The role of inflammation in the regulation of immune response in acute myeloid leukemia

项目总结/摘要 急性髓性白血病（AML）患者的生存结局受到急性髓性白血病（AML）患者中高炎症的负面影响。 在相同的分子亚组内，与低炎症患者相比，骨髓。总体目标 我们研究的目的是描述异常炎症的功能相关因素， 在不同护理标准治疗方法期间纵向炎症状态，并确定 通过针对炎症关键介质的抑制剂来靶向炎症是否可以改善 治疗反应和存活率。这个提议是由我们最近对炎症的描述引起的- 在动物模型中介导的AML进展以及与选择的突变背景的显著合作 促进白血病的发生;我们的概念是白血病细胞和白血病细胞的不同细胞重塑。 微环境促进炎症。我们认为观察到的强烈的负面治疗反应 与生存相关性独立于其他遗传贡献者，这提供了一个令人兴奋的理由， 靶向AML患者的异常炎症，以改善治疗反应和疾病进展。 这一目标将通过两个独立但互补的具体目标来实现。(1)利用我们庞大的队伍 在1，600名具有分子和临床特征并具有明确炎症状态的AML患者中， 我们将描述那些炎症程度最高和最低的患者， 和免疫反应在单细胞水平通过一个全面的多组学方法。(2)我们将跟踪 在不同的治疗过程中，炎症、免疫调节和相关克隆结构的动力学， 具有集成方法相同的多组学分析首先纵向分析收集的患者 在不同的治疗过程中选择基因型的样本，然后是患者来源的异种移植模型， 相同的患者将接受2种不同的治疗方法，然后进行系列分析，从而允许 用于直接比较和明确表征观察到的变化。最后，我们将测试 抗炎剂（IL-1抑制剂）降低炎症和预防炎症的有效性- 相关的骨髓重塑和较差的治疗反应。我们的成果将首次 提供急需的信息，为针对AML患者的异常炎症提供基础。

Project Summary/Abstract Survival outcomes of acute myeloid leukemia (AML) patients are negatively affected by high inflammation in the bone marrow compared to low inflammation patients within the same molecular subgroup. The overarching goal of our study is to delineate functionally relevant contributors to aberrant inflammation, characterize changes to the inflammatory state longitudinally during different standard-of-care treatment approaches and determine whether targeting inflammation via inhibitors that target the crucial mediators of inflammation can improve treatment response and survival. The proposal was prompted by our recent characterization of inflammation- mediated progression to AML in animal models and the notable cooperation with select mutational backgrounds to promote leukemogenesis; and our notion of distinct cellular remodeling of both leukemic cells and the microenvironment to promote inflammation. We believe that the observed strong negative treatment response and survival association that was independent from other genetic contributors provides an exciting rationale to target aberrant inflammation in AML patients in order to improve treatment response and disease progression. This goal will be achieved by two independent, but complementary Specific Aims. (1) Utilizing our large cohort of 1,600 AML patients who were molecularly and clinically characterized and have a defined inflammatory state, we will characterize those patients with the highest and the lowest inflammation and compare cell state, cell fate and immune response at the single cell level via a comprehensive multi-omic approach. (2) We will track dynamics of inflammatory, immune-regulatory and associated clonal structures during different treatments via the same multi-omic profiling with an integrated approach that first profiles longitudinally collected patient samples with select genotypes during different treatments, followed by patient derived xengraft models of the same patients that will undergo 2 different therapeutic approaches followed by serial profiling, thereby allowing for direct comparison and definitive characterization of the observed changes. Lastly, we will test the effectiveness of anti-inflammatory agents (IL-1 inhibitors) to lower inflammation and prevent the inflammation- associated bone marrow remodeling and inferior treatment response. Together, our results will, for the first time, provide critically needed information to provide a basis for targeting aberrant inflammation in AML patients.