Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA.
Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA.
J Leukoc Biol. 2019 Apr;105(4):741-753. doi: 10.1002/JLB.3A0218-054R. Epub 2019 Jan 31.
Infiltration of acute lymphoblastic leukemia (ALL) blasts into the CNS remains as a major clinical problem, with high risk for chemotherapy-resistant relapse and treatment-related morbidity. Despite the common inclusion of CNS prophylaxis treatments in therapy regimens, there are significant gaps in understanding the mechanisms that mediate leukemia cell entry into the CNS as well as roles for resident cells in the brain. In this study, we employ a xenograft model of human B cell precursor (BCP)-ALL in immunocompromised mice. This model system recapitulates key pathological characteristics of leptomeningeal involvement seen in patients and provides insights into rare cases that involve parenchymal invasion. We examine the infiltration of engrafted leukemia blasts into brains of recipient mice and provide evidence that the interaction between blasts and brain resident cells causes aberrant activation of host cells in the brain microenvironment. BCP-ALL blasts also release multiple cytokines and exosomes containing IL-15 that bind and are internalized by astrocytes and brain vessel endothelial cells. Leukemic invasion is linked to production of VEGF-AA by astrocytes and disruption of the blood-brain-barrier (BBB) integrity. Knockdown of either IL-15 or IL-15Rα in the NALM6 cell line decreases CNS infiltration in engrafted mice. These results provide important insights into the multiple mechanisms by which lymphoblasts modulate the brain microenvironment to breach the BBB for metastatic invasion.
急性淋巴细胞白血病 (ALL) blasts 浸润中枢神经系统仍然是一个主要的临床问题,具有化疗耐药复发和治疗相关发病率高的风险。尽管中枢神经系统预防治疗通常包含在治疗方案中,但对于介导白血病细胞进入中枢神经系统的机制以及驻留细胞在大脑中的作用仍存在很大的理解差距。在这项研究中,我们采用了免疫缺陷小鼠中人类 B 细胞前体 (BCP)-ALL 的异种移植模型。该模型系统重现了患者中脑膜受累的关键病理特征,并为涉及实质浸润的罕见病例提供了见解。我们检查了植入白血病blasts 对受体小鼠大脑的浸润,并提供证据表明blasts 与脑驻留细胞之间的相互作用导致宿主细胞在大脑微环境中异常激活。BCP-ALL blasts 还释放多种细胞因子和含有 IL-15 的外泌体,这些细胞因子和外泌体与星形胶质细胞和脑血管内皮细胞结合并被内化。白血病浸润与星形胶质细胞产生 VEGF-AA 和血脑屏障 (BBB) 完整性破坏有关。在 NALM6 细胞系中敲低 IL-15 或 IL-15Rα 均可减少植入小鼠的中枢神经系统浸润。这些结果为淋巴细胞调节大脑微环境以突破 BBB 进行转移浸润的多种机制提供了重要的见解。