Haemopoietic growth factors: their role in cell development and their clinical use

Mature blood cells are derived from haemopoietic stem cells which grow and proliferate to give rise to progenitor cells more restricted in their proliferation and differentiation capacity. These in turn give rise to cells belonging to any of the haemopoietic lineages. The haemopoietic growth factors interleukin 3, granulocyte-macrophage colony-stimulating factor, granulocyte colony stimulating factor, macrophage colony-stimulating factor and erythropoietin act on haemopoietic cells to promote cell survival, proliferation, differentiation and maturation, as well as many functions of the mature cells. These factors, now purified to homogeneity and molecularly cloned have recently become available. This has facilitated studies of their roles in cell production, and the range of target cells sensitive to them in vitro and in vivo in several species. The latter experimental data led to the first clinical trials where these factors have been used successfully in several clinical settings: erythropoietin to correct the anaemia of renal disease; granulocyte and granulocyte-macrophage colony-stimulating factors to accelerate haemopoietic regeneration after chemotherapy and bone marrow transplantation, and in other situations where increase in the numbers of white cells and stimulation of their function were required. The results to date allow optimism; the clinical use of growth factors not only in haematology and oncology, but in wider fields of medicine may well constitute a major breakthrough in the near future.     

The role of growth factors in self-renewal and differentiation of haemopoietic stem cells

Haemopoietic stem cells in vivo proliferate and develop in association with stromal cells of the bone marrow. Proliferation and differentiation of haemopoietic stem cells also occurs in vitro, either in association with stromal cells or in response to soluble growth factors. Many of the growth factors that promote growth and development of haemopoietic cells in vitro have now been molecularly cloned and purified to homogeneity and various techniques have been described that allow enrichment (to near homogeneity) of multipotential stem cells. This in turn, has facilitated studies at the mechanistic level regarding the role of such growth factors in self-renewal and differentiation of stem cells and their relevance in stromal-cell mediated haemopoiesis. Our studies have shown that at least some multipotential cells express receptors for most, if not all, of the haemopoietic cell growth factors already characterized and that to elicit a response, several growth factors often need to be present at the same time. Furthermore, lineage development reflects the stimuli to which the cells are exposed, that is, some stimuli promote differentiation and development of multipotential cells into multiple cell lineages, whereas others promote development of multipotential cell into only one cell lineage. We suggest that, in the bone marrow environment, the stromal cells produce or sequester different types of growth factors, leading to the formation of microenvironments that direct cells along certain lineages. Furthermore, a model system has been used to show the possibility that the self-renewal probability of multipotential cells can also be modulated by the range and concentrations of growth factors present in the environment. This suggests that discrete microenvironments, preferentially promoting self-renewal rather than differentiation of multipotential cells, may also be provided by marrow stromal cells and sequestered growth factors.     

Control of proliferation by myeloid growth factors.

At present the molecular events which regulate the proliferation and developmental fates of haemopoietic cells are poorly understood. Until recently, the only receptor for the myeloid growth factors which had been characterized extensively was that for M-CSF (c-fms). The molecular cloning of receptors for IL-3, GM-CSF and G-CSF should now permit rapid progress in the analysis of receptor-mediated haemopoietic cell differentiation and development, and should also reveal how the process of leukaemic transformation effects these events.     

Identification of a common signal associated with cellular proliferation stimulated by four haemopoietic growth factors in a highly enriched population of granulocyte/macrophage colony-forming cells.

We have prepared a population of bone marrow cells that is highly enriched in neutrophil/macrophage progenitor cells (GM-CFC). Four distinct haemopoietic growth factors can stimulate the formation of mature cells from this population, although the proportions of neutrophils and/or macrophages produced varied depending on the growth factor employed: interleukin 3 (IL-3) and granulocyte/macrophage colony-stimulating factor (GM-CSF) stimulated the formation of colonies containing both neutrophils and macrophages; macrophage colony-stimulating factor (M-CSF) produced predominantly macrophage colonies; and granulocyte colony-stimulating factor (G-CSF) promoted neutrophil colony formation. Combinations of these four growth factors did not lead to any additive or synergistic effect on the number of colonies produced in clonal soft agar assays, indicating the presence of a common set of cells responsive to all four haemopoietic growth factors. These enriched progenitor cells therefore represent an ideal population to study myeloid growth-factor-stimulated survival, proliferation and development. Using this population we have examined the molecular signalling mechanisms associated with progenitor cell proliferation. We have shown that modulation of cyclic AMP levels has no apparent role in GM-CFC proliferation, whereas phorbol esters and/or Ca2+ ionophore can stimulate DNA synthesis, indicating a possible role for protein kinase C activation and increased cytosolic Ca2+ levels in the proliferation of these cells. The lack of ability of all four myeloid growth factors to mobilize intracellular Ca2+ infers that these effects are not achieved via inositol lipid hydrolysis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Intimate contact between human yolk sac endoderm and haemopoietic precursor cells.

Although the localization of embryonic haemopoietic cells in the endodermal epithelium of the human yolk sac had been discovered several decades ago, the nature and significance of the localization were dubious, and it was supposed that light microscopic pictures represent technical artifacts. Our ultamicrographs now demonstrate that at 16--26 mm CR-length there is an intimate contact between yolk sac endoderm and free haemopoietic precursor cells: apart from interdigitations various types of intercellular contact could be discovered. These contacts, especially the gap-like ones with associated electron dense cytoplasmic areas speak for intercellular communication, i.e., the role of endoderm in early human embryonic haematopoiesis appears likely. The demonstrability of these contacts, however, does not mean that endodermal associations are indispensable for haemopoietic differentiation.     

Human placental tissue: a source of natural hematopoietic regulators

In this paper, it has been shown that human placental tissular extracts are a potent source of natural haemopoietic growth factors. The colony-stimulating activities (CSA) recovered by extraction from washed placental pulp were active both on human and murine haemopoietic progenitors, from monocytic and granulocytic lineages. Crude tissular extracts contained CSA titers at least ten fold the titers usually found in placenta culture media. Placenta is the only human tissue easily available for the study of natural tissue-bound haemopoietic regulators. Extraction on an industrial scale, as proposed for the first time in this paper, should also benefit the identification and purification of new minor molecular classes of growth and maturation factors or inhibitors involved in human haemopoiesis.     

Murine myeloid cell lines derived by in vitro infection with recombinant c-myb retroviruses express myb from rearranged vector proviruses.

To date, cellular transformation in vitro by the myb oncogene has been described for avian haemopoietic cells only. In order to exploit the well-characterized murine haemopoietic system to study transformation by myb, we have infected fetal liver cells with retroviral vectors carrying cDNAs that encode either complete or carboxy-terminally truncated c-myb proteins. We describe four cell lines which, despite our ability to efficiently infect haemopoietic target cells, were generated at low frequency. This was due, as least in part, to the requirement for a rearrangement within the vector that allowed expression of myb sequences. Three of the lines express a truncated myb protein while the fourth apparently expresses a normal c-myb protein, and thus constitutes an exception to the general association of truncation with transformation by myb. All four cell lines resemble immature cells of the myelomonocytic lineage and are dependent on colony-stimulating factors (CSFs) for their growth in vitro. One representative line could be converted to CSF-independence by infection with either Abelson murine leukaemia virus or a recombinant granulocyte-macrophage-CSF-encoding retrovirus; unlike the parental line, the resultant sublines were highly tumorigenic when injected into syngeneic mice.     

Characterization and partial purification of a haemopoietic cell growth factor in WEHI-3 cell conditioned medium.

A myelomonocytic leukaemia cell line, WEHI-3, releases into its growth medium factors which stimulate the development of pluripotential cells, granulocyte/macrophage progenitor cells, megakaryocytic and erythroid progenitor cells. Also present is a factor which is essential for the continued proliferation in vitro of a variety of haemopoietic precursor cell lines of a granulocytic nature (FDC-P cells). Characterization of this growth factor has demonstrated that it is a glycoprotein of apparent Mr 25 800, in which the carbohydrate component appears to be important for activity. After several purification steps, there is an increase in specific activity of approx. 4000-fold over the starting material. At each stage of purification, the factor necessary for the proliferation of FDC-P cells 'co-purifies' with activity which stimulates the proliferation and development of normal multipotential haemopoietic cells as well as megakaryocytic, erythroid and granulocytic committed progenitor cells. This 'co-purification' occurs to the extent that the multilineage stimulating factor and the FDC-P growth factor can be eluted from the same region of sodium dodecyl sulphate/polyacrylamide gels. Thus, evidence so far, using different starting methods and purification regimes, suggests that one molecule may have multiple activities on diverse cell types.     

Differentiation of embryonic haemopoietic stem cells from mouse blastocysts grown in vitro

Embryonic haemopoietic stem cells can differentiate from mouse blastocysts grown in vitro. Mouse blastocysts were cultured for 3 or 4 days and the resultant cells were injected intravenously into lethally X-irradiated or genetically anaemic recipient mice. Blastocysts grown in vitro did not maintain normal embryonic morphology. The presence of donor haemoglobin and donor lymphocytic glucose phosphate isomerase in grafted recipients, demonstrates the presence of embryonic haemopoietic stem cells. Recipients of embryonic haemopoietic stem cells, obtained from growth in vitro, were haematologically stable with no evidence of neoplasia. Pluripotent embryonic cells, maintained on fibroblast feeder layers, were unable to colonize X-irradiated or genetically anaemic mice. Recipients of pluripotent cells died at the same time as saline-injected controls.     

Colony-stimulating factors in the clinic.

Recombinant purified human haemopoietic growth factors are available for clinical trials and some have been licensed for therapeutic use. Some haemopoietic lineages (erythroid, neutrophilic, monocyte-macrophagic) can be selectively stimulated in order to ameliorate the cytopenias that follow cytotoxic treatment, or that characterize some haematological syndromes, and to stimulate mature cell function. Advances in the knowledge of receptor-ligand interactions and of transduction mechanisms, plus the production of synthetic or mutant molecules that may mimic, potentiate or antagonize the effects of the natural growth factors, should make novel therapeutic approaches possible.     

Expression cloning of a receptor for human granulocyte-macrophage colony-stimulating factor.

Two cDNA clones encoding a receptor for human granulocyte-macrophage colony-stimulating factor (hGM-CSF-R) were isolated by expression screening of a library made from human placental mRNA. Pools of recombinant plasmid DNA were electroporated into COS cells which were then screened for their capacity to bind radioiodinated hGM-CSF using a sensitive microscopic autoradiographic approach. The cloned GM-CSF-R precursor is a 400 amino acid polypeptide (Mr 45,000) with a single transmembrane domain, a glycosylated extracellular domain and a short (54 amino acids) intracytoplasmic tail. It does not contain a tyrosine kinase domain nor show homology with members of the immunoglobulin super gene family, but does show some significant sequence homologies with receptors for several other haemopoietic growth factors, including those for interleukin-6, erythropoietin and interleukin-2 (beta-chain) and also to the prolactin receptor. When transfected into COS cells the cloned cDNA directed the expression of a GM-CSF-R showing a single class of affinity (KD = 2(-8) nM) and specificity for human GM-CSF but not interleukin-3. Messenger RNA coding for this receptor was detected in a variety of haemopoietic cells known to display hGM-CSF binding, and cross-linking experiments revealed a similar size for the glycosylated receptors in transfected COS and haemopoietic cells.     

Erythropoietin gene expression in haemopoietic cell lines

Erythropoietin (Epo) gene expression was studied in a number of different haemopoietic cell lines by in situ hybridization and Northern Blot analysis using a radioisotope-labelled monkey Epo DNA probe. A positive message was expressed by a human cell line, CM-S, derived from a patient with congenital hypoplastic anemia, and by a murine erythro-leukaemic cell line, clone 707, derived from the spleen of Friend virus-infected mice. No message was detected in two megakaryoblastic cell lines, and in a monocytic cell line, derived from a patient with acute monocytic leukaemia. These data may fit with the hypothesis of expression of Epo and other growth factors by haemopoietic cells through a mechanism of so-called autocrine secretion.     

Direct cell-cell communication in the blood-forming system

In mammals, bone marrow is the principal tissue where blood is formed during adult life. Paracrine factors are generally considered to control this process but there is considerable evidence that gap junctions are present in haemopoietic tissues. Gap junctions have been implicated in developmental and patterning roles, and we set out to characterize the cells which are coupled, and to provide evidence for their role(s) in blood cell formation. Direct cell-cell communication, shown by dye-transfer, occurs between haemopoietic cells and certain stromal cells. In culture these stromal cells form a mat in which they retain their dye-coupling properties. Freeze-fracture electron microscopy confirms that this coupling is via gap junctions. When haemopoietic cells are cultured on top of these mats dye spreads upwards from the stromal cells into the haemopoietic cells above. Experiments in which haemopoietic cells were cultured alone, with stromal cell conditioned medium, or in direct contact with stromal cell underlays, were therefore carried out. The results of these experiments provide evidence that gap junctional communication may be playing a vital role in maintaining populations of precursor cells which would otherwise differentiate into end cells, leading to the ultimate demise of the system.     

The wall of the chick embryo aorta harbours M-CFC, G-CFC, GM-CFC and BFU-E

In the 3- to 4-day avian embryo, after the first wave of haemopoiesis which derives in the yolk sac from haemopoietic stem cells formed in situ, haemopoietic cells emerge in an intraembryonic site, the wall of the aorta. In this paper, we demonstrate that this site harbours M-CFC, G-CFC, GM-CFC and late and early BFU-E. In serum-free medium, the growth of M-CFC and GM-CFC was strictly dependent on CSF present in fibroblast-conditioned medium (FCM). The growth of G-CFC was improved when FCM was replaced by a minute quantity of chicken and fetal calf serum. Like erythroid progenitors from bone marrow, BFU-E detected here required anaemic chicken serum to differentiate into haemoglobinized cells. The frequency of the different types of haemopoietic progenitors in the aortic population was very high: 80 M-CFC, 25 G-CFC, 4 GM-CFC and 70 BFU-E for 12,500 aorta cells, i.e. two to eight times more frequent than in the bone marrow population, depending on the type of progenitors.     

The Haemopoietic Stem Cell: Between Apoptosis and Self Renewal

Self renewal and apoptosis of haemopoietic stem cells (HSC) represent major factors that determine the size of the haemopoietic cell mass. Changes in self renewal above or below the steady state value of 0.5 will result in either bone marrow expansion or aplasia, respectively. Despite the growing body of research that describes the potential role of HSC, there is still very little information on the mechanisms that govern HSC self renewal and apoptosis. Considerable insight into the role of HSC in many diseases has been gained in recent years. In light of their crucial importance, this article reviews recent developments in the understanding of the molecular, biological, and physiological characteristics of haemopoietic stem cells.     

Erythropoietin and myeloid colony stimulating factors.

The production of blood cells in the body is controlled by at least 20 polypeptide growth factors. Most of these factors have been cloned and many expressed in bacterial and eukaryotic systems to give biologically active proteins. Currently, these recombinant human proteins are undergoing intensive evaluation for their use in treating primary haemopoietic diseases, or stimulating normal haemopoiesis following drug-, radiation- or virus-induced trauma of the bone marrow. Erythropoietin (EPO) and the myeloid colony stimulating factors (IL-3, G-CSF, GM-CSF and M-CSF) were among the first to be cloned and expressed.     

Negative regulators of haemopoiesis—Current advances

The overall control of the haemopoietic system is ultimately articulated at the level of stem cell proliferative regulation. An understanding of the control processes involved is central to a full understanding of the regulation of haemopoiesis in health and disease. We describe here the recent advances in understanding of the negative regulation of primitive haemopoietic cells. The possible involvement of inhibitory factors in the development of haemopoietic malignancy is discussed. The known biological functions of many of these inhibitory molecules suggests a therapeutic potential for negative regulators.