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Therapeutic discovery for marrow failure with MDS predisposition using pluripotent stem cells
Melisa Ruiz-Gutierrez, Özge Vargel Bölükbaşı, Gabriela Alexe, Adriana G. Kotini, Kaitlyn Ballotti, Cailin E. Joyce, David W. Russell, Kimberly Stegmaier, Kasiani Myers, Carl D. Novina, Eirini P. Papapetrou, Akiko Shimamura
Melisa Ruiz-Gutierrez, Özge Vargel Bölükbaşı, Gabriela Alexe, Adriana G. Kotini, Kaitlyn Ballotti, Cailin E. Joyce, David W. Russell, Kimberly Stegmaier, Kasiani Myers, Carl D. Novina, Eirini P. Papapetrou, Akiko Shimamura
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Research Article Hematology Therapeutics

Therapeutic discovery for marrow failure with MDS predisposition using pluripotent stem cells

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Abstract

Monosomy 7 and deletion of 7q, known as del(7q), are common clonal cytogenetic abnormalities associated with high-grade myelodysplastic syndrome (MDS) arising in inherited and acquired bone marrow failure. Current nontransplant approaches to treat marrow failure may be complicated by stimulation of clonal outgrowth. To study the biological consequences of del(7q) within the context of a failing marrow, we generated induced pluripotent stem cells (iPSCs) derived from patients with Shwachman-Diamond syndrome (SDS), a bone marrow failure disorder with MDS predisposition, and genomically engineered a 7q deletion. The TGF-β pathway was the top differentially regulated pathway in transcriptomic analysis of SDS versus SDSdel(7q) iPSCs. SMAD2 phosphorylation was increased in SDS relative to wild-type cells, consistent with hyperactivation of the TGF-β pathway in SDS. Phospho-SMAD2 levels were reduced following 7q deletion in SDS cells and increased upon restoration of 7q diploidy. Inhibition of the TGF-β pathway rescued hematopoiesis in SDS iPSCs and in bone marrow hematopoietic cells from SDS patients while it had no impact on the SDSdel(7q) cells. These results identified a potential targetable vulnerability to improve hematopoiesis in an MDS predisposition syndrome and highlighted the importance of the germline context of somatic alterations to inform precision medicine approaches to therapy.

Authors

Melisa Ruiz-Gutierrez, Özge Vargel Bölükbaşı, Gabriela Alexe, Adriana G. Kotini, Kaitlyn Ballotti, Cailin E. Joyce, David W. Russell, Kimberly Stegmaier, Kasiani Myers, Carl D. Novina, Eirini P. Papapetrou, Akiko Shimamura

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Figure 2

Effect of del(7q) on hematopoiesis of SDS iPSCs.

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Effect of del(7q) on hematopoiesis of SDS iPSCs.
(A) iPSC-derived CD34+ ...
(A) iPSC-derived CD34+ and CD45+ cells at days 10, 14, and 18 of hematopoietic differentiation of normal, SDS1, SDSdel(7q), and SDSdel(7q)+7 iPSCs. (B) Graph summary of CD34 expression at day 10 of hematopoietic differentiation (top) and CD45 expression at day 18 of hematopoietic differentiation (bottom). Normal (N2.12 D1-1, 1157, n = 5), SDS (SDS1.5, SDS2.5, n = 4), SDSdel(7q) (SDS1.5D5Cre4.9#4, SDS1.5D5Cre4.9#9, n = 4), and SDSdel(7q)+7 (SDS1.5D5Cre4.9+7#1, SDS1.5D5Cre4.9+7#3, SDS1.5D5Cre4.9+7#4, n = 4). (C) iPSC-derived CD45+ and CD33+ cells at day 14 of myeloid differentiation for normal, SDS1, SDSdel(7q), and SDS del(7q)+7 iPSCs. (D) Comparative graph of percentage of CD33+ cells at day 14 of myeloid differentiation. Normal (N2.12 D1-1, 1157, n = 4), SDS (SDS1.5, SDS2.5, n = 3), SDSdel(7q) (SDS1.5D5Cre4.9#4, SDS1.5D5Cre4.9#9, n = 3), and SDSdel(7q)+7 (SDS1.5D5Cre4.9+7#3, SDS1.5D5Cre4.9+7#4, n = 3). For B and D, all results are represented as means ± SD. (E) Representative Wright-Giemsa stain of myeloid cells on day 7 of differentiation from normal (N2.12 D1-1, left) and SDS iPSCs (SDS1.5, right). Scale bar: 20 μm. (F) Representative karyotype of SDSdel(7q) iPSCs after spontaneous acquisition of additional chromosome 7 (box). (G) Western blot analysis of SBDS protein in SDS1 (SDS1.5), SDSdel(7q) (SDS1.5D5Cre4.9#2), and SDSdel(7q)+7 (SDS1.5D5Cre4.9+7#4) iPSCs. GAPDH is shown as a loading control. Numbers below the bands indicate average densitometry quantitation normalized to normal control sample values. *P < 0.05 by unpaired, 2-tailed Student’s t test.

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