A circuit level understanding of immune cells and hematological cancers has been severely impeded by a lack of techniques that enable intracellular perturbation without significantly altering cell viability and function. Here, we demonstrate that vertical silicon nanowires (NWs) enable gene-specific manipulation of diverse murine and human immune cells with negligible toxicity. To illustrate the power of the technique, we then apply NW-mediated gene silencing to investigate the role of the Wnt signaling pathway in chronic lymphocytic leukemia (CLL). Remarkably, CLL-B cells from different patients exhibit tremendous heterogeneity in their response to the knockdown of a single gene, LEF1. This functional heterogeneity defines three distinct patient groups not discernible by conventional CLL cytogenetic markers and provides a prognostic indicator for patients' time to first therapy. Analyses of gene expression signatures associated with these functional patient subgroups reveal unique insights into the underlying molecular basis for disease heterogeneity. Overall, our findings suggest a functional classification that can potentially guide the selection of patient-specific therapies in CLL and highlight the opportunities for nanotechnology to drive biological inquiry.
A circuit level understanding of immune cells and hematological cancers has been severely impeded by a lack of techniques that enable intracellular perturbation without significantly altering cell viability and function. Here, we demonstrate that vertical silicon nanowires (NWs) enable gene-specific manipulation of diverse murine and human immune cells with negligible toxicity. To illustrate the power of the technique, we then apply NW-mediated gene silencing to investigate the role of the Wnt signaling pathway in chronic lymphocytic leukemia (CLL). Remarkably, CLL-B cells from different patients exhibit tremendous heterogeneity in their response to the knockdown of a single gene, LEF1. This functional heterogeneity defines three distinct patient groups not discernible by conventional CLL cytogenetic markers and provides a prognostic indicator for patients' time to first therapy. Analyses of gene expression signatures associated with these functional patient subgroups reveal unique insights into the underlying molecular basis for disease heterogeneity. Overall, our findings suggest a functional classification that can potentially guide the selection of patient-specific therapies in CLL and highlight the opportunities for nanotechnology to drive biological inquiry.
Achieving a circuit-level understanding
of cellular function requires techniques to systematically perturb
intracellular components and measure cellular responses. Since most
perturbing agents (plasmid DNAs, siRNAs, peptides, and proteins) do
not spontaneously cross the cell membrane with high efficiency, a
host of methods has been developed to deliver various biological effectors
into living cells.[3−2] Unfortunately, in primary immune cells[3−7] and especially in resting cells and lymphocytes,[4,5] these
traditional approaches have proven ineffective. Specifically, common
lipid and cationic delivery reagents[3,1,5,7,13] yield low transfection efficiencies and induce nonspecific inflammation
in these cells[3−8,7] because the endocytic
pathways upon which these methods rely are carefully gated via foreign
element detectors (e.g., toll-like receptors[15]). Viral vectors fare poorly for similar reasons and also due to
the presence of cytoplasmic viral nucleic acid sensors.[9,8,4,15] Electroporation/nucleofection,
which enables delivery by temporarily breaking-down the cellular membrane
through the application of an electric field,[2,5,6,11,14] achieves only mild success because, even with specialized
protocols and buffers, immune cells undergo pervasive apoptosis after
electroporation. This resistance to conventional transfection has
been a major stumbling block in characterizing the molecular circuits
responsible for primary immune cell function and highlights the urgent
need to develop new approaches for efficiently perturbing these cells.Vertical silicon nanowires (NWs) provide a powerful new delivery
modality for administering biomolecular perturbants directly into
the cell cytoplasm.[12] Previous studies
have shown that NW-mediated delivery can be successfully applied in
various cell lines and primary neurons and fibroblasts.[12] However, their utility in primary immune cells
has yet to be investigated, and it was unknown if these cell types
would sense NWs as foreign substances that could be activating or
cause apoptosis. Additionally, different immune cells present vastly
different morphologies, sizes, adhesive properties, and modes of function,
and consequently, each provides distinct challenges for developing
a universal delivery platform.To develop a general NW-based
delivery modality applicable for
immune cells, we studied several mature immune cell subsets that were
immunomagnetically (MACS) isolated from mouse bone marrow and spleen
or from human blood samples. These cells included bone marrow derived
dendritic cells (BMDCs, CD11c+), B cells (CD19+), dendritic cells
(DCs, CD11c+), macrophages (MΦ, CD11b+), natural killer cells
(NK, DX5+), and T cells (CD4+) (Figure S1). For each of the immune cell types, we optimized the physical parameters
of our NWs (Figures 1 and 2, Figures S1–S13, Supporting Information (SI)). Effective delivery of biomolecules into smaller immune cells
that grow in suspension (e.g., naïve mouse B and T cells) required
the use of NWs that were longer (2–3 μm), sharper (diameter
<150 nm), and denser (0.3–1 per μm2). These
cells also needed increased preincubation periods to facilitate settling
on top of the NWs. Larger, adherent immune cells (e.g., DC and MΦ)
required the use of NWs that were slightly shorter (1–2 μm)
and less dense (0.15–0.2 per μm2). While longer
NWs (>3 μm) proved minimally invasive to murine splenocytes
and human B and T cells (Figure S2), they
negatively impacted the viability of larger, adherent mouse and human
immune cells (e.g., DC, MΦ, and BMDCs), likely due to nuclear
disruption (Figure S3). As a general rule,
we found that the NW density and, to a lesser extent, diameter needed
to be scaled to match cell size and that the NW height required adjustment
to facilitate cellular adhesion and penetration (see, for example,
Figures 1d and S2).
Figure 1
Nanowires (NWs) can deliver siRNA into ex vivo primary immune cells.
(a) Scanning electron microscope images of mouse bone-marrow dendritic
cells (BMDCs), B cells, dendritic cells (DCs), macrophages (MΦs),
natural killer (NK) cells, and T cells (false colored orange) on top
of NWs (false colored blue) taken 24 h after plating. (b) Three-dimensional
reconstruction (left) of confocally imaged mouse BMDC (membrane: magenta,
nucleus: blue) on top of Alexa-labeled NWs (white). Right center:
confocal XY slice (green plane indicated on the left). Right top and
far right: orthogonal XZ and YZ plane views (indicated by the dashed
green lines). (c) Confocal microscope image showing Cy3-labeled siRNA
(orange) delivered to mouse BMDCs (intact cytoplasms: gray outlines)
using NWs. (d) Three-dimensional reconstruction (left) of confocally
imaged human B cells (membrane: magenta) on top of Alexa-labeled NWs
(white). (e) Confocal microscope image showing Cy3-labeled siRNA (orange)
delivered to human B cells (intact cytoplasms: gray outlines) using
NWs.
Figure 2
NW mediated delivery is minimally invasive, yet effective,
in ex
vivo primary immune cells. (a) Plating cells on NWs does not diminish
cell viability relative to glass controls (blue); similarly, coating
the NWs with siRNA has negligible impact on cell health (red) (n = 3). All values are mean ± standard error; light
gray = not measured. (b) Plk2 (gray), Ppib (cyan), TAGAP (magenta), and SP110 (green) expression levels upon siRNA delivery. The degree of knockdown
is measured by qRT-PCR, relative to Gapdh/GAPDH.
Knockdowns: mouse BMDCs, 69 ± 1%; mouse B, 75 ± 4%; mouse
DC, 77 ± 2%; mouse MΦ, 73 ± 2%; mouse NK, 85 ±
2%; mouse T, 77 ± 3%; human B,71 ± 4%; human DC, 90 ±
2%, and human MΦ, 78 ± 2%; all values are mean ± standard
error for n = 10 (Plk2), n = 6 (Ppib), and n =
4 (TAGAP, SP110). (c) Cell viability measured (as
ATP activity) on three different sets of human B cells receiving either
non-targeting (NT) (dashed lines) or cell death inducing siRNA (CD)
(solid lines) shows that administering CD siRNA effectively kills
more cells than a non-targeting control. Values are mean ± standard
error, n = 3. (d) SiNWs and their cargo neither active
innate immune responses nor inhibit their induction with conventional
stimuli. Similar gene expression levels (300-gene Nanostring immune
response codeset) are observed in BMDCs whether they are plated on
glass or NWs coated with siRNA, both in the presence and absence of
lipopolysaccharide (LPS). Dashed lines represent 95% confidence intervals.
(e) Mouse T and human B cells grow and divide on NWs when activated
with conventional stimuli.
Nanowires (NWs) can deliver siRNA into ex vivo primary immune cells.
(a) Scanning electron microscope images of mouse bone-marrow dendritic
cells (BMDCs), B cells, dendritic cells (DCs), macrophages (MΦs),
natural killer (NK) cells, and T cells (false colored orange) on top
of NWs (false colored blue) taken 24 h after plating. (b) Three-dimensional
reconstruction (left) of confocally imaged mouse BMDC (membrane: magenta,
nucleus: blue) on top of Alexa-labeled NWs (white). Right center:
confocal XY slice (green plane indicated on the left). Right top and
far right: orthogonal XZ and YZ plane views (indicated by the dashed
green lines). (c) Confocal microscope image showing Cy3-labeled siRNA
(orange) delivered to mouse BMDCs (intact cytoplasms: gray outlines)
using NWs. (d) Three-dimensional reconstruction (left) of confocally
imaged human B cells (membrane: magenta) on top of Alexa-labeled NWs
(white). (e) Confocal microscope image showing Cy3-labeled siRNA (orange)
delivered to human B cells (intact cytoplasms: gray outlines) using
NWs.NW mediated delivery is minimally invasive, yet effective,
in ex
vivo primary immune cells. (a) Plating cells on NWs does not diminish
cell viability relative to glass controls (blue); similarly, coating
the NWs with siRNA has negligible impact on cell health (red) (n = 3). All values are mean ± standard error; light
gray = not measured. (b) Plk2 (gray), Ppib (cyan), TAGAP (magenta), and SP110 (green) expression levels upon siRNA delivery. The degree of knockdown
is measured by qRT-PCR, relative to Gapdh/GAPDH.
Knockdowns: mouse BMDCs, 69 ± 1%; mouse B, 75 ± 4%; mouse
DC, 77 ± 2%; mouse MΦ, 73 ± 2%; mouse NK, 85 ±
2%; mouse T, 77 ± 3%; human B,71 ± 4%; human DC, 90 ±
2%, and human MΦ, 78 ± 2%; all values are mean ± standard
error for n = 10 (Plk2), n = 6 (Ppib), and n =
4 (TAGAP, SP110). (c) Cell viability measured (as
ATP activity) on three different sets of human B cells receiving either
non-targeting (NT) (dashed lines) or cell death inducing siRNA (CD)
(solid lines) shows that administering CD siRNA effectively kills
more cells than a non-targeting control. Values are mean ± standard
error, n = 3. (d) SiNWs and their cargo neither active
innate immune responses nor inhibit their induction with conventional
stimuli. Similar gene expression levels (300-gene Nanostring immune
response codeset) are observed in BMDCs whether they are plated on
glass or NWs coated with siRNA, both in the presence and absence of
lipopolysaccharide (LPS). Dashed lines represent 95% confidence intervals.
(e) Mouse T and human B cells grow and divide on NWs when activated
with conventional stimuli.Once the NW dimensions were optimized for each
cell type, we observed
that these NWs could consistently penetrate cellular membranes (Figures 1b and d, S2, and S3)
without impacting cell health or morphology (Figures 1, 2a, 3a and
b, and S2 through S13). When the NWs were precoated with fluorescently labeled siRNAs,
plasmids, peptides, and proteins, these molecules were delivered into
nearly every cell (Figures 1c, 1e, S7, and S8) without altering viability (Figures 2a, S4 through S6, see SI). Consistent
with our previous findings in non-immune cells,[12] the biomolecular cargo delivered by the NWs was functional.
In particular, siRNAs administered using NWs yielded substantial reductions
(≥69%) in targeted mRNA levels and expected phenotypic changes
in every immune cell type tested (Figures 2b and c, see SI).
Figure 3
NWs successfully deliver LEF1 siRNA into ex vivo
human B cells obtained from normal donors and CLL patients, revealing
functional heterogeneity that correlates with clinical outcome. (a)
Scanning electron microscope images of CLL-B cells on top of NWs taken
24 h after plating. (b) CLL-B cells (intact cytoplasms: green, dead
nuclei: magenta) on full 4 × 4 mm SiNW samples (dark gray squares)
raster-imaged using a confocal microscope 24 h after plating. Administering
a cell death inducing siRNA (far right) kills a larger number of cells
than a non-targeting control (far left). The middle sample shows the
effect of LEF1 siRNA on CLL-B cell viability for
one particular patient sample. (c) The effect of LEF1 knockdown on the viability of normal B (n = 12)
and CLL B-cells (n = 29), normalized to a non-targeting
siRNA, shows tremendous heterogeneity across CLL
patient samples (see SI Methods). Median
viability for CLL samples is 78% versus 100% for normal donors (pCLL = 0.005, pNormal = 0.97, Wilcoxon signed rank test for comparison to nontargeting
control siRNA; pCLL_vs_Normal = 0.004,
Mann–Whitney rank sum test for comparison of CLL samples to
normal samples). Patients are grouped into high, low and inverse responders
based on their differential response. Colored points represent patient
samples for which microarray profiles were generated. (d) Clinical
characteristics of the 29 patients on whose CLL-B cells LEF1 knockdowns were performed. (e) Kaplan–Meier curves of the
high, low, and inverse responders.
NWs successfully deliver LEF1 siRNA into ex vivo
human B cells obtained from normal donors and CLL patients, revealing
functional heterogeneity that correlates with clinical outcome. (a)
Scanning electron microscope images of CLL-B cells on top of NWs taken
24 h after plating. (b) CLL-B cells (intact cytoplasms: green, dead
nuclei: magenta) on full 4 × 4 mm SiNW samples (dark gray squares)
raster-imaged using a confocal microscope 24 h after plating. Administering
a cell death inducing siRNA (far right) kills a larger number of cells
than a non-targeting control (far left). The middle sample shows the
effect of LEF1 siRNA on CLL-B cell viability for
one particular patient sample. (c) The effect of LEF1 knockdown on the viability of normal B (n = 12)
and CLL B-cells (n = 29), normalized to a non-targeting
siRNA, shows tremendous heterogeneity across CLL
patient samples (see SI Methods). Median
viability for CLL samples is 78% versus 100% for normal donors (pCLL = 0.005, pNormal = 0.97, Wilcoxon signed rank test for comparison to nontargeting
control siRNA; pCLL_vs_Normal = 0.004,
Mann–Whitney rank sum test for comparison of CLL samples to
normal samples). Patients are grouped into high, low and inverse responders
based on their differential response. Colored points represent patient
samples for which microarray profiles were generated. (d) Clinical
characteristics of the 29 patients on whose CLL-B cells LEF1 knockdowns were performed. (e) Kaplan–Meier curves of the
high, low, and inverse responders.Crucially, NW-mediated delivery neither activated
an immune response
nor interfered with normal immune sensing, cellular activation, or
cell proliferation in response to physiological signals. First, when
profiled with a signature set of 300 immune response genes (using
the Nanostring nCounter technology,[15,16]Table S1), BMDCs plated on NWs coated with control
siRNAs exhibited similar mRNA expression levels to BMDCs plated on
glass, both prestimulation and in the presence of conventional stimuli,
such as lipopolysachardide (LPS) (Figure 2d,
see SI). Quantitative real-time polymerase
chain reaction (qRT-PCR) for the major inflammatory cytokines[17] Tnf-α and Cxcl1, as well as virally induced[17] Cxcl10 and Type I Interferons (Ifns; e.g., Ifn-β),
gave similar results both for control siRNAs and other biomolecules
(see Figures S9 and S10). This result is
likely due to the fact that NWs deliver cargo directly into the cytoplasm
and hence bypass the endosomal pathway where innate immune sensing
can occur.[3,7,15,17,18]In fact, neither
the NWs nor their biomolecular cargo spontaneously
activated immune responses in any of the primary immune cells tested.
Specifically, murine B cells, DCs, and MΦ plated on NWs all
showed low basal expression levels of Tnf-α before stimulation
and exhibited normal inflammatory responses to appropriate stimuli
(see SI). Similar results were seen for
NK and T cells based on Ifn-γ expression levels (Figure S11;
see SI). Finally, mouse T cells and human
B cells were able to expand on NWs in response to anti-CD3/anti-CD28
& IL-2 and LPS & IL-4 stimulation, respectively (Figures 2e, S12, and S13).These findings demonstrate that NWs provide a potent, yet minimally
invasive, means of delivering perturbants into a variety of murine
and human immune cells ex vivo. NW-mediated delivery is effective
for essentially all primary immune cell types without affecting viability
(when compared to multiwell or glass coverslip controls; Figures 2a and S4 through S6),
and neither activates nor prohibits conventional induction of innate
immune responses (Figures 2d and S9 through S11).[3−8,4−13,11] The ability to deliver
functional biomolecular cargo in a minimally invasive fashion provides
a powerful new tool for studying the molecular circuitry governing
the function of immune cells in both normal and diseased states.To demonstrate this utility, we applied NW-based gene silencing
to investigate the potential basis of clinical heterogeneity in chronic
lymphocytic leukemia (CLL).[19,20] CLL, the most common
adult leukemia in North America, is characterized by the progressive
accumulation of dysfunctional mature B cells that have escaped normal
apoptotic programs.[19,20] Despite the fact that CLL-B cells
of different patients share a common immunophenotype, CLL patients
exhibit tremendous variability in their response to treatment and
in their overall survival.[19] While intensive
research efforts over the past few decades have revealed much about
this disease,[6,19−27] a clear understanding of the intracellular circuitry responsible
for CLL has yet to emerge.[6,19,21]Previous studies have shown that dysregulation of the Wnt
signaling
pathway, normally responsible for guiding proliferation and cell fate,[28−30] plays an important role in CLL.[20,23−25] By analyzing microarray data from 193 CLL-B samples, we indeed confirmed
overall dysregulation of Wnt pathway components in CLL-B cells compared
to normal CD19+ B cells[21] (see SI, Figure S14). We also found that LEF1, a terminal transcriptional activator of the Wnt signaling pathway
previously linked to CLL-B cell survival,[23] was one of the most upregulated mRNAs in CLL compared to normal
B cells.[31]To test the importance
of LEF1 for CLL B-cell
survival, we used NW-mediated siRNA delivery to silence its expression
in B cells isolated from 29 CLL patients and 12 normal donors and
examined cell survival 48 h after siRNA delivery (Figures 3a and b, S15 and S16, see SI). As a group, CLL-B cells exhibited lower viability (median 78%)
upon LEF1 knockdown than CD19+ B cells from normal
donors (100%), in agreement with previous reports[21,23] (p = 0.004, Mann–Whitney rank sum test).
This median response, however, did not fully capture the tremendous
variation in the viability of different patients’ CLL-B cells
(ranging from 10 to 204%, Figure 3c). Notably,
the observed response heterogeneity did not correlate with patients’ LEF1 expression levels (Figure S17), suggesting that the amount of LEF1 mRNA is not
sufficient to explain the observed heterogeneity. Silencing other
core Wnt pathway members in CLL-B cells from the same set of patients
yielded similar response heterogeneities (Figure
S18), suggesting that Wnt signaling, rather than LEF1 alone, influences CLL-B cell viability in a patient-specific fashion.We separated the 29 tested patient CLL-B samples into three distinct
groups based on the cells’ survival in response to LEF1 silencing: high responders (HRs, n = 9), whose CLL-B cell survival ratio (normalized to a nontargeting
siRNA control) was less than 0.60; low responders (LRs, n = 10), displaying a survival ratio between 0.75 to 0.90; and, inverse
responders (IRs, n = 5), with cell survival ratios
in excess of 1.10. Five samples with intermediate phenotypes were
excluded from our analysis to generate more clearly defined classes.
These three patient groups were not enriched for any known CLL-associated
prognostic features,[19,22] such as ZAP-70 expression or
IgVH mutation status (Figure 3d, Fisher’s
exact test, p > 0.05), and could not be discerned
using simple unbiased correlation metrics (either genome-wide or based
on Wnt pathway member expression, Figure S19). Our patient groupings nevertheless exhibited statistically significant
differences in their average time to first therapy (TTFT) (p = 0.05, Logrank test). For HRs, TTFT was 67.5 months (4
of 9 right censored), while the TTFTs for LRs and IRs were 85.5 months
(7 of 10 right censored) and 123.2 months (all 5 patients right censored),
respectively (Figure 3e). This analysis indicates
that, strikingly, the response to even a single-gene silencing can
be used to predict the clinical course of CLL patients.To examine
the molecular basis of this surprising finding, we compared
the mRNA expression profiles from 12 of the 29 NW-tested samples (4
from each of the three classes for which microarray data was available)
using a one-way analysis of variance (ANOVA). From this analysis,
we identified 823 genes (out of 20 766 total) whose expression
levels were significantly associated with the outcome of LEF1 silencing (Figure 4a, Table S2, p < 0.05; see SI). Expression signatures
for HRs and LRs were dramatically different from one another; IRs
were more similar to LRs, but displayed depressed expression across
many more genes. These differences were validated by qRT-PCR for selected
marker genes (Figure S20).
Figure 4
A potential mechanism
for the effect of LEF1 siRNA.
(a) Expression heat map for the 823 genes that are significantly different
between high- (HRs), low- (LRs), and inverse-responders (IRs), labeled
as the red, green, and blue columns, respectively (nTOTAL = 12 (4 per group); one-way ANOVA). (b) Of 181 additional
patients for whom microarray data was available, 67 could be classified
based on this ANOVA gene signature, yielding an additional 27 “HR-like”,
30 “LR-like”, and 10 “IR-like” responders
(see SI Methods). These additional patients,
when merged with the original 12 HRs, LRs, and IRs, form extended
patient groups. The remaining 114 patients could not be clearly separated
into one of the three categories (see SI Methods, Figures S18 and S20). (c) SS-GSEA of three gene modules—MYC,
Polycomb, and ES Core—associated with HSCs and ESCs (see SI). Bar height represents the negative log of
the enrichment while the direction of the bar indicates regulation.
K, from reference (33); B–P, from ref (32); M, from ref (35) (see Table S2 for list members
and p-values). (d) Model for observed effect of LEF1 knockdown based on the SS-GSEA.
A potential mechanism
for the effect of LEF1 siRNA.
(a) Expression heat map for the 823 genes that are significantly different
between high- (HRs), low- (LRs), and inverse-responders (IRs), labeled
as the red, green, and blue columns, respectively (nTOTAL = 12 (4 per group); one-way ANOVA). (b) Of 181 additional
patients for whom microarray data was available, 67 could be classified
based on this ANOVA gene signature, yielding an additional 27 “HR-like”,
30 “LR-like”, and 10 “IR-like” responders
(see SI Methods). These additional patients,
when merged with the original 12 HRs, LRs, and IRs, form extended
patient groups. The remaining 114 patients could not be clearly separated
into one of the three categories (see SI Methods, Figures S18 and S20). (c) SS-GSEA of three gene modules—MYC,
Polycomb, and ES Core—associated with HSCs and ESCs (see SI). Bar height represents the negative log of
the enrichment while the direction of the bar indicates regulation.
K, from reference (33); B–P, from ref (32); M, from ref (35) (see Table S2 for list members
and p-values). (d) Model for observed effect of LEF1 knockdown based on the SS-GSEA.When we examined the expression of the 823 genes
in an additional
181 CLL-B samples for which genome-wide expression profiles were available,
we found 27 additional patients with gene expression patterns that
resembled HRs (designated “HR-like”) and 30 and 10 additional
patients showing patterns resembling LRs (“LR-like”)
and IRs (“IR-like”), respectively (Figures 4b and S21, see SI). When we performed
a Kaplan–Meyer analysis on these extended patient groups (the
original 12 patients from which the 823 gene set was identified, as
well as the 67 additional HR-, LR-, and IR-like patients), we once
again observed significant differences in TTFT (p = 0.001, Logrank test, Figures S22 and S23) and no enrichments for any known CLL-associated clinical prognostic
markers[19,22] (Fisher’s exact test, p > 0.05, Figure S22, see Table S2), confirming similarity between our
extended groups
and our original tested samples.DAVID and single sample gene
set enrichment analyses (SS-GSEA,[29,30] Figure 4a, see Tables
S2 and S4 for full lists) showed that several canonical pathways
commonly linked to CLL and other malignancies[21,26] were enriched among the 823 genes. In particular, many of the 823
genes were associated with stem-cell pathway regulation and hematopoietic
lineage and development, consistent with the known roles of Wnt signaling
(Tables S2 and S4). To explore this connection,
we used SS-GSEA[29,30] to compare expression levels
of gene sets[32−35] that characterize hematopoietic (HSC) and embryonic stem (ES) cells—an
ES core, a Polycomb repressor complex (PRC), and a MYC module—across the patient groups (see SI). In HRs and the HR-like patient group, MYC and proliferation modules were elevated, whereas PRC and ES core
modules were repressed, similar to what has been observed previously
in short-term HSCs and many aggressive cancers[33] (Figure 4c, see Table S4). Conversely, LRs and the LR-like group showed a
signature that resembles self-renewing long-term HSCs, including increased
PRC and ES core components and repressed MYC and
proliferation genes.[32,33] Finally, the IRs and the IR-like
group presented a less distinctive signature, save for the induction
of genes targeted by STAT3.When integrated
with information regarding the relative sensitivity
toward LEF1 knockdown, the results of the SS-GSEA
analysis suggest specific hypotheses on the pathways contributing
to differentiating the three patient classes. Namely, the expression
patterns and LEF1 sensitivity of HRs hint that Wnt
signaling may influence CLL pathogenesis via regulation of MYC by the LEF1/TCF complex.[36] LRs and IRs, on the other hand, display enrichment for MYC targets with E-Box elements, such as TGF-β, suggesting interplay
between the Wnt and TGF-β signaling pathways.[37,38] Elevated TGF-β signaling in LRs and IRs (Figure 4a) can, in part, explain the heterogeneity observed in response
to LEF1 knockdown because the TGF-β pathway
can influence the LEF1/TCF complex via negative feedback[38−40] (Figure 4d).Taken together, our results
clearly show that NWs provide a minimally
invasive method for effectively delivering biomolecules into primary
immune cells, including naïve or resting cells, thereby enabling
systematical analysis of cell circuits and functional responses in
normal and malignant hematopoietic cells from both human and mouse.
In particular, our studies demonstrate that the response to NW-mediated
gene silencing can be related to clinical parameters in CLL and provide
insight into the molecular circuitry contributing to disease heterogeneity.
It is important to note that this NW-based perturbation strategy is
fully extendable to other systems: starting from the cells taken from
a single blood draw, NW-mediated gene silencing could be used to simultaneously
probe the importance of each potential driver pathway in various hematological
diseases, enabling not only the identification of gene signatures
and pharmaceutical targets, but also the development of patient-specific
combinatorial therapies.[31,41,42]
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