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Somatic mutations in the calreticulin (CALR) gene are associated with approximately 30% of essential thrombocythemia (ET) and primary myelofibrosis (PMF). CALR mutations, including the two most frequent 52 bp deletion (del52) and 5 bp insertion (ins5), induce a frameshift to the same alternative reading frame generating new C-terminal tails. In patients, del52 and ins5 induce two phenotypically distinct myeloproliferative neoplasms (MPNs). They are equally found in ET, but del52 is more frequent in PMF. We generated heterozygous and homozygous conditional inducible knock-in (KI) mice expressing a chimeric murine CALR del52 or ins5 with the human mutated C-terminal tail to investigate their pathogenic effects on hematopoiesis. Del52 induces greater phenotypic changes than ins5 including thrombocytosis, leukocytosis, splenomegaly, bone marrow hypocellularity, megakaryocytic lineage amplification, expansion and competitive advantage of the hematopoietic stem cell compartment. Homozygosity amplifies these features, suggesting a distinct contribution of homozygous clones to human MPNs. Moreover, homozygous del52 KI mice display features of a penetrant myelofibrosis-like disorder with extramedullary hematopoiesis linked to splenomegaly, megakaryocyte hyperplasia and the presence of reticulin fibers. Overall, modeling del52 and ins5 mutations in mice successfully recapitulates the differences in phenotypes observed in patients., Calreticulin del52 and ins5 mutations induce two phenotypically distinct myeloproliferative neoplasms in patients. Here the authors show that modeling these mutations in knock-in mice recapitulate the two diseases and highlight how they impact the different hematopoietic compartments.

Polycythemia vera (PV) is a clonal disorder resulting from neoplastic transformation of hematopoietic stem cells, while secondary polycythemia (SP) is a disease characterized by increased absolute red blood cell mass caused by stimulation of red blood cell production. Although the physiopathology of SP and PV is distinct, patients with these diseases share similar symptoms. The early differential diagnosis may improve the quality of life and decrease the disease burden in PV patients, as well as enable curative treatment for SP patients. PV is considered an oncoinflammatory disease because PV patients exhibit augmented levels of several pro-inflammatory cytokines. In this sense, we examined whether analysis of the cytokine production profile of SP and PV patients would help to distinguish them, despite their clinical similarities. Here we reported that SP patients exhibited decreased plasma levels of, IL-17A, IFN-γ, IL-12p70 and TNF-α when compared with PV patients, suggesting that analysis of the cytokine production profile may be an useful diagnostic biomarker to distinguish PV from SP patients.

Myeloproliferative neoplasms (MPN) are hematological disorders characterized by increased proliferation of precursor and mature myeloid cells. MPN patients may present driver mutations in JAK2, MPL, and CALR genes, which are essential to describe the molecular mechanisms of MPN pathogenesis. Despite all the new knowledge on MPN pathogenesis, many questions remain to be answered to develop effective therapies to cure MPN or impair its progression to acute myeloid leukemia. The present study examined the expression levels of the Hippo signaling pathway members in patients with polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), as well as the role that they play in disease pathogenesis. The Hippo pathway is a tumor suppressor pathway that participates in the regulation of cell proliferation, differentiation, and death. Our main findings were: (i) expression of tumor suppressor genes from Hippo pathway were downregulated and seemed to be associated with cell resistance to apoptosis and increased proliferation rate; and (ii) Hippo pathway-related gene expression was associated with mutation status in ET and PMF patients. Therefore, the decreased expression of Hippo pathway-related genes may contribute to the malignant phenotype, apoptosis resistance, and cell proliferation in MPN pathogenesis.

Introduction Bioactive lipids have been related to several biological functions such as immune system regulation, angiogenesis, cell survival, and proliferation. They are categorized into eight families: fatty acyls (fatty acids and eicosanoids), glycerolipids, glycerophospholipids, sphingolipids, sterol lipids, prenol lipids, polyketides, and saccharolipids. The deregulation of bioactive lipids secretion and production has been shown to contribute to cancer pathogenesis. Aim To quantify eicosanoids levels in bone marrow plasma from myeloproliferative neoplasms patients and healthy subjects. Subject and methods Nine polycythemia vera (PV), 8 primary myelofibrosis (PMF) and 8 essential thrombocythemia (ET) patients at diagnosis and 8 healthy subjects (CT) were investigated. CT group was composed by 4 males and 4 females with a median age of 43 years (y). The PV group was composed by 5 males and 4 females, median age of 61 y; ET group was composed of 1 male and 7 females, median age of 58, and, PMF group was composed by 3 female and 5 males, median age of 68 y. Bone marrow plasma samples were analyzed by high performance liquid chromatography followed by mass spectroscopy. The metabolomics analyzes were performed by using the mass spectral data acquired with negative electrospray ionization and the full scan of the mass/charge ratio (m/z) from 100 to 1500. Results The results showed that 7346 bioactive lipids compounds were detected in bone marrow plasma from patients and controls. Among all the analyzed compounds we found that 129 of them overlap between all comparisons, as 241 are specific to PMF, 873 to PV and 374 to ET. The predictive analysis of activity of metabolic pathways showed that for PMF and ET, the main deregulated metabolic pathways are bile acid biosynthesis and fatty acid oxidation, while for in PV the deregulated pathways are: arginine and proline metabolism, biopterin metabolism, glutamate metabolism, Glycosphingolipid biosynthesis, Glyoxylate and Dicarboxylate Metabolism, Pyruvate Metabolism, Phytanic acid peroxisomal oxidation, Sphingolipid metabolism, Vitamin E metabolism, Polyunsaturated fatty acid biosynthesis and Xenobiotics metabolism. Discussion These data suggest that the bone marrow microenvironment from MPN patients is deregulated, culminating in the deregulation of bioactive lipids and several metabolic pathways. Conclusion Each disease category presents a metabolic signature, which could be used as biomarker for diagnosis and prognosis and therapeutic target. Funding CAPES, CNPq and FAPESP (2018-01756-5; 2018/18714-7). Keywords Metabolomic analysis; Polycythemia vera; Essential thrombocythemia; Primary myelofibrosis.

Introducao As neoplasias mieloproliferativas (NMP) BCR-ABL1-negativas classicas caracterizam-se pelo aumento da proliferacao de celulas mieloides precursoras e maduras. Nesse estudo, foi avaliado o efeito das celulas mesenquimais multipotentes (MSC) normais (HS-5), na proliferacao da linhagem celular HEL 92.1.7 JAK2V617F+. As celulas mesenquimais constituem uma populacao de celulas nao hematopoeticas presentes no nicho da medula ossea. As MSC proporcionam o microambiente medularideal para a celula tronco hematopoetica manter seu potencial de auto-renovacao e as protegem de estimulos pro-apoptoticos, alem de desempenharem um papel imunoregulador. Material e metodos Celulas da linhagem HEL 92.1.7 JAK2V617F positiva (ATCC®TIB-180 ™), provenientes de paciente com policitemia vera que progrediu para leucemia mieloide aguda foram cocultivadas com celulas HS-5. As MSCna concentracao de 5x10 4 celulas por poco foram plaqueadas em placas de 6 pocos, seguido da adicao de 1x10 5 celulas HEL.92.1.7 por poco, marcadas com o fluorocromocell-trace violet (CTV). Um milhao e duzentas mil celulas foram marcadas com 1μL deCTV, por 30 minutos a 37°C na ausencia de luz. Em seguida o CTV nao ligado foiinativado pela adicao de 5 mL de meio RPMI com 10% de soro bovino fetal seguidapela centrifugacao das celulas a 400 x g por 5 minutos e o precipitado celular foiressuspenso em meio RPMI. O cocultivo foi realizado por 24, 48 e 72 horas. Aproliferacao das celulas HEL.92.1.7 foi analisada pela diminuicao da fluorescencia doCTV, por meio da analise em citometro de fluxo (FACSCanto, BD). Resultados Osresultados observados indicam que as celulas HEL.92.1.7 cultivadas na presenca da HS-5 proliferaram menos do que celulas cultivadas sem a interacao com as celulasmesenquimais HS-5 nos tempos de 24, 48 e 72 horas (p = 0,0004; p = 0,0185; p = 0,0224, respectivamente). Discussao As celulas mesenquimais parecem desempenhar um papelimunossupressor sobre as celulas JAK2V617F positivas, diminuindo sua proliferacaocelular. Conclusao As celulas estromais mesenquimais multipotentes representam uma ferramenta atraente para reduzir a resposta e proliferacao de celulas positivasJAK2V617F. Financiamento: CAPES (codigo 001), CNPq and FAPESP (2018-01756-5;2018/19714-7). Palavras chave: neoplasias mieloproliferativas, celulas estromais mesenquimaismultipotentes, HEL 92.1.7, mutacao JAK2V617F, proliferacao celular.

Homoeostasis of bone marrow microenvironment depends on a precise balance between cell proliferation and death, which is supported by the cellular-extracellular matrix crosstalk. Multipotent mesenchymal stromal cells (MSC) are the key elements to provide the specialized bone marrow microenvironment by supporting, maintaining, and regulating the functions and fate of haematopoietic stem cells. Despite the great potential of MSC for cell therapy in several diseases due to their regenerative, immunomodulatory, and anti-inflammatory properties, they can also contribute to modulate tumor microenvironment. The extracellular vesicles that comprise exosomes and microvesicles are important mediators of intercellular communication due to their ability to change phenotype and physiology of different cell types. These vesicles may interact not only with neighbouring cells but also with cells from distant tissues to either maintain tissue homoeostasis or participate in disease pathogenesis. This review focuses on the current knowledge about the physiological role of MSC-extracellular vesicles, as well as their deregulation in haematological malignancies and their potential applications as biomarkers for diagnosis, progression, and treatment monitoring of such diseases.

Background: Resistance to apoptosis in chronic myeloid leukemia (CML) is associated with constitutive tyrosine kinase activity of the Bcr-Abl oncoprotein. The deregulated expression of apoptosis-related genes and alteration in epigenetic machinery may also contribute to apoptosis resistance in CML. Tyrosine kinase inhibitors target the Bcr-Abl oncoprotein and are used in CML treatment. The resistance of CML patients to tyrosine kinase inhibitors has guided the search for new compounds that may induce apoptosis in Bcr-Abl+ leukemic cells and improve the disease treatment. Methods: In the present study, we investigated whether the L-amino acid oxidase isolated from Bothrops moojeni snake venom (BmooLAAO-I) (i) was cytotoxic to Bcr-Abl+ cell lines (HL-60.Bcr-Abl, K562-S, and K562-R), HL-60 (acute promyelocytic leukemia) cells, the non-tumor cell line HEK-293, and peripheral blood mononuclear cells (PBMC); and (ii) affected epigenetic mechanisms, including DNA methylation and microRNAs expression in vitro. Results: BmooLAAO-I induced ROS production, apoptosis, and differential DNA methylation pattern of regulatory apoptosis genes. The toxin upregulated expression of the pro-apoptotic genes BID and FADD and downregulated DFFA expression in leukemic cell lines, as well as increased miR-16 expression - whose major predicted target is the anti-apoptotic gene BCL2 - in Bcr-Abl+ cells. Conclusion: BmooLAAO-I exerts selective antitumor action mediated by H2O2 release and induces apoptosis, and alterations in epigenetic mechanisms. These results support future investigations on the effect of BmooLAAO-I on in vivo models to determine its potential in CML therapy.

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome, which generates the oncogene BCR-ABL1. Protease-activated receptor 1 (PAR1) is involved in tumor progression and angiogenesis. We have previously reported that PAR1 expression is elevated in human leukemias that display a more aggressive clinical behavior, including the blast crisis of CML. In this study, we analyzed the crosstalk between the oncoprotein BCR-ABL and PAR1 in CML. Leukemic cell lines transfected with the BCR-ABL1 oncogene showed significantly higher expression levels of PAR1 compared with that of wild-type counterparts. This phenomenon was reversed by treatment with tyrosine kinase inhibitors (TKIs). Conversely, treatment with the PAR1 antagonist SCH79797 inhibited BCR-ABL expression. The PAR1 antagonist induced apoptosis in a dose- and time-dependent manner. Higher vascular endothelial growth factor (VEGF) levels were observed in cells transfected with BCR-ABL1 than in their wild-type counterparts. VEGF expression was strongly inhibited after treatment with either TKIs or the PAR1 antagonist. Finally, we evaluated PAR1 expression in CML patients who were either in the blast or chronic phases and had either received TKI treatment or no treatment. A significant decrease in PAR1 expression was observed in treatment-responsive patients, as opposed to a significant increase in PAR1 expression levels in treatment-resistant patients. Patients classified as high risk according to the Sokal index showed higher PAR1 expression levels. Our results demonstrate the crosstalk between BCR-ABL and PAR1. These data may offer important insight into the development of new therapeutic strategies for CML.

The HIV/AIDS pandemic still represents an important global health issue. There is no sterilizing cure, therefore a continuous treatment is necessary, which caused the emerged idea of HIV as a chronic inflammatory disease that may also affect healthy aging. Considering that the activation profile of some innate cells such as natural killer cells has previously been associated to HIV progression, it remains to be better defined this activation status of NK cells considering the time of HIV infection. In this study, we characterized NK cell phenotype and function during acute and chronic HIV infection and also investigated markers of immunosenescence in these cells. Our results showed that chronic infected patients remained with elevated levels of some plasma inflammatory molecules (IP-10, sCD14) and a concurrent expansion of the non-functional NK cell subset (CD3-CD56-CD16+). NK cells from the chronic infected group displayed an activated profile with higher levels of cytokines and chemokines production (TNF-α, IL-12, IFN-α2, IFN-γ, IL-6, RANTES, MCP-1, IL-10, IL-4 and IL-5). The production of these molecules was positively correlated to the time of infection. Moreover, we noted a possible association of higher global DNA methylation frequency of NK cells in two HIV patients in the advanced stage of disease. Chronic infected patients also showed a trend towards higher production of reactive oxygen species by their NK cells which altogether suggest the evolution of these cells to a senescent state that might be further evaluated.

As neoplasias mieloproliferativas (NMP) são doenças hematológicas caracterizadas pela proliferação aumentada e acúmulo de células mieloides maduras de uma ou mais séries hematopoéticas: granulocítica, eritrocítica, megacariocítica ou mastocítica. Os pacientes com NMP podem apresentar mutações como a JAK2V617F, MPL e CALR, cujas descrições foram fundamentais para o início da elucidação da fisiopatologia das NMP. As células neoplásicas das NMP apresentam resistência à apoptose e proliferação celular exacerbada. Sabe-se ainda que essas doenças são consideradas oncoinflamatórias e pré-leucêmicas. Apesar de todos esses conhecimentos sobre os mecanismos moleculares e celulares envolvidos na patogênese das NMP, não há até a presente data tratamentos eficazes que curam ou alteram a história natural de progressão dessas desordens para LMA. Pelo exposto, foi aqui investigada a potencial participação dos membros da via de sinalização Hippo na fisiopatologia das NMP BCR-ABL1 negativas mais frequentes, a policitemia vera (PV), trombocitemia essencial (TE) e mielofibrose primária (MF). A via de sinalização Hippo foi descrita como supressora de tumor e é uma das responsáveis pela regulação da proliferação, diferenciação e morte celular. Foi analisada, ainda nesse estudo, a correlação dos níveis de expressão dos genes da via Hippo com o perfil de citocinas plasmáticas dos pacientes com PV, TE e MF, a associação com o \"status mutacional\" e com a expressão dos genes que regulam a apoptose celular pela via intrínseca. Os principais achados nos pacientes com PV foram a diminuição da expressão dos genes supressores de tumor LATS2, MST1 e MST2 acompanhada pela presença de elevada concentração de citocinas pró-inflamatórias e fenótipo de resistência a apoptose. Na TE, os dados relevantes foram a detecção da diminuição da expressão dos genes supressores de tumor LATS1, LATS2 MST1 e SAV1, e o observação da relação entre alta expressão dos genes SAV1 e MOB1B e a mutação da CALR. Em MF destaca-se a redução da expressão dos genes SAV1 e TAZ da via de sinalização Hippo e do gene AURKB do ciclo celular. Em conclusão, os dados indicam que a diminuição da expressão dos genes supressores de tumor da via Hippo contribui para a fisiopatologia e para o fenótipo de resistência das células neoplásicas à apoptose das NMP. Myeloproliferative neoplasms (MPN) are hematological disorders characterized by increased proliferation of mature myeloids cells of one or more hematopoietic series: granulocytic, erythrocytic, megakaryocytic or mastocytic. Patients with MPN may present mutations such as JAK2V617F, MPL and CALR, which were essential descriptions for the beginning of pathophysiological elucidation of MPN. The NMP neoplastic cells show resistance to apoptosis and exacerbated cell proliferation. It is known that these entities are considered also oncoinflamatory and pre-leukaemic. Despite all this knowledge about the molecular and cellular mechanisms involved in the pathogenesis of MPN, there are no effective treatments that cure or alter the natural history of progression of these disorders to AML. For the above, a participatory potential of the Hippo signaling pathway members in the pathophysiology of the most frequent negative BCR-ABL1 MPN, the polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) were investigated. The Hippo signaling pathway has been described as tumor suppressor and is responsible for the regulation of proliferation, differentiation and cell death. The correlation analysis of the expression levels of the Hippo pathway genes with the plasma cytokine profile of patients with PV, ET and PMF, the association with the mutational status and the expression of the genes that regulate intrinsic cellular apoptosis were performed. The main findings in patients with PV were decreased expression of the tumor suppressor genes LATS2, MST1 and MST2 accompanied by the presence of high concentration of proinflammatory cytokines and phenotype of resistance to apoptosis. In ET, relevant data were the detection of decreased expression of the tumor suppressor genes LATS1, LATS2 MST1 and SAV1, and the observation of the relationship between high expression of the SAV1 and MOB1B genes and the mutation of the CALR. In PMF, stands out the reduction of the SAV1 and TAZ gene expression of the Hippo signaling pathway and the AURKB gene of the cell cycle. In conclusion, the data indicate that decreased expression of the tumor suppressor genes of the Hippo pathway contributes to the pathophysiology and neoplastic cell resistance phenotype to the apoptosis of MPN.

Objectives: Three decades after HIV recognition and its association with AIDS development, many advances have emerged – especially related to prevention and treatment. Undoubtedly, the development of Highly Active Antiretroviral Therapy (HAART) dramatically changed the future of the syndrome that we know today. In the present study, we evaluate the impact of Highly Active Antiretroviral Therapy on macrophage function and its relevance to HIV pathogenesis. Methods: PBMCs were isolated from blood samples and monocytes (CD14+ cells) were purified. Monocyte-Derived Macrophages (MDMs) were activated on classical (MGM-CSF+IFN-γ) or alternative (MIL-4+IL13) patterns using human recombinant cytokines for six days. After this period, Monocyte-Derived Macrophages were stimulated with TLR2/Dectin-1 or TLR4 agonists and we evaluated the influence of HIV-1 infection and Highly Active Antiretroviral Therapy on the release of cytokines/chemokines by macrophages. Results: The data were obtained using Monocyte-Derived Macrophages derived from HIV naïve or from patients on regular Highly Active Antiretroviral Therapy. Classically Monocyte-Derived Macrophages obtained from HIV-1 infected patients on Highly Active Antiretroviral Therapy released higher levels of IL-6 and IL-12 even without PAMPs stimuli when compared to control group. On the other hand, alternative Monocyte-Derived Macrophages derived from HIV-1 infected patients on Highly Active Antiretroviral Therapy released lower levels of IL-6, IL-10, TNF-α, IP-10 and RANTES after LPS stimuli when compared to control group. Furthermore, healthy individuals have a complex network of cytokines/chemokines released by Monocyte-Derived Macrophages after PAMP stimuli, which was deeply affected in MDMs obtained from naïve HIV-1 infected patients and only partially restored in MDMs derived from HIV-1 infected patients even on regular Highly Active Antiretroviral Therapy. Conclusion: Our therapy protocols were not effective in restoring the functional alterations induced by HIV, especially those found on macrophages. These findings indicate that we still need to develop new approaches and improve the current therapy protocols, focusing on the reestablishment of cellular functions and prevention/treatment of opportunistic infections. Keywords: HIV-1, Innate immune response, HAART, Macrophages

Innate immune cells play a critical role during the onset of HIV infection and remain active until the final events that characterize AIDS. The viral impact on innate immune cell response may be a result of direct infection or indirect modulation, and each cell type responds in a specific manner to HIV. During HIV infection, the immune system works in a dynamic way, where innate and adaptive cells contribute with each other stimulating their function and modulating phenotypes and consequently infection resolution. Understanding the alterations in the cell populations induced by the virus is pivotal and can help to combat HIV at the time of infection and above all, to prevent the establishment of viral reservoirs. In this review, we will describe the frequency and the subtypes of infected cells such as of monocytes, DCs, neutrophils, eosinophils, mast cells/basophils, NK cells, NKT cells and γδ T cells, and we discuss the possibility of cell-targeting strategies. Our aim is to consolidate the existing knowledge of the interaction between HIV and cells that constitute the innate immune response.

Cytokines are key immune mediators in physiological and disease processes, whose increased levels have been associated with the physiopathology of hematopoietic malignancies, such as myeloproliferative neoplasms.This study examined the plasma cytokine profiles of patients with essential thrombocythemia, primary myelofibrosis, polycythemia vera and of healthy subjects, and analyzed correlations with JAK2 V617F status and clinical-hematological parameters.The proinflammatory cytokine levels were increased in myeloproliferative neoplasm patients, and the presence of the JAK2 V617F mutation was associated with high IP-10 levels in primary myelofibrosis patients.Essential thrombocythemia, primary myelofibrosis, and polycythemia vera patients exhibited different patterns of cytokine production, as revealed by cytokine network correlations. Together, these findings suggest that augmented cytokine levels are associated with the physiopathology of myeloproliferative neoplasms.

Frameshift mutations in the calreticulin (CALR) gene are present in 30% of essential thrombocythemia and myelofibrosis patients. The two most frequent mutations are CALR del52 (type 1, approximately 60%) and CALR ins5 (type 2, around 30%), but many other rarer mutations exist accounting each for less than 2% of all CALR mutations. Most of them are structurally classified as type 1-like and type 2-like CALR mutations according to the absence or presence of a residual wild-type calcium-binding motif and the modification of the alpha-helix structure. Yet, several key questions remain unanswered, especially the reason of such low frequencies of these other mutations. In an attempt to investigate specific pathogenic differences between type 1-like and type 2-like CALR mutations and del52 and ins5, we modeled two type 1-like (del34 and del46) and one type 2-like (del19) mutations in cell lines and in mice. All CALR mutants constitutively activate JAK2 and STAT5/3/1 in a similar way in the presence of the thrombopoietin receptor (MPL) and induced cytokine-independent cell growth but to a lesser extent with rare mutants over time. This correlates with reduced expression levels of rare CALR mutants compared to del52 and ins5. Lethally irradiated mice that were engrafted with bone marrow transduced with the different CALR mutations developed thrombocytosis, but to a much lesser extent with ins5 and the type 2-like CALR mutation. In contrast to type 2-like mice, type 1-like mice developed marked myelofibrosis and splenomegaly 10 months after engraftment. Similar to del52, type 1-like CALR mutations induced an expansion at an early stage of hematopoiesis compared to ins5 and type 2-like mutation. Thus, type 1-like and type 2-like CALR mutants structurally and functionally resemble del52 and ins5 mutants, respectively.

Monocytes are key cells in the immune dysregulation observed during human immunodeficiency virus (HIV) infection. The events that take place specifically in monocytes may contribute to the systemic immune dysfunction characterized by excessive immune activation in infected individuals, which directly correlates with pathogenesis and progression of the disease. Here, we investigated the immune dysfunction in monocytes from untreated and treated HIV + patients and associated these findings with epigenetic changes. Monocytes from HIV patients showed dysfunctional ability of phagocytosis and killing, and exhibited dysregulated cytokines and reactive oxygen species production after M. tuberculosis challenge in vitro. In addition, we showed that the expression of enzymes responsible for epigenetic changes was altered during HIV infection and was more prominent in patients that had high levels of soluble CD163 (sCD163), a newly identified plasmatic HIV progression biomarker. Among the enzymes, histone acetyltransferase 1 (HAT1) was the best epigenetic biomarker correlated with HIV - sCD163 high patients. In conclusion, we confirmed that HIV impairs effector functions of monocytes and these alterations are associated with epigenetic changes that once identified could be used as targets in therapies aiming the reduction of the systemic activation state found in HIV patients.

Background Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm whose pathogenesis is linked to the Philadelphia chromosome presence that generates the BCR–ABL1 fusion oncogene. Tyrosine kinase inhibitors (TKI) such as imatinib mesylate (IM) dramatically improved the treatment efficiency and survival of CML patients by targeting BCR–ABL tyrosine kinase. The disease shows three distinct clinical-laboratory stages: chronic phase, accelerated phase and blast crisis. Although patients in the chronic phase respond well to treatment, patients in the accelerated phase or blast crisis usually show therapy resistance and CML relapse. It is crucial, therefore, to identify biomarkers to predict CML genetic evolution and resistance to TKI therapy, considering not only the effects of genetic aberrations but also the role of epigenetic alterations during the disease. Although dysregulations in epigenetic modulators such as histone methyltrasnferases have already been described for some hematologic malignancies, to date very limited data is available for CML, especially when considering the lysine methyltransferase MLL2/KMT2D and MLL3/KMT2C. Methods Here we investigated the expression profile of both genes in CML patients in different stages of the disease, in patients showing different responses to therapy with IM and in non-neoplastic control samples. Imatinib sensitive and resistant CML cell lines were also used to investigate whether treatment with other tyrosine kinase inhibitors interfered in their expression. Results In patients, both methyltransferases were either upregulated or with basal expression level during the chronic phase compared to controls. Interestingly, MLL3/KMT2C and specially MLL2/KMT2D levels decreased during disease progression correlating with distinct clinical stages. Furthermore, MLL2/KMT2D was decreased in patients resistant to IM treatment. A rescue in the expression of both MLL genes was observed in KCL22S, a CML cell line sensitive to IM, after treatment with dasatinib or nilotinib which was associated with a higher rate of apoptosis, an enhanced expression of p21 (CDKN1A) and a concomitant decrease in the expression of CDK2, CDK4 and Cyclin B1 (CCNB1) in comparison to untreated KCL22S control or IM resistant KCL22R cell line, which suggests involvement of p53 regulated pathway. Conclusion Our results established a new association between MLL2/KMT2D and MLL3/KMT2C genes with CML and suggest that MLL2/KMT2D is associated with disease evolution and may be a potential marker to predict the development of therapy resistance.

Background: Chronic myeloid leukemia (CML) is a BCR-ABL1+ myeloproliferative neoplasm marked by increased myeloproliferation and presence of leukemic cells resistant to apoptosis. The current first-line therapy for CML is administration of the tyrosine kinase inhibitors imatinib mesylate, dasatinib or nilotinib. Although effective to treat CML, some patients have become resistant to this therapy, leading to disease progression and death. Thus, the discovery of new compounds to improve CML therapy is still challenging. Here we addressed whether MjTX-I, a phospholipase A2 isolated from Bothrops moojeni snake venom, affects the viability of imatinib mesylate-resistant Bcr-Abl+ cell lines. Methods: We examined the cytotoxic and pro-apoptotic effect of MjTX-I in K562-S and K562-R Bcr-Abl+ cells and in the non-tumor HEK-293 cell line and peripheral blood mononuclear cells, using the 3-(4,5-dimethylthiazol-2-yl) −2,5-diphenyltetrazolium bromide and the hypotonic fluorescent solution methods, associated with detection of caspases 3, 8, and 9 activation and poly (ADP-ribose) polymerase (PARP) cleavage. We also analyzed the MjTX-I potential to modulate the expression of apoptosis-related genes in K562-S and K562-R cells. Results: MjTX-I decreased the viability of K562-S and K562-R cells by 60 to 65%, without affecting the viability of the non-tumor cells, i.e. it exerted selective cytotoxicity towards Bcr-Abl+ cell lines. In leukemic cell lines, the toxin induced apoptosis, activated caspases 3, 8, and 9, cleaved PARP, downregulated expression of the anti-apoptotic gene BCL-2, and upregulated expression of the pro-apoptotic gene BAD. Conclusion: The antitumor effect of MjTX-I is associated with its potential to induce apoptosis and cytotoxicity in Bcr-Abl positive cell lines sensitive and resistant to imatinib mesylate, indicating that MjTX-I is a promising candidate drug to upgrade the CML therapy.

Introduction BCR-ABL-negative myeloproliferative neoplasms (MPNs) result from the transformation of a hematopoietic stem cell (HSC). Somatic mutations in the calreticulin (CALR) gene are associated with approximately 30% of essential thrombocythemia (ET) and primary myelofibrosis (PMF). All CALR mutations induce a frameshift to the same alternative reading frame generating a new C-terminal tail. The two most frequent CALR mutations are a 52 bp deletion (del52) or type 1 and a 5 bp insertion (ins5) or type 2. In patients, del52 and ins5 are equally found in ET but del52 is more frequent in PMF. In mouse retroviral model, del52 mice progress from ET to myelofibrosis (MF) while ins5 mice remain mostly with an ET. Methods In order to study the effect of endogenous levels of del52 and ins5 in hematopoiesis, we generated conditional knock-in (KI) mice expressing the murine CALR del52 or ins5 with the human mutated C-terminal tail under the control of a Scl-driven tamoxifen-inducible Cre recombinase (Scl-CreERT). We have also used Ubi-GFP transgenic mice to perform competitive engraftments. Results After tamoxifen-induction, both del52 and ins5 KI mice developed a rapid thrombocytosis, more severe in the homozygous than the heterozygous setting. In contrast, leukocytosis was observed only in homozygous setting. At similar zygosity, del52 induced a higher thrombocytosis compared to ins5. After 10 months of induction, both the bone marrow (BM) and the spleen of homozygous del52 KI mice and, to a much lower extent of homozygous ins5 KI mice, presented a significant increase in megakaryocytes (MKs) and in MK progenitors by flow cytometry. Von Willebrand factor staining showed that both del52 and ins5 homozygous mice displayed giant polylobulated MKs, associated with a similar increase in ploidy (mean ploidy 32N-33N). Heterozygous del52 presented also an increase ploidy of MK (mean of 25N) compared to controls (mean of 17N), whereas the MK ploidy of heterozygous ins5 mice was similar to control mice. The increase in number and size of MKs in homozygous del52 mice partially explained the significant decrease in BM cellularity and the splenomegaly. Moreover, we observed a decrease in BM erythroblasts and, in spleen, an increase in both erythroblast and granulocytic precursors together with a decrease in lymphocytes associated with a major disorganization of white pulp territories. Thus, the del52 homozygous KI mice developed features of a MF-like disease further illustrated by the presence of reticulin fibers stained with silver, mainly in spleen. Presence of fibrosis was not as pronounced in heterozygous del52 mice and more rarely observed in spleen of homozygous ins5 KI mice. In homozygous del52 KI mice, there was a significant amplification of the HSC compartment in both BM and spleen that was stronger than in homozygous ins5 mice. To study whether del52 and ins5 could provide a competitive advantage to HSCs, we performed BM transplantation with increasing percentages of non-induced homozygous del52 or ins5 cells with wild-type GFP+ cells into lethally-irradiated recipient mice. The homozygous del52 BM cells strongly competed wild-type hematopoiesis from an initial engraftment as low as 10% of mutated clones, reaching 100% in both blood myeloid cells and BM HSC compartments at 4 months. In contrast, out-competition of wild-type hematopoiesis by homozygous ins5 cells was slower, especially when less than 50% of mutated cells were initially engrafted suggesting that del52 provides a stronger advantage to the HSCs than ins5. Conclusion In conclusion, these results demonstrate that modeling CALRdel52 and ins5 mutations in mice can successfully recapitulate the differences in phenotype observed in patients, i.e del52 KI mice recapitulate an ET progressing to MF while ins5 KI mice only mimic an ET. This might be explained by a more profound effect of del52 than ins5 at the level of HSC. These KI mice offer solid in vivo models to investigate the mechanism of action of both types of mutations on HSCs and MKs and will be used to test new therapeutic approaches. Disclosures: No relevant conflicts of interest to declare. Disclosures Constantinescu: AlsaTech: Other: Co-Founde; Wiley & Sons: Other: Editor in Chief, Journal of Cellular and Molecular Medicine; Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AgenDix GmbH: Other: Co-Founder, MyeloPro Research and Diagnostics.

The human immunodeficiency virus (HIV) is responsible for more than 2 million new infections per year and opportunistic infections such as Salmonella spp. Gastroenteritis is an important cause of mortality and morbidity in developing countries. Monocytes and macrophages play a critical role in the innate immune response against bacterial infections. However during HIV infection the virus can infect these cells and although they are more resistant to the cytopathic effects, they represent an important viral reservoir in these patients. Our aim was to evaluate the monocyte functions from HIV-1 infected patients after in vitro exposition to Salmonella Enteritidis. Our results suggest impairment of monocytes phagocytic and microbicidal activity in HIV-1 non-treated patients, which was more evident in women, if compared with men. Moreover, monocytes from HIV-1 infected and non-treated patients after stimulation with the bacteria, produced more pro-inflammatory cytokines than monocytes from HIV-treated patients, suggesting that HIV-1 infected patients have their functions unbalanced, once in the presence of an opportunistic infection in vitro.

The Hippo pathway participates in the regulation of cell proliferation, differentiation and apoptosis. It is composed by a large array of proteins whose deregulation has been associated with pro-oncogenic and antioncogenic processes. The present review focuses on the Hippo pathway signalling network and discusses its dual role in oncogenesis, particularly in haematological malignancies.

O vírus da imunodeficiência humana (HIV) é o responsável pela pandemia mundial da síndrome da imunodeficiência adquirida (AIDS). Uma vez infectado pelo HIV, o hospedeiro apresenta a forma aguda da doença, caracterizada por aumento da carga viral circulante, rápido declínio das células TCD4+ e ativação da resposta imune inata. Quando o HIV se estabelece no organismo, induz latência em algumas células e leva à cronicidade da infecção e nessa fase o principal alvo do HIV são as células T CD4+, observa-se então constante diminuição desta população, que tem como consequência a imunodeficiência, com desativação de outras células imunes, como os monócitos, macrófagos, células Natural Killer e neutrófilos. Portanto, há o favorecimento das infecções oportunistas por fungos, bactérias, parasitas e outros vírus, além do surgimento de neoplasias principais responsáveis pela morbidade e mortalidade relacionadas à AIDS. Para conter a destruição do sistema imune pelo vírus, inicia-se a terapia antirretroviral (TARV), sendo que o parâmetro disponível na clínica para início da terapia é a carga viral e contagem de células TCD4+. Neste sentido, investigamos se fatores relacionados à função e fenótipo de monócitos de pacientes HIV+ poderiam servir como biomarcadores da progressão da infecção. Para tanto, monócitos provenientes do sangue periférico de indivíduos HIV+, virgens ou não de tratamento e de indivíduos controle foram ou não infectadas in vitro com Salmonella Enteritidis. A capacidade fagocítica, a atividade microbicida, a produção de óxido nítrico (NO) e de citocinas foi avaliada e para avaliar a produção de espécies reativas do oxigênio (EROs), os monócitos foram ainda estimulados ou não com PMA. Concluímos que a infecção pelo HIV leva ao aumento da capacidade fagocítica de monócitos de homens quando comparados à mulheres nas mesmas condições, entretanto a infecção não altera funções como a atividade microbicida, produção de EROs ou NO, entretanto, o perfil de citocinas entre os grupos foi muito diferente, entretanto o uso de TARV é capaz de recuperar parcialmente as correlações formadas entre citocinas comparadas ao grupo controle. Desta forma uma bioassinatura funcional poderia ser descrita, tendo como base a produção diferencial de citocinas e quimiocinas, como IL-1?, IL-6 e IL-12p70. The human immunodeficiency virus (HIV) is the responsible for the acquired immunodeficiency syndrome (AIDS) global pandemic. Once infected with HIV, the host has an acute form of the disease, characterized by a very high circulating level of virus and a rapid decline in CD4+ T cells, and then, the activation of innate immune response. The HIV is established in the body, inducing latency in some cells and leads to chronic infection, phase which the main target of HIV are the CD4+ T cells, and then what we observe is the constant decline of this population, which brings the immunodeficiency as a consequence, characterized by the deactivation of other immune cells, such as monocytes, macrophages, natural killer and neutrophils. In this way, opportunistic infections by fungal, bacteria, parasites and others viuses in adition to the neoplasm are established, being the main responsible for the morbidity and mortality related to AIDS. To contain the immune system destruction by the virus, the antiretroviral therapy (HAART) can be initiated, and the clinical parameter available considered to the onset of therapy to is the viral load and CD4+ T cell counts. In this sense, we have investigated if the factors related to the function and phenotype of monocytes from HIV+ patients could serve as biomarkers of the progression of infection. To this end, monocytes from the peripheral blood of HIV+ patients treated or not with HAART and control subjects were infected or not in vitro with Salmonella Enteritidis. The phagocytic capacity, microbicidal activity, the production of nitric oxide (NO) or cytokines were evaluated and when monocytes were stimulated or not with PMA, the production of reactive oxygen species (ROS) was evaluated. We conclude that HIV infection leads to increased phagocytic ability of monocytes of men compared to women in the same conditions, however, the infection does not alter functions such as microbicidal activity and ROS and NO production, however, the cytokine profile between groups was very different, however the use of HAART is able to partially recover the correlations formed between cytokines compared to the control group. Thus a functional biosignature could be described based on the differential production of cytokines and chemokines such as IL-1?, IL-6 and IL-12p70.

Background:Successful highly active antiretroviral therapy (HAART) has changed the outcome of AIDS patients worldwide because the complete suppression of viremia improves health and prolongs life expectancy of HIV-1+ patients. However, little attention has been given to the immunological profile of patients under distinct HAART regimens. This work aimed to investigate the differences in the immunological pattern of HIV-1+ patients under the first- or second-line HAART in Brazil. Methods:CD4+ T cell counts, Viral load, and plasma concentration of sCD14, sCD163, MCP-1, RANTES, IP-10, IL-1β, IL-6, TNF-α, IL-12, IFN-α, IFN-γ, IL-4, IL-5, and IL-10 were assessed for immunological characterization of the following clinical groups: Non-infected individuals (NI; n = 66), HIV-1+ untreated (HIV; n = 46), HIV-1+ treated with first-line HAART (HAART 1; n = 15); and HIV-1+ treated with second-line HAART (HAART 2; n = 15). Results:We found that the immunological biosignature pattern of HAART 1 is similar to that of NI individuals, especially in patients presenting slow progression of the disease, while patients under HAART 2 remain in a moderate inflammatory state, which is similar to that of untreated HIV patients pattern. Network correlations revealed that differences in IP-10, TNF-α, IL-6, IFN-α, and IL-10 interactions were primordial in HIV disease and treatment. Heat map and decision tree analysis identified that IP-10>TNF-α>IFN-α were the best respective HAART segregation biomarkers. Conclusion:HIV patients in different HAART regimens develop distinct immunological biosignature, introducing a novel perspective into disease outcome and potential new therapies that consider HAART patients as a heterogeneous group.