Le corps humain est composé de plus de 100 000 protéines qui interagissent entre elles afin d’assurer son bon fonctionnement. Néanmoins, il peut arriver que certaines de ces protéines subissent une mutation changeant l’équilibre de fonctions du corps telles que la réplication cellulaire. Ces mutations affectant la réplication cellulaire peuvent mener à des cancers, une maladie qui touche de plus en plus de gens à travers le monde. Afin de développer des médicaments efficaces contre cette maladie, il est nécessaire de bien comprendre les mécanismes biologiques impliqués pour établir une approche thérapeutique. Cette compréhension repose notamment sur l’utilisation d’outils moléculaires, de petites molécules possédant des fonctions chimiques versatiles pouvant donner des informations critiques dans le développement de médicaments. Ce présent mémoire se consacre sur le développement d’outils moléculaires à travers deux projets ayant des objectifs distincts. Le premier projet avait comme principal objectif d’approfondir les connaissances sur l’inhibition de la protéine RAS, une GTPase responsable de plus de 30% des cancers. À cet effet, l’approche privilégiée a été celle de la synthèse de macrocycles peptidiques se liant à la cystéine 118 de RAS d’après la structure du monobody NS1. Les structures cristallines et les données protéomiques obtenues ont permis d’identifier les interactions clés entre la protéine RAS et une série d’inhibiteurs cherchant à émuler les effets biologiques de NS1. Le second projet s’intéresse quant à lui aux effets du composé UM171 sur les cellules souches. En effet, cette petite molécule possède la capacité d’empêcher la différenciation des cellules souches hématopoïétiques et permet donc leur multiplication. Cette propriété est une source d’espoir dans le traitement des leucémies et des transplantions. Cependant, la cible biologique de ce composé reste un mystère à ce jour. Ainsi la seconde partie de ce mémoire mettra de l’avant la synthèse d’outils moléculaire à base de diazirines pour tenter de venir identifier la cible d’intérêt en utilisant la protéomique. / The human body is made up of more than 100 000 proteins which interact with each other to keep it functioning properly. However, it can happen that some of these proteins undergo a mutation which changes the balance of body functions such as cell proliferation. These mutations affecting cell proliferation can lead to cancer, a disease that is affecting more and more people around the world. To develop effective drugs against this disease, it is necessary to understand the biological mechanisms involved in order to establish a therapeutic approach. This understanding is particularly based on the use of molecular tools, small molecules with versatile chemical functions that can provide critical information for drug development. This thesis is devoted to the development of molecular tools through two projects with distinct objectives. The main objective of the first project was to deepen knowledge about the inhibition of the RAS protein, a GTPase responsible for more than 30% of cancers. To this end, the preferred approach has been the synthesis of peptide macrocycles binding to RAS cysteine 118 based on the structure of NS1 monobody. The crystal structures and proteomic data obtained have made it possible to identify key interactions between the RAS protein and a series of inhibitors seeking to emulate the biological effects of NS1. The second project focuses on the effects of compound UM171 on stem cells. Indeed, this small molecule can prevent the differentiation of hematopoietic stem cells and therefore allows their multiplication. This property is a source of hope in the treatment of leukemia and transplants. However, the biological target of this compound remains a mystery to this day. Thus, the second part of this thesis will focus on the synthesis of molecular tools based on diazirines in an attempt to identify the target of interest using proteomics.

Clonal haematopoiesis of indeterminate potential, or CHIP are a family of mutations present in the general population. CHIP-mutations are prevalent in the haematopoietic stem cells and in the more mature cell populations, T-lymphocytes, B-lymphocytes and myeloid cells (CD3+, CD19+ and CD33+ cells) in blood. By separating these cell populations using magnetic isolation, extracting DNA from the cell populations, and detecting the same mutation in all cell populations, one can prove the presence of CHIP-mutations in a hematopoietic stem cell. At least 50 ng good quality DNA is needed for the gene analysis to detect CHIP-mutations. The magnet separated cell population may be very small, so the DNA extraction method must be optimized to achieve enough DNA yield. The main purpose of the method development was to compare two storage methods before DNA-extractions, and then three different DNA-quantification methods after the DNA-extractions. After the best storage and quantification methods were identified, five samples of cryo-preserved viable cells were used to isolate cell populations using magnetic beads covered in specific antibodies and a magnetic field, and then quantified. Results of the study showed that the best way was to store the cells in ATL-buffer and Proteinase K. To quantify DNA, qPCR was the most accurate method, since the other methods showed incorrect results because of the low DNA concentrations. Magnet cell separation was partly successful. All except one of the DNA yields from the cell separation protocols reached the critical amount of DNA, but some yields were not pure yields of the sought-after cell population. In general, the method must be worked on more with further research.

Indiana University-Purdue University Indianapolis (IUPUI) / Internal tandem duplications in FMS-like receptor tyrosine kinase (FLT3-ITDs) are seen in approximately 25% of all acute myeloid leukemia (AML) patients. FLT3-ITDs induce FLT3 ligand (FL)-independent cellular hyperproliferation, promiscuous and aberrant activation of STAT5, and confer a poor prognosis in patients; however, the molecular mechanisms contributing to FLT3-ITD-induced malignancy remain largely unknown. The protein tyrosine phosphatase, Shp2, is important for normal hematopoiesis as well as hematopoietic stem cell (HSC) differentiation, engraftment, and self-renewal. Furthermore, FLT3-ITD- or constitutive active STAT5-expressing CD34+ cells demonstrate enhanced hematopoietic stem cell self-renewal. Together with the previous findings that Shp2 is critical for normal hematopoiesis, that dysregulated Shp2 function contributes to myeloid malignancies, and that Shp2 has been shown to interact with WT-FLT3 tyrosine 599, which is commonly duplicated in FLT3-ITDs, a positive role for Shp2 in FLT3-ITD-induced signaling and leukemogenesis is implied. I demonstrated that Shp2 is constitutively associated with the reported FLT3-ITDs, N51-FLT3 and N73-FLT3, compared to WT-FLT3; therefore, I hypothesized that increased Shp2 recruitment to N51-FLT3 or N73-FLT3 contributes to hyperproliferation and hyperactivation of STAT5. I also hypothesized that Shp2 cooperates with STAT5 to activate STAT5 transcriptional targets contributing to the up-regulation of pro-leukemic proteins. Finally, I hypothesized that reduction of Shp2 would result in diminished N51-FLT3-induced hyperproliferation and activation of STAT5 in vitro, and prevent FLT3-ITD-induced malignancy in vivo. I found that genetic disruption of Ptpn11, the gene encoding Shp2, or pharmacologic inhibition of Shp2 with the novel Shp2 inhibitor, II-B08, resulted in significantly reduced FLT3-ITD-induced hematopoietic cell hyperproliferation and STAT5 hyperphosphorylation. I also demonstrated a novel role of Shp2 in the nucleus of FLT3-ITD-expressing hematopoietic cells where Shp2 and STAT5 co-localized at the promoter region of STAT5-transcriptional target and pro-survival protein, Bcl-XL. Furthermore, using a Shp2flox/flox;Mx1Cre+ mouse model, I demonstrated that reduced Shp2 expression in hematopoietic cells resulted in an increased latency to and reduced severity of FLT3-ITD-induced malignancy. Collectively, these findings demonstrate that Shp2 plays an integral role in FLT3-ITD-induced malignancy and suggest that targeting Shp2 may be a future therapeutic option for treating FLT3-ITD-positive AML patients.

Animal models have greatly contributed to the understanding of different aspects of human biology, as well as a variety of human-related pathogens and diseases. In order to study them, humanized mice susceptible to pathogens that replicate in human immune cells have been developed (e.g., humanized Rag2-/-γc-/- mice). These animals are engrafted with human hematopoietic stem cells (HSCs), resulting in the de novo development and maturation of the major functional components of the human adaptive immune system and the production of a variety of human cell types. Primary and secondary lymphoid organs in the mouse are populated with human cells, and animals have long term engraftment. These features make humanized mice an excellent in vivo model to study pathogenesis of human-specific viruses in the context of a human antiviral immune response. In addition, humanized mice have been shown to be useful preclinical models for the development and validation of antiviral therapeutics. In the present study, we aimed to successfully re-establish the humanized Rag2-/-γc-/- mouse model using cord blood-derived HSCs in our laboratory. We have shown that these mice sustain long term engraftment and systemic expansion of human cells, including the major targets of Kaposi's sarcoma Herpesvirus (KSHV) and Human immunodeficiency virus type 1 (HIV-1), in peripheral blood and different lymphoid organs. Further, we have begun to evaluate the susceptibility of the humanized Rag2-/-γc-/- mouse model to infection with KSHV. We demonstrate that human lymphocytes differentiated in reconstituted Rag2-/-γc-/- mice are permissive to KSHV infection ex vivo. This finding was corroborated by detection of KSHV mRNA expression in the spleen of a humanized mouse at 6 months post infection. In a different study, we tested the in vivo antiviral efficacy of a novel HIV-1 fusion inhibitor (PIE-12-trimer) in humanized Rag2-/-γc-/- mice. We have determined the half life of PIE-12-trimer in mouse plasma. Furthermore, the administration of PIE-12-trimer to HIV-1 infected humanized Rag2-/-γc-/- mice prevents depletion of CD4+ T cells in blood, thus it may be useful to prevent AIDS in human patients.

Human induced pluripotent stem cells (iPSCs) represent a scalable cell source for the generation of hematopoietic progenitor cells (iHPCs); however, a lack of efficient iHPC expansion in vitro currently limits translational applications. To address this translational bottleneck, we assessed a panel of stem cell agonist cocktails (SCACs), originally developed to enhance cord-blood derived HSPC (CB-HSPC) expansion, on iHPC expansion. Three SCACs and GAS6 (X2A, X2A+GAS6, SM6, or SMA) were supplemented during iHPC differentiation and subsequent expansion using the STEMdiff™ Hematopoietic Kit. This monolayer differentiation strategy yielded a population of CD34⁺CD43⁺ and CD45⁺CD34⁺ iHPC. SCAC supplementation during iHPC differentiation yielded up to 2.5-fold higher frequency of CD34⁺CD43⁺ hematopoietic progenitors and up to 2.9-fold higher frequency of CD45⁺CD34⁺CD45RA⁻CD90⁺ HSC-like cells compared to non-treated controls. Subsequent SCAC supplementation during 2 weeks of expansion culture also significantly increased iHPC expansion (X2A+GAS6: 3.8-fold, X2A: 3.5-fold, SM6: 2.8-fold, SMA: 2.0-fold). The expanded iHPCs retained high levels of CD34⁺CD43⁺ expression but we observed an increase in the expansion of HSC-like cell fraction. The collective expansion observed with the SCACs was 1.5- to 2.8-fold higher than UM171 treatment alone. Furthermore, all SCAC-supplemented iHPCs retained multilineage potency, producing erythroid and granulocyte-macrophage progenitors in CFU assays. However, prolonged expansion, beyond 7 days, reduced multilineage potential, indicating a limited expansion window. Although optimal timing and composition of SCAC supplementation remains to be refined, these results highlight that exploiting the additive and synergistic effects of multiple small molecules represents a promising approach for enhancing iHPC expansion yields and biomanufacturing.

[ES] Los síndromes mielodisplásicos (SMD) constituyen un grupo heterogéneo de enfermedades de naturaleza clonal caracterizadas por presentar una hematopoyesis ineficaz, citopenias y riesgo variable de evolución a leucemia mieloide aguda (LMA) secundaria. En la última década, las nuevas tecnologías de secuenciación masiva han revelado que más del 80 % de pacientes con SMD presenta mutaciones somáticas y que éstas pueden agruparse en diversas categorías en función de las rutas biológicas que se vean alteradas. Además, se ha visto que existen patrones de concurrencia y exclusión entre estas categorías de mutaciones. La adquisición secuencial y la concurrencia entre estas mutaciones desencadenan, en parte, el desarrollo de la enfermedad y genera la heterogeneidad clínica característica de los SMD. Las mutaciones en factores de splicing aparecen a menudo simultáneamente con mutaciones en reguladores epigenéticos como es el caso de los genes U2 Small Nuclear RNA Auxiliary Factor 1 (U2AF1) y Ten-eleven translocation 2 (TET2) que se encuentran co-mutados en un 13 % de los casos. A pesar de su prevalencia, los efectos de la concurrencia en las mutaciones en U2AF1 y TET2 no han sido estudiados. Por ello, en esta tesis nos propusimos estudiar esta cooperación cruzando, en primer lugar, dos líneas mutantes de ratón generadas mediante el sistema de edición genética CRISPR/Cas9. El efecto de estas alteraciones sobre la hematopoyesis de las tres líneas mutantes, U2af1mut/+, Tet2-/- y U2af1mut/+ Tet2-/-, fue examinado mediante el hemograma, citometría de flujo (CF), análisis morfológicos, ensayos de Unidades Formadoras de Colonias (CFU) y estudios funcionales como el trasplante hematopoyético. Para finalizar, se realizó un análisis transcriptómico mediante secuenciación de ARN (ARN-seq) para detectar los posibles cambios en el patrón de splicing entre las líneas mutantes y los controles. La línea mutante U2af1mut/+ no presentó ninguna alteración destacable de la hematopoyesis ni en ratones jóvenes (12-13 semanas) ni envejecidos (2 años). Sin embargo, sus células madre y progenitoras hematopoyéticas (HSPC) fueron incapaces de injertar en la médula ósea de ratones trasplantados. En el caso de los ratones mutantes Tet2-/-, observamos un incremento de células mieloides, esplenomegalia, aumento del compartimento LSK (HSPC con inmunofenotipo Linaje- Sca-1+ c-kit+) y, en los experimentos de trasplante, una capacidad de reconstitución hematopoyética superior a la de los controles. Por último, la cooperación de ambas alteraciones en la línea doble mutante U2af1mut/+ Tet2-/-, no mostró un efecto sinérgico entre ellas. Así pues, se detectaron variaciones en los progenitores mieloeritroides y un aumento significativo de células mieloides y LSK. No obstante, igual que ocurría con la línea U2af1mut/+, las HSPC no producían prendimiento en los ratones trasplantados. A pesar de las alteraciones observadas, ninguna de las tres líneas mutantes desarrollaba SMD ni fallecía antes que los controles. Respecto al análisis transcriptómico, el salto de exón fue el evento de splicing alternativo observado con mayor frecuencia en las líneas U2af1mut/+, Tet2-/- y U2af1mut/+ Tet2-/-. Únicamente un 6.6 % del total de genes que presentaba eventos de splicing alternativo fueron coincidentes en las tres líneas mutantes. A pesar de que en el análisis bioinformático se detectaron alteraciones en las rutas biológicas relacionadas con el ciclo celular, en los ratones U2af1mut/+, y el daño al ADN, en las líneas U2af1mut/+ y U2af1mut/+ Tet2-/-, en la validación mediante CF no se encontraron variaciones respecto a los controles. Para concluir, nuestros datos sugieren que, a pesar de producirse alteraciones en la hematopoyesis, la cooperación entre la mutación en U2af1 y la pérdida de Tet2 es insuficiente para iniciar SMD en ratón. / [CA] Les síndromes mielodisplàstiques (SMD) constituïxen un grup heterogeni de malalties de naturalesa clonal caracteritzades per presentar una hematopoesi ineficaç, citopènies i risc variable d'evolució a leucèmia mieloide aguda (LMA) secundària. En l'última dècada, les noves tecnologies de seqüenciació massiva han revelat que més del 80 % de pacients amb SMD presenta mutacions somàtiques i que aquestes poden agrupar-se en diverses categories en funció de les rutes biològiques que es vegen alterades. A més, s'ha vist que hi ha patrons de concurrència i exclusió entre aquestes categories de mutacions. L'adquisició seqüencial i la concurrència entre aquestes mutacions desencadenen, en part, el desenvolupament de la malaltia i genera l'heterogeneïtat clínica característica de les SMD. Les mutacions en factors de splicing apareixen sovint simultàniament amb mutacions en reguladors epigenètics com és el cas dels gens U2 Small Nuclear RNA Auxiliary Factor 1 (U2AF1) i Ten-eleven translocation 2 (TET2) que es troben co-mutats en un 13 % dels casos. A pesar de la seua prevalença, els efectes de la concurrència en les mutacions en U2AF1 i TET2 no han sigut estudiats. Per això, en aquesta tesi ens vam proposar estudiar aquesta cooperació creuant, en primer lloc, dos línies mutants de ratolí generades per mitjà del sistema d'edició genètica CRISPR/Cas9. L'efecte d'aquestes alteracions sobre l'hematopoesi de les tres línies mutants, U2af1mut/+, Tet2-/- i U2af1mut/+ Tet2-/-, va ser examinat per mitjà de l'hemograma, citometría de flux (CF), anàlisis morfològiques, assajos d'Unitats Formadores de Colònies (CFU) i estudis funcionals com el trasplantament hematopoètic. Per últim, es va realitzar l'anàlisi transcriptòmic per mitjà de seqüenciació d'ARN (ARN-seq) per a detectar els possibles canvis en el patró de splicing entre les línies mutants i els controls. La línia mutant U2af1mut/+ no va presentar cap alteració destacable de l'hematopoesi ni en ratolins jóvens (12-13 setmanes) ni envellits (2 anys). No obstant això, les seues cèl·lules mare i progenitores hematopoetiques (HSPC) van ser incapaços d'empeltar en la medul·la òssia de ratolins trasplantats. En el cas dels ratolins mutants Tet2-/-, observarem un increment de cèl·lules mieloides, esplenomegàlia, augment del compartiment LSK (cèl·lules mare amb inmunofenotip Llinatge- Sca-1+ c-kit+) i, en els experiments de trasplantament, una capacitat de reconstitució hematopoética superior a la dels controls. Finalment, la cooperació d'ambdues alteracions en la línia doble mutant U2af1mut/+ Tet2-/-, no va mostrar un efecte sinèrgic entre elles. Així, doncs, es van detectar variacions en els progenitors mieloeritroids i un augment significatiu de cèl·lules mieloides i LSK. No obstant això, igual que ocorria amb la línia U2af1mut/+, les HSPC no produïen empelt en els ratolins trasplantats. A pesar de les alteracions observades, cap de les tres línies mutants desenvolupava SMD ni moria abans que els controls. Respecte a l'anàlisi transcriptòmic, el salt d'exó va ser l'esdeveniment de splicing alternatiu observat amb major freqüència en les línies U2af1mut/+, Tet2-/- i U2af1mut/+ Tet2-/-. Únicament un 6.6 % del total de gens que presentava esdeveniments de splicing alternatiu van ser coincidents en les tres línies mutants. Encara que en l'anàlisi bioinformàtica es van detectar alteracions en les rutes biològiques relacionades amb el cicle cel·lular, en els ratolins U2af1mut/+, i el dany a l'ADN, en les línies U2af1mut/+ i U2af1mut/+ Tet2-/-, en la validació per mitjà de CF no es van trobar variacions respecte als controls. Per a concloure, les nostres dades suggerixen que, a pesar de produir-se alteracions en l'hematopoesi, la cooperació entre la mutació en U2af1 i la pèrdua de Tet2 és insuficient per a iniciar SMD en ratolí. / [EN] Myelodysplastic syndromes (MDS) comprise a heterogeneous group of clonal malignancies characterized by ineffective hematopoiesis, cytopenia and a variable risk of progression to secondary acute myeloid leukemia (AML). In the last decade, next-generation sequencing technologies have deciphered that more than 80 % of MDS patients have somatic mutations and that those can be grouped into several categories depending on which biological routes have been altered. Furthermore, it has been observed that there are concurrency and exclusion patterns among these mutation categories. The sequential acquisition and the concurrency between these driver mutations trigger, in part, the development of the disease and generate the clinical heterogeneity characteristic of MDS. The splicing factor mutations often occur simultaneously with mutations in epigenetic regulators such as the U2 Small Nuclear RNA Auxiliary Factor 1 (U2AF1) and Ten-eleven translocation 2 (TET2) genes, which are found co-mutated in 13 % of cases. Despite their prevalence, the effects of concurrence in mutations in U2AF1 and TET2 have not been studied. Consequently, in this thesis we aim to study this cooperation. Firstly, we crossed two mutant mouse lines that were previously generated using the CRISPR/Cas9 gene editing system. The effects of these alterations on hematopoiesis in the three mutant lines, U2af1mut/+, Tet2-/- y U2af1mut/+ Tet2-/-, was examinated by the blood counts, flow cytometry (FC), morphological analysis, Colony Forming Units assays (CFU) and functional studies such as the hematopoietic transplantation. Finally, transcriptomic analysis was peformed by RNA sequencing (RNA-seq) to detect possible splicing pattern changes between mutant lines and control samples. U2af1mut/+ mutant line did not present any remarkable alteration of hematopoiesis in either in young (12-13 weeks) or aged (2 years) mice. However, their hematopoietic stem and progenitor cells (HSPC) were unable to engraft into the bone marrow of transplanted mice. In the case of Tet2-/- mutant mice, we observed an increase of myeloid cells, splenomegaly, an increased LSK compartment (HSPC: Lineage- Sca-1+ c-kit+) and an enhanced ability, relative to wild-type, to reconstitute hematopoiesis in transplantation assays. Finally, the cooperation of both alterations in U2af1mut/+ Tet2-/- double mutant line did not show a synergistic effect between them. Nonetheless, the myeloerythroid progenitors were altered and also myeloid and LSK cells were increased. However, as in the U2af1mut/+ line, HSPC did not produce any engraftment in transplanted mice. Despite the observed alterations, none of the three mutant lines developed MDS or die earlier than control mice. Regarding the transcriptomic analysis, exon skipping was the most frequently observed alternative splicing event in the U2af1mut/+, Tet2-/- y U2af1mut/+ Tet2-/- lines. Only 6.6 % of the total number of genes showing alternative splicing events were coincident in the three mutant lines. Although the bioinformatic analysis revealed alterations in biological pathways related to the cell cycle in the U2af1mut/+ mice and DNA damage in the U2af1mut/+ and U2af1mut/+ Tet2-/- lines, the validation by CF found no variations with respect to the controls. In conclusion, our data suggest that, despite alterations in hematopoiesis, the cooperation between U2af1 mutation and Tet2 loss is insufficient to initiate MDS in mice. / Martínez Valiente, C. (2022). Desarrollo y caracterización de un modelo de ratón doble mutante en U2af1 y Tet2 para el estudio de los Síndromes Mielodisplásicos [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/187749 / TESIS

Graft-versus-host disease (GvHD) is a frequent, and often life-threatening, complication after an allogeneic, hematopoietic stem cell transplantation (allo-SCT). It can appear in an acute or a chronic form and presents different grades of severity. Particularly, the severe forms of GvHD are often responsible for a change of the curative intent for allo-SCT into a palliative goal of care. For this non-systematic review, we conducted a focused literature search in the MEDLINE database via PubMed to examine whether patients with severe forms of GvHD might have special needs and burdens from a supportive and palliative care perspective. To draw a comprehensive picture of this patient group, we included findings on quality of life (QoL) and physical symptoms and function as well as psychological and spiritual well-being. In most domains, patients with severe forms of GvHD showed greater impairment and a higher symptom burden compared to patients with milder forms of GvHD. However, we could not identify any studies that specifically investigated patients with severe forms of GvHD. Further research in this field is necessary to guarantee the highest standard of care for this very special patient group.

<p dir="ltr">Hematopoietic stem cells (HSCs) originating from aorta-gonad-mesonephros (AGM) could self-renew and develop into various immune cells, such as T cells, neutrophil and natural killer (NK) cells, rendering them as a promising cell source for immunotherapy. NK cells belong to the family of the innate lymphoid cells, and are employed as one of immunotherapy to cure solid and hematological malignancies including leukemia. Neutrophils are one of the granulocytes, and they are emerging as a new therapeutic target in various cancers. Due to the lack of reliable sources for the amounts of HSCs and immune cells required for clinical infusions (~10⁹ cells/patient), it remains as a major challenge to realize their full potential in targeted cell and immunotherapy. While substantial efforts have been made to generate native cell-like HSPCs and immune cells from human pluripotent stem cells (hPSCs), intricate molecular process governing the differentiation of HSCs and immune cells remain elusive, preventing the development of robust strategies for HSC and immune cell productions.</p><p dir="ltr">In this study, we first demonstrated that critical role of temporally regulating Wnt signaling in initiating AGM-like hematopoiesis across 11 hPSC lines. By inhibiting TGFβ at the stage of aorta-like CD34+SOX17⁺ hemogenic endothelium, which led to the downregulation of Wnt signaling, we established a chemically defined, feeder-free culture system that efficiently produced robust AGM-like hematopoietic cells. Furthermore, we investigated how hypoxia affects the <i>in vitro</i> hPSC differentiation into HSPCs, which resulted in a hypoxia-enhanced HSPC differentiation platform.</p><p dir="ltr">Next, the temporal roles of transcription factors (TFs), including <i>NFIL3</i>, <i>ID2</i>,<i> </i>and <i>SPI1</i>, in regulating and promoting NK cell differentiation from hPSCs are determined. <i>NFIL3</i> and <i>SPI1</i> have been reported to influence the early stages of NK cell development, while <i>ID2</i> has an impact on the generation of NK cells throughout the early and intermediate stage. We genetically modified hPSCs with doxycycline-inducible expression of <i>NFIL3</i>, <i>ID2</i>,<i> </i>and <i>SPI1</i>, and investigated their roles in NK cell induction from hPSCs. Among these three TFs, forced expression of <i>ID2</i> yielded the highest percentage of NK cells under a chemically defined, feeder-free monolayer culture condition, demonstrating that forced expression of NK-specific TFs improves the efficiency of NK cell differentiation from hPSCs.</p><p dir="ltr">Chimeric antigen receptor (CAR) is an artificial cell receptor expressed on immune T or NK cells that has been engineered to allow T or NK cells to re-target cancer cells by exclusively binding to a cancer-specific protein. CAR engineering has significantly improved the anti-tumor efficacy of NK cell therapy, resulting in 6 FDA-approved CAR-T therapies and many other ongoing clinical trials. Recently, a chlorotoxin (CLTX)-based CAR was developed and shown to specifically bind to a variety of heterogenous glioblastoma (GBM) cell lines. To test whether CLTX-CAR could improve the anti-tumor cytotoxicity of hPSC-derived NK cells, hPSCs were engineered with CLTX-CAR for stable and homogenous CAR expression via Cas9-mediated homologous recombination. The expression of CLTX-CAR did not affect the pluripotency and NK cell differentiation potential of hPSCs, and CLTX-CAR significantly improved the cytotoxicity of hPSC-derived NK cells against GBM cells.</p><p dir="ltr">Finally, we implemented a GBM-on-a-chip microfluidic model to interrogate the tumor microenvironment (TME). Microfluidics are an emerging device for investigating cancer biology with spatiotemporal control over signaling modulators by using a small volume. The interaction between hPSC-drived neutrophils and GBM was explored in this microfluidic device. GBM TME is very complex and involves many cell types, including neurons, microglia, immune T and NK cells. In the future, microfluidic models with isogenic cell components will be designed and implemented to better model GBM TME.</p><p dir="ltr">In summary, these discoveries confirm the pivotal role of Wnt signaling in guiding hPSCs towards hematopoietic lineages, while also highlighting <i>ID2</i> as a potent enhancer of NK cell differentiation from hPSC-derived hematopoietic progenitor cells. Additionally, CAR engineering enhances the anti-tumor capabilities of hPSC-derived NK cells. Furthermore, microfluidic models are employed to interrogate GBM TME.</p>

Rituximab (R) is increasingly incorporated in reduced intensity conditioning (RIC) regimens for allogeneic hematopoietic cell transplantation (alloHCT) in patients with B-cell malignancies, not only to improve disease control, but also to prevent graft-versus-host disease (GVHD). There are no randomized prospective data to validate this practice, although single center data and the CIBMTR analysis have shown promising results. We aimed at validation of these findings in a large registry study. We conducted a retrospective analysis using the EBMT registry of 3,803 adult patients with B-cell malignancies undergoing alloHCT (2001–2013) with either rituximab (R-RIC-9%) or nonrituximab (RIC-91%) reduced intensity regimens respectively. Median age and median follow up were 55 years (range 19.1–77.3) and 43.2 months (range 0.3–179.8), respectively. There was no difference in transplant outcomes (R-RIC vs RIC), including 1-year overall survival (69.9% vs 70.7%), 1-year disease-free survival (64.4% vs 62.2%), 1-year non-relapse mortality (21% vs 22%), and day-100 incidence of acute GVHD 2-4° (12% vs 12%). In summary, we found that addition of rituximab in RIC regimens for B-cell malignancies had no significant impact on major transplant outcome variables. Of note, data on chronic GVHD was not available, limiting the conclusions that can be drawn from the present study.

Hematopoietic stem cells (HSCs) are critical to the development of the hematopoietic system during ontogeny and maintaining hematopoiesis under steady-state. Several genes implicated in asymmetric cell division (ACD) have been found to influence HSC self-renewal in normal hematopoiesis and various leukemias. From a separate survey of genes associated with ACD, I now present the results from dedicated functional studies on two genes – Arhgef2 and Staufen1 – in HSCs and identify their potential contributions to benign hematopoietic disorders. Specifically, I present evidence that demonstrates a conserved role of Arhgef2 in orienting HSC division, the loss of which leads to HSC exhaustion that may underlie and contribute to the pathogenesis of Shwachman-Diamond syndrome. I also identify Staufen1 as a critical RNA-binding protein (RBP) in HSC function, downregulation of which elicits expression signatures consistent with clinical anemias reminiscent of aplastic anemia and/or paroxysmal nocturnal hemoglobinuria. I end by reviewing how RBPs function in HSCs and discuss future research directions that could further elucidate how bone marrow failure syndromes arise at the stem cell level. / Thesis / Doctor of Philosophy (PhD)