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Bone marrow stromal cells from β-thalassemia patients have impaired hematopoietic supportive capacity
Stefania Crippa, … , Giuliana Ferrari, Maria Ester Bernardo
Stefania Crippa, … , Giuliana Ferrari, Maria Ester Bernardo
Published April 1, 2019; First published February 25, 2019
Citation Information: J Clin Invest. 2019;129(4):1566-1580. https://doi.org/10.1172/JCI123191.
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Categories: Clinical Medicine Stem cells Transplantation

Bone marrow stromal cells from β-thalassemia patients have impaired hematopoietic supportive capacity

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Abstract

BACKGROUND. The human bone marrow (BM) niche contains a population of mesenchymal stromal cells (MSCs) that provide physical support and regulate hematopoietic stem cell (HSC) homeostasis. β-Thalassemia (BT) is a hereditary disorder characterized by altered hemoglobin beta-chain synthesis amenable to allogeneic HSC transplantation and HSC gene therapy. Iron overload (IO) is a common complication in BT patients affecting several organs. However, data on the BM stromal compartment are scarce. METHODS. MSCs were isolated and characterized from BM aspirates of healthy donors (HDs) and BT patients. The state of IO was assessed and correlated with the presence of primitive MSCs in vitro and in vivo. Hematopoietic supportive capacity of MSCs was evaluated by transwell migration assay and 2D coculture of MSCs with human CD34+ HSCs. In vivo, the ability of MSCs to facilitate HSC engraftment was tested in a xenogenic transplant model, whereas the capacity to sustain human hematopoiesis was evaluated in humanized ossicle models. RESULTS. We report that, despite iron chelation, BT BM contains high levels of iron and ferritin, indicative of iron accumulation in the BM niche. We found a pauperization of the most primitive MSC pool caused by increased ROS production in vitro which impaired MSC stemness properties. We confirmed a reduced frequency of primitive MSCs in vivo in BT patients. We also discovered a weakened antioxidative response and diminished expression of BM niche–associated genes in BT-MSCs. This caused a functional impairment in MSC hematopoietic supportive capacity in vitro and in cotransplantation models. In addition, BT-MSCs failed to form a proper BM niche in humanized ossicle models. CONCLUSION. Our results suggest an impairment in the mesenchymal compartment of BT BM niche and highlight the need for novel strategies to target the niche to reduce IO and oxidative stress before transplantation. FUNDING. This work was supported by the SR-TIGET Core grant from Fondazione Telethon and by Ricerca Corrente.

Authors

Stefania Crippa, Valeria Rossella, Annamaria Aprile, Laura Silvestri, Silvia Rivis, Samantha Scaramuzza, Stefania Pirroni, Maria Antonietta Avanzini, Luca Basso-Ricci, Raisa Jofra Hernandez, Marco Zecca, Sarah Marktel, Fabio Ciceri, Alessandro Aiuti, Giuliana Ferrari, Maria Ester Bernardo

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Figure 4

Iron metabolism in HD- and BT-MSCs.

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Iron metabolism in HD- and BT-MSCs.
(A) Quantification of total iron (μg...
(A) Quantification of total iron (μg/dl) and ferritin level (ng/ml) in the plasma of HD (n = 7) and BT (n = 11) BM aspirates. Each error bar shows mean ± SEM. (B) Expression of free iron transporter (DMT1, ZIP14, ZIP8), transferrin (TFR1), and ferritin (FTL, FTH) genes at the basal level in HD-MSCs (n = 7) and BT-MSCs (n = 8). Results are expressed as ΔΔCT. Each error bar shows mean ± SEM. (C) Expression of free iron transporter (DMT1, ZIP14, ZIP8), transferrin (TFR1), and ferritin (FTL, FTH) genes in HD-MSCs (n = 6) and BT-MSCs (n = 6) exposed to 40 μM ferric ammonium citrate (+ iron) for 5 days. Results are expressed as fold change relative to untreated MSCs. Each error bar shows mean ± SEM. In all panels, each square represents one HD sample (blue: >18 years; light blue: <18 years). Each circle represents one BT sample (red: >18 years; orange: <18 years). P values were determined by Student’s t test (*P < 0.05; **P < 0.001). (D) Representative images of iron deposition assessment in HD- and BT-MSCs at the basal level and after 5 days of 40 μM iron treatment (+ iron), using Perl’s staining. Number of samples positive for iron deposits are indicated below each panel. (E) qPCR expression analysis of free iron transporter (DMT1, ZIP14, ZIP8) and transferrin (TFR1) genes in untreated BT-MSCs (black) and in BT-MSCs treated with 100 μM DFO (+ DFO) for 24 hours (gray). Data are mean ± SEM. Experiments were performed in triplicate; n = 3. P values were determined by Student’s t test (*P < 0.05).
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