Inhibition of MDR1 does not sensitize primitive chronic myeloid leukemia CD34⁺ cells to imatinib

<p><b>Objective:</b> To investigate the interaction of imatinib mesylate (IM) with the clinically relevant adenosine triphosphate-binding cassette efflux transporter MDR1 (ABCB1) in cells from patients with chronic myeloid leukemia (CML) and to explore whether inhibition of this transporter would improve IM's efficacy in the elimination of CML CD34<sup>+</sup> cells by increasing cell-associated drug accumulation.</p> <p><b>Materials and Methods:</b> Cells from newly diagnosed chronic-phase CML patients were harvested by leukapheresis and enriched to >95% CD34<sup>+</sup>. Expression of the transporter gene MDR1 was performed by quantitative reverse transcription polymerase chain reaction. Interaction of IM with MDR1 was analyzed by substrate (rhodamine 123) displacement assay. Cell-associated levels of IM in CML CD34<sup>+</sup> cells were measured by high-pressure liquid chromatography. Intracellular phospho-CrkL levels, apoptosis in total CML CD34<sup>+</sup> cells and high-resolution tracking of cell division were assayed by flow cytometry.</p> <p><b>Results:</b> Measurements of cell-associated IM uptake showed significantly lower drug levels in CD34<sup>+</sup> cells, particularly the CD38<sup>-</sup> subpopulation, as compared to IM-sensitive K562 cells. MDR1 was expressed at low level and dye efflux studies demonstrated very little MDR1 activity in CML CD34<sup>+</sup> cells. Furthermore, combination treatment of primitive CML cells with IM and the MDR1 inhibitor PSC833 did not result in elevated cell-associated IM levels. Although we observed slightly enhanced cytostasis with IM when combined with PSC833, this was independent of BCR-ABL inhibition because no associated decrease in phospho-CrkL was observed.</p> <p><b>Conclusions:</b> Our findings demonstrate that inhibition of MDR1 neither enhances the effect of IM against BCR-ABL activity, nor significantly potentiates IM's efficiency in eliminating primitive CML cells.</p&gt

Late Winter Biogeochemical Conditions Under Sea Ice in the Canadian High Arctic

With the Arctic summer sea-ice extent in decline, questions are arising as to how changes in sea-ice dynamics might affect biogeochemical cycling and phenomena such as carbon dioxide (CO2) uptake and ocean acidification. Recent field research in these areas has concentrated on biogeochemical and CO2 measurements during spring, summer or autumn, but there are few data for the winter or winter–spring transition, particularly in the High Arctic. Here, we present carbon and nutrient data within and under sea ice measured during the Catlin Arctic Survey, over 40 days in March and April 2010, off Ellef Ringnes Island (78° 43.11′ N, 104° 47.44′ W) in the Canadian High Arctic. Results show relatively low surface water (1–10 m) nitrate (<1.3 µM) and total inorganic carbon concentrations (mean±SD=2015±5.83 µmol kg−1), total alkalinity (mean±SD=2134±11.09 µmol kg−1) and under-ice pCO2sw (mean±SD=286±17 µatm). These surprisingly low wintertime carbon and nutrient conditions suggest that the outer Canadian Arctic Archipelago region is nitrate-limited on account of sluggish mixing among the multi-year ice regions of the High Arctic, which could temper the potential of widespread under-ice and open-water phytoplankton blooms later in the season

Identifying viable regulatory and innovation pathways for regenerative medicine:A case study of cultured red blood cells

The creation of red blood cells for the blood transfusion markets represents a highly innovative application of regenerative medicine with a medium term (5–10 year) prospect for first clinical studies. This article describes a case study analysis of a project to derive red blood cells from human embryonic stem cells, including the systemic challenges arising from (i) the selection of appropriate and viable regulatory protocols and (ii) technological constraints related to stem cell manufacture and scale up to clinical Good Manufacturing Practice (GMP) standard. The method used for case study analysis (Analysis of Life Science Innovation Systems (ALSIS)) is also innovative, demonstrating a new approach to social and natural science collaboration to foresight product development pathways. Issues arising along the development pathway include cell manufacture and scale-up challenges, affected by regulatory demands emerging from the innovation ecosystem (preclinical testing and clinical trials). Our discussion reflects on the efforts being made by regulators to adapt the current pharmaceuticals-based regulatory model to an allogeneic regenerative medicine product and the broader lessons from this case study for successful innovation and translation of regenerative medicine therapies, including the role of methodological and regulatory innovation in future development in the field

Prospects for the manufacture of red cells for transfusion

Whilst red cell transfusion is a well established cellular therapy, the problems of insufficiency of supply, transfusion transmitted infections and the requirement for immunological matching persist. The possibility of generating large numbers of O Rh D negative red cells at Good Manufacturing Practice grade as a route to circumvent these issues is therefore an attractive proposition. Significant numbers of erythrocytes can be generated from somatic haematopoietic stem cells, but it seems unlikely that these can provide sufficient volumes for large scale manufacture. However, human embryonic stem cells (hESC) and, potentially, induced pluripotent stem cells (iPSC), may provide a route to this objective. Red cell transfusion is an attractive goal for pluripotent stem cell-derived therapeutics because it is a well-characterised single cell suspension that lacks nucleated cells and has a low expression of human leucocyte antigen molecules, but many challenges remain in translating this cellular therapy to the clinic

Isolation and therapeutic potential of human haemopoietic stem cells

The haemopoietic stem cell (HSC) has long been regarded as an archetypal, tissue specific, stem cell, capable of completely regenerating haemopoiesis after myeloablation. It has proved relatively easy to harvest HSC, from bone marrow or peripheral blood. In turn, isolation of these cells has allowed therapeutic stem cell transplantation protocols to be developed, that capitalise on their prodigious self renewal and proliferative capabilities. &lt;i&gt;Ex vivo&lt;/i&gt; approaches have been described to isolate, genetically manipulate and expand pluripotent stem cell subsets. These techniques have been crucial to the development of gene therapy, and may allow adults to enjoy the potential advantages of cord blood transplantation. Recently, huge conceptual changes have occurred in stem cell biology. In particular, the dogma that, in adults, stem cells are exclusively tissue restricted has been questioned and there is great excitement surrounding the potential plasticity of these cells, with the profound implications that this has, for developing novel cellular therapies. Mesenchymal stem cells, multipotent adult progenitor cells and embryonic stem cells are potential sources of cells for transplantation purposes. These cells may be directed to produce HSC, &lt;i&gt;in vitro&lt;/i&gt; and in the future may be used for therapeutic, or drug development, purposes

Functional ABCG2 is overexpressed on primary CML CD34⁺ cells and is inhibited by imatinib mesylate

Imatinib mesylate (IM) therapy for chronic myeloid leukemia (CML) has transformed the treatment of this disease. However, the vast majority of patients, despite major responses, still harbor Philadelphia chromosome-positive (Ph&lt;sup&gt;+&lt;/sup&gt;) cells. We have described a population of primitive Ph&lt;sup&gt;+&lt;/sup&gt; cells that are insensitive to IM and may be a source of IM resistance. Cell line studies have suggested that the drug transporter ABCG2 may be a mediator of IM resistance, however there is considerable debate about whether IM is an ABCG2 substrate or inhibitor. We demonstrate here that primitive CML CD34&lt;sup&gt;+&lt;/sup&gt; cells aberrantly overexpress functional ABCG2 but that cotreatment with IM and an ABCG2 inhibitor does not potentiate the effect of IM. We definitively show that IM is an inhibitor of, but not a substrate for, ABCG2 and that, therefore, ABCG2 does not modulate intracellular concentrations of IM in this clinically relevant cell population

Punish the parent not the progeny

Chronic myeloid leukemia (CML) is sustained by a rare population of primitive, quiescent, BCR-ABL&lt;sup&gt;+&lt;/sup&gt; cells and represents an excellent example of a malignancy in which tumor-initiating cells represent the key to disease eradication. CML is also the first malignancy for which targeted therapy has replaced conventional chemotherapy. Within a vast excess of proliferating progenitor cells that express breakpoint cluster regionabelson (BCR-ABL) and are exquisitely sensitive to the tyrosine kinase inhibitor imatinib mesylate (IM) resides a small population of quiescent leukemic cells that, despite higher levels of BCR-ABL transcripts, exhibits innate insensitivity to IM. These cells remain after IM therapy, even when apparently complete responses are achieved, and they probably explain molecular disease persistence. Although it can be argued that patients may survive for many years with low levels of leukemia still present, it is possible to achieve disease clearance at the molecular level following an allogeneic stem cell transplantation. The emergence of drug resistance with IM monotherapy also argues in favor of complete disease eradication that we believe should remain the ultimate therapeutic goal in CML. New approaches to the elimination of these primitive CML cells may thus be crucial to the development of curative strategies

Nilotinib exerts equipotent antiproliferative effects to imatinib and does not induce apoptosis in CD34⁺ CML cells

Chronic myeloid leukemia (CML) stem and progenitor cells overexpress BcrAbl and are insensitive to imatinib mesylate (IM). We therefore investigated whether these cells were efficiently targeted by nilotinib. In K562, the inhibitory concentration (IC50) of nilotinib was 30 nM versus 600 nM for IM, consistent with its reported 20-fold-higher potency. However, in primary CD34&lt;sup&gt;+&lt;/sup&gt; CML cells, nilotinib and IM were equipotent for inhibition of BcrAbl activity, producing equivalent but incomplete reduction in CrkL phosphorylation at 5 mu M. CML CD34&lt;sup&gt;+&lt;/sup&gt; cells were still able to expand over 72 hours with 5 mu M of either drug, although there was a concentration-dependent restriction of amplification. As for IM, the most primitive cells (CFSEmax) persisted and accumulated over 72 hours with nilotinib and remained caspase-3 negative. Furthermore, nilotinib with IM led to further accumulation of this population, suggesting at least additive antiproliferative effects. These results confirmed that, like IM, the predominant effect of nilotinib is antiproliferative rather than proapoptotic

Proton magnetic resonance and human cervical neoplasia

Proton chemical-shift imaging at 8.5 T has been used to detect malignant foci in small (6 mm3) biopsies from the human uterine cervix. Images based on the lipid resonances of frankly malignant cells discriminate between tumor tissue and host stroma and distinguish invasive from preinvasive cervical cancer (n = 7). With this method, foci of malignant cells were revealed in 500 μm slices with an in-plane resolution of 40 by 160 μm. The MR intensity maps reflected the local distribution of malignant cells as assessed by histopathology. The lower signal-to-noise ratio inherent for these non-water-based images was improved by applying postacquisitional matched Gaussian window functions, thus effecting a substantial increase in contrast with minimal loss in spatial resolution

Red blood cells from pluripotent stem cells for use in transfusion

The use of donated red blood cells in transfusion is a well-established cellular therapy. However, problems including insufficient supply, transfusion-transmitted infections and the need for immunological matching hamper even in the best services. These issues may be eliminated by using pluripotent stem cells to generate universal donor group O, Rhesus D-negative red blood cells. Human embryonic stem cells can be maintained and expanded indefinitely and can, therefore, produce the very large cell numbers required for this application. Red blood cell production is also an attractive goal for pluripotent stem cell-derived therapeutics because it is a well-characterized single cell suspension, lacking nucleated cells and with a low expression of HLA molecules. Much progress has been made; however, a number of challenges remain including scale-up, clinical effectiveness and product safety