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Clonality analysis in B-Cell Chronic Lymphocytic Leukemia (B-CLL) associated with Richter's syndrome
(2006)
B-cell chronic lymphocytic leukemia (B-CLL) comprises 90% of chronic lymphoid leukemias in Western countries and patients with B-CLL have a heterogeneous clinical course. Approximately 3-5% of B-CLL patients encounter transformation to an aggressive lymphoma, mainly diffuse large B-cell lymphoma (DLBCL) or Hodgkin’s lymphoma (HL) which has been defined as Richter’s syndrome and is associated with a poor clinical outcome. The mutational status of the immunoglobulin heavy chain variable region (IgVH) gene not only implies the developmental stage at which the neoplastic transformation occurs in a given B-cell lymphoma, but also constitutes an important prognostic factor in B-CLL, since B-CLL patients with unmutated IgVH genes usually have a poor clinical outcome. Sparse molecular analyses performed in Richter’s syndrome so far suggest that it can occur in B-CLL patients carrying mutated or unmutated IgVH genes, and tumor cells in DLBCL or HL can be clonally identical to the B-CLL clone or arise as an independent, secondary lymphoma. To determine the clonal relationship between DLBCL or Hodgkin/Reed-Sternberg (HRS) cells and pre-existing B-CLL cells in a larger series, to identify the IgVH gene usage and the mutational status and to explore possible prognostic factors in B-CLL undergoing Richter’s transformation, we utilized a PCR-based GeneScan approach with subsequent sequencing of the IgVH genes. In cases with HRS/HRS-like cells laser capture microdissection (LCM) was employed to isolate these cells. In addition, a thorough morphological and immunohistochemical analysis was performed. In total, specimens from 48 patients were investigated including 40 cases of Richter’s syndrome and additional 8 cases of B-CLL cases with the presence of CD30-positive HRS-like cells. Among 40 cases of Richter’s syndrome, 34 B-CLL cases showed transformation to DLBCL and 6 cases transformed from B-CLL to HL. Sequencing was performed in 23 paired B-CLL and DLBCL cases. In 18 cases, B-CLL and DLBCL were clonally identical, whereas DLBCL developed as a clonally independent neoplasm in 5 patients. Among the clonally related pairs, 11 out of 15 cases carried unmutated IgVH genes in both the B-CLL and DLBCL component, whereas 5 of 6 B-CLL cases that showed transformation to HL carried mutated IgVH genes. HRS cells in two samples and HRS-like cells in one sample were clonally distinct from the B-CLL clone and infected by EBV, whereas one sample of HRS-like cells was related to the clone from the surrounding B-CLL cells and did not express latent membrane protein-1 (LMP1). The VH genes VH3-23, VH3-74, VH1-2 and VH3-9 were overused in B-CLL cases that transformed to DLBCL, whereas VH4-34 and VH3-48 were used in over half of the B-CLL cases with transformation to HL. Immunohistochemical staining of ZAP70 was significantly associated with unmutated IgVH genes in B-CLL cases undergoing Richter’s transformation. Clinical follow-up data could be obtained from 24 patients. The median survival times of B-CLL patients with transformation to DLBCL or HL were 7 and 21 months, respectively. No significantly different survival times were found between clonally related or unrelated cases, or between IgVH-mutated or -unmutated cases. We conclude that in Richter’s transformation, DLBCL can evolve by clonal transformation of the pre-existing B-CLL clone or occur as an independent, clonally unrelated neoplasm. In the majority of cases (78% in our series), B-CLL and DLBCL are clonally identical. In a subset of patients, however, DLBCL develops as an independent secondary neoplasm that is not clonally related to the B-CLL. Clonal transformation into DLBCL predominantly occurs in B-CLL patients with unmutated IgVH genes, whereas most B-CLL patients that show transformation to HL or CD30-positive HRS-like cells carry mutated IgVH genes. The tendency that IgVH-unmutated B-CLL transforms to DLBCL and IgVH-mutated B-CLL transforms to HL implies different transformation pathways in the two subtypes of Richter’s syndrome. In addition, important pathogenetic differences are likely to exist between DLBCL cases derived from a pre-existing B-CLL as compared to de novo DLBCL cases, since de novo DLBCL is usually characterized by mutated IgVH genes. The biased usage of IgVH genes in the two subtypes of Richter’s syndrome suggests a possible role for antigen involvement in tumorigenesis also in B-CLL cases that undergo Richter’s transformation. Finally, EBV-association in the HL variant of Richter’s syndrome occurs more frequently in clonally unrelated secondary malignancies.
With the progress in sequencing of the honey bee genome new data become available which allows the search and identification of genes coding for homologous proteins found in other organism. Two genes coding for c-type lysozymes were identified in the genome of A. mellifera through an online-based BLAST search. Expression of both intron-less genes seems not to be under the regulatory control of either of the two pathways involved in humoral insect immunity, i.e. Toll and Imd, since no NF-κB transcription factor binding sites are found upstream of the genes. The encoded Lys-1 and Lys-2 are 157 and 143 amino acid long, respectively, and share a sequence similarity of 90%. Further in silico analysis revealed a signal peptidase cleavage site at the N-terminus of each amino acid sequence, strongly suggesting a secretion of the enzymes into the surrounding environment of the producing cells. Sequence alignments of both amino acid sequences with other c-type lysozymes identified the highly conserved active site glutamic acid (Glu32) as well as eight highly conserved cysteine residues. However, an important aspartic acid (Asp50) in the active site that helps to stabilize a substrate intermediate during catalysis is replaced by a serine residue in the lysozymes of A. mellifera. The replacement of the active site aspartic acid in the honey bee lysozymes suggests a different catalytic mechanism and/or a different substrate-specificity in respect to other c-type lysozymes. Furthermore, 3D-models of Lys-1 and Lys-2 were generated based on the sequence similarity of A. mellifera lysozymes with other c-type lysozymes. The published 3D structure of the lysozyme from the silkmoth Bombyx mori, which shares the highest sequence similarity of all available structures with A. mellifera lysozymes, was used as template for the construction of the 3D-models. The models of Lys-1 and Lys-2 suggest that both enzymes resemble, in large part, the structure of B. mori lysozyme. In order to identify the set of AMPs in the hemolymph of A. mellifera, hemolymph of immunized bees was analyzed. Applying SDS-polyacrylamide gel electrophoresis and mass spectrometry on hemolymph from immunized bees, three out of the four peptides were identified, i.e. abaecin, defensin 1 and hymenoptaecin. Furthermore, Lys-2 was identified in the hemolymph by mass spectrometry, conclusively demonstrating the presence of a lysozyme in the hemolymph of A. mellifera for the first time. However, the protein levels of Lys-2 were not affected by bacterial injection, suggesting that the gene expression of the putative antibacterial protein is not under the regulatory control of the Imd and/or Toll pathway. Besides the abovementioned antimicrobial peptides, the 76 kDa large transferrin was also identified. Transferrin is an iron-binding protein that has been implicated in innate immunity in the honey bee. Furthermore, the effect of pathogenic dose, the timeline of peptide induction and the age-related accumulation of the aforementioned AMPs were studied. The intensity of expression of the antimicrobial peptides, abaecin, defensin 1, and hymenoptaecin as well as transferrin increased proportionally with the amount of bacteria injected into the hemocoel. No such effect was observed for the protein levels of Lys-2. Furthermore, up-regulation of the three antibacterial peptides and transferrin was observed within the first 24 h following infection with E. coli (gram-). Infection with the gram+ bacterium Micrococcus flavus resulted in high and moderate protein levels for transferrin and abaecin, respectively, whereas hardly any accumulation of hymenoptaecin was observed, indicating that the gene expression of abaecin and transferrin is somehow positively correlated, and would suggest a shared regulatory pathway that differs from that of hymenoptaecin. Although bacterial infections didn’t seem to stimulate the production of Lys-2, different concentrations in the hemolymph were observed in bees of different ages, suggesting a correlation between the expression of Lys-2 and the age-related division of labor of adult worker honey bees, also known as age polyethism. The results further allow a proposed causal connection between the age-dependent accumulation of Lys-2 and the hemolymph titer of the gonotrophic hormone juvenile hormone, which is the “behavioral pacemaker” in adult honey bees.
In this thesis two genes involved in causing neurodegenerative phenotypes in Drosophila are described. olk (omb-like), a futsch allele, is a micotubule associated protein (MAP) which is homologous to MAP1B and sws (swiss cheese) a serine esterase of yet unknown function within the nervous system. The lack of either one of these genes causes progressive neurodegeneration in two different ways. The sws mutant is characterized by general degeneration of the adult nervous system, glial hyperwrapping and neuronal apoptosis. Deletion of NTE (neuropathy target esterase), the SWS homolog in vertebrates, has been shown to cause a similar pattern of progressive neural degeneration in mice. NTE reacts with organophosphates causing axonal degeneration in humans. Inhibition of vertebrate NTE is insufficient to induce paralyzing axonal degeneration, a reaction called "aging reaction" is necessary for the disease to set in. It is hypothesized that a second "non-esterase" function of NTE is responsible for this phenomenon. The biological function of SWS within the nervous system is still unknown. To characterize the function of this protein several transgenic fly lines expressing different mutated forms of SWS were established. The controlled expression of altered SWS protein with the GAL4/UAS system allowed the analysis of isolated parts of the protein that were altered in the respective constructs. The characterization of a possible non-esterase function was of particular interest in these experiments. One previously described aberrant SWS construct lacking the first 80 amino acids (SWSΔ1-80) showed a deleterious, dominant effect when overexpressed and was used as a model for organophosphate (OP) intoxication. This construct retains part of its detrimental effect even without catalytically active serine esterase function. This strongly suggests that there is another characteristic to SWS that is not defined solely by its serine esterase activity. Experiments analyzing the lipid contents of sws mutant, wildtype (wt) and SWS overexpressing flies gave valuable insights into a possible biological function of SWS. Phosphatidylcholine, a major component of cell membranes, accumulates in sws mutants whereas it is depleted in SWS overexpressing flies. This suggests that SWS is involved in phosphatidylcholine regulation. The produced α-SWS antibody made it possible to study the intracellular localization of SWS. Images of double stainings with ER (endoplasmic reticulum) markers show that SWS is in great part localized to the ER. This is consistent with findings of SWS/ NTE localization in yeast and mouse cells. The olk mutant also shows progressive neurodegeneration but it is more localized to the olfactory system and mushroom bodies. Regarding specific cell types it seemed that specifically the projection neurons (PNs) are affected. A behavioral phenotype consisting of poor olfactory memory compared to wt is also observed even before histologically visible neurodegeneration sets in. Considering that the projection neurons connect the antennal lobes to the mushroom bodies, widely regarded as the "learning center", this impairment was expected. Three mutants where identified (olk1-3) by complementation analysis with the previously known futschN94 allele and sequencing of the coding sequence of olk1 revealed a nonsense mutation early in the protein. Consistent with the predicted function of Futsch as a microtubule associated protein (MAP), abnormalities are most likely due to a defective microtubule network and defects in axonal transport. In histological sections a modified cytoskeletal network is observed and western blots confirm a difference in the amount of tubulin present in the olk1 mutant versus the wt. The elaboration of neuronal axons and dendrites is dependent on a functional cytoskeleton. Observation of transport processes in primary neural cultures derived from olk1 mutant flies also showed a reduction of mitochondrial transport. Interaction with the fragile X mental retardation gene (dfmr1) was observed with the olk mutant. A dfmr1/ olk1 double mutant shows an ameliorated phenotype compared to the olk1 single mutant. tau, another MAP gene, was also shown to be able to partially rescue the olk1 mutant.