker expression in modified expansion medium. 88 Both the expansion and the modified expansion medium contain a mix of cytokines that activate multiple signaling cascades and promote multilineage differentiation within the myeloid branch of hematopoiesis. To investigate whether the altered commitment of NF-E2 overexpressing HC and PV cells toward the erythroid and megakaryocytic lineage is specifically influenced by certain cytokines, CD34+ cells were cultured in media containing different concentrations of Tpo or Epo only or both Tpo+Epo. In all cases, SCF was supplemented to sustain cell proliferation. On day 12 of culture the cells were collected and analyzed for lineage marker expression. In these media there was no elevation in erythroid marker expression when NF-E2 was overexpressed in HC CD34+ cells (Fig. 4.5.4 a) nor in PV CD34+ cells (Fig.4.5.4 b). NF-E2 silencing in PV CD34+ cells did not reduce the amount of erythroid cells in culture either (Fig.4.5.4 c). Later NF-E2 quantification in cells stimulated with EPO shows that the PV cells transduced with a scrambled shNF-E2 vector do not reach the level of expression detected in untransduced cells (Fig.4.6.1). Therefore an eventual effect of NF-E2 silencing on erythroid differentiation in PV cannot be excluded. Fig.4.5.4 The effect of: different TPO concentrations, TPO and EPO in combination, and EPO alone on later erythroid differentiation. The CD34+ cells were cultured in SFEM medium containing 50ng/mL TPO (50T), 200ng/mL TPO (200T), 50ng/mL TPO with 1IU/mL EPO (E+T) or 1IU/mL EPO (Epo) in each case 25ng/mL SCF was added to the medium. On day 12 of culture the cells were collected, stained with CD36 and CD235a and analysed by FACS. The y axis in all three graphs represents the 89 percentage of cells double positive for CD36 and CD235a. a) cells transduced with pLeGO-iG-NF-E2 (NF-E2) or empty pLeGO-iG (Empty), b) HC and PV cells and c) PV cells transduced with pLeGO-GshNF-E2 or pLeGO-G-scrambled (scr) control vector. While erythroid differentiation was not influenced by TPO and EPO signaling alone or in combination, TPO had an effect on the megakaryocytic differentiation of NF-E2 overexpressing HC and PV CD34+ cells (Fig.4.5.5 a and b). In both cases, the amount of cells double positive for CD41/CD42 was decreased. Interestingly, silencing of NF-E2 in PV cells also reduced the number of CD41/CD42 double positive cells (Fig. 4.5.5 c) but only in one cytokine condition (50ng/mL TPO, 25ng/mL SCF) where the strongest silencing was achieved (Fig. 4.6.1). Fig.4.5.5 The effect of: different TPO concentrations, TPO and EPO in combination, and EPO alone on later megakaryocytic differentiation. The CD34+ cells were cultured in SFEM medium containing 50ng/mL TPO (50T), 200ng/mL TPO (200T), 50ng/mL TPO with 1IU/mL EPO (E+T) or 1IU/mL EPO (Epo) all supplemented with 25ng/mL SCF. On day 12 of culture the cells were collected, stained with CD41a and CD42b and analyzed by FACS. The percentage of double positive cells for CD41a and CD42b is depicted in all three graphs. a) cells transduced with pLeGO-iG-NF-E2 (NF-E2) or empty pLeGO-iG (Empty), b) HC and PV cells and c) PV cells transduced with pLeGO-G-shNF-E2 or pLeGO-Gscrambled (scr) control vector. * p=0.01 to 0.05, ** p= 0.001 to 0.01. V617F UPN: 2388 1703 10393 Age: 49 57 58 PRV-1 (+) (-) NA JAK2 UPN: Age: PRV-1 JAK2 status (-) (-) NA V617F status Table.4.5.3 PV patients analysed for erythroid and megakaryocytic marker expression in different concentration of TPO, EPO and TPO and Epo in combination. NA – not available, (+) – positive, (-) negative Table.4.5.4 PV patients analysed for shNF-E2 effect on erythroid and megakaryocytic marker expression in different concentration of TPO, EPO and TPO and Epo90 in combination. NA – not available, (+) – positive, (-) negative 2388 1703 10393 1892 49 57 58 52 (+) (-) NA (+) (-) (-) NA NA During the process of maturation the megakaryocytic cells undergo a process called endomitosis thus becoming fully functional megakaryocytes able to shed platelets. During endomitosis the amount of DNA and the size of the megakaryocyte are doubled but the cell does not divide. By measuring the quantity of DNA the ploidy state can be determined, which is a hallmark of megakaryocytic maturation and function. Megakaryocytes derived from PV cells in-vitro increased their ploidy to a higher level than the HC (Fig.4.5.6 a). In PV there were more megakaryocytes with 8N and more than 8N class of ploidy. Silencing of NF-E2 in PV reversed the phenotype by promoting the generation of more immature megakaryocytes (Fig.4.5.6 b). Mainly by increasing the number of megakaryocytes with 2N ploidy and reducing the number of ones with 8N. Higher than 8N plody class was not affected by the silencing. This finding may suggest that NF-E2 is more important in initial stages of megakaryocyte development. Fig.4.5.6 Megakaryocytic ploidy. CD34+ cells cultured for 12 days in SFEM medium supplemented with 50ng/mL TPO and 25ng/mL SCF were stained with Hoechst and anti-CD41a/anti-CD42b antibodies. Large cells (with high FSC value), double positive for CD41a and CD42b were analyzed for their DNA content (Hoechst fluorescent intensity) with FACS. a) n=3 for PV and n=5 for HC independent experiments were performed. b) PV cells transduced with pLeGO-G-shNF-E2 or pLeGOG-scrambled. Statistical significance was determined by using unpaired t-test in a), while in b) paired t-test was used. Where * p=0.01 to 0.05, ** p= 0.001 to 0.01, ***p≤0.001. 91 4.6 Cytokine dependent NF-E2 expression The amount of NF-E2 mRNA expressed in CD34+ cells cultured in different cytokine conditions was detected by qRT-PCR. To evaluate the level of expression the ∆∆Ct method was used. Since this method offers only relative comparison between the analyzed samples, the sample with lowest expression of NF-E2 was used as a common calibrator. Within the analyzed samples the lowest expression was detected when NF-E2 was silenced in PV cells cultured in 50 ng/mL TPO and 25 ng/mL SCF. Fig. 4.6.1 depicts the relative expression of NF-E2 influenced by different cytokine stimulation. In healthy controls EPO induced NF-E2 expression while TPO had an antagonistic effect. EPO caused around 10 fold expression, but addition of TPO together with EPO decreased NF-E2 expression to levels not much higher than when only TPO was used. The lowest expression of NF-E2 was detected when cells were cultured in expansion medium (Tpo, Flt3, SCF, IL-6). NF-E2 expression was elevated in PV cells in all culture conditions. Fig.4.6.1 Cytokine dependent NF-E2 expression. CD34+ cells originated from either healthy controls (HC) and PV patients, or PV cells transduced with pLeGO-G-shNF-E2 and control pLeGO-G-scrambled vector were cultured in different cytokine conditions. The basic medium was SFEM containing 50ng/mL TPO (50T), 200ng/mL TPO (200T), 50ng/mL TPO with 1IU/mL EPO (E+T) or 1IU/mL EPO (Epo) all supplemented with 25ng/mL SCF and modified expansion medium (mix). Cells were collected for mRNA extraction on day12 of culture, except when cultured in modified expansion medium where NF-E2 expression was scored on day8 of culture. After cDNA synthesis the amount of NF-E2 transcripts was detected by qRT-PCR. The ΔΔCt method was used for data analysis where the sample with lowest NF-E2 expression in the silencing experiments was set as a common calibrator. The dashed line represents the reference value which equals 1. 92 4.7 Effect of NF-E2 overexpression on apoptosis and proliferation in CD34+ cells Since NF-E2 overexpression affects the expansion of both HSC and progenitor cells, and terminally differentiating cells within the myeloid lineage, an important question to address is whether the expansion observed is because of alterations in the processes of cell apoptosis and proliferation. To study eventual induction of apoptosis the amount of outer membrane phosphatidylserine exposure was detected by staining with AnnexinV. Approximately 24h and 48 h after the first viral transduction with pMYSiG-NF-E2 or pMYSiG-Empty vector the CD34+ cells were collected and stained with Annexin V. There was no difference in the amount of apoptotic cells between NF-E2 and Empty vector transduced cells (Fig. 4.7.1 a and b). When the cells were cultured in modified expansion medium the percentage of apoptotic cells was from 10% to 15% for both time points (Fig. 4.7.1 a). However, when the cells were cultured in erythroid differentiation promoting medium containing EPO (Vaincheker medium), as expected the amount of apoptotic cells was lower (Fig.4.7.1 b). The observed decrease in apoptosis happens due to upregulated BclXL expression as a result of EPO stimulation 65. Fig.4.7.1 NF-E2 overexpression does not affect apoptosis in CD34+ cells. After one day in culture the cells were retrovirally transduced with pMYSiG-NF-E2 or pMYSiG-Empty vector. Two and three days after transduction the cells were collected and the apoptotic status was determined by Annexin-V/Sytox Orange staining. Single positive cells for Annexin-V were taken as apoptotic cells. The cells were cultured in modified expansion medium a) or Vainchenker medium b). Bars represent mean with standard error. The groups were compared to each other by using paired t-test, but statistical significance was not detected. To estimate the status of proliferation in NF-E2 or empty vector transduced cells two separate methods were used. One of the methods is based on the ability of proliferating cells to reduce a substrate contained in the AlamarBlue reagent which changes its fluorescence properties. 24h, 48h and 72h after viral transduction 1000 93 CD34+ cells were seeded out and cultured in modified expansion or Vainchenker medium with 10% AlamarBlue. Fluorescence detected as relative fluorescent units (RFU) was measured daily. An example plot from one time point comparing NF-E2 and empty vector transduced cells proliferation status is shown in Fig. 4.7.2 a. As depicted in the plot (Fig. 4.7.2 a) NF-E2 overexpression did not affect proliferation of CD34+ cells in either modified expansion or Vainchenker medium (Table 4.7.1). A more sensitive method (ClickItEdu) was used to evaluate cell proliferation and cell cycling of NF-E2 and empty vector transduced CD34+ cells. The cells were incubated for 4h with Edu (a thymidine analog), during which time only the cells going through cell division could incorporate Edu into their DNA. Afterward the cells were fixed, permeabilised and fluorescently stained against Edu. Hoechst was used to stain DNA. The detection of the fluorescent signals for Edu and Hoechst was done with the ScanR screening microscope. Only the GFP+ (transduced) cells were analysed for Edu incorporation. There was not a significant difference detected for Edu incorporation between the NF-E2 and Empty control transduced CD34+ cells during day 1 to 3 after the first viral transduction (Fig. 4.7.2 b). Fig.4.7.2 NF-E2 overexpression does not affect proliferation of CD34+ cells. The ability of CD34+ cells to reduce the AlamarBlue reagent or to incorporate Edu was used to test their proliferation status. a) Around 1000 pMYSiG-NF-E2 or pMYSiG-Empty vector transduced CD34+ cells were cultured up to 1 week in modified expansion or Vainchenker medium including 10% AlamarBlue reagent. Fluorescence was measured daily as relative fluorescence units (RFU). b) 20.000 CD34+ cells transduced with pMYSiG-NF-E2 or pMYSiG-Empty vector were incubated on an adherent slide in modified expansion medium containing Edu for 4h. Fluorescently labeled Edu and the GFP signal were detected microscopically. N is the number of independent experiments included for statistical analysis. Statistical significance was evaluated by using the paired t-test. When using the AlamarBlue method proliferation is monitored during a longer time window (around 5 days long until the reaction gets saturated). This enables detection of changes in cell proliferation during the process of differentiation. On the other hand the ClickIt Edu method gives information about the ability of the cells to 94 proliferate within a short time frame (4h in the experiments done), but it is more sensitive that the AlamarBlue method. Table.4.7.1 CD34+ cells proliferation is not affected during differentiation in modified expansion and Vainchenker medium. The time points when the cells were seeded out and put in culture with AlamarBlue are indicated in the top column. NS indicated non significant difference in proliferation for pMYSiG-NF-E2 or pMYSiG-Empty vector transduced cells for each time point. An example plot for measurement performed for one time point is depicted in Fig.4.7.2 4.8 NF-E2 overexpression in-vivo influences cell cycle in murine HSC and progenitor cells, but not apoptosis. To study the effect of NF-E2 overexpression in-vivo, a transgenic mouse overexpressing human NF-E2 in the hematopoietic system was generated in our lab. A vav promoter regulated the transcription of the hNF-E2 transgene, ensuring its expression in HSC and progenitors up to their more differentiated progeny. The transgenic mice displayed a complex phenotype reflecting many features typical for MPNs like: thrombocytosis, leukocytosis, expansion of the HSC and progenitor pool (mainly CMPs and MEPs). To see whether the expansion in the HSC and progenitor compartments is caused by disrupted cell cycle regulation or a defect in apoptosis, bone marrow cells were specifically stained and analyzed by FACS. The KSL (kit+sca-1+Lin-) population containing HSCs and the KL (kit+sca-1-Lin-) population composed of hematopoietic progenitors were analysed for DNA content and Annexin-V exposure. Less of the transgenic (TG) KSL cells were in cycle (Fig. 4.8.1 a), while on the other hand more cells of the KL population were cycling (Fig. 4.8.1 c) when compared to wild type (WT) mice. The amount of apoptotic cells in both KL and KSL was equal for both TG and WT mice (Fig.4.8.1 c and d). 95 Fig.4.8.1 Cell cycle and apoptosis status in HSC (KSL population) from hNF-E2 transgenic and wild type mice. Total BM was stained with surface specific antibodies against lineage markers, sca-1 and c-kit. The KSL (Lin-, sca-1+, c-kit+) and the KL (Lin-, sca-1 -, c-kit+) population were analyzed for DNA content, detected by Hoechst staining a) and c) and for Annexin-V exposure on the outer membrane b) and d). Cell containing more than 2n are defined as cycling cells, while cells positive for Annexin-V and unstained by Sytox (necrotic marker) are defined as apoptotic. Statistical significance was determined with t-test, bars represent mean values with standard deviation. Since some MPN patients respond well to therapy with vorinostat (HDAC inhibitor) and reduce the levels of NF-E2 expression during the therapy, we have treated the TG mice with this drug to see whether it could reverse the MPN phenotype observed. The treatment reduced hNF-E2 expression and platelet numbers in the TG mice 79 . Possibly it also reverses the phenotype observed within the TG KSL and KL population, by normalizing the cell cycling (Fig.4.8.2 a and c), while not affecting apoptosis (Fig.4.8.2 b and d). 96 Fig.4.8.2 Cell cycle and apoptosis status in hematopoietic stem cell and progenitor populations from hNF-E2 transgenic and wild type mice treated with Vorinostat (SAHA). Total BM isolated from Vorinostat (SAHA) treated animals was stained with surface specific antibodies against lineage markers, sca-1 and c-kit. The KSL (Lin-, sca-1+, c-kit+) and the KL (Lin-, sca-1 -, c-kit+) population were analyzed for DNA content, detected by Hoechst staining a) and c) and for Annexin-V exposure on the outer membrane b) and d). Cell containing more than 2n are defined as cycling cells, while cells positive for Annexin-V and unstained by Sytox (necrotic marker) are defined as apoptotic. Statistical significance was determined with t-test, bars represent mean values with standard deviation. 97 5. Discussion 5.1 NF-E2 expression is 2 fold higher in CD34+ cells derived from PV patient’s peripheral blood. The overexpression of NF-E2 in PV patients was first detected and quantified in granulocytes, where the overexpression was 2 to 40 fold higher than in healthy controls 72 cell types . The overexpression was also confirmed in other terminally differentiated 77, 78 . However fluctuations in TF expression during hematopoiesis are important for lineage commitment and/or maintenance in primed (still not fully committed) stages of differentiation. This is why the concentrations of hematopoietic TFs are different in early and late stages of hematopoiesis. Already few decades ago the expression of NF-E2 has been detected in terminally differentiated cells of the myeloid lineage (erythroid, megakaryocytic, granulocytic) 78 . With the development of more sensitive and sophisticated techniques during the years, the expression of NFE2 in less differentiated progenitors became feasible. There are few publications describing the expression of NF-E2 during earlier stages of hematopoiesis. A study done by Edvardsson et al. 80 reports the expression of NF-E2 in CMPs, its sequential 0,5 fold down-regulation in GMPs and around 2 fold up-regulation in MEPs. CD34+ cells derived from healthy donors bone marrow were used for these experiments. In another study the same group investigated the expression of NF-E2 during erythroid and neuthrophil differentiation of bone marrow healthy donor derived CD34+ cells cultured in-vitro 81 . During neutrophil maturation the expression of NF-E2 was down- regulated, while during erythroid culture NF-E2 was up-regulated gradually as the cells were becoming more erythroid. It was of great importance to confirm that the overexpression of NF-E2 is present during early stages of differentiation in PV patients derived cells. For this reason CD34+ cells isolated from peripheral blood were cultured in-vitro and the amount of NF-E2 expression was detected by qRT-PCR from day 4 to day 8 of culture. During this time frame the overexpression of NF-E2 in PV CD34+ cells remained constantly elevated by 1.5 to 2 fold (Fig. 4.1.1 b). Also there weren’t any changes in the amount of NF-E2 expression between the different days. The CD34+ population is a heterogeneous population containing HSCs and HPCs. During the invitro culture in expansion medium the cells maintain the immature HSC and HPC 98 phenotype until day 5 (Fig. 4.2.3; 4.2.4; 4.2.5), after which the cells get differentiated and gradually lose CD34 expression (Fig. 4.1.1 a). In conclusion peripheral blood derived CD34+ cells from PV patients ovrexpress NF-E2 by around 2 fold during early stages of differentiation (HSCs and HPCs). The same level of overexpression (2 fold more than healthy controls) is maintained also in the more differentiated progeny generated in-vitro regardless of the cytokines included in the culture medium (Fig.4.6.1). 5.2 NF-E2 overexpression in HC CD34+ cells promotes HSC, MPP, CMP and GMP expansion. Once the overexpression of NF-E2 in CD34+ cells from PV patients was confirmed the next question addressed in this thesis was to determine what influence a 2 fold NF-E2 overexpression has on early hematopoiesis. When PB CD34+ cells isolated from healthy donors were transduced with lentivirus encoding NF-E2 and 2 fold level of overexpression was achieved, the amount of HSC, CMP, GMP and MEP were quantified. The amount of HSCs, MPPs, CMPs and GMPs was significantly elevated while MEPs number decreased (Fig. 4.2.5). Exactly these compartments are being affected in PV and moreover reported to be elevated in peripheral blood of PV patients 168 . This observation in human CD34+ cells overexpressing NF-E2 fits with our hNF-E2 transgenic mouse model where we have also observed an increase in the frequency of HSC and CMP populations 79 . The difference between the mouse model and the human CD34+ in-vitro system is that the GMP frequency is not affected in the mouse, while being expanded in the human system. Although bone marrow cells from the transgenic mice were able to form more CFU-GMs and had elevated neutrophil counts in peripheral blood. Also MEP frequency is increased in the NF-E2 transgenic mice (accompanied with an elevation in CFU-E and BFU-E formation), but is decreased in the human system. The discrepancies between the two experimental systems may be due to differences between mouse and human physiology, which is also reflected in the surface marker expression used for defining the progenitor populations (Fig.2.5). The human CD34+ in-vitro system was designed to study early EPO independent stages of hematopoiesis in a controlled cytokine environment , while the mouse model studies the broad physiological effects of NFE2 overexpression. The different level of NF-E2 overexpression achieved in the human CD34+ cells (2 fold) and the two hNF-E2 transgenic mouse strains studied (3 99 fold and 30 fold) could also play a role in the expansion of MEPs and GMPs. Despite the slight discrepancies between the two experimental systems we can conclude that NF-E2 plays an important role in the physiology of HSC and progenitor compartments and its overexpression is connected to MPN’s pathology. Another question that arises here is whether JAK2V617F mutation is the dominant mutation responsible for PV pathology or there is a preceding event affecting hematopoiesis in MPN . Indeed JAK2V617F has an effect on PV development, but most likely other molecular defects acting earlier in hematopoiesis have to be acquired prior JAK2V617F in order to develop PV. A recent study demonstrates that JAK2V617F influences later stages of hematopoiesis and does not affect the expansion of HSC and HPC compartments in MPN patients 169. Moreover expansion of the early hematopoietic compartments is observed even in the absence of JAK2V617F. Aberrations in the function of other molecules linked to MPN and leukemia also lead to an increase in HSC numbers. For example, TET2 loss of function mutations led to an increase of the LSK population in a murine model, prior development of myeloid leukemia phenotype in the mice 184 . All together these findings strongly suggest that aberrations in NF-E2 expression during early stages of hematopoieis are a crucial event in the development of MPNs. What are the exact molecular mechanisms triggered by NF-E2 overexpression leading to expansion of the HSC and early progenitor compartments remain to be further elucidated. Following the pattern of NF-E2 expression during normal human hematopoiesis elevation in NF-E2 expression in CMPs should lead to the generation of MEPs, while the decrease of expression in CMPs should result in GMPs generation 80 . Logically it would be expected that NF-E2 overexpression starting from HSC would eventually promote MEP generation while reducing GMP generation. Elevated MEP numbers could offer an explanation for the erythrocytosis typical for PV patients, although the frequency of the MEP population is not elevated in PV patients 168 . However, unexpectedly the amount of MEPs was lower while the number of GMPs was higher in CD34+ cells overexpressing NF-E2 in the culture conditions used (expansion medium) for the experiments performed in this thesis (Fig. 4.2.5). A possible explanation for this observation would be the concentration of NF-E2 within the differentiating CD34+ cells. As discussed before, transcription factor concentration regulated by cytokine signaling is crucial for lineage commitment and fate decision. The cytokine mix used in these experiments (Flt3, TPO, IL-6, SCF –expansion 100 medium) keeps the expression of NF-E2 on a lower level (Fig. 4.6.1). Lower levels of NF-E2 might be enough to prime the CMP towards both MEP and GMP differentiation, but higher expression of NF-E2 within the MEP might be necessary to sustain their survival, proliferation and further maturation. NF-E2 expression and functional activity during different maturation stages in hematopoiesis is regulated by cytokine stimulation and depends on the differential expression of cytokine receptors on cells differentiating along a certain lineage. EPO is a cytokine that regulates NFE2 expression and activity and has a indispensable role in erythroid differentiation. Although EPO is not the only factor regulating NF-E2 expression and its expression occurs even in the absence of EPO, there are few studies providing evidence on how EPO affects NF-E2. In erythroid cell lines the stability of NF-E2 mRNA was higher than in myeloid cell lines and the stimulation of the erythroid cell line with EPO induced the expression of NF-E2 185 . Also in CD34+ cells differentiating in-vitro the expression of NF-E2 protein increased 3 days after EPO stimulation, but the occupancy of HS sites within the α-globin locus by NF-E2 was present before EPO stimulation 186 . The recruitment of Pol II on the same HS sites in the α-globin locus increased upon EPO stimulation 186 . Moreover the expression of the EPO receptor was detected to be moderate in CMPs, high in MEPs and low in GMPs 80, 187 , which fits with the expression level of NF-E2 in these progenitors 80 (Fig.5.4.1). These findings would argue that NF-E2 is able to prime immature hematopoietic cell types, but the later lineage outcome (expression of lineage specific genes) is highly dependent on cytokine signaling. However in the absence of EPO a slight (1.5 to 2 fold) increase in the amount of NF-E2 in HSCs and HPCs delays hematopoietic maturation and promotes GMP expansion (chapter 4.2). Regarding PV hematopoieis a possible model uniting both NF-E2 overexpression and JAK2 mutations leading to abnormal amplification and/or independence of cytokine signals would be the following: - NF-E2 ovrexpression increases the pool of HSCs, MPPs , CMPs in the patients - The CMPs (possibly the MEPs and the GMPs) are primed by NF-E2 and other cooperating factors making the transcription regulatory elements from a variety of lineage specific genes accessible and prone to activation after the cell receives the proper cytokine signal. 101 - After cytokine stimulation the lineage specific genes “primed” by NF-E2 get transcribed and lineage commitment occurs. - Most of the cytokines identified to guide myeloid, erythroid and megakaryocytic lineage commitment and differentiation activate JAK2 signaling cascades. - Inappropriate signaling through mutant JAK2 (cytokine independent or unphysiologically amplified) in CMPs, MEPs, GMPs and lineage committed cell boosts the generation of terminally differentiated cells (erythrocytes, platelets and granulocytes). - NF-E2 overexpression combined with JAK2 mutations leads to trilineage hyperplasia in PV patients 5.3 NF-E2 overexpression in HC CD34+ cells promotes Epo-independent erythroid maturation. The ability of PV cells to mature as erythroid in the absence of EPO is a well described feature and it is used as a diagnostic tool 188 . PV patient’s derived cells from bone marrow or peripheral blood can form EPO independent colonies (endogenous erythroid colonies - EECs) when cultured in semisolid medium 189-192. In these early studies either total bone marrow or the mononuclear cell fraction from peripheral blood was used. Ugo et al. have confirmed that CD34+ cells from PV patients become more erythroid than healthy controls when cultured in liquid serum free medium without EPO (the medium contained IL-3 and SCF) 193. We were able to enhance the observation done by Ugo et al. in a culture medium containing Flt3, TPO, IL-6, SCF (modified expansion medium). In these conditions EPO independent erythroid differentiation was present in both healthy donor and PV patient CD34+ cells differentiating in-vitro, but the amount of erythroid cells was 2 fold higher in PV cells (Fig.4.1.2). Up to my knowledge there is only one publication describing the formation of EECs induced by NF-E2 overexpression. In this study NF-E2 overexpression in primary hematopoietic progenitors from mouse liver induced EEC formation 185 . NF- E2 overexpression in human CD34+ cells was tested in our lab and in our experimental system NF-E2 overexpression in healthy human CD34+ cells enhanced EPO-independent eyrthroid differentiation by 2 fold. Thus recapitulating the PV 102 phenotype we have observed when culturing the cells in modified expansion medium. 5.4 Epo-independent erythroid maturation most likely occurs through another progenitor cell type independently of MEP Since NF-E2 overexpression in healthy donor CD34+ cells promotes HSC, MPP, CMP and GMP expansion at the expense of MEPs, the next question to ask was how this shift influences terminal differentiation. The amount of myeloid and granulocytic cells were slightly elevated when NF-E2 was overexpressed (Fig. 4.4.2), which corresponds to the slight increase in the frequency of GMPs. On the other hand the amount of megakaryocytic cells was less, while the amount of erythroid cells was more (Fig. 4.4.1). The fact that there are less MEPs and less megakaryocytic cells when NF-E2 is overexpressed in CD34+ cells cultured in expansion medium, while there are more erythroid and myeloid cells made us consider an alternative hierarchy of hematopoiesis (Fig. 5.4.1). The most accepted “classical” model of hematopoiesis follows a linear scheme while the new myeloid model follows a less hierarchical scheme (see introduction chapter 2.4). Our experimental data is not sufficient to prove either of these models but it supports the notion that erythroid cells can be generated through an alternative way than through the MEP. MEPs upregulate the expression of the EPO receptor and their further development is highly dependent on the EPO signaling cascade. Since in our experimental system EPO was not included, the generation of erythroid cells should go through progenitors which do not depend on EPO signaling. These progenitors may be a subset of cells within the CMP population that have a mixed myeloid-erythroid potential and could be defined as common myeloid-eyrthroid progenitors (CMEP). A cell type in human hematopoiesis having both eyrthroid and myeloid potential has been described only in one study up to date 176. These cells are double positive for CD36 and CD13. NF-E2 overexpression in healthy control CD34+ cells led to doubling the amount of CD36+CD13+ cells (Fig. 4.3.1 b). In the cohort of PV patients investigated in this thesis 2 out of 5 patients showed a doubling increase of the CD36+CD13+ (Fig. 4.3.1 d). Although more experimental evidence is necessary to characterize the CD36+CD13+ population as a separate entity 103 functioning as an intermediate of both erythroid and myeloid differentiation, it is likely that the enhanced EPO-independent differentiation (formation of EECs) in PV is due to increased numbers of progenitor cells that can become erythroid without EPO. Fig. 5.4.1 Alternative model of hematopoiesis and the influence of NF-E2 overexpression during hematopoietic development. Black arrows show already established and experimentally proven transitions from more immature to committed cell types. Dashed arrow lines show a possible transitions or increase in frequency of a certain cell population that need stronger experimental evidence. Red arrow lines indicate how NF-E2 overexpression influences the frequency of a certain cell type - upward arrows indicate an increase and downward arrows a decrease. Side boxes contain information about the relative mRNA expression of TPOR, EPOR and NF-E2 during the different stages of hematopoiesis along the myeloid lineage. HSC-hematopoietic stem cell, MPP – multipotent progenitor, CMP – common myeloid progenitor, CMEP – common myeloid-erythroid progenitor, MEP – megakaryocite-erythroid progenitor, GMP – granulocyte-monocyte progenitor, TPOR – thrombopoietin receptor (c-mpl), EPOR – erythropoietin receptor, NF-E2 – nuclear factor-erythroid 2. Fig. 5.4.1 describes how NF-E2 influences hematopoiesis in our liquid culture system and offers an alternative to the classical model of hematopoiesis. The differential expression of the TPOR 80, 187 , EPOR 187 and NF-E2 79-81 (additionally see Fig.4.6.1 for NF-E2 expression in erythroid and megakaryocytic cells) during human hematopoiesis is also described. Another novelty in this scheme is the expression of NF-E2 that starts from the HSC, which was not acknowledged before. 104 5.5 NF-E2 overexpression does not affect apoptosis and proliferation in HC CD34+ cells, but most likely it influences proliferation and cell cycle in murine HSC and HPC populations. A possible explanation for the expansion of the HSC, MPP, CMP and GMP populations in CD34+ cells transduced with NF-E2 would be enhanced proliferation and survival or impaired apoptosis caused by NF-E2 expression. However, this was not the case. NF-E2 overexpression did not influence the rate of DNA synthesis in CD34+ cells nor did it affect their survival (Fig. 4.7.2). This was proven by two different methods that asses metabolic activity and rate of DNA synthesis. Also apoptosis was not influenced by NF-E2 overexpression in both modified expansion medium and erythroid differentiation (Vainchenker) medium (Fig. 4.7.1). As expected EPO (Vainchenker medium) lowered the amount of apoptotic cells in both control and NF-E2 overexpressing cells. Moreover, the cell counts were equal in Empty vector and NF-E2 transduced healthy donor CD34+ cells. Because of technical limitations it was not possible to detect the effect of NF-E2 overexpression within separate cell populations (HSC, MPP, CMP, GMP, MEP and lineage committed cells). In the hNF-E2 transgenic mice (TG) the findings were different. Here we have studied the amount of cells in cycle (in S and G2M phase of the cell cycle) in the KSL and KL population. The KSL population is enriched in HSC and MPPs, while the KL population contains oligopotent progenitors (CMPs, MEPs, GMPs). The KSL population which was significantly elevated in the TG mice had less cycling cells and more cells that had the ability to efflux Hoechst (Fig.4.8.1 a). Cells able to efflux Hoechst through the ABCG2 transporters (mdr type of cell surface transporters) have been defined as the side population (SP) 194 . The SP cells express surface markers typical for HSC and are able to reconstitute the hematopoietic system in lethally irradiated mice 172 . The detection of the SP is done by plotting blue against red fluorescence of Hoechst. In our experimental setup we could only detect blue fluorescence of Hoechst, where a sub G1 peak was always present only in the KSL population (Fig. 3.8.2.1). Treatment with Verapamil (a drug blocking Ca++ channels and ABCG2 transporters, thus blocking Hoechst efflux) 173 diminished the sub G1 peak meaning that the cells in the sub G1 peak are mostly cells that could be defined as the SP. Still the detection of the red fluorescent signal of Hoechst is necessary to increase the sensitivity of the method. An increase in the amount of SP cells and a 105 decrease in cycling cells within the KSL population would mean that the hNF-E2 overexpression in mice increases the amount of quiescent HSCs. However, a more sensitive method should be used to confirm this observation. An alternative would be to use RNA and DNA staining in combination. Quiescent cells (G0 of the cell cycle) have low amounts of both RNA and DNA 195. On the other hand hNF-E2 overexpression in the TG mice leads to an increase in the amount of cycling cells within the KL population (Fig. 4.8.1 c). This can explain the increased number of cells with KL phenotype and would mean that NF-E2 overexpression increases the proliferation rate in oligopotent progenitors. Indeed NF-E2 overexpression has an effect on cell cycle regulation of the KSL and KL populations in mice, but to explain the opposite effect in both populations a more detailed study should be done. It would be interesting to search for genes involved in cell cycle regulation transcriptionally regulated by NF-E2 and compare their differential expression in KSL and KL populations. As in the human system, apoptosis was not affected by hNF-E2 overexpression in both KSL and KL population in the TG mice (Fig. 4.8.1 b and d). SAHA (Vorinostat) is a chemical compound that acts like a broad HDAC (histone deacethylases) inhibitor. It has gone through several Phase I and II clinical trials for treatment of advanced solid tumors and hematological malignancies 196-198 . 17% of the patient suffering from advanced leukemias or myelodisplastic syndromes showed complete recovery or hematologic improvement 199 . Givinostat is another type of broad HDAC inhibitor that has been used in a Phase II trial for treatment of MPN patients 200 . The expression of NF-E2 in Givinostat treated patients decreased 84 days after the start of the treatment 79 . Vorinostat had the same effect on NF-E2 expression in our TG mice. Treatment with HDAC inhibitors completely alters the cell biology of both normal and malignant cells. It affects crucial processes like apoptosis 201 , autophagy 201 , cell cycle 202, 203 and metabolic enzymatic activity 204 . It was previously reported that SAHA treatment of various cell lines induces apoptosis 205, 206 and regulates cell cycle progression 201, 202, 203 . However, SAHA treatment did not influence apoptosis in KL and KSL populations. The amount of apoptotic cells stayed at the same level before and after SAHA treatment in both TG and WT mice (Fig. 4.8.2 b and d). This observation gives supporting evidence that NF-E2 does not influence apoptosis during early hematopoiesis (both mouse and human) even when its concentration reaches unphysiological values. Most likely SAHA treatment 106 induces cell cycle in the KSL population of the TG mice while not affecting the WT, thus reversing the phenotype caused by hNF-E2 overexpression (compare Fig.4.8.1a to Fig 4.8.2 a). The effect on the KL population was again an increase of the number of cells entering the cell cycle, but the effect was equally present in both TG and WT animals. More experimental data is necessary to confirm these observations (Fig. 4.8.2 a and c). SAHA treatment was previously connected to blockage in the G1 phase of the cell cycle by inducing p21 (cell cycle kinase inhibitor) in a study done with a human bladder carcinoma cell line, but this effect was present only when low dose of SAHA was used. Increasing SAHA concentrations resulted in an increase of the number of cells in G2 phase 203 . Although the influence of SAHA on cell cycle is dose and cell type specific it is possible that the induction of cell cycle in TG mouse KSLs and WT and TG mice KL upon SAHA treatment is caused by the decrease of NF-E2 amount which may influence the expression of p21. 5.6 Megakaryocytic differentiation is delayed in CD34+ cells overexpressing NF-E2, as in PV CD34+ cells cultured in-vitro. In this work the effect of NF-E2 overexpression in CD34+ cells on megakaryocytic differentiation was tested in few cytokine conditions. In expansion medium the number of cells expressing megakaryocytic markers was less when NF-E2 was overexpressed. When using modified expansion medium containing 10 times more TPO and 5 times less SCF the results were opposite: there were more megakaryocytic cells than the Empty control (Fig.4.5.3 a). Since TPO is the major cytokine influencing megakaryopoiesis and changes in its concentration on the background of other cytokines (Flt3, IL-6 and SCF) possibly promoted megakaryocytic differentiation of NF-E2 overexpressing CD34+ we have decided to test different concentrations of TPO. Moreover defects in TPO signaling have been previously reported in PV patients 40, 41, 207 . When using culture media containing only TPO and SCF the CD34+ cells become preferentially megakaryocytic, unlike in expansion and modified expansion media that support differentiation to all cell types of the myeloid lineage. Like this terminal megakaryocytic differentiation can be studied in detail, while eliminating changes in the amount of megakaryocytic cells due to shifted lineage commitment. For the purpose media containing 50 and 200 ng/ml TPO and 25ng/ml SCF were used. A 107 combination of TPO and EPO was also tested where the cells differentiated either as megarakaryocytic or erythroid. In all conditions NF-E2 overexpressing cells demonstrated a delay in megakaryocytic differentiation (Fig.4.5.5 a) that recapitulated the phenotype of CD34+ cells from PV patients (Fig.4.5.5 b). Silencing of NF-E2 in PV cells did not have an effect on the amount of megakaryocytic cells generated, except when 50ng/ml TPO was used where the strongest silencing was achieved (Fig.4.5.5 c). However there was an effect on megakaryocytic ploidy in PV cells when NF-E2 was silenced (Fig.4.5.6 b). PV cells had more megakaryocytes with 8N and more than 8N ploidy than the healthy controls (Fig.4.5.6 a) and silencing of NF-E2 in PV partially reversed the phenotype (Fig.4.5.6 b). The data confirms that NF-E2 has an important role on different aspects of megakaryocytic physiology and moreover its overexpression affects megakaryocytic maturation in the same manner as in PV patients. Indeed megakyrocyte function is impaired in PV patients. Bone marrow histology shows abnormally clustered and large megakaryocytes in PV that have increased ploidy proplatelet formation are also affected in PV patients 208 .The ultrastructure and 209, 210 . In-vitro cultured megakaryocytes from both ET and PV patients formed more proplatelets that generated more tips and shaft bifurcations compared to PMF an healthy control megakaryocytes 210. 5.7 EPO enhances NF-E2 expression, while TPO has an antagonistic effect. To date not much is known about which cytokines regulate the expression of NFE2. While there are few publications reporting upregulation of NF-E2 after EPO stimulation in cell lines (J2E, UT-7/GMT) and CD34+ cells 185, 186, 211 , not much is known about how other cytokines influence NF-E2 expression. A publication from 1998 describes the expression levels of NF-E2 after TPO stimulation of the UT7/GMT cell line 211 . In this cell line signaling through the TPO receptor lead to an increase in NF-E2 expression during the initial days of culture which was followed by a slight decrease during later days of cell culture. Since both TPO and EPO were previously reported to regulate NF-E2 expression and moreover signaling through the EPO and TPO cascades is impaired in MPN patients we have investigated the effect of these cytokines on NF-E2 expression in differentiating CD34+ cells from healthy donors and PV patients. Stimulation with 2 108 different concentrations of TPO (50 ng/ml and 200ng/ml) increased NF-E2 expression 1 to 2 fold over the control. Increase of TPO concentration did not influence NF-E2 expression. Stimulation with EPO as previously reported 185, 186 , increased the amount of NF-E2 expression by 15 fold over the control in healthy control in-vitro differentiated CD34+ cells (Fig.4.6.1). Interestingly, when the cells were stimulated with both EPO and TPO the expression of NF-E2 went down to 2-3 fold over the control (Fig.4.6.1), which would mean that TPO can override EPO signaling and downregulate NF-E2 expression in healthy CD34+ cells differentiated in-vitro. The disadvantage of the experimental approach used for these experiments is that NF-E2 expression was scored only on day 12 of culture and not during earlier time points of differentiation. On day 12 of culture the CD34+ cells have already became terminally differentiated as erythroid when cultured with EPO or megakaryocytic when cultured with TPO. Combination of EPO and TPO gave rise to both erythoid and megakaryocytic cells. This would mean that the qRT-PCR data represents the level of NF-E2 expression in erythroid and respectively megakaryocytic cells. More frequent measurements of NF-E2 transcription in defined populations would be necessary to determine the rate and differentiation stage on which EPO and TPO signaling start differentially regulating NF-E2 expression. The expression and the intensity of signaling of the EPO and TPO receptor is variable during distinct stages of hematopoieis. There are few publications describing the expression pattern of EPO and TPO receptors during hematopoiesis 80, 81, 187, 212 . The expression of the EPO receptor starts from the CMP, is upregulated in MEPs and terminally differentiating erythroid cells, while it gets downregulated in megakaryocytic cells. On the other hand TPOR expression has been detected in HSCs, CMPs, MEPs and committed erythroid and megakaryocytic cells. Its expression gets elevated in MEPs, stays high in megakaryocytic cells while it gets lower in erythroid cells (Fig.5.4.1). Putting together the pattern of EPO and TPO receptor expression and NF-E2 expression in CD34+ cells terminally differentiated in the presence of TPO, EPO or both TPO and EPO in combination leads to the following conclusions: - Signaling through the EPO receptor increases NF-E2 expression and promotes erythroid differentiation of otherwise undifferentiated CD34+ cells 109 - Signaling through the TPO receptor maintains NF-E2 expression on basal levels and most likely can modulate NF-E2 expression stimulated by EPO signaling. TPO signaling promotes terminal megakaryocytic differentiation of CD34+ cells cultured in-vitro - EPO receptor expression is higher in erythroid than in megakaryocytic cells, while the opposite is true for the TPO receptor. From these conclusions one can deduce that: - One possible mechanism by which EPO and TPO signaling guide erythroid respectively megakaryocytic lineage commitment is by regulating the concentration of NF-E2 (Fig.5.4.1). 5.8 The endogenous overexpression of NF-E2 in PV CD34+ cells is not dependent on EPO and TPO signaling cascades. As discussed in the previous section signaling through EPO and TPO receptors influences NF-E2 expression. Since NF-E2 expression is elevated in PV patients we hypothesized that elevation of NF-E2 expression observed in PV patients may be due to defective EPO and/or TPO signaling. PV patients show several abnormalities regarding EPO and TPO signaling. The main lesion affecting both EPO and TPO signaling cascades is the presence of JAK2V617F mutated protein that renders the receptors constitutively active by phosphorylating the receptors even in the absence of ligands. EPO signaling defects in PV patients are demonstrated by the generation of EPO independent erythroid colonies 8, 10 and lower serum levels of EPO. However, the expression, kinetics and turnover of the EPO receptor in PV have not been studied in detail. TPO receptor expression on PV platelets and megakaryocytes was reported to be low or completely absent 40 . A micro RNA (miR-28) inhibiting TPOR translation was also detected to be more in platelets from a subset of PV patients 213 . In peripheral blood mononuclear cells TPOR (c-mpl) transcripts were present in all patients with CML and only in 2 out of 5 PV patients 207 . On the other hand the amount of CD34+ cells coexpressing the TPOR in bone marrow samples from healthy controls and PV patients was equal - around 1% 207. Since TPO signaling in HSC is essential for their development, self-renewal, proliferation and maintenance complete lack of its expression wouldn’t be possible in HSCs of PV patients. Moreover, deficiency in 110 TPOR expression leads to congenital amegakaryocytic thrombocytopenia, a rare and lethal hematological disorder which is demonstrated during early childhood 39, 214 which would mean that TPOR expression in PV is diminished during later stages of megakaryocytic differentiation. In our experimental model TPO stimulation of CD34+ cells from PV patients resulted in generation of megakaryocytic cells overexpressing NF-E2 by 2 fold over healthy controls. Changes in TPO concentration did not influence the expression of NF-E2 in PV cells (Fig.4.6.1). Again NF-E2 overexpression was 2 fold higher in PV cells cultured in the presence of EPO or EPO and TPO in combination. The same difference was observed when a cytokine mix was (Flt3, TPO, IL-6, SCF) used (Fig.4.6.1). This means that abnormal NF-E2 expression in PV cells is not influenced by the cytokines investigated and cannot be modulated by controlling cytokine concentrations or the intensity of the conveyed signal through the mentioned signaling cascades. 111 6. Appendix 6.1 Abbreviations aa Ab AML APS BCL-X BCR-ABL BFU BM C/EBP CBFA2 CFU CLP CMEP CML CMP CREB Ct CTD DC ddH2O DMEM DMSO DNA dNTPs DTT ECL Edu EEC EKLF EPOR ET EZH2 FACS FCS FLI-1 FOG-1 GATA-1 G-CSF GFI1 GFP GM-CSF GMP amino acid antibody Acute myeloid leukemia Ammonium persulfat Bcl-2–associated X protein Breakpoint Cluster Region - Abelson Murine Leukemia fusion protein Burst forming unit bone marrow CCAAT/Enhancer-Binding protein Core-Binding Factor, RUNT domain Alpha subunit 2 Colony forming unit common lymphoid progenitor common myeloid-eyrthroid progenitors Chronic Myelogenous Leukemia common myeloid progenitor cAMP-response elements binding protein threshold cycle COOH-terminal domain dendritic cell double destiled H2O Dulbecco's Modified Eagle Medium Dimethylsulfoxid Deoxyribonucleic acid Desoxyribonukleosidtriphosphate Dithiothreitol Enhanced chemiluminescence 5-ethynyl-2´-deoxyuridine Endogenous erythroid colonies Erythroid Kruppel-Like Factor Erythropoietin receptor Essential throbocythemia Enhancer of zeste homolog 2 Fluorescent Activated Cell Sorting foetal calf serum Friend Leukemia Virus Integration 1 Friend of GATA 1 GATA-binding protein 1 granulocyte colony stimulating factor Growth Factor independent 1 Green fluorescent protein granulocyte-macrophage stimulating factor granulocyte-monocyte progenitor 112 h HBSS HC HDAC HEPES HPC HRP HS HSA HSC IAA IFN IL IMDM IRES ITCH JAK2 JNK LDL LNK M-CSF mdr MEP MFI MGG min. MNC MPN MPP NaCl NAPP NEDD4 NK NLS NS PB PBS PCR PF4 PLT PMF POD Pol II PRV-1 PTEN PV PVDF hour Hank's Buffered Salt Solution Healthy control Histone deacetylase 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid hematopoietic progenitor cell Horse raddish peroxidase hypersensitive site human serum albumin hematopoietic stem cell Iodoacetamide Interferon interleukine Iscove's Modified Dulbecco's Medium internal ribosome entry site E3 ubiquitin-protein ligase Itchy homolog Janus kinase 2 c-Jun N-terminal kinase low density lipoprotein lymphocyte adaptor protein macrophage stimulating factor multi drug resistance megakaryocyte-erytroid progenitor Mean fluorescent intensity May-Grünwald Geimsa minute Mononuclear cells Myeloproliferative Neoplasms multipotent progenitor natrium chloride NF-E2 associated polypeptide NPC-expressed, developmentally down-regulated 4 natural killer cell nucleus locating sequence statistically non-significant Peripheral blood Phosphate buffered saline Polymerase Chain Reaction Platelet Factor 4 platelets Primary myelofibrosis Promyelocytic oncogenic domain RNA Polymerase II Polycythemia rubra vera protein -1 Phosphatase and tensin homolog Polycythemia vera polyvinylidene difluoride 113 qRT-PCR rhEPO rhFlt3-Ligand rhIL-6 rhSCF rhTPO RNA ROS rpm RT s SAHA SCL scr SDF-1 SDS SFFV shNF-E2 SOCS SP quantitative reverse transcribtion polymerase chain reaction recombinant human erythropoietin recombinant human FMS related tyrosine kinase 3 ligand recombinant human interleukin 6 recombinant human stem cell factor recombinant human thrombopoietin Ribonucleic acid reactive oxygen species revolutions per minute room temperature second suberoylanilide hydroxamic acid Stem Cell Leukemia Hematopoietic Transcription Factor scrambled shNF-E2 sequence Stromal cell-Derived Factor 1 Sodium dodecyl sulfate spleen focus-forming virus short hairpin sequence against NF-E2 Suppressor of cytokine signaling side population TAF II 130 TBS TEL TET2 TF TG TPOR USF v/v w/v WHO WT YAP TATA box-binding protein associated factor II 130 Tris buffered saline Translocation ETS Leukemia ten eleven translocation transcription factor Transgenic mice Thrombopoietin receptor Upstream Stimulatory Factor volume per volume weight per volume World Health Organisation Wild type mice Yes associated protein 114 6.2 References [1] Fauser AA, Messner HA. 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