Understanding and targeting bone marrow microenvironment in myelofibrosis

项目摘要/摘要 了解和靶向异常的肿瘤微环境对于制定有效的治疗方案至关重要 心理治疗。原发性骨髓纤维化(PMF)是一种骨髓增生性肿瘤(MPN)，通常进展为 致命性白血病。PMF的治疗选择有限，唯一潜在的治愈方法是干细胞移植。 对大多数患者来说毒性太大了。因此，PMF迫切需要新的有效的治疗方法。复发性 导致JAK-STAT通路异常激活的突变已被证明是导致 疾病。因此，JAK抑制剂被开发出来用于治疗PMF。然而，这些抑制物只会减少 一些体质症状对致病白血病干细胞(LSCs)无明显影响。一个 对PMF发病机制的深入了解将为更好地治疗该病提供机会。这个 骨髓微环境是PMF发病机制中的重要组成部分。我们的初步数据显示骨头 骨髓Lepr基质细胞是纤维化的来源。我们还确定了LEPR的几个关键调解人 细胞纤维化。在这项建议中，我们建议阐明LSCs的细胞和分子机制 在体内与纤维化的壁龛相互作用。我们将测试以纤维化介质为目标是否会导致有效 消除LSCs，并与JAK抑制剂有协同作用。通过更深入地了解 LSC与生态位之间的相互作用，我们针对患病生态位的策略可能会提供新的 治疗学到PMF。

Project summary/Abstract Understanding and targeting abnormal tumor microenvironment is critically important for developing effective therapy. Primary myelofibrosis (PMF) is a form of myeloproliferavtie neoplasm (MPN) that often progresses to lethal leukemia. Treatment options are limited for PMF, and the only potential cure, stem cell transplantation, is prohibitively toxic for most patients. Thus, novel and effective therapies are in great need for PMF. Recurrent mutations resulting in abnormal activation of the JAK-STAT pathway have been shown to be the driver of the disease. As a result, JAK inhibitors have been developed to treat PMF. However, these inhibitors only reduce some constitutional symptoms without significant impact on disease-causing leukemia stem cells (LSCs). A deeper understanding of the pathogenesis of PMF will offer the opportunity to better treat the disease. The bone marrow niche is a critical component to the pathogenesis of PMF. Our preliminary data show that bone marrow LepR+ stromal cells are the source of fibrosis. We have also identified several key mediators of LepR+ cell fibrosis. In this proposal, we propose to elucidating the cellular and molecular mechanisms of how LSCs interact with the fibrotic niche in vivo. We will test whether targeting the fibrosis mediators will lead to efficient elimination of LSCs and have synergistic effects with JAK inhibitors. By having a deeper understanding of the interaction between LSCs and the niche, our strategy of targeting the diseased niche may provide novel therapeutics to PMF.