The BACH1 inhibitor ASP8731 inhibits inflammation and vaso-occlusion and induces fetal hemoglobin in sickle cell disease.

In sickle cell disease (SCD), heme released during intravascular hemolysis promotes oxidative stress, inflammation, and vaso-occlusion. Conversely, free heme can also activate expression of antioxidant and globin genes. Heme binds to the transcription factor BACH1, which represses NRF2-mediated gene transcription. ASP8731, is a selective small molecule inhibitor of BACH1. We investigated the ability of ASP8731 to modulate pathways involved in SCD pathophysiology. In HepG2 liver cells, ASP8731 increased HMOX1 and FTH1 mRNA. In pulmonary endothelial cells, ASP8731 decreased VCAM1 mRNA in response to TNF-α and blocked a decrease in glutathione in response to hemin. Townes-SS mice were gavaged once per day for 4 weeks with ASP8731, hydroxyurea (HU) or vehicle. Both ASP8731 and HU inhibited heme-mediated microvascular stasis and in combination, ASP8731 significantly reduced microvascular stasis compared to HU alone. In Townes-SS mice, ASP8731 and HU markedly increased heme oxygenase-1 and decreased hepatic ICAM-1, NF-kB phospho-p65 protein expression in the liver, and white blood cell counts. In addition, ASP8731 increased gamma-globin expression and HbF+ cells (F-cells) as compared to vehicle-treated mice. In human erythroid differentiated CD34+ cells, ASP8731 increased HGB mRNA and increased the percentage of F-cells 2-fold in manner similar to HU. ASP8731 and HU when given together induced more HbF+ cells compared to either drug alone. In CD34+ cells from one donor that was non-responsive to HU, ASP8731 induced HbF+ cells ~2-fold. ASP8731 and HU also increased HBG and HBA, but not HBB mRNA in erythroid differentiated CD34+ cells derived from SCD patients. These data indicate that BACH1 may offer a new therapeutic target to treat SCD.

Preclinical models of nicotinamide phosphoribosyltransferase inhibitor-mediated hematotoxicity and mitigation by co-treatment with nicotinic acid.

Nicotinamide adenine dinucleotide (NAD) is an essential co-factor in glycolysis and is a key molecule involved in maintaining cellular energy metabolism. Nicotinamide phosphoribosyltransferase (NAMPT) catalyzes the rate-limiting step of an important salvage pathway in which nicotinamide is recycled into NAD. NAMPT is up-regulated in many types of cancer and NAMPT inhibitors (NAMPTi) have potential therapeutic benefit in cancer by impairing tumor metabolism. Clinical trials with NAMPTi APO-866 and GMX-1778, however, failed to reach projected efficacious exposures due to dose-limiting thrombocytopenia. We evaluated preclinical models for thrombocytopenia that could be used in candidate drug selection and risk mitigation strategies for NAMPTi-related toxicity. Rats treated with a suite of structurally diverse and potent NAMPTi at maximum tolerated doses had decreased reticulocyte and lymphocyte counts, but no thrombocytopenia. We therefore evaluated and qualified a human colony forming unit-megakaryocyte (CFU-MK) as in vitro predictive model of NAMPTi-induced MK toxicity and thrombocytopenia. We further demonstrate that the MK toxicity is on-target based on the evidence that nicotinic acid (NA), which is converted to NAD via a NAMPT-independent pathway, can mitigate NAMPTi toxicity to human CFU-MK in vitro and was also protective for the hematotoxicity in rats in vivo. Finally, assessment of CFU-MK and human platelet bioenergetics and function show that NAMPTi was toxic to MK and not platelets, which is consistent with the clinically observed time-course of thrombocytopenia.

Mesenchymal stem cell mechanics from the attached to the suspended state.

Human mesenchymal stem cells (hMSCs) are therapeutically useful cells that are typically expanded in vitro on stiff substrata before reimplantation. Here we explore MSC mechanical and structural changes via atomic force microscopy and optical stretching during extended passaging, and we demonstrate that cytoskeletal organization and mechanical stiffness of attached MSC populations are strongly modulated over >15 population doublings in vitro. Cytoskeletal actin networks exhibit significant coarsening, attendant with decreasing average mechanical compliance and differentiation potential of these cells, although expression of molecular surface markers does not significantly decline. These mechanical changes are not observed in the suspended state, indicating that the changes manifest themselves as alterations in stress fiber arrangement rather than cortical cytoskeleton arrangement. Additionally, optical stretching is capable of investigating a previously unquantified structural transition: remodeling-induced stiffening over tens of minutes after adherent cells are suspended. Finally, we find that optically stretched hMSCs exhibit power-law rheology during both loading and recovery; this evidence appears to be the first to originate from a biophysical measurement technique not involving cell-probe or cell-substratum contact. Together, these quantitative assessments of attached and suspended MSCs define the extremes of the extracellular environment while probing intracellular mechanisms that contribute to cell mechanical response.

Hematopoietic colony-forming cell assays.

Hematopoiesis is the process by which stem cells divide and differentiate to produce the multiple types of mature cells found in blood. The process begins in early embryonic development and continues throughout adult life, primarily in the bone marrow. Various in vivo and in vitro assays have been developed to detect and assess stem cells and early multi-potential progenitors. While highly informative about primitive hematopoietic cells these assays are long and labour intensive. Alternatively, colony-forming cell (CFC) assays may be used to quantify more lineage-restricted progenitors in a simple in vitro assay. When cultured in a semi-solid medium containing the appropriate cytokines, CFCs are able to divide and differentiate into a colony of more mature cells that can be detected by light microscopy. This allows for the quantification of erythroid, myeloid, lymphoid, megakaryocytic, and multi-potential cell lineages from various cell sources. This chapter outlines the materials and methods used for the culture and assessment of CFC from humans, mice, and other species.

Culture of human and mouse mesenchymal cells.

Normal human and mouse bone marrow is composed of hematopoietic and nonhematopoietic cells. The latter have also been termed stromal cells, microenvironment cells, colony-forming-unit fibroblasts (CFU-F), and mesenchymal cells. These cells were originally thought to provide an appropriate matrix for hematopoietic cell development, but recent examination of these cell populations suggests a much broader spectrum of activity, including the generation of bone, cartilage, muscle, tendon, and fat. In the future, these mesenchymal cell populations could be used for the treatment of specific diseases and to enhance the engraftment of hematopoietic cells. This chapter describes methods for the human CFU-F assay, culture and expansion of mesenchymal cells, as well as their differentiation to adipocytes. In addition, this chapter describes the mouse CFU-F assay.