Approche des mécanismes de résistance des cellules souches leucémiques de leucémie myéloïde chronique aux inhibiteurs de tyrosine kinase

Les Inhibiteurs de l'activité Tyrosine Kinase (ITK) de BCR-ABL (Imatinib (IMA), Nilotinib (NIL) et Dasatinib (DAS)) ont révolutionné le traitement de la Leucémie Myéloïde Chronique (LMC), mais la cinétique et l'intensité des réponses thérapeutiques restent variables. Par ailleurs, plusieurs travaux démontrent qu'il persiste chez la majorité des patients des cellules souches leucémiques (CSL) CD34+ résistantes aux ITK et capables de reconstituer la maladie. Partant du principe que la thérapie ciblée (les ITK) devait atteindre le compartiment cellulaire et du constat qu'aucune méthode ne permettait d'évaluer la quantité d'ITK dans les cellules malignes vivantes, nous avons développé un procédé en cytométrie en flux pour quantifier ces molécules dans les cellules de la LMC. Nous avons ainsi démontré que la mort cellulaire des lignées K562 et KCL22 à 24h est étroitement corrélée à la quantité d'IMA accumulée dès la 1ère heure. L'application du procédé aux cellules primaires a montré un taux intracellulaire d'ITK dépendant des caractéristiques des cellules et variable d'un sujet à l'autre (Article 1). Pour l'instant, en raison de l'hétérogénéité de notre cohorte, nous n'avons pas pu mettre en évidence de corrélation entre l'accumulation des ITK et la réponse thérapeutique de la LMC. Notre procédé nous a permis de suivre l'accumulation in vivo du DAS dans les blastes circulants d'un patient LMC en phase d'acutisation, en parallèle de la réactivation de pSyk348 - que nous avons identifié comme marqueur de progression - au moment de l'échappement au DAS (Article 2). Un avantage majeur du procédé est la possibilité d'analyser les différentes sous-populations, dont les cellules CD34+ de LMC. Ces dernières ont un taux d'ITK intracellulaire plus faible que les cellules matures, voire absent chez certains patients. Pour l'instant une corrélation significative avec les tests clonogéniques effectués en parallèle est retrouvée seulement avec le DAS. Enfin, nos résultats préliminaires suggèrent des différences entre les cellules CD34+ du sang et de la moelle. En conclusion, ce procédé permet d'évaluer la quantité d'ITK dans des sous-populations cellulaires précises et viables. Nous envisageons de poursuivre ce projet par l'évaluation de l'intérêt d'un dosage précoce du taux d'ITC intracellulaire in vivo (après la 4ème prise) d'une part et d'autre part par l'étude de l'influence du microenvironnement sur la résistance des CSL de LMC aux ITK et sur certaines dérégulations propres à ce compartiment cellulaire.The Tyrosine Kinase Inhibitors (TKI) of BCR-ABL (Imatinib (IMA), Nilotinib (NIL) and dasatinib (DAS)) have revolutionized the treatment of Chronic Myeloid Leukemia (CML). However therapeutic responses remain variable. Moreover, several studies showed that most patients have persistent CD34+ leukemic stem cells (LSCs) resistant to TKI and the origin of disease relapse. Given that the targeted therapy (TKI) should reach malignant cells and that no method was able to assess the amount of TKI in viable target cells, we have developed a process by flow cytometry for TKI quantification in target cells. By using K562 and KCL22 cell lines we showed that cell death at 24hrs was closely related to IMA uptake after one hour of incubation. We then applied our method to primary cells and showed an intracellular level of IMA, NIL and DAS dependent on cell characteristics and heterogeneous from one subject to another (Article 1). Probably because of the heterogeneity of our series, we did not find any correlation between the accumulation of TKI and therapeutic response of CML. Moreover, we used our process to observe a decrease in DAS accumulation in vivo in circulating blasts of a CML patient with acute transformation, in spite of significant DAS uptake, we observed a recurrence of Syk phosphorylation in Y348 that we identified as a potential marker of acutisation, at the same time of disease resistance (Article 2). A major advantage of our process is the possibility to analyze the different cell subsets, including CD34+ CML cells. These cells had a lower (even absent in cells from some patients) level of intracellular TKI compared to mature cells. The clonogenic assays performed in parallel showed a significant correlation with DAS only. Finally, our preliminary results suggest differences between CD34+ cells from blood and those from bone marrow. In conclusion, our process allows evaluating the amount of TKI in viable cell subpopulations. This project will be continued with i) the study of the potential interest of the early evaluation of in vivo intracellular level of TKI (after the fourth dose) and ii) the influence of the microenvironment on CSL resistance to TKI and epigenetics deregulations

Applicability of the long‐term uncertainty in measurement ( LTUM ) method for analytical performance assessment in clinical cytometry laboratories

International audienc

Collaborative Decision in Multi-Agent Learning of Action Models

International audienceWe address collaborative decision in the Multi-Agent Consistency-based online learning of relational action models. This framework considers a community of agents, each of them learning and rationally acting following their relational action model. It relies on the idea that when agents communicate, on a utility basis, the observed effect of past actions to other agents, this results in speeding up the online learning process of each agent in the community. In the present article, we discuss how collaboration in this framework can be extended to the individual decision level. More precisely, we first discuss how an agent's ability to predict the effect of some action in its current state is enhanced when it takes into account all the action models in the community. Secondly, we consider the situation in which an agent fails to produce a plan using its own action model, and show how it can interact with the other agents in the community in order to select an appropriate action to perform. Such a community aided action selection strategy will help the agent revise its action model and increase its ability to reach its current goal as well as future ones

Collaborative Online Learning of an Action Model

International audienceA number of recent works have designed algorithms that allow an agent to revise a relational action model from interactions with its environment and uses this model for building plans and better exploring its environment. This article addresses Multi Agent Relational Action Learning: it considers a community of agents, each rationally acting following some relational action model, and assumes that the observed effect of past actions that led an agent to revise its action model can be communicated to other agents of the community, potentially speeding up the on-line learning process of agents in the community. We describe and experiment a framework for collaborative relational action model revision where each agent is autonomous and benefits from past observations memorized by all agents of the community

Multi Agent Learning of Relational Action Models

International audienceMulti Agent Relational Action Learning considers a community of agents, each rationally acting following some relational action model. The observed effect of past actions that led an agent to revise its action model can be communicated, upon request, to another agent, speeding up its own revision. We present a framework for such collaborative relational action model revision

DNA Methylation and Intra-Clonal Heterogeneity: The Chronic Myeloid Leukemia Model

International audienceChronic Myeloid Leukemia (CML) is a model to investigate the impact of tumor intra-clonal heterogeneity in personalized medicine. Indeed, tyrosine kinase inhibitors (TKIs) target the BCR-ABL fusion protein, which is considered the major CML driver. TKI use has highlighted the existence of intra-clonal heterogeneity, as indicated by the persistence of a minority subclone for several years despite the presence of the target fusion protein in all cells. Epigenetic modifications could partly explain this heterogeneity. This review summarizes the results of DNA methylation studies in CML. Next-generation sequencing technologies allowed for moving from single-gene to genome-wide analyses showing that methylation abnormalities are much more widespread in CML cells. These data showed that global hypomethylation is associated with hypermethylation of specific sites already at diagnosis in the early phase of CML. The BCR-ABL-independence of some methylation profile alterations and the recent demonstration of the initial intra-clonal DNA methylation heterogeneity suggests that some DNA methylation alterations may be biomarkers of TKI sensitivity/resistance and of disease progression risk. These results also open perspectives for understanding the epigenetic/genetic background of CML predisposition and for developing new therapeutic strategies

Method validation of a set of 12 GEM® Premier™ 4000 blood gas analyzers for point-of-care testing in a university teaching hospital

International audienceBackground: Blood gas analyzers are o0.ften integrated into point-of-care testing provisions. International standards (ISO 22870 and 15189) as adapted to French COFRAC regulations make accreditation of point-ofta-care testintag obligatory. We installed and assessed 12 GEM PREMIER 4000 analyzers for pH, pCO 2 , pO 2 , Na + , K + , Cl-, Ca 2+ , lactate, hemoglobin and oxyhemoglobin (O 2 Hb) at Clermont-Ferrand Hospital. These instruments were distributed across 11 care sites in the hospital. Methods: Precision was studied at two control levels for each parameter. Comparisons between GEM analyzers were performed (on 30 samples) for pH, pCO 2 , pO 2 , Na + , K + , Cl-, Ca 2+ , lactate, hemoglobin and O 2 Hb; and between GEM analyzers and the central laboratory for Na + , K + , Cl-, Ca 2+ and hemoglobin (on 30-50 samples). Uncertainty in measurement (UM) was evaluated with an approach using reproducibility and accuracy data. Results: The coefficients of variation (CVs) were in line with recommendations, except for the repeatability CV for pO 2. All CVs were below 4%. All comparisons complied with recommendations. Uncertainties of measurement were also validated. Conclusion: Our results met standard requirements and the 12 analyzers were assessed as suitable for point-of-care testing in services of academic medical centers, as exemplified at Clermont-Ferrand hospital

Freezing Does Not Alter Sperm Telomere Length despite Increasing DNA Oxidation and Fragmentation

Correlations were reported between sperm telomere length (STL) and male fertility, sperm DNA fragmentation, and oxidation. Sperm freezing is widely used for assisted reproductive techniques, fertility preservation, and sperm donation. However, its impact on STL remains unknown. For this study, semen surplus from patients who underwent routine semen analysis were used. The impact of slow freezing on STL was analyzed by performing qPCR before and after freezing. Sperm populations with different STL were evaluated using Q-FISH. The relationship between sperm DNA oxidation, DNA fragmentation, and STL was assessed in fresh and frozen sperm samples. No significant impact of slow freezing on STL was observed, neither measured by qPCR nor Q-FISH. However, Q-FISH allowed for the distinguishing of sperm populations with different STLs within individual sperm samples. Slow freezing induced different STL distributions for some of the analyzed sperm samples, but no correlation was found between STL and sperm DNA fragmentation or oxidation. Slow freezing does not alter STL despite increasing sperm DNA oxidation and fragmentation. As STL alterations could be transmitted to offspring, the lack of impact of the slow freezing method on STL ensures the safety of this procedure

Hormonal Therapy Resistance and Breast Cancer: Involvement of Adipocytes and Leptin

Obesity, a recognized risk factor for breast cancer in postmenopausal women, is associated with higher mortality rates regardless of menopausal status, which could in part be explained by therapeutic escape. Indeed, adipose microenvironment has been described to influence the efficiency of chemo- and hormonal therapies. Residual cancer stem cells could also have a key role in this process. To understand the mechanisms involved in the reduced efficacy of hormonal therapy on breast cancer cells in the presence of adipose secretome, human adipose stem cells (hMAD cell line) differentiated into mature adipocytes were co-cultured with mammary breast cancer cells and treated with hormonal therapies (tamoxifen, fulvestrant). Proliferation and apoptosis were measured (fluorescence test, impedancemetry, cytometry) and the gene expression profile was evaluated. Cancer stem cells were isolated from mammospheres made from MCF-7. The impact of chemo- and hormonal therapies and leptin was evaluated in this population. hMAD-differentiated mature adipocytes and their secretions were able to increase mammary cancer cell proliferation and to suppress the antiproliferative effect of tamoxifen, confirming previous data and validating our model. Apoptosis and cell cycle did not seem to be involved in this process. The evaluation of gene expression profiles suggested that STAT3 could be a possible target. On the contrary, leptin did not seem to be involved. The study of isolated cancer stem cells revealed that their proliferation was stimulated in the presence of anticancer therapies (tamoxifen, fulvestrant, doxorubicine) and leptin. Our study confirmed the role of adipocytes and their secretome, but above all, the role of communication between adipose and cancer cells in interfering with the efficiency of hormonal therapy. Among the pathophysiological mechanisms involved, leptin does not seem to interfere with the estrogenic pathway but seems to promote the proliferation of cancer stem cells

Beneficial effects of hypotaurine supplementation in preparation and freezing media on human sperm cryo-capacitation and DNA quality

International audienceAbstract Background Although widely used, slow freezing considerably modifies the functions of human spermatozoa. Cryopreservation induces nuclear sperm alterations and cryo-capacitation, reducing the chances of pregnancy. Hypotaurine is naturally present in the male and female genital tracts and has capacitating, osmolytic and anti-oxidant properties. The analysis were performed on surplus semen of men with normal ( n = 19) or abnormal ( n = 14) sperm parameters. Spermatozoa were selected by density gradient centrifugation before slow freezing. For each sample, these steps were performed in parallel with (“H+” arm) or without (“H-” arm) hypotaurine supplementation. After thawing, we measured total and progressive mobility, vitality, acrosome integrity, markers of capacitation signaling pathway and nuclear quality. For the latter, we focused on sperm chromatin packaging, DNA fragmentation and the presence of vacuoles in the sperm nucleus. Results Post-thaw spermatozoa selected and frozen in the presence of hypotaurine had a higher vitality (+ 16.7%, p < 0.001), progressive and total motility (+ 39.9% and + 21.6% respectively, p < 0.005) than spermatozoa from the control “H-” arm. Hypotaurine also reduced the non-specific phosphorylation of the capacitation protein markers P110 and P80 ( p < 0.01), indicating a decrease in cryo-capacitation. Hypotaurine supplementation reduced chromatin decondensation, measured by chromomycin A3 (− 16.1%, p < 0.05), DNA fragmentation (− 18.7%, p < 0.05) and nuclear vacuolization (− 20.8%, p < 0.05). Conclusion Our study is the first to demonstrate beneficial effects of hypotaurine supplementation in preparation and freezing procedures on human spermatozoa sperm fertilization capacity and nucleus quality. Hypotaurine supplementation limited cryo-capacitation, increased the proportion of live and progressively motile spermatozoa and reduces the percentage of spermatozoa showing chromatin decondensation, DNA fragmentation and nuclear vacuolation. Trial registration Clinical Trial, NCT04011813 . Registered 19 May 2019 - Retrospectively registered.Résumé Contexte Bien que largement utilisée, la congélation lente modifie considérablement les fonctions des spermatozoïdes humains. La cryoconservation induit des altérations nucléaires du sperme et une cryocapacitation, réduisant les chances de grossesse. L’hypotaurine est. naturellement présente dans les voies génitales masculines et féminines et possède des propriétés capacitantes, osmotiques et anti-oxydantes. Les mesures ont été réalisées sur le reliquat de sperme d’hommes avec des paramètres spermatiques normaux ( n = 19) ou anormaux ( n = 14). Les spermatozoïdes ont été sélectionnés par centrifugation sur gradient de densité (test de migration survie) avant congélation lente. Pour chaque prélèvement, ces étapes ont été réalisées en parallèle avec des milieux supplémentés en hypotaurine (bras « H+ ») ou sans hypotaurine (bras « H- »). Après décongélation, nous avons mesuré la mobilité totale et progressive, la vitalité, l’intégrité de l’acrosome, des marqueurs de la voie de signalisation de la capacitation et la qualité nucléaire. Pour cette dernière, nous nous sommes concentrés sur la condensation de la chromatine, la fragmentation de l’ADN et la présence de vacuoles dans le noyau du sperme. Résultats Post-décongélation, les spermatozoïdes sélectionnés et congelés en présence d’hypotaurine avaient une vitalité plus élevée (+ 16,7%, p < 0,001), une motilité progressive et totale (+ 39,9% et + 21,6% respectivement, p < 0,005) que les spermatozoïdes du bras « H- » sans suplémentation. L’hypotaurine a également réduit la phosphorylation non spécifique des marqueurs protéiques de capacitation P110 et P80 ( p < 0,01), indiquant une diminution de la cryocapacitation. La supplémentation en hypotaurine a réduit la décondensation de la chromatine, mesurée par la chromomycine A3 (− 16,1%, p < 0,05), la fragmentation de l’ADN (− 18,7%, p < 0,05) et la vacuolisation nucléaire (− 20,8%, p < 0,05). Conclusion Notre étude est. la première à démontrer les effets bénéfiques de la supplémentation en hypotaurine dans les milieux de préparation et de congélation sur la capacité de fécondation des spermatozoïdes humains et leur qualité nucléaire. La supplémentation en hypotaurine a limité la cryocapacitation, augmenté la proportion de spermatozoïdes vivants et progressivement mobiles et réduit le pourcentage de spermatozoïdes présentant une décondensation de la chromatine, une fragmentation de l’ADN et une vacuolisation nucléaire. Enregistrement de l’essai essai clinique, NCT04011813 . Enregistré le 19 mai 2019 - Enregistré rétrospectivement