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Immortalized cell lines representative of chronic lymphocytic leukemia (CLL) can assist in understanding disease pathogenesis and testing new therapeutic agents. At present, very few representative cell lines are available. We here describe the characterization of a new cell line (PCL12) that grew spontaneously from the peripheral blood (PB) of a CLL patient with progressive disease and EBV infection. The CLL cell origin of PCL12 was confirmed after the alignment of its IGH sequence against the “original” clonotypic sequence. The IGH gene rearrangement was truly unmutated and no CLL-related cytogenetic or genetic lesions were detected. PCL12 cells express CD19, CD20, CD5, CD23, low levels of IgM and IgD and the poor-outcome-associated prognostic markers CD38, ZAP70 and TCL1. In accordance with its aggressive phenotype the cell line is inactive in terms of LYN and HS1 phosphorylation. BcR signalling pathway is constitutively active and anergic in terms of p-ERK and Calcium flux response to α-IgM stimulation. PCL12 cells strongly migrate in vitro in response to SDF-1 and form clusters. Finally, they grow rapidly and localize in all lymphoid organs when xenotrasplanted in Rag2-/-γc-/- mice. PCL12 represents a suitable preclinical model for testing pharmacological agents.

Chimeric antigen receptors (CAR)-modified T cells are an emerging therapeutic tool for chronic lymphocytic leukemia (CLL). However, in patients with CLL, well-known T-cell defects and the inhibitory properties of the tumor microenvironment (TME) hinder the efficacy of CAR T cells. We explored a novel approach combining CARs with lenalidomide, an immunomodulatory drug that tempers the immunosuppressive activity of the CLL TME. T cells from patients with CLL were engineered to express a CAR specific for CD23, a promising target antigen. Lenalidomide maintained the in vitro effector functions of CD23.CAR+ T cells effector functions in terms of antigen-specific cytotoxicity, cytokine release and proliferation. Overall, lenalidomide preserved functional CAR T-CLL cell immune synapses. In a Rag2−/−γc−/−-based xenograft model of CLL, we demonstrated that, when combined with low-dose lenalidomide, CD23.CAR+ T cells efficiently migrated to leukemic sites and delayed disease progression when compared to CD23.CAR+ T cells given with rhIL-2. These observations underline the therapeutic potential of this novel CAR-based combination strategy in CLL.

HS1, the hematopoietic homolog of cortactin, acts as a versatile actin-binding protein in leucocytes. After phosphorylation, it is involved in GTPase and integrin activation, and in BCR, TCR, and CXCR4 downstream signaling. In normal and leukemic B cells, HS1 is a central cytoskeletal interactor and its phosphorylation and expression are prognostic factors in chronic lymphocytic leukemia (CLL) patients. We here introduce for the first time a super-resolution imaging study based on single-cell 3D-STED microscopy optimized for revealing and comparing the nanoscale distribution of endogenous HS1 in healthy B and CLL primary cells. Our study reveals that the endogenous HS1 forms heterogeneous nanoclusters, similar to those of YFP-HS1 overexpressed in the leukemic MEC1 cell line. HS1 nanoclusters in healthy and leukemic B cells form bulky assemblies at the basal sides, suggesting the recruitment of HS1 for cell adhesion. This observation agrees with a phasor-FLIM-FRET and STED colocalization analyses of the endogenous MEC1-HS1, indicating an increased interaction with Vimentin at the cell adhesion sites. In CLL cells isolated from patients with poor prognosis, we observed a larger accumulation of HS1 at the basal region and a higher density of HS1 nanoclusters in the central regions of the cells if compared to good-prognosis CLL and healthy B cells, suggesting a different role for the protein in the cell types analyzed. Our 3D-STED approach lays the ground for revealing tiny differences of HS1 distribution, its functionally active forms, and colocalization with protein partners.

Chronic Lymphocytic Leukemia (CLL) represents the most common leukemia in the western world and remains incurable. Leukemic cells organize and interact in the lymphoid tissues, however what actually occurs in these sites has not been fully elucidated yet. Studying primary CLL cells in vitro is very challenging due to their short survival in culture and also to the fact that traditional two-dimensional in vitro models lack cellular and spatial complexity present in vivo. Based on these considerations, we exploited for the first time three-dimensional (3D) bioprinting to advance in vitro models for CLL. This technology allowed us to print CLL cells (both primary cells and cell lines) mixed with the appropriate, deeply characterized, hydrogel to generate a scaffold containing the cells, thus avoiding the direct cell seeding onto a precast 3D scaffold and paving the way to more complex models. Using this system, we were able to efficiently 3D bioprint leukemic cells and improve their viability in vitro that could be maintained up to 28 days. We monitored over time CLL cells viability, phenotype and gene expression, thus establishing a reproducible long-term 3D culture model for leukemia. Through RNA sequencing (RNAseq) analysis, we observed a consistent difference in gene expression profile between 2D and 3D samples, indicating a different behavior of the cells in the two different culture settings. In particular, we identified pathways upregulated in 3D, at both day 7 and 14, associated with immunoglobulins production, pro-inflammatory molecules expression, activation of cytokines/chemokines and cell-cell adhesion pathways, paralleled by a decreased production of proteins involved in DNA replication and cell division, suggesting a strong adaptation of the cells in the 3D culture. Thanks to this innovative approach, we developed a new tool that may help to better mimic the physiological 3D in vivo settings of leukemic cells as well as of immune cells in broader terms. This will allow for a more reliable study of the molecular and cellular interactions occurring in normal and neoplastic conditions in vivo, and could also be exploited for clinical purposes to test individual responses to different drugs.

Chronic lymphocytic leukemia (CLL) is a B-cell neoplasia characterized by protumor immune dysregulation involving nonmalignant cells of the microenvironment, including T lymphocytes and tumor-associated myeloid cells. Although therapeutic agents have improved treatment options for CLL, many patients still fail to respond. Some patients also show immunosuppression. We have investigated trabectedin, a marine-derived compound with cytotoxic activity on macrophages in solid tumors. Here, we demonstrate that trabectedin induces apoptosis of human primary leukemic cells and also selected myeloid and lymphoid immunosuppressive cells, mainly through the TRAIL/TNF pathway. Trabectedin modulates transcription and translation of IL6, CCL2, and IFNα in myeloid cells and FOXP3 in regulatory T cells. Human memory CD8+ T cells downregulate PD-1 and, along with monocytes, exert in vivo antitumor function. In xenograft and immunocompetent CLL mouse models, trabectedin has antileukemic effects and antitumor impact on the myeloid and lymphoid cells compartment. It depletes myeloid-derived suppressor cells and tumor-associated macrophages and increases memory T cells. Trabectedin also blocks the PD-1/PD-L1 axis by targeting PD-L1+ CLL cells, PD-L1+ monocytes/macrophages, and PD-1+ T cells. Thus, trabectedin behaves as an immunomodulatory drug with potentially attractive therapeutic value in the subversion of the protumor microenvironment and in overcoming chemoimmune resistance.

Chronic lymphocytic leukaemia (CLL) is one of the most common and incurable B cell leukaemia. CLL cells traffic between peripheral blood, bone marrow and secondary lymphatic tissues where interact with the microenvironment. These processes are affected by the mechanical-forces present in the environment and by the capability of the cells to sense the forces. In this context we demonstrated that Hematopoietic-cell-specific Lyn-substrate-1 (HS1) protein is a cytoskeletal regulator and a prognostic factor in CLL. We proved that interfering with HS1 expression impacts on the progression and homing of CLL cells. To further study HS1 role in CLL we knocked-down HS1 expression by CRISPR/CAS9 technology in a CLL cells line (MEC1). By RNAseq and network analysis on MEC1HS1ko vs MEC1UT we found that HS1-KO significantly affects the expression of molecules involved in: cell motility, adhesion, cell-cell communication, focal adhesion formation. In particular, we found LEF1, FAK and Cortactin genes are up-regulated in MEC1HS1ko, suggesting their involvement in the mechano-signalling pathway. To study the nano-mechanical properties of those cells we are performing AFM measurements of single cell. The results provide an evaluation of the cell stiffness that is related to its deformation in response to an externally applied force. By AFM we found that MEC1HS1ko cells are less stiff if compared with MEC1UT cells. This results demonstrates a putative role for HS1 in regulating the mechanical properties of CLL cells. Due to the prognostic value of HS1 we are currently performing AFM measurement on selected patients and healthy B cells.

Chronic lymphocytic leukaemia (CLL) is one of the most common and incurable B cell leukaemia. CLL cells traffic between peripheral blood, bone marrow and secondary lymphatic tissues where interact with the microenvironment. These processes are affected by the mechanical-forces present in the environment and by the capability of the cells to sense the forces. In this context we demonstrated that Hematopoietic-cell-specific Lyn-substrate-1 (HS1) protein is a cytoskeletal regulator and a prognostic factor in CLL. We proved that interfering with HS1 expression impacts on the progression and homing of CLL cells. To further study HS1 role in CLL we knocked-down HS1 expression by CRISPR/CAS9 technology in a CLL cells line (MEC1). By RNAseq and network analysis on MEC1HS1ko vs MEC1UT we found that HS1-KO significantly affects the expression of molecules involved in: cell motility, adhesion, cell-cell communication, focal adhesion formation. In particular, we found LEF1, FAK and Cortactin genes are up-regulated in MEC1HS1ko, suggesting their involvement in the mechano-signalling pathway. To study the nano-mechanical properties of those cells we are performing AFM measurements of single cell. The results provide an evaluation of the cell stiffness that is related to its deformation in response to an externally applied force. By AFM we found that MEC1HS1ko cells are less stiff if compared with MEC1UT cells. This results demonstrates a putative role for HS1 in regulating the mechanical properties of CLL cells. Due to the prognostic value of HS1 we are currently performing AFM measurement on selected patients and healthy B cells. We are planning to study in depth the role of HS1 in regulating the mechanical properties of the leukemic cells and how this contributes to leukemia development, progression and resistance to therapy.

Chronic lymphocytic leukaemia (CLL) is one of the most common and incurable B cell leukaemia. CLL cells traffic between peripheral blood, bone marrow and secondary lymphatic tissues where interact with a supportive microenvironment. These processes are affected by the mechanical forces present in the environment and by the capability of the cells to sense the forces. In order to migrate from a fluid environment like the blood to a significantly more viscous surrounding, B lymphocytes need to modify their cytoskeleton and consequently their rigidity. Those processes are known to be regulated by Hematopoietic-cell-specific Lyn-substrate-1 (HS1) protein, which promotes the homing processes and is involved in cell-cell communication and focal adhesions formation. From a nanomechanical point of view, cytoskeleton rearrangements can be observed as a difference in the force distribution along the cell and, ultimately, as a change of the overall rigidity of the cell. To measure this change, we used Atomic Force Microscopy (AFM) as an external pressure stimulus and we observed the cell deformation, which finally determines the value of its stiffness. By AFM we measured primary B lymphocytes from selected CLL patients and healthy donors, and we found a significant decrease of stiffness in leukaemia cells compared to healthy ones. We also performed Real-Time Deformability Cytometry (RT-DC) to test the rigidity of cells in flow condition. Finally, we tested the effect of a first line drug (Ibrutinib) on the mechanical properties of leukemic and healthy cells with both techniques in order to understand its effect on the mechanics of cells along their path to development of the disease.

The role of monocytes/macrophages in the development and progression of chronic lymphocytic leukemia (CLL) is poorly understood. Transcriptomic analyses show that monocytes/macrophages and leukemic cells cross talk during CLL progression. Macrophage depletion impairs CLL engraftment, drastically reduces leukemic growth, and favorably impacts mouse survival. Targeting of macrophages by either CSF1R signaling blockade or clodrolip-mediated cell killing has marked inhibitory effects on established leukemia also. Macrophage killing induces leukemic cell death mainly via the TNF pathway and reprograms the tumor microenvironment toward an antitumoral phenotype. CSF1R inhibition reduces leukemic cell load, especially in the bone marrow, and increases circulating CD20(+) leukemic cells. Accordingly, co-targeting TAMs and CD20-expressing leukemic cells provides a survivalbenefit in the mice. These results establish the important role of macrophages in CLL and suggest therapeutic strategies based on interfering with leukemia-macrophage interactions.

The identification of molecules involved in tumor initiation and progression is fundamental for understanding disease’s biology and, as a consequence, for the clinical management of patients. In the present work we will describe an optimized proteomic approach for the identification of molecules involved in the progression of Chronic Lymphocytic Leukemia (CLL). In detail, leukemic cell lysates are resolved by 2-dimensional Electrophoresis (2DE) and visualized as “spots” on the 2DE gels. Comparative analysis of proteomic maps allows the identification of differentially expressed proteins (in terms of abundance and post-translational modifications) that are picked, isolated and identified by Mass Spectrometry (MS). The biological function of the identified candidates can be tested by different assays (i.e. migration, adhesion and F-actin polymerization), that we have optimized for primary leukemic cells.

"\"\\\"HS1 (Hematopoietic cell-specific Lyn substrate-1) is a cytoskeletal interactor in the B-cell receptor (BCR) signaling pathway whose phosphorylation correlates with prognosis in Chronic Lymphocytic Leukemia (CLL) patients. The differentially phosphorylated sites and the kinases that regulate HS1 activity in CLL remain poorly understood. We demonstrate that HS1 activity is differentially regulated by LYN kinase that, in a sizable subset of patients, phosphorylates HS1 on Tyrosine (Y)397, resulting in its activation. This correlates with increased cytoskeletal functionality in terms of migration, adhesion and F-actin polymerization. In these patients, LYN is also activated on Y396 residue and its inhibition with the Tyrosine Kinase Inhibitor Dasatinib abrogates HS1-Y397 phosphorylation. This results in the reduction of HS1 activation along with that of VAV1 and ERK also in the presence of microenvironmental stimuli including BCR and CXCR4 stimulation. Interestingly, targeting LYN\\\\\\\/HS1 axis in vitro with Dasatinib leads to the concomitant reduction of the cytoskeletal activity, BCR signaling and cell survival in the selected subset of patients with activated LYN\\\\\\\/HS1. Moreover in a transplantable mouse model based on the EμTCL1 transgenic mouse, LYN\\\\\\\/HS1 signaling pharmacological inhibition interferes with CLL progression and lymphoid organ infiltration. These data suggest that the LYN\\\\\\\/HS1 axis marks distinct signaling profiles and cytoskeletal-related features that may represent valuable targets for cytoskeleton-targeted therapeutic intervention in a sizable fraction of CLL patients.. . \\\"\""