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Cellule staminali e cellule staminali tumorali Quali cellule sono responsabili per la crescita del tumore? Cellule staminali • Sono cellule che hanno la capacitá di perpetuarsi indefinitamente (“self-renewal”) • Attraverso il differenziamento, esse danno vita alle cellule “mature” • Le cellule differenziate originano dalle cellule staminali del medesimo compartimento • Plasticitá delle cellule staminali: apparentemente, le cellule staminali di un tessuto possono dare origine anche a cellule mature di altri tessuti Cellule staminali e cellule tumorali •Il tumore è costituito da cellule con una capacità di self-renewal indefinita •La comprensione dei meccanismi di self-renewal delle cellule staminali puó aiutarci a comprendere il tumore Pathway coinvolti nel selfrenewal e nell’oncogenesi • Ipotesi: le cellule tumorali -capaci di selfrenewal- utilizzano la “machinery” presente nelle cellule staminali • Dimostrazione indiretta di tale ipotesi é il fatto che diversi pathway associati all’oncogenesi sono stati coinvolti nel selfrenewal delle cellule staminali I pathway di Notch, Shh, Wnt • Notch: l’attivazione di questo pathway é associata ad un aumento del pool delle cellule staminali • Shh: popolazioni arricchite di cellule staminali umane rispondono in vitro a Shh con un aumentato self-renewal • Wnt: la sua attivazione espande il pool di cellule staminali, mentre la sua soppressione inibisce la proliferazione delle cellule staminali Rules of Normal Tissue Growth 1 2 3 Stem cells self renew--?immortal non-stem cells have finite life span Traditional View of Tumor Growth 1 2 3 Rules: 1.) Tumors are clonal – starts in a single cell 2.) All tumor cells have infinite lifespan 3.) All tumor cells divide symmetrically 30 cell divisions = 1 billion cells = 1 cm tumor Non-stem tumor model: every cell in a tumor should initiate a new tumor Experiments showed that very rare cells in a tumor can transplant a new tumor: Tumor Stem Cells Origin of the Theory of Cancer Stem Cells Only a small subset of cancer cells is capable of extensive proliferation Liquid Tumors In vitro colony forming assays: - 1 in 10,000 to 1 in 100 mouse myeloma cells obtained from ascites could form colonies In vivo transplantation assays: - Only 1-4% of transplanted leukaemic cells could form spleen colonies Solid Tumors - A large number of cells are required to grow tumors in xenograft models - 1 in 1,000 to 1 in 5,000 lung cancer, neuroblastoma cells, ovarian cancer cells, or breast cancer cell from cell lines can form colonies in soft agar or in vivo (fewer with 10 tumor cells) Tumor growth is similar to normal tissue growth Normal Tissues Adult stem cell = undifferentiated Transit amplifying cell Normal differentiated cell Tumor Tumor stem cell = tumorigenic Non-tumorigenic cell Cellule staminali tumorali: organogenesi aberrante • Il tumore puó essere immaginato come un organo aberrante originato da una cellula trasformata che ha acquisito la capacitá di proliferare indefinitamente attraverso varie mutazioni • La popolazione tumorale é eterogenea, e spesso contiene cellule a diversi stadi di differenziamento (seppure anomali): data la clonalitá dei tumori, questo dato implica che la progenie delle cellule tumorali si diversifica (“differenzia”) Evidenze per la presenza di cellule staminali tumorali Hematopoietic Stem Cells Stem Cells Multipotent Progenitors Oligolineage Progenitors CD34CD38+ Mature Cells CD20+ CD8+ CD8+ CD34+ CD38- CD34CD38- CD4+ CD4+ CD36+ CD35+ Reya et al. 2001 Nature 414:105-111 Cellule staminali ematopoietiche • Le cellule caratterizzate con maggiore precisione, grazie ad esperimenti di ripopolamento di topi letalmente irradiati e ricostituiti con popolazioni cellulari altamente purificate a partire dal midollo osseo • Le cellule staminali (0.05% delle cellule totali del midollo) danno origine ai progenitori ematopoietici che perdono il loro potenziale di self-renewal Self-renewal Assay in NOD/SCID Mice FACS Cell Sorter Cancer Cells ex: Leukaemia cells Sublethally irradiated NOD/SCID Mice CD34 Expression (Non-obese diabetic/severe combined immunodeficiency) CD38 Expression Leukaemia stem cells exist in human acute myeloid leukaemia (AML) CD34+/ CD38- Leukaemic blasts from AML patients CD34+/ CD38+ N O D / S C I D m i c e LEUKAEMIA NO LEUKAEMIA John Dick and Dominique Bonnet Leukaemia is arranged as a hierarchy similar to normal haematopoiesis LEUKAEMIA NORMAL CD34+/ CD38- HSC Leukaemogenic events lymphoid progenitor myeloid progenitor Bulk leukaemia cells (CD34+/CD38- and other cells) Block terminal differentiation John Dick and Dominique Bonnet B-cell T-cell Erythrocyte Platelet Monocyte Granulocyte Le cellule staminali tumorali come meccanismo di mantenimento del tumore 1. 2. 3. Isolamento di sub-popolazioni cellulari con marcatori di superficie caratteristici delle SC normali (CD34+CD38-), o di cellule piú differenziate, da blasti leucemici di pazienti affetti da varie forme di leucemia mieloide acuta Reinoculo di queste cellule in topi NOD/SCID ed analisi della loro capacitá leuchemogenica Mentre le cellule CD34+38- sono leuchemogeniche, quelle CD34+CD38+ non possono trasferire la leucemia nell’animale immunocompromesso 4. Le cellule tumorali non sono tutte uguali, e le CSC sono responsabili del mantenimento della massa tumorale Evidenze da altri tumori Nei tumori solidi si può osservare sperimentalmente una simile struttura gerarchica (i marker sono definiti in maniera meno precisa) Therapeutic predictions of tumor stem cell model Tumor stem cells Non-tumorigenic cells Therapeutic predictions of tumor stem cell model rapid growing cells killed kill stem cells tumor grows back tumor degenerates Therapeutic implications of Cancer Stem Cells Hypothesis: -Most therapies (chemotherapy and radiation) target rapidly proliferating, non-tumorigenic cells and spare the relatively quiescent cancer stem cells -Cell surface pumps -Cancer stem cells have greater invasive and migratory properties and can home to specific tissue niches Cancer stem cells sono più resistenti alle terapie antitumorali Experimental models in vitro models (ex vivo ) • Cultured cell from human gliomas: D456MG D54MG • Patient glioblastoma samples in vivo models • Human xenograft models in immunocompromised mice Brain tumor stem cells: identified by intracranial transplantation of CD133+ cells into adult NOD/SCID mouse forebrain. CD133+ CD133+ CD133- Singh et al. 2004 Nature 432: 396-401 Resistance to radiation: → given by CD133+ in vivo CD133+ enrichment after radiation • Glioma xenograft D456MG: →enriched CD133+ population 48h after radiation (3-5x) in vitro CD133+ enrichment after radiation • Cultures from human glioma xenograft (D54MG): • Patient glioblastoma samples: →48h after radiation: 3x enrichment Irradiation effects at molecular level Early DNA damage checkpoint responses: Early DNA damage checkpoint responses (phosphorylation) checked before treatment and after 1h. Higher amount of phosphorylated proteins in CD133+. CD133+ subpopulation has cancer stem cell properties in vivo tumorigenic potential of purified CD133+ tumor cells in vitro irradiation CD133+ cells (104) from patient sample or xenograft transplanted into brains of immunocompromised mice. Brain observed at appearence of neurological signs or after 8 weeks. D456MG CD133- (2 x 106) formed small tumors in 2 out of 5 xenotransplanted in immunocompromised mice. Domanda fondamentale È sufficiente attaccare esclusivamente le CSC? Nessuno ha finora dimostrato che l'incapacità di self-renewal delle CSC sia sufficiente ad impedire lo sviluppo di un tumore Acute Promyelocytic Leukemia (APL) Myeloid differentiation Monoblast Promyelocytes PML Chr 15 RAR Chr 17 PML RAR t(15;17) Leukemia-free survival (%) Leukemogenesis is a multi-stage process Pre-leukemia At the pre-leukemic stage, hematopoiesis is apparently norma Molecular mechanism of PML-RAR action DNMT/HMTs RA From DeThe and C ATRA acts on bulk APL cells, and on LICs APL ATRA Tumor Recurrenc tumor grows back PML-RAR degradation Bulk Cells LICs Continuous treatment with HDACi is required for prolonging survival of leukemic mice Continuous treatment with HDACi is required for prolonging survival of leukemic mice rapid growing cells killed tumor grows back An assay to measure LICs Bulk LIC (Ly5.1+)) Vehicle Treatment No Effect Leukemic Cells (Ly5.2) Drug treatment Harvest leukemic cells (Ly5.2+) treated/untreated LIC Expansion Transplant in Limiting Dilutions (Ly5.1+) LIC Reduction An assay to measure LICs Bulk LIC (Ly5.1+) Vehicle Treatment No Effect Leukemic Cells (Ly5.2) Drug treatment Harvest leukemic cells (Ly5.2+) treated/untreated LIC Expansion Transplant in Limiting Dilutions (Ly5.1+) LIC Reduction ATRA treatment reduces LIC frequency ≈ 100 fold VPA spares LICs Limiting Dilution Vehicle LIC Frequency 2.5x10^4 VPA 3.9x10^4 Short-term inhibition of multiple HDACs with SAHA tackles LICs but does not prolong survival Survival LIC assay LIC Frequency Vehicle SAHA 2.5x10^4 2.3x10^6 In Summary… Leukemia ATRA Tumor Recurrenc ? SAHA VPA Bulk Cells LICs Eradication of APL by ATRA-SAHA-VPA No leukemic cells detectable Self-renewal Assay in NOD/SCID Mice FACS Cell Sorter Solid Tumor Mince (small pieces) Single Cell Suspension Surgical Implantation CD44 Expression For solid tumors: surgical orthotopic implantation (SOI) CD24 Expression CD 44 staining of breast cancer model T. A. Ince 2001 Breast Cancer Stem Cells: CD44+ CD24low Lin- B38.1+ ESA+ CD44 and CD24 – adhesion molecules B38.1 – breast/ovarian cancer-specific marker ESA – epithelial specific antigen Al-Hajj (2003) PNAS 100, 3983 Biological characterization of WT and ErbB2 Mammospheres 1. Are Clonal in origin 2. Grow serially (self-renewal) 3. Contain SCs Transplantation into the cleared fat pad of syngenic mice: • WT mammospheres form a normal breast tissue • ErbB2 mammospheres form tumors cell n. wt (FVB) 100000 5/5 10000 11/11 1000 6/6 ErbB2 4/4 2/2 6/6 Analysis of the replicative potential of Normal and Tumor mammospheres: (serial growth) WT WT 12 6 6 0 0 1 2 3 4 5 45000 160 30000 80 15000 0 6 0 1 passages cumulative sphere number 12 ErbB2 240 sphere number 18 cumulative sphere number sphere number 18 ErbB2 2 3 4 5 6 passages decrease in number during passages (limited lifespan) 1,E+05 105 increase in number during passages (near-immortal) ErbB2 cumulative sphere number 1,E+04 R2: 0,98 502% decrease 1,E+03 103 1,E+02 ErbB2 : fixed increase at every passage (502%) (exponential curves) 1,E+01 101 R2: 0,99 64% decrease 1,E+00 1,E-01 10-1 WT 1,E-02 1 3 passages 5 WT : fixed decrease at every passage (64%) Stem Cell divisions permit generation of more SCs (‘self-renewal’) and production of cells that differentiate 1. Asymmetric cell division Pr. SC Mechanisms: 1. Asymmetric localizzation of cell polarity (PINS and aPKC) and cell fate determinants (Numb and Prospero) SC 2. Asymmetric placement of daughter cells relative to the stem cell niche Each SC divides to generate one daughter with SC fate and one that differentiates This strategy leaves stem cells (progenitror) unable to expand in number 2. Symmetric cell division Pr. Each SC divides to generate daughter cells that are destined to acquire the same fate SC SC SC SC Limited data available on the modes of division of mammalian SCs: 1. Some mammalian SCs use conserved mechanism to divide asymmetrically; 2. Mammalian SCs can expand in number during development (HSCs, Neural and Epidermal SCs) or after injury (neural SCs after stroke or HSCs after chemotherapy). Increased frequency of Symmetric Divisions in tumor cells (ErbB2) vs WT cells ErbB2 WT Uncertain Asymmetric 10,3% 11,5% Uncertain 33,3% Symmetric 7,2% Asymmetric 59,5% Symmetric 78,2% Nuovi risultati e incertezze • I dati di maggiore rilevanza a supporto della teoria delle CSC derivano da xenotrapianti di cellule tumorali umane in topi immunocompromessi • Molto recentemente è apparso un lavoro molto importante sulla caratterizzazione delle CSC nel melanoma, dove emerge che: – almeno in questo tumore, il numero di cellule con caratteristiche di CSC è altissimo (se si accettano alcune assunzioni, si arriva quasi al 100% delle cellule): se tutte le cellule sono CSC, le CSC non esistono – i protocolli sperimentali per gli xenotrapianti possono influenzare l’attecchimento di determinate sottopopolazioni Importanza del topo ricevente e delle condizioni sperimentali I melanomi possono iniziare a partire da una singola cellula Ci sono modelli complementari/alternativi? • Plasticità fenotipica: non c’è una vera e propria gerarchia (staminale->non-staminale), ma diversi stati cellulari determinati dalle condizioni “ambientali” (microambiente e segnali) – La stessa cellula può assumere reversibilmente morfologia diversa, espressione di diversi pattern trascrizionali e non di mutazioni irreversibili, manifestando nei suoi diversi fenotipi una maggiore o minore propensione alla “staminalità”