Leukemia stem cells (LSC) comprise subpopulations of cells in acute or chronic leukemia that have acquired ?stem cell? properties including the ability to endure unlimited self-renewal, maintain aberrant clonal hematopoiesis and achieve quiescence upon exposure to chemotherapy or other bio-stressors thereby conferring resistance to antileukemia treatments. Currently available cell-cycle-dependent chemotherapy and other molecular targeting agents are unable to eliminate these LSCs. Thus new effective treatments to abrogate LSC are an unmet need. MicroRNAs (miRNAs) are short non-coding RNAs that regulate levels of multiple target proteins, thereby controlling a wide array of cellular programs. Among miRNAs that are deregulated in leukemia, higher expression of miR-126-3p (miR-126) is associated with LSC-gene expression signatures and poor outcome. Furthermore, higher levels of miR-126 controls quiescence both in normal hematopoietic stem cells (HSC) and LSC, but while attenuated miR-126 activity increases HSC hematopoietic output, it drives LSC to exhaustion. The central hypothesis of this proposal is that miR-126 is critical for the homeostasis of LSC and mediates LSC therapy resistance, thus represents a promising LSC-directed therapeutic target. The major objective of this application is to understand how miR-126 expression is aberrantly regulated in LSC and to develop an effective therapeutic approach to inhibit miR-126 in LSC, while sparing normal hematopoiesis. As a proof-of-principle, we will focus on targeting miR-126 in acute myeloid (AML) and chronic myeloid leukemia (CML), but similar principles could be expanded to other types of leukemia. We propose the following specific aims (SA): SA1. To dissect and overcome the molecular mechanisms of therapy resistance mediated by a newly discovered SPRED1/miR-126 autoregulatory loop in LSC. We will test that a tyrosine kinase (TK)-dependent SPRED1/miR-126 autoregulatory loop is operative in AML and CML, which mediate miR-126-dependent mechanisms of resistance to tyrosine kinase inhibitors (TKI). We will 1) assess the activity of SPRED1/miR-126 autoregulatory loop in distinct subtypes of AML; 2) define TK-dependent SPRED1 phosphorylation sites; 3) create leukemia mouse models to dissect the interplay of SPRED1/miR-126 autoregulatory loop with aberrantly active TK. SA2. To define the role of miR- 126 in maintaining a LSC niche within the bone marrow microenvironment. We will develop genetically engineered AML and CML models with conditional miR-126 deletion in LSC and endothelial cells (EC). We will determine 1) the contribution of miR-126 produced by LSC; 2) the contribution of miR-126 in the EC compartment; 3) whether deletion of miR-126 could enhance treatment-mediated elimination of LSC. SA3. To develop and optimize a synthetic inhibitor that targets miR-126 in LSC and the LSC niche. We will perform PK and PD analyses and preclinical studies to define the active dose/schedule of an antimiR-126 conjugated with CpG-oligodeoxynucleotide (ODN) for optimal targeted cell delivery.

Public Health Relevance

Cancer is now the leading cause of death in an increasingly aged population in the United States. In order to improve health and treatment outcomes of patients with leukemia [i.e., acute myeloid leukemia (AML) or chronic myelogenous leukemia (CML) and others], it is extremely important to understand the regulation of leukemia stem cells (LSC) which are leukemia cells capable of initiating leukemia, most resistant to chemotherapy and other molecular targeted agents and contribute to relapse. This proposal seeks to understand the role of short non-coding microRNAs in LSC transformation and maintenance, and to develop a novel microRNA targeting therapies to completely eliminate LSC thereby preventing disease recurrence.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Developmental Therapeutics Study Section (DT)
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O'Hayre, Morgan
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Beckman Research Institute/City of Hope
United States
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Maestrini, Davide; Abler, Daniel; Adhikarla, Vikram et al. (2018) Aging in a Relativistic Biological Space-Time. Front Cell Dev Biol 6:55
Zhang, Bin; Nguyen, Le Xuan Truong; Li, Ling et al. (2018) Bone marrow niche trafficking of miR-126 controls the self-renewal of leukemia stem cells in chronic myelogenous leukemia. Nat Med 24:450-462
Kumar, B; Garcia, M; Weng, L et al. (2018) Acute myeloid leukemia transforms the bone marrow niche into a leukemia-permissive microenvironment through exosome secretion. Leukemia 32:575-587