Rôle des protéines de choc thermique dans les néoplasies myéloprolifératives : implication de HSP27 dans la myélofibrose

Myelofibrosis (MF) is the most aggressive myeloproliferative neoplasms (MPN) with the highest degree of morbidity and mortality, including progressive bone marrow fibrosis resulting into bone marrow failure. JAK2 kinase inhibitors have been successfully used for a few years in MPN and more particularly for MF treatment. Nevertheless, their beneficial effects are mainly restricted on symptoms and not on the course of the disease. Recently, heat shock protein 90 (HSP90) - known to stabilize JAK2 - has been reported as a promising therapeutic target in MPN. However HSP90 inhibitors show toxicity and induce the expression of stress-inducible proteins such as HSP70 and, most likely HSP27 as previously shown in other cancers. In addition, we and others have shown that HSP27, was strongly expressed in patients with idiopathic pulmonary or kidney tubulointerstitial fibrosis, underlying a relevant role of HSP27 in fibrotic processes. Taking into account both the beneficial effects of HSP inhibitors in leukemia and in MPN, and the possible implication of HSP27 in fibrosis, we have evaluated here the status of HSP27 in MF patient’s samples and assess the effectiveness of an HSP27 oligonucleotide inhibitor called OGX-427 in murine models. We report here the effect of OGX-427 in two murine models of thrombopoietin- and JAKV617F-induced myelofibrosis. OGX-427 limited the progression of the disease associated with a reduction of spleen weight and of megakaryocytic expansion. And more recently, our additional results show a decrease of reticulin fibrosis in JAK2V617F’s bone marrow. We show that HSP27 regulates JAK2/STAT5 proliferative effect through direct interactions, and we report an increase expression of HSP27 both in CD34+ circulating progenitors and in the serum of patients with NMP with fibrosis. Taking altogether, this work supports that extra and intracellular HSP27 plays a key role of in the pathophysiology in MF and highlight the potential therapeutic benefit of HSP27 inhibitors in this disorder.La myélofibrose (MF) est la plus agressive des néoplasies myéloprolifératives (NMP). Elle porte à elle seule le plus mauvais pronostic pour les patients puisqu’elle s’accompagne d’une fibrose de la moelle osseuse évoluant vers une insuffisance médullaire. Les inhibiteurs de la kinase JAK2 ont apporté de nouveaux espoirs pour le traitement des NPM mais leurs effets ont été essentiellement bénéfiques sur les symptômes et non sur la fibrose elle-même ni sur le cours de la maladie. Plus récemment, la protéine de choc thermique 90 (HSP90) - connue pour stabiliser JAK2 - est apparue comme une cible thérapeutique prometteuse pour les NMP. Cependant, les inhibiteurs de la HSP90 ont montré une toxicité importante accompagnée d’une expression compensatoire des HSPs inductibles (i.e HSP70, HSP27), connues pour favoriser l’émergence de phénomène de résistance. Par ailleurs, des études ont montré que HSP27 était fortement exprimée chez les patients présentant une fibrose pulmonaire idiopathique ou rénale montrant l’importance de HSP27 dans les processus fibrotiques. Sur la base de l’ensemble de ces données, nous avons évalué d’une part l'efficacité chez l’animal d'un oligonucléotide inhibiteur spécifique de HSP27 appelé OGX-427 (en essai clinique dans plusieurs cancers). D’autre part, nous avons déterminé le niveau d’expression intra- et extracellulaire de HSP27 chez des patients atteints de MF. L'effet de l'OGX-427 a été évalué dans deux modèles murins de myélofibrose, laquelle est induite soit par la sécrétion excessive de thrombopoïétine (TPOhigh) soit par la mutation JAKV617F. Nous avons mis en évidence dans les souris traitées par l’OGX-427, une réduction de la taille de la rate, de la prolifération mégacaryocytaire et de l’hématopoïèse extramédullaire par rapport aux souris contrôles, révélant ainsi un effet bénéfique de l’inhibition de HSP27 sur la progression de la maladie. De toutes récentes observations complémentaires à ce travail ont également montré une diminution de la fibrose réticulinique dans la moelle osseuse de souris JAKV617F. Au niveau moléculaire, nous démontrons que l'effet prolifératif induit par la voie de signalisation exacerbée - JAK2/STAT5 - est régulé par HSP27 via des interactions directes. Pour finir, nous avons détecté une augmentation de l'expression de HSP27 aussi bien dans les progéniteurs circulants CD34+ que dans le sérum des patients atteints de NMP avec MF. Ce travail révèle pour la première fois le rôle intra et extracellulaire de HSP27 dans la physiopathologie de la MF et le bénéfice thérapeutique potentiel de l’utilisation des inhibiteurs de HSP27 dans cette maladie

Role of heat shock protein in myeloproliferative neoplasms : involvement of HSP27 in myelofibrosis

La myélofibrose (MF) est la plus agressive des néoplasies myéloprolifératives (NMP). Elle porte à elle seule le plus mauvais pronostic pour les patients puisqu’elle s’accompagne d’une fibrose de la moelle osseuse évoluant vers une insuffisance médullaire. Les inhibiteurs de la kinase JAK2 ont apporté de nouveaux espoirs pour le traitement des NPM mais leurs effets ont été essentiellement bénéfiques sur les symptômes et non sur la fibrose elle-même ni sur le cours de la maladie. Plus récemment, la protéine de choc thermique 90 (HSP90) - connue pour stabiliser JAK2 - est apparue comme une cible thérapeutique prometteuse pour les NMP. Cependant, les inhibiteurs de la HSP90 ont montré une toxicité importante accompagnée d’une expression compensatoire des HSPs inductibles (i.e HSP70, HSP27), connues pour favoriser l’émergence de phénomène de résistance. Par ailleurs, des études ont montré que HSP27 était fortement exprimée chez les patients présentant une fibrose pulmonaire idiopathique ou rénale montrant l’importance de HSP27 dans les processus fibrotiques. Sur la base de l’ensemble de ces données, nous avons évalué d’une part l'efficacité chez l’animal d'un oligonucléotide inhibiteur spécifique de HSP27 appelé OGX-427 (en essai clinique dans plusieurs cancers). D’autre part, nous avons déterminé le niveau d’expression intra- et extracellulaire de HSP27 chez des patients atteints de MF. L'effet de l'OGX-427 a été évalué dans deux modèles murins de myélofibrose, laquelle est induite soit par la sécrétion excessive de thrombopoïétine (TPOhigh) soit par la mutation JAKV617F. Nous avons mis en évidence dans les souris traitées par l’OGX-427, une réduction de la taille de la rate, de la prolifération mégacaryocytaire et de l’hématopoïèse extramédullaire par rapport aux souris contrôles, révélant ainsi un effet bénéfique de l’inhibition de HSP27 sur la progression de la maladie. De toutes récentes observations complémentaires à ce travail ont également montré une diminution de la fibrose réticulinique dans la moelle osseuse de souris JAKV617F. Au niveau moléculaire, nous démontrons que l'effet prolifératif induit par la voie de signalisation exacerbée - JAK2/STAT5 - est régulé par HSP27 via des interactions directes. Pour finir, nous avons détecté une augmentation de l'expression de HSP27 aussi bien dans les progéniteurs circulants CD34+ que dans le sérum des patients atteints de NMP avec MF. Ce travail révèle pour la première fois le rôle intra et extracellulaire de HSP27 dans la physiopathologie de la MF et le bénéfice thérapeutique potentiel de l’utilisation des inhibiteurs de HSP27 dans cette maladie.Myelofibrosis (MF) is the most aggressive myeloproliferative neoplasms (MPN) with the highest degree of morbidity and mortality, including progressive bone marrow fibrosis resulting into bone marrow failure. JAK2 kinase inhibitors have been successfully used for a few years in MPN and more particularly for MF treatment. Nevertheless, their beneficial effects are mainly restricted on symptoms and not on the course of the disease. Recently, heat shock protein 90 (HSP90) - known to stabilize JAK2 - has been reported as a promising therapeutic target in MPN. However HSP90 inhibitors show toxicity and induce the expression of stress-inducible proteins such as HSP70 and, most likely HSP27 as previously shown in other cancers. In addition, we and others have shown that HSP27, was strongly expressed in patients with idiopathic pulmonary or kidney tubulointerstitial fibrosis, underlying a relevant role of HSP27 in fibrotic processes. Taking into account both the beneficial effects of HSP inhibitors in leukemia and in MPN, and the possible implication of HSP27 in fibrosis, we have evaluated here the status of HSP27 in MF patient’s samples and assess the effectiveness of an HSP27 oligonucleotide inhibitor called OGX-427 in murine models. We report here the effect of OGX-427 in two murine models of thrombopoietin- and JAKV617F-induced myelofibrosis. OGX-427 limited the progression of the disease associated with a reduction of spleen weight and of megakaryocytic expansion. And more recently, our additional results show a decrease of reticulin fibrosis in JAK2V617F’s bone marrow. We show that HSP27 regulates JAK2/STAT5 proliferative effect through direct interactions, and we report an increase expression of HSP27 both in CD34+ circulating progenitors and in the serum of patients with NMP with fibrosis. Taking altogether, this work supports that extra and intracellular HSP27 plays a key role of in the pathophysiology in MF and highlight the potential therapeutic benefit of HSP27 inhibitors in this disorder

HSP90 and HSP70: Implication in Inflammation Processes and Therapeutic Approaches for Myeloproliferative Neoplasms

Myeloproliferative neoplasms (MPN) are clonal stem cell disorders that lead to the excessive production of one or more blood cell lineages. It has been reported that, in most MPN, inflammatory cytokines are frequently increased, indicating that inflammation plays a crucial role in these disorders. Heat shock proteins (HSP) are induced in response to many stressful conditions from heat shock to hypoxia and inflammation. Besides their chaperone and cytoprotective functions, HSPs are key players during inflammation, hence the term “chaperokine.” Through their chaperone activity, HSP90, a stabilizer of many oncogenes (e.g., JAK2), and HSP70, a powerful antiapoptotic chaperone, tightly regulate Nuclear Factor-kappa B signalling, a critical pathway in mediating inflammatory responses. In light of this potential, several HSP90 inhibitors have been generated as anticancer agents able to degrade oncogenes. As it turns out, however, these drugs are also potent inhibitors of the inflammatory response in various diseases. Given the chaperone potential of HSP70 and the fact that HSP90 inhibitors induce HSP70, interest in HSP70 inhibitors is also increasing. Here, we focus on the implication of HSP90 and HSP70 in inflammatory responses and on the emergence of new therapeutic approaches in MPN based on HSP inhibitors

Important Requirements for Desorption/Ionization Mass Spectrometric Measurements of Temozolomide-Induced 2′-Deoxyguanosine Methylations in DNA

In clinical pharmacology, drug quantification is mainly performed from the circulation for pharmacokinetic purposes. Finely monitoring the chemical effect of drugs at their chemical sites of action for pharmacodynamics would have a major impact in several contexts of personalized medicine. Monitoring appropriate drug exposure is particularly challenging for alkylating drugs such as temozolomide (TMZ) because there is no flow equilibrium that would allow reliable conclusions to be drawn about the alkylation of the target site from plasma concentrations. During the treatment of glioblastoma, it appears, therefore, promising to directly monitor the alkylating effect of TMZ rather than plasma exposure, ideally at the site of action. Mass spectrometry (MS) is a method of choice for the quantification of methylated guanines and, more specifically, of O6-methylguanines as a marker of TMZ exposure at the site of action. Depending on the chosen strategy to analyze modified purines and 2′-deoxynucleosides, the analysis of methylated guanines and 2′-deoxyguanosines is prone to important artefacts due to the overlap between masses of (i) guanines from DNA and RNA, and (ii) different methylated species of guanines. Therefore, the specific analysis of O6-methyl-2′deoxyguanosine, which is the product of the TMZ effect, is highly challenging. In this work, we report observations from matrix-assisted laser desorption/ionization (MALDI), and desorption electrospray ionization (DESI) MS analyses. These allow for the construction of a decision tree to initiate studies using desorption/ionization MS for the analysis of 2′-deoxyguanosine methylations induced by TMZ

Important Requirements for Desorption/Ionization Mass Spectrometric Measurements of Temozolomide-Induced 2′-Deoxyguanosine Methylations in DNA

In clinical pharmacology, drug quantification is mainly performed from the circulation for pharmacokinetic purposes. Finely monitoring the chemical effect of drugs at their chemical sites of action for pharmacodynamics would have a major impact in several contexts of personalized medicine. Monitoring appropriate drug exposure is particularly challenging for alkylating drugs such as temozolomide (TMZ) because there is no flow equilibrium that would allow reliable conclusions to be drawn about the alkylation of the target site from plasma concentrations. During the treatment of glioblastoma, it appears, therefore, promising to directly monitor the alkylating effect of TMZ rather than plasma exposure, ideally at the site of action. Mass spectrometry (MS) is a method of choice for the quantification of methylated guanines and, more specifically, of O6-methylguanines as a marker of TMZ exposure at the site of action. Depending on the chosen strategy to analyze modified purines and 2′-deoxynucleosides, the analysis of methylated guanines and 2′-deoxyguanosines is prone to important artefacts due to the overlap between masses of (i) guanines from DNA and RNA, and (ii) different methylated species of guanines. Therefore, the specific analysis of O6-methyl-2′deoxyguanosine, which is the product of the TMZ effect, is highly challenging. In this work, we report observations from matrix-assisted laser desorption/ionization (MALDI), and desorption electrospray ionization (DESI) MS analyses. These allow for the construction of a decision tree to initiate studies using desorption/ionization MS for the analysis of 2′-deoxyguanosine methylations induced by TMZ

Approaching Sites of Action of Temozolomide for Pharmacological and Clinical Studies in Glioblastoma

Temozolomide (TMZ), together with bulk resection and focal radiotherapy, is currently a standard of care for glioblastoma. Absorption, distribution, metabolism, and excretion (ADME) parameters, together with the mode of action of TMZ, make its biochemical and biological action difficult to understand. Accurate understanding of the mode of action of TMZ and the monitoring of TMZ at its anatomical, cellular, and molecular sites of action (SOAs) would greatly benefit precision medicine and the development of novel therapeutic approaches in combination with TMZ. In the present perspective article, we summarize the known ADME parameters and modes of action of TMZ, and we review the possible methodological options to monitor TMZ at its SOAs. We focus our descriptions of methodologies on mass spectrometry-based approaches, and all related considerations are taken into account regarding the avoidance of artifacts in mass spectrometric analysis during sampling, sample preparation, and the evaluation of results. Finally, we provide an overview of potential applications for precision medicine and drug development

Calreticulin Mutations in Myeloproliferative Neoplasms: Comparison of Three Diagnostic Methods.

Calreticulin (CALR) mutations have recently been reported in 70-84% of JAK2V617F-negative myeloproliferative neoplasms (MPN), and this detection has become necessary to improve the diagnosis of MPN. In a large single-centre cohort of 298 patients suffering from Essential Thrombocythemia (ET), the JAK2V617F, CALR and MPL mutations were noted in 179 (60%), 56 (18.5%) and 13 (4.5%) respectively. For the detection of the CALR mutations, three methods were compared in parallel: high-resolution melting-curve analysis (HRM), product-sizing analysis and Sanger sequencing. The sensitivity for the HRM, product-sizing analysis and Sanger sequencing was 96.4%, 98.2% and 89.3% respectively, whereas the specificity was 96.3%, 100% and 100%. In our cohort, the product-sizing analysis was the most sensitive method and was the easiest to interpret, while the HRM was sometimes difficult to interpret. In contrast, when large series of samples were tested, HRM provided results more quickly than did the other methods, which required more time. Finally, the sequencing method, which is the reference method, had the lowest sensitivity but can be used to describe the type of mutation precisely. Altogether, our results suggest that in routine laboratory practice, product-sizing analysis is globally similar to HRM for the detection of CALR mutations, and that both may be used as first-line screening tests. If the results are positive, Sanger sequencing can be used to confirm the mutation and to determine its type. Product-sizing analysis provides sensitive and specific results, moreover, with the quantitative measurement of CALR, which might be useful to monitor specific treatments

HSP27 is a partner of JAK2-STAT5 and a potential therapeutic target in myelofibrosis

Myelofibrosis is a chronic degenerative disorder characterized by progressive bone marrow fibrosis. Here, the authors show that the chaperone HSP27 contributes to myelofibrosis via regulation of the JAK2/STAT5 pathway, and that antisense oligonucleotides targeting HSP27 are effective in two mouse models of the diseas

Results of <i>CALR</i> mutations among 83 ET patients.

<p>Results of <i>CALR</i> mutations among 83 ET patients.</p