Translational Oncopathology, National Cancer Research Institute, Genoa, Italy.
Pediatr Blood Cancer. 2012 Jul 15;59(1):44-51. doi: 10.1002/pbc.23339. Epub 2011 Oct 12.
At diagnosis, children with neuroblastoma (NB) present with either localized or metastatic disease. Since the mechanisms responsible for BM invasion are not well known, we investigated the transcriptome of resident BM cells from NB patients as compared to healthy children.
Ninety-two and 88 children with localized and metastatic NB, respectively, and 15 healthy children were included in the study. BM resident cells recovered from BM aspirates by immunomagnetic bead manipulation were subjected to genome-wide microarray analysis. After validation in an independent set of samples, the genes significantly modulated in resident BM cells from NB patients were tested for their diagnostic/prognostic values.
BM resident cells, irrespective of neoplastic cell invasion, significantly overexpressed genes involved in innate immune responses, and interferon (IFN) and IFN-DRS signatures were enriched. Genes coding for metallothioneins and zinc finger proteins, and involved in histone and nucleosome/chromatin organization were also overexpressed. Resident BM cells from NB patients significantly downregulated genes involved in cell adhesion, and in erythrocyte, myeloid, and platelet differentiation pathways. Among downregulated genes, CXCL12 expression reached near complete silencing in patients with metastatic disease. The downregulation of CXCL12 expression was independent of contact between NB cell and resident BM cell.
We demonstrated that NB tumor growth at the primary site can alter the BM microenvironment, and the presence of BM-infiltrating NB cells makes the alterations more pronounced. Therefore, the restoration of a BM physiological state by means of IFN-α monoclonal antibody, Sifalimumab, and selective noradrenaline receptor blockers should be further studied to ameliorate patients' clinical management.
神经母细胞瘤(NB)患儿在诊断时表现为局限性或转移性疾病。由于导致 BM 浸润的机制尚不清楚,我们比较了 NB 患儿和健康儿童的 BM 固有细胞的转录组。
本研究纳入了 92 例局限性 NB 患儿和 88 例转移性 NB 患儿,以及 15 名健康儿童。通过免疫磁珠操作从 BM 抽吸物中回收 BM 固有细胞,进行全基因组微阵列分析。在独立样本中验证后,对 NB 患者 BM 固有细胞中显著调节的基因进行了诊断/预后价值的检测。
无论是否存在肿瘤细胞浸润,BM 固有细胞均显著上调参与固有免疫反应的基因,且干扰素(IFN)和 IFN-DRS 特征富集。编码金属硫蛋白和锌指蛋白的基因以及参与组蛋白和核小体/染色质组织的基因也被过度表达。NB 患者的 BM 固有细胞显著下调参与细胞黏附以及红细胞、髓样和血小板分化途径的基因。在下调的基因中,CXCL12 的表达在转移性疾病患者中几乎完全沉默。CXCL12 表达的下调与 NB 细胞与 BM 固有细胞之间的接触无关。
我们证明了 NB 肿瘤在原发部位的生长可以改变 BM 微环境,而 BM 浸润的 NB 细胞的存在使这种改变更加明显。因此,通过 IFN-α 单克隆抗体、西法利姆单抗和选择性去甲肾上腺素受体阻滞剂恢复 BM 的生理状态,应进一步研究以改善患者的临床管理。