BCR-associated factors driving chronic lymphocytic leukemia cells proliferation ex vivo

International audienceA chronic antigenic stimulation is believed to sustain the leukemogenic development of chronic lymphocytic leukemia (CLL) and most of lymphoproliferative malignancies developed from mature B cells. Reproducing a proliferative stimulation ex vivo is critical to decipher the mechanisms of leukemogenesis in these malignancies. However, functional studies of CLL cells remains limited since current ex vivo B cell receptor (BCR) stimulation protocols are not sufficient to induce the proliferation of these cells, pointing out the need of mandatory BCR co-factors in this process. Here, we investigated benefits of several BCR co-stimulatory molecules (IL-2, IL-4, IL-15, IL-21 and CD40 ligand) in multiple culture conditions. Our results demonstrated that BCR engagement (anti-IgM ligation) concomitant to CD40 ligand, IL-4 and IL-21 stimulation allowed CLL cells proliferation ex vivo. In addition, we established a proliferative advantage for ZAP70 positive CLL cells, associated to an increased phosphorylation of ZAP70/SYK and STAT6. Moreover, the use of a tri-dimensional matrix of methylcellulose and the addition of TLR9 agonists further increased this proliferative response. This ex vivo model of BCR stimulation with T-derived cytokines is a relevant and efficient model for functional studies of CLL as well as lymphoproliferative malignancies. Like in most mature lymphoproliferative malignancies, an antigenic stimulation is believed to drive the leukemo-genic process in chronic lymphocytic leukemia (CLL) 1-3. A restricted use of IGHV genes and the existence of ste-reotypic B cell receptor (BCR) on CLL cells 4-6 provides evidence in favor of antigenic stimulation where different microbial antigens, as well as auto-antigens, have been suspected as actors of this chronic stimulation 7. In addition , a chronic BCR self-activation has been shown in subtypes of CLL cells 8. Moreover, several signaling aberrations have been described downstream of the BCR, notably in aggressive CLL with unmutated IGHV (UM-CLL), in which the expression of ZAP70 reinforces BCR responsiveness 9-12. BCR activation, which is essential for the physiological development of lymphocytes 13 would also be indispensable for the survival and proliferation of CLL cells in vivo 2. Accordingly, withdrawal of this stimulation is believed to be responsible for the rapid spontaneous apoptosis of CLL cells ex vivo 14. The cellular consequences of this BCR activation has been extensively studied an

Study of mechanisms of NKG2D ligands expression during lymphoproliferative syndromes

Des lésions de l’ADN sont impliquées dans les mécanismes de l’oncogenèse. De plus, la prolifération incontrôlée des cellules tumorales induit l’accumulation d’aberrations géniques. En réponse à ce stress génotoxique, les cellules en transformation expriment les ligands NKG2D MICA et MICB, molécules du CMH de classe I non conventionnelles qui activent une réponse cytotoxique T et NK contre cette transformation. Dans les syndromes lymphoprolifératifs chroniques, les mécanismes de la leucémogenèse reposent essentiellement sur une stimulation antigénique ou une activation des voies du récepteur à l’antigène (BCR) qui induit la prolifération cellulaire. De plus, les ligands MICA/B ne sont pas retrouvés à la surface de ces cellules. Les objectifs de cette thèse sont (i) rechercher si l’activation de la prolifération lymphocytaire peut induire l’expression de MICA/B et (ii) étudier les mécanismes induisant cette expression et leurs liens avec les voies de lésions/réparations de l’ADN. Pour cela, nous avons mis en place des conditions d’activation du récepteur à l’antigène permettant d’obtenir une prolifération (objectivée après marquage par CFSE) de lymphocytes B sains et de lymphocytes issus de patients porteurs de leucémie lymphoïde chronique (LLC), la plus fréquente des leucémie de l’adulte. L’expression des ligands MICA et MICB a ensuite été évaluée par qPCR, cytométrie en flux, western blots et ELISA. L’implication des différentes voies de signalisation en aval du récepteur à l’antigène a été analysée, ainsi que la cinétique d’apparition des lésions de l’ADN durant ce processus. Mes résultats montrent que MICA/B ne sont pas exprimés à la surface des lymphocytes B issus de donneurs sains ou de patients porteurs de LLC. Cependant, l’activation de la prolifération lymphocytaire induit une activation transcriptionnnelle de MICA ainsi que son expression à la surface de ces cellules. Cette expression est induite par différentes voies du récepteur à l’antigène ainsi que par la voie JAK/STAT et est indépendante des lésions de l’ADN qui surviennent plus tardivement dans la cellule. Au total, l’activation du récepteur à l’antigène qui induit la prolifération lymphocytaire induit également l’expression du ligand MICA (et non MICB) à la surface des lymphocytes sains et cette capacité d’expression est conservée dans les cellules de LLC qui ne l’expriment pas. Ces résultats suggèrent que MICA pourrait jouer un rôle crucial aux stades précoces de l’immunité anti-proliférative, ce qui ouvre la voie à de potentielles applications thérapeutiques.Tumor cell’s uncontrolled proliferation induces an accumulation of genetic aberrations. In response to this genotoxic stress, most cells in transformation express NKG2D ligands (not expressed on resting cells), including MICA and MICB, which are non-conventional MHC class I molecules that could induce a cytotoxic T and NK response against the transformed cell. In chronic lymphoproliferative conditions, leukemogenic mechanisms rely in part on antigenic stimulations and/or activation of the B cell antigen receptor (BCR) pathways that induce cell proliferation. My thesis aims at studying : (i) the induction of MICA/B expression during lymphocyte proliferation and (ii) the mechanisms inducing this expression and their relationship with the DNA damage/repair pathways.I did generate BCR activation conditions to obtain B cells proliferation from healthy control individuals and from patients suffreing from chronic lymphocytic leukemia (CLL), the most common leukemia in adults. MICA and MICB expression was assessed by quantitative PCR, flow cytometry, Western blotting and ELISA after activation of B-cell proliferation. The different signaling pathways downstream BCR were analyzed, as were the kinetics of the DNA damage during this process. The results show that MICA/B aren’t expressed on cell surface of B cells from healthy control individuals or CLL patients before activation. Lymphoproliferative stimulation however up-regulates both MICA mRNA and surface protein in these same cells. This expression was induced by several BCR and by JAK/STAT pathways and seems to be indpendant of DNA damage. In conclusion, antigen receptor activation that induces lymphocyte proliferation also induces MICA expression (but not MICB) on B cells surface from healthy control individuals and this expression capacity is conserved in B cells from patients suffering from CLL. These results suggest that MICA may play a crucial role in the early stages of anti-proliferative immunity, which opens the avenue for therapeutic interventions

Study of mechanisms of NKG2D ligands expression during lymphoproliferative syndromes

Des lésions de l’ADN sont impliquées dans les mécanismes de l’oncogenèse. De plus, la prolifération incontrôlée des cellules tumorales induit l’accumulation d’aberrations géniques. En réponse à ce stress génotoxique, les cellules en transformation expriment les ligands NKG2D MICA et MICB, molécules du CMH de classe I non conventionnelles qui activent une réponse cytotoxique T et NK contre cette transformation. Dans les syndromes lymphoprolifératifs chroniques, les mécanismes de la leucémogenèse reposent essentiellement sur une stimulation antigénique ou une activation des voies du récepteur à l’antigène (BCR) qui induit la prolifération cellulaire. De plus, les ligands MICA/B ne sont pas retrouvés à la surface de ces cellules. Les objectifs de cette thèse sont (i) rechercher si l’activation de la prolifération lymphocytaire peut induire l’expression de MICA/B et (ii) étudier les mécanismes induisant cette expression et leurs liens avec les voies de lésions/réparations de l’ADN. Pour cela, nous avons mis en place des conditions d’activation du récepteur à l’antigène permettant d’obtenir une prolifération (objectivée après marquage par CFSE) de lymphocytes B sains et de lymphocytes issus de patients porteurs de leucémie lymphoïde chronique (LLC), la plus fréquente des leucémie de l’adulte. L’expression des ligands MICA et MICB a ensuite été évaluée par qPCR, cytométrie en flux, western blots et ELISA. L’implication des différentes voies de signalisation en aval du récepteur à l’antigène a été analysée, ainsi que la cinétique d’apparition des lésions de l’ADN durant ce processus. Mes résultats montrent que MICA/B ne sont pas exprimés à la surface des lymphocytes B issus de donneurs sains ou de patients porteurs de LLC. Cependant, l’activation de la prolifération lymphocytaire induit une activation transcriptionnnelle de MICA ainsi que son expression à la surface de ces cellules. Cette expression est induite par différentes voies du récepteur à l’antigène ainsi que par la voie JAK/STAT et est indépendante des lésions de l’ADN qui surviennent plus tardivement dans la cellule. Au total, l’activation du récepteur à l’antigène qui induit la prolifération lymphocytaire induit également l’expression du ligand MICA (et non MICB) à la surface des lymphocytes sains et cette capacité d’expression est conservée dans les cellules de LLC qui ne l’expriment pas. Ces résultats suggèrent que MICA pourrait jouer un rôle crucial aux stades précoces de l’immunité anti-proliférative, ce qui ouvre la voie à de potentielles applications thérapeutiques.Tumor cell’s uncontrolled proliferation induces an accumulation of genetic aberrations. In response to this genotoxic stress, most cells in transformation express NKG2D ligands (not expressed on resting cells), including MICA and MICB, which are non-conventional MHC class I molecules that could induce a cytotoxic T and NK response against the transformed cell. In chronic lymphoproliferative conditions, leukemogenic mechanisms rely in part on antigenic stimulations and/or activation of the B cell antigen receptor (BCR) pathways that induce cell proliferation. My thesis aims at studying : (i) the induction of MICA/B expression during lymphocyte proliferation and (ii) the mechanisms inducing this expression and their relationship with the DNA damage/repair pathways.I did generate BCR activation conditions to obtain B cells proliferation from healthy control individuals and from patients suffreing from chronic lymphocytic leukemia (CLL), the most common leukemia in adults. MICA and MICB expression was assessed by quantitative PCR, flow cytometry, Western blotting and ELISA after activation of B-cell proliferation. The different signaling pathways downstream BCR were analyzed, as were the kinetics of the DNA damage during this process. The results show that MICA/B aren’t expressed on cell surface of B cells from healthy control individuals or CLL patients before activation. Lymphoproliferative stimulation however up-regulates both MICA mRNA and surface protein in these same cells. This expression was induced by several BCR and by JAK/STAT pathways and seems to be indpendant of DNA damage. In conclusion, antigen receptor activation that induces lymphocyte proliferation also induces MICA expression (but not MICB) on B cells surface from healthy control individuals and this expression capacity is conserved in B cells from patients suffering from CLL. These results suggest that MICA may play a crucial role in the early stages of anti-proliferative immunity, which opens the avenue for therapeutic interventions

Matching for the non-conventional MHC-I MICA gene significantly reduces the incidence of acute and chronic GVHD

Graft-versus-host disease (GVHD) is among the most challenging complications in unrelated donor hematopoietic cell transplantation (HCT). The highly polymorphic "MHC class I chain-related gene A", MICA, encodes a stress-induced glycoprotein expressed primarily on epithelia. MICA interacts with the invariant activating receptor NKG2D; expressed by cytotoxic lymphocytes. The MICA gene is located in the MHC, next to HLA-B; hence MICA has the requisite attributes of a bona fide transplantation antigen. Using high-resolution sequence-based genotyping of MICA, we retrospectively analyzed the clinical impact of MICA mismatches in a multicenter cohort of 922 unrelated donor HLA-A, -B, -C, -DRB1, and -DQB1 10/10 allele-matched HCT. Among the 922 pairs, 113 (12.3%) were mismatched in MICA MICA mismatches were significantly associated with an increased incidence of grade III-IV acute GVHD (HR, 1.83; 95% CI, 1.50 to 2.23; P<0.001), chronic GVHD (HR, 1.50; 95% CI, 1.45 to 1.55; P<0.001) and non-relapse mortality (HR, 1.35; 95% CI, 1.24 to 1.46; P<0.001). The increased risk of GVHD was mirrored by a lower risk of relapse (HR, 0.50; 95% CI, 0.43 to 0.59; P<0.001), indicating a possible graft-versus-leukemia effect. In conclusion, when possible, selecting a MICA-matched donor significantly influences key clinical outcomes of HCT in which a marked reduction of GVHD is paramount. The tight linkage disequilibrium between MICA and HLA-B renders identifying a MICA-matched donor readily feasible in clinical practice

Matching for the nonconventional MHC-I MICA gene significantly reduces the incidence of acute and chronic GVHD

Graft-versus-host disease (GVHD) is among the most challenging complications in unrelated donor hematopoietic cell transplantation (HCT). The highly polymorphic MHC class I chain-related gene A, MICA, encodes a stress-induced glycoprotein expressed primarily on epithelia. MICA interacts with the invariant activating receptor NKG2D, expressed by cytotoxic lymphocytes, and is located in the MHC, next to HLA-B. Hence, MICA has the requisite attributes of a bona fide transplantation antigen. Using high-resolution sequence-based genotyping of MICA, we retrospectively analyzed the clinical effect of MICA mismatches in a multicenter cohort of 922 unrelated donor HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 10/10 allele-matched HCT pairs. Among the 922 pairs, 113 (12.3%) were mismatched in MICA. MICA mismatches were significantly associated with an increased incidence of grade III-IV acute GVHD (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.50-2.23; P < .001), chronic GVHD (HR, 1.50; 95% CI

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old