Generation of hematopoietic stem/progenitor cells with sickle cell mutation from induced pluripotent stem cell in serum-free system

ABSTRACT Introduction Sickle cell disease (SCD) is a monogenic disease and it is estimated that 300,000 infants are born annually with it. Most treatments available are only palliative, whereas the allogeneic hematopoietic stem cell transplantation offers the only potential cure for SCD. Objective Generation of human autologous cells, when coupled with induced pluripotent stem cell (iPSC) technology, is a promising approach for developing study models. In this study, we provide a simple and efficient model for generating hematopoietic cells using iPSCs derived from a sickle cell anemia patient and an inexpensive in-house-prepared medium. Method This study used iPSCs previously generated from peripheral blood mononuclear cells (PBMCs) from a patient with sickle cell anemia (iPSC_scd). Hematopoietic and erythroid differentiation was performed in two steps. Firstly, with the induction of hematopoietic differentiation through embryoid body formation, we evaluated the efficiency of two serum-free media; and secondly, the induction of hematopoietic stem/progenitor cells to erythroid progenitor cells was performed. Results The patient-specific cell line generated CD34+/CD45+ and CD45+/CD43+ hematopoietic stem/progenitor cells and erythroid progenitors, comprising CD36+, CD71+ and CD235a+ populations, as well as the formation of hematopoietic colonies, including erythroid colonies, in culture in a semi-solid medium. Conclusion In conjunction, our results described a simple serum-free platform to differentiate human the iPSCs into hematopoietic progenitor cells. This platform is an emerging application of iPSCs in vitro disease modeling, which can significantly improve the search for new pharmacological drugs for sickle cell disease.

Anemia de Diamond Blackfan: un diagnóstico de exclusión / Anemia of Diamond Blackfan: an exclusión diagnosis

La anemia de Diamond Blackfan es un trastorno genético y clínico raro, caracterizado por aplasia eritrocitaria, que clásicamente se manifiesta durante el primer año de vida, típicamente a los 2-3 meses de edad. El 25% de los afectados presentan anemia severa en la infancia, normo o macrocitosis, reticulocitopenia y disminución selectiva de células precursoras eritroides en medula ósea. Es causada por mutaciones que afectan genes que codifican para proteínas ribosomales, inicialmente fue identificado RPS19, que codifica la proteína S19 y las mutaciones a otros genes que codifican proteínas ribosomales. Se presenta el caso de una paciente de cuatro meses de edad quien debutó con anemia severa, quien no mejoró con la suplencia de hierro, vitamina B12, y ácido fólico y además fueron descartadas sistemáticamente causas frecuentes de anemia. El diagnóstico de anemia de Diamond Blackfan en nuestro medio es un diagnóstico de exclusión, dada la dificultad para acceso a pruebas de confirmación genética. Se establece el diagnóstico y se da manejo con glucocorticoides con buena respuesta clínica y paraclínica

The Diamond Blackfan anemia is a rare genetic and clinical disorder. It is characterized by red cell aplasia, which typically occurs during the first year of life, typically during the second to the third month of age. 25% of the patients had severe anemia during their childhood, normo or macrocytosis, reticulocyte and selective decrease in the number of erythroid precursor cells in bone marrow. It is caused by mutations affect genes encoding ribosomal proteins, RPS19 initially was identified, which encodes S19 protein and mutations in other genes encoding ribosomal proteins. We present a case of a four-month-old who debuted with severe anemia in whom the substitution were iron supplements, vitamin B12 and folic acid, showed no improvement and who also were systematically discarded as common causes of anemia. The diagnosis of Diamond Blackfan anemia in our country is a diagnosis of exclusion, given the difficulty of access to genetic confirmation tests. In this article the diagnosis is established and gives management with glucocorticoid with good clinical and paraclinical response

As infecções genitais podem alterar os resultados dos testes preditivos do parto prematuro? / Can genital infections alter the results of preterm birth predictive tests?

OBJETIVOS: Verificar se a presença de agentes infecciosos no conteúdo vaginal ou cervical pode alterar os resultados dos testes da proteína-1 fosforilada ligada ao fator de crescimento insulina-símile (phIGFBP-1) e das medidas do comprimento do colo uterino (CC) pela ultrassonografia transvaginal. MÉTODOS: Um total de 107 gestantes com antecedente de prematuridade espontânea foram submetidas ao teste da phIGFBP-1 e à realização da ultrassonografia transvaginal para medida do comprimento do colo uterino, a cada três semanas, entre 24 e 34 semanas. As infecções genitais foram pesquisadas imediatamente antes da realização dos testes. As pacientes foram distribuídas em quatro grupos (GA, GB, GC e GD) e dentro de cada grupo foi avaliada a correlação entre infecção genital e alteração nos testes utilizando a análise das razões de chance (OR) e o coeficiente de correlação de Pearson. RESULTADOS: Em cada grupo, mais de 50% das pacientes apresentaram infecção genital (GA 10/17; GB 28/42; GC 15/24; GD 35/53), sendo a vaginose bacteriana a principal alteração de flora vaginal. O resultado positivo para phIGFBP-1 (GA 10/10; GB 18/28; GC 15/15; GD 19/35) e CC≤20 mm (GA 10/10; GB 20/28; GC 10/15; GD 20/35) foram os resultados encontrados com maior frequência nas pacientes com infecção genital em todos os grupos. Porém, aplicando o coeficiente de correlação de Pearson foi identificada correlação entre infecção genital e positividade para os marcadores. CONCLUSÃO: A presença de alteração da flora vaginal e de outras infecções genitais não alteram significativamente os resultados do teste da phIGFBP-1 e da medida do colo uterino quando comparados aos casos sem infecção. No entanto, é necessária ...

PURPOSE: To determine if the presence of infectious agents in vaginal or cervical content can alter the results of the insulin-like growth factor binding protein-1 (phIGFBP-1) test and the measurement of cervical length (CC) by transvaginal ultrasonography. METHODS: A total of 107 pregnant women with a history of spontaneous preterm birth were submitted to the phIGFBP-1 test and to measurement of CC by transvaginal ultrasonography every 3 weeks, between 24 and 34 weeks of gestation. Genital infections were determined immediately before testing. The patients were distributed into four groups (GA, GB, GC, and GD) and the correlation between genital infection and changes in the tests was determined within each group based on the odds ratio (OR) and the Pearson correlation coefficient. RESULTS: In each group, over 50% of the patients had genital infections (GA 10/17; GB 28/42; GC 15/24; GD 35/53), with bacterial vaginosis being the main alteration of the vaginal flora. Positive results for phIGFBP-1(GA 10/10; GB 18/28; GC 15/15; GD 19/35) and CC≤20 mm (GA 10/10; GB 20/28; GC 10/15; GD 20/35) were obtained more frequently in patients with genital infection in all groups. Nonetheless, when applying the Pearson correlation coefficient we detected a poor correlation between genital infection and positivity for markers. CONCLUSION: The presence of changes in the vaginal flora and of other genital infections does not significantly alter the results of phIGFBP-1 and the measurement of cervical length when compared to cases without infection. However, more studies with larger samples are necessary to confirm these results. .

Doenças hematológicas associadas ao eritrovírus / Hematologic diseases associated with eritrovírus

O eritrovírus infecta células precursoras eritroides, determinando a interrupção temporária da eritropoese. Neste contexto, é importante o conhecimento das principais doenças hematológicas que podem estar associadas à presença do vírus, principalmente quando estão presentes em condições mórbidas, tais como nas anemias hemolíticas hereditárias. Este trabalho tem como objetivo relatar as principais doenças hematológicas que cursam com a infecção pelo eritrovírus B19.

Erythroviruses infect precursor erythroid cells, determining a temporary disruption of erythropoiesis. Thus, knowledge of the main hematological diseases that may be associated with the virus is important, especially when they are present in morbid conditions, such as in hereditary hemolytic anemia. This paper aims at reporting the main hematological diseases that are associated with erythrovirus infections.

Human erythroid progenitors from adult bone marrow and cord blood in optimized liquid culture systems respectively maintained adult and neonatal characteristics of globin gene expression

In vitro suspension culture procedures for erythroid progenitor cells make it possible for us to obtain large cultures of erythrocyte populations for the investigation of globin gene switching. In this study we aimed to establish optimized culture systems for neonatal and adult erythroblasts and to explore the globin expression patterns in these culture systems. To culture CD34+ cells purified from human umbilical cord blood (CB) and adult bone marrow (BM), we respectively replaced the fetal bovine serum (FBS) with human cord serum and human adult serum. These CD34+ cells were then induced to erythroid differentiation. All the globin mRNA (including alfa-, xi-, vita-, gama-and epsilón-globin), the hemoglobin (Hb)-producing erythroid cells and the cellular distribution of fetal hemoglobin (Hb F) were identified during the culture process. The results showed that the globin expression pattern during erythroid differentiation in our culture systems closely recapitulated neonatal and adult patterns of globin expression in vivo, suggesting that our specially optimized culture systems not only overcame the higher Hb F levels in the BM-derived CD34+ culture in FBS-containing medium but also eliminated the disadvantages of low cell proliferation rate and low globin mRNA levels in serum-free medium.

Análise comparativa das técnicas manual e automatizada (ADVIA tm 120) para contagem de reticulócitos / Comparative analysis of manual and automated (ADVIA tm 120) reticulocytes counting

Os reticulócitos são células de origem eritróide com resíduos de RNA, sendo esses evidenciados com a utilização de colorações supravitais. O número de reticulócitos no sangue periférico reflete a atividade eritropoética da medula óssea. Considerando a importância da implantação de uma contagem de reticulócitos mais rápida e precisa, este trabalho tem por objetivo avaliar a correlação entre as técnicas manual e automatizada (ADVIA TM 120, Bayer Diagnostics) para contagem de reticulócitos. O equipamento ADVIA TM 120 utiliza uma reação citoquímica para a diferenciação e contagem de reticulócitos. Foram utilizadas nesse estudo 64 amostras de sangue obtidas de diferentes pacientes. As contagens foram realizadas pelas técnicas manual e automatizada, sendo que elas variaram de 0,6 a 10 porcento. Ao analisar os resultados obtidos pelas duas técnicas, foi possível observar uma forte correlação (r=0,9778, p<0,001) entre ambas. A implantação da técnica automatizada tem contribuído com a rotina do Laboratório Central de Análises Clínicas - ISCMPA, fornecendo resultados mais precisos em um menor tempo. A contagem de reticulócitos realizada no ADVIA tm 120 apresentou excelente correlação com a contagem manual, sendo bem mais prática, rápida e precisa.

Toxicidad del aluminio sobre el sistema eritropoyético: mecanismos involucrados / Aluminum toxicity in erythropoiesis: related mechanisms

En la presente revisión se expone una discusión de resultados publicados que involucran al aluminio como uno de los factores que pueden afectar al sistema eritropoyético. En células K562 se determinó que el receptor específico para transferrina presente en la membrana de células eritroides posee afinidad similar para esa proteína cuando transporta hierro o aluminio y que la captación celular de hierro disminuye por la presencia de aluminio. Este metal provoca, en células eritroides, una disminución de la síntesis de hemoglobina. En base a los resultados obtenidos en estudios experimentales in vitro e in vivo se postulan dos hipótesis que involucran: la interferencia del aluminio con la captación y/o utilización celular de hierro y la interacción del aluminio con componentes de la membrana celular. Este último hecho afectaría no sólo la estructura de la membrana sino también sus características fisicoquímicas y/o sus funciones, como la unión de ligandos a sus receptores específicos de la superficie de la membrana celular. Los mecanismos que se discuten permiten adjudicar a la presencia de aluminio en el organismo tanto la inhibición del crecimiento y/o la diferenciación de células progenitoras eritroides como las diferentes alteraciones morfológicas de eritrocitos maduros

Increased fetal hemoglobin levels in patients infected with human immunodeficiency virus (HIV1/2)

Fetal hemoglobin was measured in HIV1/2 patients under treatment with combined therapy (zidovudine and a protease inhibitor). A total of 143 patients and 103 normal individuals were investigated by the quantitative method of Betke and the semi-quantitative acid elution method of Kleihauer. In the normal person, hemoglobin F makes up less than 1 percent and an increase higher than 1.5 percent was observed in 21.4 percent of HIV patients by the method of Betke and in 24.8 percent of HIV-infected patients by the method of Kleihauer. The quantitative biochemical method of Betke showed that the populations were significantly different (two-tailed Mann-Whitney test). The reason for this hemoglobin F increase might be ascribed to the effect of zidovudine or to direct viral action on gamma chain expression. The finding of a higher F cell frequency indicated by the method of Kleihauer rather suggests that there is an increased F cell clone proliferation rather than an increase in hemoglobin F level in every cell

Expansión de células progenitoras hematopoyéticas: metodología, ensayos experimentales y aplicaciones clínicas / Stem cells expantion: Experimental procedures and clinical aplications

La expansión ex vivo de células stem y progenitoras hematopoyéticas tiene un importante potencial de aplicación clínica, incluyendo la terapia génica, purgado de células tumorales y la producción de células dendríticas para inmunoterapia. En las dos últimas décadas se han publicado numerosos trabajos demostrando expansión de células progenitoras es factible en casi todas las condiciones de cultivos ex vivo, desde cultivos estáticos en bolsas permeables a gases a cultivos de perfusión continua en bioreactores. En el presente trabajo se describen las diferentes alternativas de cultivo ex vivo de células stem y las potenciales ventajas y aplicaciones clínicas de la expansión de células de la médula ósea, sangre periférica y cordón umbilical

Citometría de flujo: una herramienta en el laboratorio inmunohematológico / Flow citofluorometry: a tooc in the immunohematological laboratory

Aplication of flow cytofluorometry to blood transfusion: flow citofluorometry has been applied to transfusion medicine for nearly twenty years now. Many of these applications have been for purposes, but several have been suggested for more routine uses. In this summary it is expected to reach of aplication the description of more intervention in the transfusion medicine: detection and quantitation of protein bound to blood cells; detection and quantitation of minor cell population; detection and quantitation of cellular antigens; detection of platelet and WBC antibodies; demostration of platelet activation; demos-tration and quantitation of mocyte interaction with IgG-sensitized RBCs

Blockade of the in vitro effects of testosterone and erythropoietin on Cfu-E and Bfu-E proliferation by pretreatment of the donor rats with cyproterone and flutamide

Erythropoietin is obligatory to support the terminal proliferation and differentiation of erythroid cells but it is not the only agent in modulating red cell production. Previously, we have shown that Testosterone enhances erythropoiesis, at least in part, by increasing renal erythropoietin production. Testosterone may also influence directly the behavior of the erythroid progenitor cells increasing erythroid stem cell proliferation. To gain further insight into the role of testosterone in regulation of erythropoiesis and its interactions with erythropoietin, we studied the effect of testosterone and erythropoietin, using clonal cultures of erythropietic progenitors, to observe CFU-E and late and early BFU-E colonies proliferation from bone marrow cells of donor rats pretreated for 2 days with the androgen antagonists cyproterone (10 mg/Kg/day) and flutamide (160 mg/Kg/day). Specific nuclear receptors for testosterone were demonstrated in marrow erythroid cells. Then, erythroid progenitors may come with their androgen receptors blocked by pretreatment. Cultures were prepared using the methylcellulose technique containing a standard dose of erythropoietin (250 mu/ml) or testosterone (10(-7) M). Results obtained demonstrate that testosterone produced a significant stimulation on CFU-E and BFU-E colony formation. A dose effect correlation was apparent. Testosterone enhances proliferation of late BFU-E more than CFU-E and produce only a slight augmentation of early BFU-E. As expected, erythropoietin markedly stimulate all erythroid colony growth, mainly CFU-E. The effects of testosterone were completely abolished in cultures from bone marrow cells of rats pretreated with cyproterone and flutamide. Activation of the specific androgen nuclear receptors in erythroid cells appears to be necessary for testosterone to develop the erythropoietic effect. Surprisingly, the effects of erythropoietin on erythroid colonies proliferation were also completely blocked by pretreatment with flutamide and partially blocked by pretreatment with cyproterone. Right now, we do not have a satisfactory explanation regarding inhibition of the effects of erythropoietin by pretreatment to marrow donor rats with the androgen antagonists. In conclusion, we postulate triggering late BFU-E cells, a marrow erythropoietin responsive cell population, into active cell cycle, as well as by increasing blood erythropoietin concentration.

Acción del factor de crecimiento epidérmico sobre el desarrollo de las células estriatales cultivadas / Epidermal growth factor effects on striatal cells cultures

En este trabajo se describe la acción del factor de crecimiento epidérmico (FCE) sobre las células del estriado embrionario en un sistema de cultivo disociado de neuronas y glías. El cultivo de células se preparó a partir de embriones de ratas de 16-17 días. En el sistema de cultivo empleado, la población celular fue cultivada durante 20-24 horas en un medio que contenía suero y, y posteriormente, fue tratada con 20 ng/mL del FCE en un medio libre de suero. La eliminación del suero en este período inicial de desarrollo provocó una disminución apreciable de las células vivas en los cultivos tratados y en los controles. Al parecer, la población de células sobrevivientes estaba integrada, en su mayoría, por precursores celulares teniendo en cuenta su capacidad proliferativa. La acción del FCE sobre las células se manifestó en un aumento del número de células debido fundamentalmente a un estímulo de la proliferación de los precursores neuronales y astrocitos. Este efecto estuvo acompañado por una reducción de la diferenciación morfológica neural cuando se comparó con los cultivos controles. En los cultivos, a los 16 días, la detección de la actividad específica de la colina acetiltrasferasa evidenció la diferenciación de una subpoblación neural colinérgica, las cuales respondieron al tratamiento con el factor de crecimiento nervioso con un aumento de la actividad de la enzima

Inhibition of hematopoiesis by a plasma factor in a case of aplastic anemia associated with systemic lupus erythematosus

Systemic Lupus Erythematosus (SLE) may be associated with inhibition of hematopoiesis mediated by antibodies, T-cells or both. A 41-year-old woman with a five-year history of SLE treated with prednisone was admitted to Cabrini Medical Center in New York. The patient complained of fever, chills, arthralgias, general malaise, weakness and dyspnea on exertion, and showed malar rash, pallor, and a systolic ejection murmur along the left sternal border. Admission work up included a CBC with evidence of moderate pancytopenia, a normal EKG, and a normal chest X-ray. The patient's anemia was symptomatic and required a transfusion of packed red blood cells (PRBC's). Bone marrow biopsy and aspiration revealed an aplastic marrow with few hypoplastic islands of hematopoietic elements. The patient was treated with plasmapheresis, achieving immediate progress towards recovery. Bone marrow culture studies (erythroid BFU-E, and myeloid CFU-GM) were done by incubating various titers of the patient's acute phase plasma with normal bone marrow cells. This was done to determine if the patient's plasma contained any hematopoietic inhibitory activity, as has been reported in other cases. Our experiments demonstrated marked inhibition of erymathropoiesis and myelopoiesis in vitro, when various titers of the patient's plasma were included in the culture media. Control plasma produced no inhibition. These studies support the hypothesis that a circulating antibody which inhibits hematopoiesis may be produced in SLE patients with aplastic anemia, and be responsible for it

Detecçäo de progenitores hemopoiéticos eritróides (BFU-E e CFU-E) em medula óssea, sangue de cordäo umbilical e sangue periférico usando rh-EPO / Detection of erythroid haemopoietic progenitors (BFU-E and CFU-E) in bone marrow, peripheral blood, and umbilical-cord blood using rh-EPO

A detecçäo de progenitores hemopoiéticos da linhagem eritróide, BFU-E e CFU-E, envolveu a cultura de células mononucleares hemopoiéticas obtidas de medula óssea, sangue periférico e sangue de cordäo umbilical em meio de IMDM, suplementado com antibióticos, soro bovino fetal 25 porcento, soroalbumina bovina 1 porcento, meio condicionado da linhagem celular 5637 (como fonte exogena de fatores de crescimento) 1 porcento e adiçäo de eritropoietina humana recombinante em matriz semi-sólida (metilcelulose). Usando-se a técnica, populaçöes distintas de células progenitoras de linhagem eritróide puderam ser detectadas e definidas em sua linhagem pela capacidade de orientar colônias de aspecto característico, após um período de incubaçäo de 14-20 dias, à 37§C, em atmosfera úmida, com 5-19 porcento de CO2. Os tipos de colônias de BFU-E e CFU-E observados foram de tamanho variado, apresentado coloraçäo vermelha em tons variáveis. Células hemopoiéticas constituintes da linhagem eritróide, em diferentes graus de maturaçäo, foram morfologicamente identificadas após coloraçäo panóptica. A frequência de colônias de BFU-E e CFU-E observada, em nossos estudos foram, respectivamente: 33 mais ou menos 4,4 e 30,3 mais ou menos 5,4 para medula óssea; 12,7 mais ou menos 4,3 e 9,3 e 9,3 mais ou menos 1,5 para sangue periférico; 26,6 mais ou menos 8,7 e 25,6 mais ou menos 11 para sangue de cordäo umbilical

Enhancement of erythroid colony growth by triiodothyronine in cell cultures from bone marrow of normal and anemic rats with chronic renal failure

Para contribuir a clarificar el rol de las hormonas tiroideas en la modulación de la eritropoyesis y profundizar en el conocimiento de los efectos de estas hormonas en la anemia de la insuficiencia renal crónica (CRF), estudiamos "in vitro" la acción de la l-triiodotironina (LT) y DT3, un isómero dextrorotatorio no-calorigénico de la T3 sobre precursores eritroides comprometidos maduros (CFU-E) y primitivos (BFU-E) de la médula ósea de ratas normales anémicas. Los cultivos fueron preparados usando la técnica de la metilcelulosa conteniendo una dosis standard de eritropoyetina (Ep) (182 mU/ml), LT3 y DT3 en dosis de o.5, y 1.5 ug/ml. Las hormonas tiroideas fueron agregadas a los cultivos en ausensia de Ep. Nuestros resultados demuestram que LT3 y DT3 producen una estimulación significativa y directa sobre la formación de CFU-E y un moderado incremento de BFU-E. Hubo una aparente relación dosis-dependiente en los cultivos que contienen las hormonas tiroideas. La DT3 fue menos activa que la LT3. Como se esperaba, la Ep produjo un significativo incremento en la formación de colonias eritroides, principalmente CFU-E. Los efectos de LT3, DT3 y Ep sobre el desarrollo de las colonias eritroides fue significativamente mayor en cultivos celulares de médula ósea de ratas anémicas con CRF, indicando la existencia de una cinética celular proliferativa más elevada en los progenitores eritroides comprometidos en respuesta a estas drogas.

Murine splenic proliferative response to human recombinant erythropoietin along hypoxia

La hipoxia constituye el mejor stress fisiológico para la pertubación del estado estacionario eritropoyético. El present estudio tiende a analizar la respuesta proliferativa eritropoyética esplénica con diferentes dosis de eritropoyentina humana recombinante bajo condiciones hipóxicas a lo largo 18 días mediante el ensayo de síntesis del DNA. Los progenitores esplénicos normóxicos no sufren proliferación eritroide significativa al día 0. Una clara respuesta proliferativa a rh Epo se verificó entre los 2 y 8 días de hipoxia. La proliferación de los progenitores eritroides esplénicos hipóxicos retornó a un patrón basal desde los 10 días hasta el final de la experiencia. La mayor creatividad proliferativa, 25 veces sobre el control (p<0.001), se produjo a los 6 días de condicionamiento desde 62.5 hasta 250mU/ml de rh Epo. estos resultados son concordantes con el concepto que durante la daptación fisiológica a la hipoxia, las células progenitoras eritroides esplénicas modifican transitoriamente su tasa proliferativa observable por variaciones en la relación dosis-respueta a Epo