All-trans retinoic acid directly inhibits granulocyte colony-

From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
1994 84: 2940-2945
All-trans retinoic acid directly inhibits granulocyte colonystimulating factor-induced proliferation of CD34+ human
hematopoietic progenitor cells
EB Smeland, L Rusten, SE Jacobsen, B Skrede, R Blomhoff, MY Wang, S Funderud, G Kvalheim
and HK Blomhoff
Updated information and services can be found at:
http://www.bloodjournal.org/content/84/9/2940.full.html
Articles on similar topics can be found in the following Blood collections
Information about reproducing this article in parts or in its entirety may be found online at:
http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests
Information about ordering reprints may be found online at:
http://www.bloodjournal.org/site/misc/rights.xhtml#reprints
Information about subscriptions and ASH membership may be found online at:
http://www.bloodjournal.org/site/subscriptions/index.xhtml
Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American
Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036.
Copyright 2011 by The American Society of Hematology; all rights reserved.
From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
All-Trans Retinoic Acid Directly Inhibits Granulocyte Colony-Stimulating
Factor-Induced Proliferation of CD34+ Human Hematopoietic
Progenitor Cells
By Erlend B. Smeland, Leiv Rusten, Sten E.W. Jacobsen, Bjsrn Skrede, Rune Blomhoff, Meng Yu Wang,
Steinar Funderud, Gunnar Kvalheim, and Heidi Kiil Blomhoff
In this study we examine the effects of retinoids on purified mediated. Retinoids also significantly inhibited G-CSF-inCD34+ human hematopoietic progenitor cells. All-trans reti- duced colonyformation in semisolid medium,with 88% inhinoicacid inhibitedgranulocytecolony-stimulatingfactor
bition observed at a concentrationof retinoicacid of 1 pmoll
(G-CSF)-induced proliferation of CD34+ cells in short-term
L. However, we did not observe any effects of retinoic acid
liquid cultures in a dose-dependent fashion with maximal
on G-CSF-induced differentiation as assessed by morphol1
ogy and flowcytometry. Similar to previous findings using
inhibition of 72% at aconcentrationofretinoicacidof
pmol/L. Although no significant effects were observed on
total bone marrow mononuclear cells,
we observed a stimuor
granulocyte-macrophage CSF (GM-CSFI- interleukin-3lation of GM-CSF-induced colony formation after 14 days.
stem cell factor (SCF)-induced proliferation, the combinaWe also observed a stimulatory effect of low doses of retiwere all inhibited.
tions of G-CSF and each of these cytokines
noic acid(30 nmol/L) on blast-cell colonyformation on stroMoreover, retinol(3 pmol/L) and chylomicron remnant retimal cell layers. Taken together, the data indicate that vitanyl esters (0.1 pmol/L) in concentrations normally found in
min A present in human plasma has inhibitory as well as
human plasma alsohad inhibitory effects. Single-cell experi- stimulatory effects on myelopoiesis.
0 1994 by The American Society of Hematology.
ments showedthat the effects of retinoic acidwere directly
V
ITAMIN A plays an important role in embryogenesis
and in the regulation of growth and differentiation in
various cell types."3 Retinol (ROH) is the major retinoid in
plasma, and is transported from liver to extrahepatic target
cells as retinol bound to retinol-binding protein.' Newly absorbed retinol is also present as retinyl esters in chylomicrons
and their remnants (CMR). After uptake into target cells,
retinol can be oxidized to retinoic acid (RA).
Retinoids have been found to exert profound effects on
the growth and maturation of hematopoietic cell^.^.^ Thus,
retinoids induce monocytic and/or granulocytic differentiation in various myeloid cell line^.^.^ As RA promotes dramatic inhibition of proliferation along with induced differentiation in acute promyelocytic leukemia both in vitro and in
V ~ V O , ~all-trans
~ " ~
RA is currently used for therapy in this
Interestingly, it has recently been shown that this
type of leukemia is characterized by a translocation
[t(15;17)] that involves the gene encoding the RA receptorCY (RAR-a).I6.I7
Conflicting data exist regarding the effects of retinoids on
normal hematopoiesis in vitro, although RA has generally
been found to stimulate the growth of CFTJ-GMS.~*'"~~
Thus,
RA has been suggested to both inhibitz3," and to stimulate"
granulopoiesis. Because vitamin A can promote a mixture
From the Department of Immunology and the Department of Tu-
mor Biology, Institute for Cancer Research, The Norwegian Radium
Hospital; andtheInstitute
for Nutrition Research, University of
Oslo, Oslo, Norway.
Submitted September 20, 1993; accepted June 29, 1994.
Supported by the Norwegian Cancer Society and the Norwegian
Royal Council for Industrial and Scient@ Research.
Address reprint requests to Erlend B. Smeland, MD, PhD, Department of Immunology, Institute for Cancer Research, Montebello, N0310 Oslo, Norway.
The publication costs of this article were defrayed in part by page
charge payment. This article must therefore be hereby marked
"advertisement" in accordance with 18 U.S.C. section 1734 solely to
indicate this fact.
0 1994 by The American Society of Hematology.
0006-4971/94/8409-02$3.00/0
2940
of direct and indirect effects in heterogeneous cell populations like total bone marrow (BM) mononuclear cells, we
wanted to examine the effects of retinoids in a more restricted population of purified hematopoietic progenitor
cells. In humans, most committed progenitor cells capable
of forming colonies in semisolid culture assays have been
found to reside in the CD34+ subpopulation of BM
The CD34 population, which represents 1% to 4% ofBM
mononuclear cells, also includes more primitive hematopoietic progenitor cells.26~29-32
Recent data have shown that enriched CD34+ marrow cells can reconstitute hematopoiesis
in vivo in humans and nonhuman p r i r n a t e ~ .In
~ ~this
. ~ ~study
we used immunomagnetically purified CD34+ cells to examine the effects of retinoids on enriched populations of hematopoietic progenitor cells. We found that retinoids potently
inhibited G-CSF-induced proliferation and colony formation ofCD34' cells. The effect was directly mediated as
similar inhibition was observed in single-cell cultures. In
addition, physiologic concentrations of retinol and CMR retinyl esters were found to exert similar effects.
MATERIALS AND METHODS
Growth factorsand reagents. Purified recombinant human (rHu)
granulocyte colony-stimulating factor (G-CSF) and rHu stem cell
factor (SCF) were generously supplied by Dr Ian K. McNiece (Amgen Inc. Thousand Oaks, CA). rHu granulocyte-macrophage CSF
(GM-CSF) and rHu interleukin-3 (L-3) were generously provided
by Dr Steven Gillis (Immunex Corp, Seattle, WA). Unless otherwise
indicated, all growth factors were used at predetermined optimal
concentrations: rHuG-CSF (20 ng/mL), rHuGM-CSF (50 ng/mL),
rHuIL-3 (20 ng/mL), and rHuSCF (50 ng/mL).
Retinol (Sigma, St Louis, MO) and RA (Sigma) were solubilized
in ethanol and kept dark bottled at -20°C. Chylomicron remnants
were prepared as described previously."
Cells. BM was obtained by iliac crest aspiration from normal
adult volunteers with informed consent and the approval of the Ethics
Committee of The Norwegian Radium Hospital. BM cells were
collected in syringes containing preservative-free heparin (5,000 I U /
10 mL BM). Mononuclear cells were isolated by Ficoll-Hypaque
gradient centrifugation (Lymphoprep; Nyegaard, Oslo, Norway).
Positive selection of CD34' cells was performed as de~cribed.2~
Briefly, BM mononuclear cells were rosetted with Dynabeads M450
Blood, Vol84, No 9 (November l),1994: pp 2940-2945
From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
2941
RETINOIDS INHIBIT G-CSF-INDUCEDPROLIFERATION
(Dynal, Oslo, Norway) directly coated with the anti-CD34 monoclonal antibody (MoAb) BI-3C5 for 45 minutes at 4°C on an apparatus that provided both gentle tilting and rotation (1 to 2 X IO7 BM
mononuclear cells/mL; bead-to-cell ratio l:]). Rosetted cells were
attracted to a samarium cobalt magnet and nonrosetting cells (CD34cells) were removed by pipetting, and rosetted cells were washed
( ~ 7 ) Detachment
.
of beads from positively selected cells was performed by incubation with anti-Fab antiserum (DETACHaBEAD,
Dynal) at a concentration of 35 mg/mL in 0.3 mL for 45 minutes
at room temperature. Beads were removed by attachment to a magnet
( ~ 2 and
) isolated cells were washed in medium (X2) and counted.
The punty of cells isolated by this method was reproducibly greater
than 90% CD34+ cells, as determined by flow cytometric analyses.*'
Flow cyrometry. Direct immunofluorescence was performed according to standard techniques with phycoerythrin (PE)-labeled
HPCA-2 (CD34; Becton Dickinson, San Jose, CA). An isotypematched, PE-conjugated irrelevant MoAb served as control (Serotec,
Oxford, UK). To block unspecific binding via Fc receptors, aggregated human IgG (Dakopatts, Copenhagen, Denmark) was included
at a concentration of 100 pg/mL.
Flow cytometric analyses were performed on a FACScan flow
cytometer (Becton Dickinson) equipped with an argon-ion laser
tuned at 488 nm. Data acquisition and analysis were performed using
Lysis I1 software (Becton Dickinson).
Cell cultures in liquid medium. Cells were grown in triplicates
(5 x IO3 cells/0.2 mL) in round-bottomed mictrotiter wells (Costar,
Cambridge, MA) in Iscove's modified Dulbecco's medium (IMDM)
supplemented with 10%fetal calf serum (FCS), penicillin, and streptomycin and different cytokines in the absence or presence of retinoids. Cells were pulsed with 1 pCi of 3H-thymidine (The Radiochemical Centre, Amersham, UK) for the last 24 hours of a 6-day
incubation, harvested on a Skatron cell harvester (Lier, Norway),
and counted on a liquid scintillation counter.
Cell phenofyping. Morphologic analysis of stimulated cells was
performed by differential counts on May-Griinwald-Giemsa-stained
cytocentrifuge cell preparations.
Colony formation in semisolid media. Cells (1 X IO3 CD34'
cells per tissue-culture grade 35-mm Petri dish) were plated in a
volume of 1 mL IMDM (GIBCO, Paisley, UK) supplemented with
20% FCS (Sera-lab, Sussex, UK), 1.2% methylcellulose, 5 X
mol/L 2-mercaptoethanol, 300 m g L L-glutamine, 66 mg/L penicillin, 1 0 0 mg/L streptomycin, and recombinant human growth factors
as indicated. Colonies (>40 cells) were counted using an inverted
microscope after 1 or 2 weeks of incubation at 37°C and 5% CO2
in air.
Single-cell proliferation assay. CD34' cells were seeded in Terasaki plates (Greiner, Frickenhausen, Germany) at a concentration
of 1 cell per well (300 wells per group) in 20 pL IMDM containing
20% FCS, extra L-glutamine, penicillin, and streptomycin. Wells
were scored for proliferation (> 10 cells) after 2 weeks of incubation
at 37°C and 5% CO2 in air.
Blast colony formation on stromal feeder layers. The blast colony cultures were set up essentially as described by Gordon et al.36
First, feeder layers of stromal cells were prepared by plating 2 X
IO' BM mononuclear cells in 10 mL of IMDM medium supplemollL
mented with 10% FCS, 10% horse serum, and 5 X
hydrocortisone sodium succinate (Sigma; No. H-4881) in 50 mL
culture tissue flasks. The stromal cultures were fed weekly by complete replacement of the medium, as described above, until a confluent layer of stromal cells covered the base of each dish. In the second
step, CD34' cells (2 X IO4 cells) in 10 m1 of RA containing medium
were added to the irradiated stromal layers. After 2 hours of incubation at 37°C in 5% humified CO2 in air, unattached cells were removed, and the medium was replaced by 10 mL of 0.3% agar in
IMDM medium containing RA and 10% FCS. The number of colo-
T
T
I
Fig 1. Effects of all-trans RA onproliferation of CD34+cellsin
short-term liquid cultures. Cells were cultured in triplicate 15 x lo3
cells/0.2 mL) in microtiter wells with the indicated stimuli in the
absence (0)or presence of 30 nmollL (81and 1 pmol/L 1. of RA.
Cells were pulsedwith ['HI-thymidine from day 5 to day 6. Data are
presented as mean
(SEMI of six experiments. 'Statistical dgnificance
( P < ,051 using the paired Wilcoxon test.
nies (>20 cells) with blast cell morphology was counted after 1
week of culture.
RESULTS
Retinoids inhibit G-CSF-induced [3H]-thymidineincorporation of CD34+ cells in short-term liquid cultures. BM
mononuclear cells represent a very heterogeneous cell population allowing a mixture of direct and indirect effects when
assessing the effects of biologically active substances. Previous studies on the role of retinoids in hematopoiesis have
mostly investigated the effects on unfractionated BM mononuclear cells. Because most progenitors in human BM express the CD34 antigen, we took advantage of a recently
developed method for isolation of humanCD34'
cellsz9
using immunomagnetic beads andan anti-Fab antiserum
(DETACHaBEAD) to study the effects of retinoids on a
restricted population of immature hematopoietic cells.
We first studied the effects of all-trans RA on CSF- and
SCF-induced proliferation of CD34+ cells in liquid cultures (Fig l). All-trans RA alone had no effects on the [3H]thymidine incorporation of CD34+ cells. G-CSF-induced
proliferation was inhibited in a dose-dependent waywith
maximal inhibition of 72% at 1 pmol/L of all-trans RA and
significant effects were also observed at physiologic levels
(30 nmoliL) of all-trans RA (P< .05). In contrast, all-trans
RA did not significantly influence the proliferation induced
by IL-3, GM-CSF, or SCF. However, when GM-CSF, IL3, or SCF were combined with G-CSF, all-trans RA potently
inhibited r3H]-thymidine incorporation (Fig 2). The RA-mediated inhibition was evident from the onset of the cultures,
and cell counting at various time points up to day 14 after
stimulation confirmed the inhibitory effects of all-trans RA
on G-CSF-induced proliferation of CD34' cells (data not
shown). Furthermore, single CD34+ cell proliferation assays
showed that the inhibitory effects of all-trans RA on G-CSFinduced proliferation of CD34+ progenitors were directly
mediated (Table 1).
Effect of retinol and retinyl esters bound to chylomicron
remnantparticles (CMR). Although effects of all-trans RA
on hematopoiesis have been well described, generally retinol
From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
2942
2
SMELAND ET AL
100
,
I
Table 2. Effects of Retinoids and CMR Retinyl Ester on DNA
Synthesis of CD34+ Cells in Short-Term Liquid Cultures
[ W T h v m i d i n e Incorporation (cpm)
1
L
8
l1
.-
40
.E
30
5
20
5
10
T
-
O
z
Exp 1
Exp 2
Exp 1
Exp 2
1,709
1,123
1,087
1,260
233
1,421
3,222
3,436
2,751
599
2,227
1,221
5,195
2,574
2,919
2,699
1,968
6,761
36,047
21,560
15,130
16,140
22,595
30,554
50
No addition
RA ( 100 nmol/L)
C
E
G-CSF
Medium
,
T
RA (30 nmol/L)
ROH (3 pmol/L)
CMR-RE (0.1 pmol/L)
CMR (0.1 pmollL)
G-CSF+IL-3
G-CSF+GM-CSF
G-CSF
G-CSF+SCF
Fig 2. Effects of all-trans RA on G-CSF-induced proliferation of
CD34+ cells in liquid cultures. Cells were culturedas described in the
legend to Fig 1 with the indicated cytokines in the absence (0)
or
presence of 30 nmol/L ( W , 100 nmol/L (U), or 1 pmol/L (m) of RA.
Data are presented as mean (SEMI of six experiments.
has been found to have less or no effects on hematopoietic
progenitor cell^.^^".^' However, as shown in Table 2, retinol
also inhibited G-CSF-induced proliferation in short-term
liquid cultures, albeit to a smaller degree than all-trans RA.
Moreover,wealso wanted tostudytheeffects
of retinol
bound to its physiologic carriers. As shownin Table 2, physiologic levels of CMR-bound retinyl esters (0.1 pmol/L) also
inhibited G-CSF-induced proliferation, again indicating that
thisisaphysiologiceffect
of retinoids. In contrast, CMR
alone did not significantly modulate G-CSF-mediated proliferationat
equal concentrations, althoughCMRalone
tended to inhibit proliferation of CD34+ cells at higher concentrations.
Effects of retinoidson in vitro colony formation. The
majority of committed colony-forming cells (CFCs) in BM
reside
in
the CD34'
In agreement the
with
["HI-thymidine incorporation data, we observed a dose-dependent inhibition of G-CSF induced day7 colony formation
(CFU-G) by all-rrans RA (Fig 3). Maximal inhibition of on
average 87% was obtained at 1 pmol/L of all-trans RA (n =
6, P < .OS). In addition, retinol (3 ,umol/L) also significantly
inhibited G-CSF-induced colony formation (Fig 3). The effects of all-trans RA were completely reversible after exposure of CD34' cells to 100 nmol/L of RA for 24hours (data
not shown). This suggests that the observed inhibition was
not caused by toxic effects of RA.
Previous work has established that RA stimulates the formation of CFU-GM colonies.'*-*' In thepresentstudy
we
5 X I O 3 CD34' cells were cultured in triplicate0.2 mL of medium in
microtiter wells and pulsed with 3H-thymidine from day 5 to day 6.
found a weak stimulation of day 14 GM-CSF-induced colonygrowth(Table
3), whereas no distinct colonies were
apparent on day 7 on stimulation with rHuGM-CSF alone.
In addition, we observed an RA-induced stimulation of day
14CFU-GM colonyformationinresponse
to different
growth factor combinations in six of eight experiments, al( P = .06,
though this did notreachstatisticalsignificance
data not shown). In contrast, and inagreementwiththe
results presented in Fig 3, G-CSF-induced colony formation
was strongly inhibited at day 7 at all concentrations of alltransRA tested, whereasthe effects of RA on G-CSFinduced colony formation at day 14 were less pronounced
(Table 3). Although all-trans RA preferentially inhibited GCSF-induced colony formation at day 7, we also observed
significant inhibition of day 14 colony formation in 11 experiments using concentrations of all-trans RA of 1 pmoVL ( P
< ,001) or 100 nmol/L ( P < .05, data not shown).
The CD34' population also contains, in addition to committed progenitors like CFU-GM, moreprimitive hematopoietic progenitor cells that are not detected in standard colony
assays.'x~'4Several lines of evidence indicate that cells capa-
Table 1. Effects of All-Trans RA in Single-Cell Cultures
~~
No. of Positive Wells/
300 Cells
Fig 3. Effects of retinoids on G-CSF-induced colony formation
(CFU-G) of CD34+ cells. CD34+ cells were cultured for 7 days in methylcellulose cultures as described in Materials and Methods at 1 x lo3
cellslplate with 20 ng/mL of rHu G-CSF alone (0)
or in combination
55 G-CSF
38
with 30 nmol/L (B), 100 nmol/L (U)or 1 pmol/L ( W ) of all-trans RA
G-CSF + RA (100 nmol/L)
22
10
or 3 pmollL of retinol (!B). Results are presented as mean (SEMI
Single CD34- cells were plated in microtiter wells. Cultures were
number of colonies from six separate experiments with triplicate
scored for proliferation ( > l 0 cells) after 14 days at 37°C and 5% CO2
determinations.*Statistical significance ( P < .05, paired Wilcoxon
in air. Median values from two representative experiments are shown.test).
Exp 1
Exp 2
From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
2943
RETINOIDS INHIBIT G-CSF-INDUCEDPROLIFERATION
day 7 colony formation induced by G-CSF usingnormal
BM cells. However, in their study it was not shown whether
the effect was directly mediated. In apparent contrast, van
Exp 1
Exp 2
Bockstaele et alZ5found that all-trans RA weakly stimulated
Growth Factor
Day 7
Day 14
Day?
Day 14
the formation of day 14 CFU-G colonies, using isolated
32
(3.6)
39
(4.0)
36
(2.5)
39
(4.0)
G-CSF (20ng/mL)
CD34+ cells stimulated with a combination of several cyto+RA 30 nmol/L
6 (0.6)
5 (1.2)
29 (3.5)
25 (4.6)
kines, whereas the total number of colonies found, including
1 (1.0) 16 (2.6)
1 (0.6)
16 (3.8)
+RA 1 pmol/L
CFU-M and BFU-E colonies, were significantly depressed.
However, it is difficult to directly compare the results of
0
(1.2)
22
0
(3.2) 19
GM-CSF (50 ng/mL)
these studies because of the use of different cytokines or
+RA 30 nmol/L
0
25 (4.0)
0
(3.5) 34
cytokine combinations. In addition, whereas we observed
0
(4.6) 18
0
29 (5.0)
+RA 1 Mmol/L
the most potent inhibition of G-CSF-induced colony formaCD34+ cells (2 x lo3 cells/dish) were cultured with growth factors
tion at day 7, van Bockstaele et a1 scored CFU-G colonies
in methyl cellulose, as described in Materials and Methods. Data reponly at day 14.
resent mean of triplicates (SD). Two representative experiments are
shown.
Most available data suggest that retinoids also can stimulate normal hematopoietic progenitor cells. A stimulatory
effect of RA on CFU-GM was first shown by Douer and
Koeffler,I8 using BM mononuclear cells. This finding has
ble of adhering to a stromal feeder layer and giving rise to
and is in general
blast colonies represent more primitive progenitor cells.26,30*36 later been confirmed by several gro~ps,'~-''
agreement with our results on GM-CSF-induced colony forWhen examining the capacity of CD34+ cells to generate
mation of isolated CD34+ cells. Taken together, the data
B1-CFCs, we found that all-trans RA at low concentrations
therefore suggest that retinoids can have both stimulatory
(30 nmoVL) consistently stimulated blast cell colony formaand inhibitory effects on committed progenitor cells, and
tion (on average twofold, P < .05), whereas high concentrathat the effects on such cells are strongly dependent on the
tions (1 FmoVL) were inhibitory (Table 4), indicating a bidiCSFs stimulating their growth.
rectional, dose-dependent effect on blast-cell colony
Few reports have examined the effects of retinoids on
formation.
more immature myeloid cells. A few reports have studied
RA does not injuence G-CSF-induced difSerentiation of
the effects ofRA on CFU-Mix and no clear effects were
CD34' cells.CD34'
cells were cultured in bulk liquid
f o ~ n d . ' ~We
, ~ found
~
that all-trans RA in low concentrations
cultures with G-CSF with or without all-trans RA, and mor(30 nmol/L) stimulated blast colony formation on preformed
phologic analyses were performed after culture for 3, 6, and
stromal layers, whereas higher concentrations (1 pmol/L)
12 days. As can be seen in Table 5, no effects of all-trans
were inhibitory. It is possible that the stimulatory effects
RA on the relative frequency of blasts or different stages of
observed on blast-cell colony formation in the present study
myeloid cells were observed. In agreement with this we also
are caused by RA-induced cytokine production in the prefound no difference in G-CSF-induced expression of the
formed stromal cell layer. Interestingly, we have recently
granulocytic antigen CD15 in the absence or presence of allshown in the murine system that primitive progenitor cells
trans RA after 6 days of culture (data not shown).
(Lin-Sca-l+) are profoundly and directly inhibited by allDISCUSSION
trans RA and 9-cis RA in various assays, including high
proliferative potential colony-forming cells colony formaRetinoids have been shown to influence growth and differtion!'
Similarily, we have recently also found that RA inhibentiation of various hematopoietic cells. However, most
its the growth of CD34+CD38- cells in single cell assays
studies of the effects of retinoids on normal hematopoiesis
(L. R., unpublished results, November 1992). Whether retihave used unfractionated BM mononuclear cells. As retinoids
also can directly stimulate subpopulations of immature
noids may have indirect effects, for instance via induced
hematopoietic cells will require further studies.
secretion of ~ y t o k i n e s , it
~ ~is. ~
important
~
to use highly enriched and more homogenous populations of hematopoietic
progenitors for such studies. In this study, we have used
highly purified CD34+ BM cells, which contain most of the
Table 4. Effects of All-Trans RA on Blast Colony Numbers
progenitor cells in the
We observed a specific and
No. of Colonies/2 x IO' CD34+ cells
marked inhibition of G-CSF-induced [3H]-thymidine incorNo addition
(25)
88
poration and colony formation. The effects of all-trans RA
+RA (30 nmol/L)
(49)' 178
on G-CSF-induced proliferation ofCD34' cells were di+RA (1 bmol/L)
64 (25)*
rectly mediated, as all-trans RA also inhibited growth of
CD34' cells (2 x IO') cells were added to irradiated, preformed
CD34' cells in single-cell experiments. G-CSF is known to
stromal layers. After 2 hours of incubation a t 37°C in 5% CO, humidisynergize with several other hematopoietic growth factors,
fied atmosphere, unattached cells were removed, and the medium
including SCF?' and we found that all-trans RA also powas replaced by 10 mL of 0.3% agar in IMDM medium containing
tently inhibited G-CSF-induced proliferation induced by
10% FCS. The number of colonies with blast cell morphology were
two-factor combinations of G-CSF and IL-3, GM-CSF, or
counted after 1 week of culture. Data represent mean (SEMI of six
SCF. Our results are in agreement with the findings of Tohda
experiments.
et al.24who showed a specific inhibition by all-trans RA on
P < .05, paired Wilcoxon test.
Table 3. Effects of All-Trms RA on G-CSF- and GM-CSHnduced
Day 7 and 14 Colony Formation
~~
~
~
~~
~
From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
SMELAND ET AL
2944
Table 5. Effects of All-Trans RA on G-CSF-Induced Differentiation of CD34' BM Cells
Blasts
Promyelocytes
53
0
23
5
1
18
19
8
64 7
16
0
0
2
6
12
2
9
Band Granulocytes
Segmented
Neutrophils
2
34
15
4
37
10
10
58
ND
72
ND
4
39
16
3
ND
35
6
62
ND
Metamyelocytes
Myelocytes
Peroxidase
G-CSF
d 3 (1 exp)
d 6 (3 exp)
d 12 (3 exp)
G-CSF + RA
d 3 (1 exp)
d 6 (3 exp)
d 12 ( 3 exd
0
5
0
70
CD34' cells were grown in liquid cultures in the presence of G-CSF (100 ng/mL) with or without RA (100 nmol/L). Themorphologic evaluation
was performed on cytospin specimens stained with May-GrOnwald-Giemsa. Figures represent percentages. Freshly isolated CD34' cells contained >90% cells with blast-cell morphology.
Retinoids are known to induce terminal differentiation of
several human and murine myeloid cell lines, especially cell
lines expressing features of relatively mature cells (ie, HL60 and U-937).5-9Moreover, RA has been shown to induce
granulocytic differentiation of acute promyelocytic leukemia
cells in vivo and in vitro.''-16 RA-induced differentiation of
cell lines is generally accompanied by reduced proliferation,
but inhibited cell growth is not always accompanied by differentiati~n.~
However, the effects on differentiation of normal hematopoietic progenitors are controversial. Although
the early inhibition of G-CSF-induced growth observed in
this study (Table 1) suggests an inhibitory effect by all-trans
RA onproliferation, we did not observe any significant effect
of all-trans RA on G-CSF-induced differentiation of CD34+
cells in liquid cultures. Although this is in agreement with
most previous st~dies,2'*~~"
others have found inhibited
granulocyticz3 or increased monocytic differentiati~n."~
However, it is difficult to directly compare the results of
these studies, as different hematopoietic growth factors were
used. Moreover, in most of these studies heterogeneous cell
populations were used, and therefore possible effects on differentiation of small subpopulations of the cells could easily
be overlooked.
One of the main limitations in most in vitro studies using
vitamin A is that the retinoids are administered to the cells
solubilized in ethanol or Me,SO, and notbound to its physiological carriers. In vivo, however, retinol is transported in
plasma bound to retinol-binding protein (RBP),' and is taken
up by target cells via RBP-receptors.' Newly absorbed retinol is also present as retinyl esters in CMR, which are taken
up by cells presumably via binding to low density lipoprotein
(LDL) receptors or LDL receptor related protein (LW).' In
this study we have observed effects of all-trans RA and
retinol in physiological
Similar effects
were also observed using CMR-bound retinyl esters at concentrations of 0.1 ymoVL. Taken together, our experiments
therefore suggest that the effects of retinoids on hematopoiesis are physiologically relevant.
REFERENCES
1. Blomhoff R, Green MH, Berg T, Norum K: Transport and
storage of vitamin A. Science 250:399, 1990
2. Sporn M B , Roberts AB: Role of retinoids in differentiation
and carcinogenesis. Cancer Res 43:3034, 1983
3. Blomhoff HK, Smeland EB: The role of retinoids in normal
hematopoiesis and the immune system, in Blomhoff R (ed): Vitamin
A in Health and Disease. New York, NY, Decker, 1994, p 451
4. Amatruda TT, Koeffler H P Retinoids and cells of the hematopoietic system, in Sherman, MI e d Retinoids and Cell Differentiation. Boca Raton, %, CRC 1986, p 79
5. Breitman TR, Selonick SE, Collins, SJ: Induction of differentiation of the human promyelocytic leukemia cell line (HL-60) by
RA. Proc Natl Acad Sci USA 77:2936, 1980
6. Koeffler H P Human acute myeloid leukemia lines: Models of
leukemogenesis. Semin Hematol 23:223, 1986
7. Tobler A, Dawson MI, Koeffler Hp: Retinoids. Structure-function relationship in normal and leukemic hematopoiesis in vitro. J
Clin Invest 78:303, 1986
8. Peck R, Bollag W: Potentiation of retinoid-induced differentiation of HL-60 and U937 cell lines by cytokines. Eur J Cancer 2753,
1991
9. Wathne K-0, Norum KR, Smeland E, Blomhoff R:Retinol
bound to physiological carrier molecules regulates growth and differentiation of myeloid leukemic cells. J Biol Chem 263:8691, 1988
10. Nakamaki T, Sakashita A, San0 M, Hino K, Suzuki K, Tomoyasu S, Tsuruoka N, Homna Y, Hozumi M: Granulocyte-colony
stimulating factor and RA cooperatively induce granulocytic differentiation of acute promyelocytic leukemia cells in vitro. Jpn J Cancer
Res 80:1077, 1989
11. Chomienne C, Ballerini P, Balitrand N, Daniel MT. Fenaux P,
Castaigne S, Degos L All-trans retinoic acid in acute promyelocytic
leukemias. 11. In vitro studies: Structure-function relationship.
Blood 76:1710, 1990
12. Sakashita A, Kizaki M, Pakkala S, Schiller G, Tsuruoka N,
Tomasaki R, Cameron JF, Dawson MI, Koeffler H P 9-cis-retinoic
acid: Effects on normal and leukemic hematopoiesis in vitro. Blood
81:1009, 1993
13. Chen Z-X, Zue Y-Q, Zhang R, Tao R-F, XiaX-M, Li C,
Wang W, Zu W-Y, Yao X-Z, Ling BJ: A clinical and experimental
study on all-trans retinoic acid-treated acute promyelocytic leukemia
patients. Blood 78:1413, 1991
14. Meng-er H, Yu-chen Y, Shu-rong C, Jin-ren C, Jia-Xiang L,
Lin Z, Long-jun G, Zhen-yi W: Use of all-trans retinoic acid in the
treatment of acute promyelocytic leukemia. Blood 72: 567, 1988
15. Castaigne S, Chomiennie C, Daniel MT, Ballerini P, Berger
R, Fenaux P, Degos L All-trans retinoic acid as a differentiation
therapy for acute promyelocytic leukemia. I Clinical results. Blood
76:1704, 1990
From www.bloodjournal.org by guest on October 21, 2014. For personal use only.
RETINOIDS INHIBIT G-CSF-INDUCEDPROLIFERATION
16. Kakizuka A, Miller WH Jr, Umesono K, Warrell RP Jr. Frankel SR, Murty VVVS, Dimitrovsky E, Evans RM: Chromosomal
translocation t(15;17) in human acute promyelocytic leukemia fuses
RAR-a with a novel putative transcription factor, PML. Cell 66:663,
1991
17. de T h B H, Lavau C, Marchio A, Chomienne C, Degos L,
Dejean A: The PML-RAR-A fusion mRNA generated by the
t(15;17) translocation in acute promyelocytic leukemia encodes a
functionally altered RAR. Cell 66:675, 1991
18. Douer D, Koeffler H P Retinoic acid enhances colony-stimulating factor-induced clonal growth of normal human myeloid progenitor cells in vitro. Exp Cell Res 138:193, 1982
19. Aglietta M, Piacibello W, Stacchini A, Sanavio F, Gavosto
F In-vitro effect of retinoic acid on normal and chronic myeloid
leukemia granulopoiesis. Leukemia Res 9: 879, 1984
20. Swanson G, Picozzi V, Morgan R, Hecht F, Greenberg P:
Responses of hemopoietic precursors to 13-cis retinoic acid and
1.25 dihydroxyvitamin D3 in the myelodysplastic syndromes. Blood
67: 1154, 1986
21. Fabian I, Shvartzmayer S : Effect of a new retinoidal benzoic
acid derivative on normal human hematopoietic progenitor cell
growth in vitro. Cancer Res 46:2413, 1886
22. Aglietta M, Piacibello W, Sanavio F, Visconti A: Retinoic
acid enhances the growth of only one subpopulation of granulomonocyte precursors. Acta Haemat. 71:97, 1984
23. Bradley EC, Ruscetti F W , Steinberg H, Paradise C, Blaine K:
Inhibition of differentiation and proliferation of colony-stimulating
factor-induced clonal growth of normal human marrow cells in vitro
by retinoic acid. J Natl Cancer Inst 71:1189, 1983
24. Tohda S , Minden MD, McCulloch EA: Interactions between
retinoic acid and colony stimulating factors affecting the blast cells
of acute myeloblastic leukemia. Leukemia 5:951, 1991
25. van Bockstaele DR. Lenjou M, Snoeck H-W, Lardon F,
Stryckmans P, Peetermans M E Direct effects of 13-cis and all-trans
retinoic acid on normal bone marrow (BM) progenitors: comparative
study on BM mononuclear cells and on isolated CD34+ BM cells.
Ann Hematol 66:61, 1993
26. Watt SM, Visser JWM: Recent advances in the growth and
isolation of primitive human haematopoietic progenitor cells. Cell
Prolif 25:263, 1992
27. Andrews RG, Singer J W , Bernstein ID: Precurors of colonyforming cells in humans can be distinguished from colony-forming
cells by expression of the CD33 and CD34 antigens and light scatter
properties. J Exp Med 169:1721, 1989
28. Civin CL, Trischmann TM, FacMer MJ, Bernstein ID, Blihring H, Campos L, Greaves MF, Kamoun M, Katz DR, Landsorp
PM, Look AT, Seed B, Sutherland DR, Tindle RW, UchanskaZiegler B: Report on the CD34 cluster workshop, in Knapp W,
Dorken B, Gilks WR, Rieber EP, Schmidt RE, Stein H, von dem
Borne AEGK (eds): Leukocyte Typing IV; White Cell Differentiation Antigens. Oxford, UK, Oxford University, 1990, p 818
29. Smeland EB, Funderud S , Kvalheim G, Gaudernack G, Rasmussen A-M, Rusten L, Wang MY, Tindle R, Blomhoff HK, Egeland T Isolation and characterization of human hematopoietic progenitor cells: An effective method for positive selection of CD34+
cells. Leukemia 6:1, 1992
30. Moore MAS: Clinical implications of positive and negative
hematopoietic stem cell regulators. Blood 78:1, 1991
2945
3 1. Andrews RG, Singer J W , Bernstein ID: Human hematopoietic
precursors in long-term culture: Single CD34+ cells that lack detectable T cell, B cell, and myeloid cell antigens produce multiple colony-forming cells when cultured with marrow stromal cells. J Exp
Med 172:355, 1990
32. Terstappen LWMM, Huang S, Safford M, Lansdorp PM, Loken MR. Sequential generations of hematopoietic colonies derived
from single nonlineage-committed CD34+CD38 progenitor cells.
Blood 77:1218, 1991
33. Berenson RJ, Andrews WI, Bensinger D, Kalamasz G, Knitter
CD, Bernsten ID: CD34+ marrow cells engraft lethally irradiated
baboons. J Clin Invest 81:951, 1988
34. Berenson RJ, Bensinger WI, Hill RS, Andrews RG, GarciaLopez J, Kalamasz, Still BJ, Spitzer G, Buckner D, Bernstein ID,
Thomas ED: Engraftment after infusion of CD34+ marrow cells in
patients with breast cancer or neuroblastoma. Blood 77: 1717, 1991
35. Wathne KO, Carlander B, Norum K, Blomhoff R: Uptake of
retinyl ester in HL-60 cells via the low-destiny-lipoprotein-receptor
pahtway. Biochem J 257:239, 1989
36. Gordon MY, Dowding R, Riley GP, Greaves M F Characterization of stroma-dependent blast colony-forming cells in human
marrow. J Cell Physiol 130:150, 1987
37. Trechsel U, EvQuoz V, Fleisch H: Stimulation of interleukin
I and 3 production by retinoic acid in vitro. Biochem J 230:339,
1985
38. Ralph P, Warren MD, Lee MT, Csejtey J, Weaver JF, Broxmeyer, Williams DE, Stanley ER, Kawasaki ES: Inducible production of human macrophage growth factor, CSF-I. Blood 3:633, 1986
39. F& LA, De Benedetti F, Lohrey N, Birchenall-Roberts MC,
Ellingsworth LW, Faltynek CR, Ruscetti F W : Induction of transforming growth factor-p1 , (TGF-P,) receptor expression and TGFP,-mediated autrocrine inhibition. Blood 6:1248, 1991
40. Bernstein ID, Andrews RG, Zsebo KM: Recombinant human
stem cell factor enhances the formation of colonies by CD34+ and
CD34+lin- cells, and the generation of colony-forming cell progeny
from CD34+lin- cells cultured with interleukin-3, granulocyte colony-stimulating factor, or granulocyte-macrophage colony-stimulating factor. Blood 77:2316, 1991
41. Nagler A, Riklis I, Kletter Y, Tatarsky I, Fabian I: Effect
of1,25 dihydroxyvitamin D3and retinoic acid on normal human
pluripotent (CFU-mix), erythroid (BFU-E), and myeloid (Cm-C)
progenitor cell growth and differentiation patterns. Exp Hematol
14:60, 1986
42. Jacobsen SEW, Fahlman C, BlomhoffHK, Okkenhaug C,
Rusten LS, Smeland EB: All trans and 9-cis retinoic acid: Potent
direct inhibitors of primitive murine hematopoietic progenitors in
vitro. J Exp Med 179:1665, 1994
43. Bender JG, Stewart CC, Van Epps DE, Walker DE: 13-cis
retinoic acid augments the production of macrophages in mouse
bone marrow cultures stimulated with interleukin 3. Exp Hematol
18:990, 1990
44. Fabian I, Shvartzmayer S: Effect on a new retinoidal benzoic
acid derivative on normal human hematopoietic progenitor cell
growth in vitro. Cancer Res 46:2413, 1986
45. Blomhoff R, Skrede B, Norum KR: Uptake of chylomicron
remnant retinyl ester via the low density lipoprotein receptor: Implications for the role of vitamin A as a possible preventive for some
forms of cancer. J Int Med 228:207, 1990