Origin of Repopulating Cells after Localized Bone Marrow Depletion

Hematopoietic Stem Cell Niche in Health and Disease

Regulation of stem cells in adult tissues is a key determinant of how well an organism can respond to the stresses of physiological challenge and disease. This is particularly true of the hematopoietic system, where demands on host defenses can call for an acute increase in cell production. Hematopoietic stem cells receive the regulatory signals for cell production in adult mammals in the bone marrow, a tissue with higher-order architectural and functional organization than previously appreciated. Here, we review the data defining particular structural components and heterologous cells in the bone marrow that participate in hematopoietic stem cell function. Further, we explore the case for stromal-hematopoietic cell interactions contributing to neoplastic myeloid disease. As the hematopoietic regulatory networks in the bone marrow are revealed, it is anticipated that strategies will emerge for how to enhance or inhibit production of specific blood cells. In that way, the control of hematopoiesis will enter the domain of therapies to modulate broad aspects of hematopoiesis, both normal and malignant.

The endosteal 'osteoblastic' niche and its role in hematopoietic stem cell homing and mobilization

The concept of hematopoietic stem cell (HSC) niche was formulated in 1978, but HSC niches remained unidentified for the following two decades largely owing to technical limitations. Sophisticated live microscopy techniques and genetic manipulations have identified the endosteal region of the bone marrow (BM) as a preferential site of residence for the most potent HSC - able to reconstitute in serial transplants - with osteoblasts and their progenitors as critical cellular elements of these endosteal niches. This article reviews the path to the discovery of these endosteal niches (often called 'osteoblastic' niches) for HSC, what cell types contribute to these niches with their known physical and biochemical features. In the past decade, a first wave of research uncovered many mechanisms responsible for HSC homing to, and mobilization from, the whole BM tissue. However, the recent discovery of endosteal HSC niches has initiated a second wave of research focusing on the mechanisms by which most primitive HSC lodge into and migrate out of their endosteal niches. The second part of this article reviews the current knowledge of the mechanisms of HSC lodgment into, retention in and mobilization from osteoblastic niches.

Stem-cell ecology and stem cells in motion

This review highlights major scientific developments over the past 50 years or so in concepts related to stem-cell ecology and to stem cells in motion. Many thorough and eloquent reviews have been presented in the last 5 years updating progress in these issues. Some paradigms have been challenged, others validated, or new ones brought to light. In the present review, we will confine our remarks to the historical development of progress. In doing so, we will refrain from a detailed analysis of controversial data, emphasizing instead widely accepted views and some challenging novel ones.

Oxygen and Cell Fate Decisions

Molecular oxygen has been known to play a critical role in a wide range of biological processes including glycolysis, mitochondrial respiration, angiogenesis, pulmonary functions, and cardiovascular activities. An emerging theme has developed in recent years that oxygen has significant impact on embryonic development, maintenance of stem cells, and cellular differentiation or cell fate decisions. Among the notable observations, early embryonic development takes place in a hypoxic microenvironment. Hematopoietic stem cells appear to be located in hypoxic regions within the bone marrow. Majority of the current observations have shown that hypoxia seems to prevent cellular differentiation and to maintain pluripotency of stem/progenitor cells. Genetic studies have demonstrated a critical role of hypoxia-inducible factors 1α and 2α in embryonic development. These intriguing observations demonstrate an important role of molecular oxygen in such fundamental biological processes as stem cell maintenance and regulation of cell fate decisions. Herein, we describe some of the latest advances in the biology of molecular oxygen and provide our perspectives on the potential impact of these interesting findings.

An in situ study of CD34(+) cells in human fetal bone marrow

The purpose of this study was to characterize the spatial distribution, number and size of CD34(+) cells in fetal bone marrow. Thin sections of normal fetal bone marrow from lumbar vertebrae were stained using CD34 antibody QBend/10. Sections were used under light microscopy with various eyepiece graticules to make measurements of CD34(+) cells in situ. Results showed that at mid- and late gestation, approximately 2% and 0.5% of fetal bone marrow cells were CD34(+) respectively. The mean distance of CD34(+) cells from the nearest trabecular bone surface was 61 +/- 4 and 46 +/- 4 microm, respectively, for mid- and late gestation. The mean distance to the nearest neighbour was 46 +/- 5 and 105 +/- 15 microm, and the mean distance to the nearest blood vessel was 13 +/- 1 and 17 +/- 2 microm respectively. The concentration of CD34(+) cells in the peripheral region was 6.5 times greater than that at the centre of the sections. Overall, the percentage number of CD34(+) cells decreased with gestational age. The cellular and nuclear diameters of CD34(+) cells remained unchanged throughout mid- and late gestation at 5.4 +/- 0.1 and 3.8 +/- 0.1 microm respectively. This information will be used to calculate the natural background alpha-radiation dose to haemopoietic stem cells.

Intramembranous trabecular generation in normal bone

The ability of trabeculae to reform following localized ablation may provide further insight into the sequence of events in cancellous regeneration. Histological features of cancellous repair were examined in the iliac crest of aged female sheep at intervals after removal of a 1-cm diameter biopsy. Comparison was made with normal intramembranous trabecular formation in the foetal lamb. The first immature trabeculae to form in the defects within 3 weeks were exclusively intramembranous, not endochondral, and the systematic process was indistinguishable from that in the intact growing foetal lamb. In both the young and old skeleton, two features were prominent. First, the damaged endosteum of the sheep functioned like the intact periosteum of the lamb to produce orderly migrating arrays of discrete coarse collagenous fibres, 5-25 microns thick, which penetrated the surrounding soft tissues to form a polarised preliminary framework. Without this structure, primary trabecular development did not take place. Throughout subsequent bone apposition the preliminary framework, which bonded hard to soft tissues and new bone to old, remained largely unmineralised. Second, intratrabecular resorption channels divided the established, thickened primary bars into networks of mature secondary trabeculae. It is concluded that the two features are central and universal to trabecular proliferation and may provide a morphological basis for future trabecular restitution of the depleted elderly skeleton.

Transfusion of circulating stem cells

Bone marrow collected from all species including man contains specific cells, putative pluripotential stem cells, capable of reestablishing hemopoiesis in a syngeneic or genetically identical member of the same species which has been treated with whole body irradiation. The question of whether similar pluripotential stem cells are present in the circulation in all animals is not yet resolved. In mice, reconstitution of hemopoiesis can be achieved by transfusion of peripheral blood cells only. The same result can be obtained in dogs and probably in baboons. In dogs, experiments with fresh and cryopreserved blood mononuclear cells have confirmed a dose-response relationship--below a certain number of mononuclear cells failure of hemopoietic reconstitution can be predicted. In man, isolated anecdotal case reports suggest that pluripotential stem cells in the circulation may or may not be valuable in repopulating a bone marrow defective as a result of primary disease or following chemotherapy. Indirect evidence from in vitro culture of circulating myeloid progenitor cells suggests but does not prove that pluripotential stem cells circulate in normal man. Pluripotential stem cell numbers are probably greatly increased in the circulation in patients with chronic granulocytic leukemia: such cells can be collected, cryopreserved, and used at a later date as "bone marrow autografts". Whether circulating stem cells can be collected and used in an analogous manner for patients with other leukemias or other neoplasms is not yet established.

The effects of conventionally fractionated, extended portal radiotherapy on the human peripheral blood count

Conventionally fractionated, extended portal radiotherapy (CFEPRT) has been used to treat two diseases in which there was no marrow infiltration (viz. Hodgkin's disease and medulloblastoma). Blood count indices have been monitored during therapy and in the recovery phase. The lymphocytes were the most sensitive and the monocytes the most refractory leucocytes to change; the monocyte count tended to recover during CFEPRT. The platelet count fell gradually and soon after the neutrophil count. The nadir counts for white cells and platelets occurred early or toward the middle of CFEPRT, after which levels were maintained. The hemoglobin slightly and progressively declined. The patterns of change were similar for the two portals analyzed. Absolute eosinophilia occurred in 9 of the 53 CFEPRT patients, often in the recovery period. All patients who maintained their early nadir levels throughout the rest of the CFEPRT demonstrated fast recovery of all indices following completion of radiotherapy; the lymphocyte count recovered fastest. Recent prior CFEPRT or standard MVPP (nitrogen mustard, vinblastine, procarbazine, prednisolone) chemotherapy rendered the blood count more liable to radiation induced cytopenia. A lapse of more than 3 months between MVPP and CFEPRT allowed greater tolerance to the radiotherapy. Recent MVPP may be less myelosuppressive than recent mantle radiotherapy with respect to subsequent tolerance to CFEPRT.

Identification of a hypoxic population of bone marrow cells

A technique using collagenase has been devised to release and separate, with reproducibility, hematopoietic cells (HC) from various microenvironments of mouse femurs. HC were assayed by an in vitro gel culture technique used traditionally to score granulocyte-macrophage precursor cells (CFU-C). CFU-C which resided in the medullary cavity and endosteal regions were sensitive to ionizing radiation and resistant to misonidazole (MISO) cytotoxicity. CFU-C which resided within the compact bone were resistant to ionizing radiation and sensitive to the cytotoxic action of MISO. These results suggest that HC which reside in the bone are hypoxic and retain clonogenic potential. When animals were exposed to various treatments with MISO followed by myelotoxic doses of cyclophosphamide (CTX) or total body irradiation (TBI), the LD50 of both agents was significantly reduced. This result suggests that a hypoxic component of HC could be important in the regenerative process within the marrow after such myelotoxic trauma.

Haemopoietic stem cell concentration and CFUs in DNA synthesis in bone marrow from different bone regions

The concentration of colony-forming cells (CFUs) is about 40% less in sternal marrow than in the marrow of lumbar vertebrae and femora. Marrow of trabecular bones in lumbar vertebrae contains fewer mitotically active CFUs than marrow of trabecular bones in the femoral distal epiphysis and metaphysis, or the peripheral marrow near the cortical bone in the femoral diaphysis. Only a minor part of the variability of the results in the CFU-assay is due to differences in CUF-concentrations between individual donor mice; pooling of the cell suspensions does not substantially decrease variability. Specific pathogen-free mice yield the same results as BALB/c mice from conventional breeding.

The effect of age on the long-term response of bone marrow to local fractionated irradiation

The in-field long-term progressive response of bone marrow to localized fractionatedradiation to the thoracic spine was observed in weanling and adult rats. Total dose levels were 1800,3600 and 5400 rads given in daily fractions of 180 rads for 900 rads perweek, to simulate the clinical setting. Animals were sacrificed at 4 1/2, 6, 8, and 10months after irradiation, and bone marrow from within the treated area was ezamined. The juvenile marrow repopulated to higher levels of cellularity and after higher doses of radiation than the adult. The degree of marrow depletion, time of repopulation, and ultimate level of repopulation after cessation of irradiation were all dependent on the total dose. Some of the suggested clinical implications include re-evaluation of the lower doses given to children.