# Vascular Remodeling in the Bone Marrow Leukemic Niche: A Therapeutic Target?

> **NIH NIH R01** · BECKMAN RESEARCH INSTITUTE/CITY OF HOPE · 2024 · $485,048

## Abstract

Leukemia stem cells (LSCs) are at the apex of the acute myeloid leukemia (AML) cellular
hierarchy and have the capability of unlimited self-renewal and of initiating disease. The quiescent
fraction of LSCs provides a reservoir of self-renewing cells that sustain leukemia growth, prevent
clonal exhaustion, and are treatment resistant; thus eliminating LSCs is the “holy grail” of anti-
leukemia treatment. AML blasts profoundly modify the bone marrow (BM) niche by causing loss
of non-permeable arteriolar vessels in the endosteal marrow and enrichment of permeable,
fenestrated sinusoid vessels in the central marrow. The remodeled BM niche is permissive of LSC
expansion and leukemia growth, yet the fine molecular mechanisms of this vascular remodeling
remain to be fully elucidated. MicroRNAs (miRNAs) are small non-coding RNAs that target
messenger RNAs and regulate protein levels. miR-126 plays an important role in quiescence,
self-renewal and drug resistance of AML LSCs. Recently we showed that miR-126 is mostly
expressed in the Sca-1+ endothelial cells (ECs) of arteriolar vessels, which are responsible for
supplying miR-126 in the BM niche. Under normal conditions, miR-126 supply from Sca-1+ ECs
regulates the homeostasis and activity of hematopoietic stem cells (HSCs). We discovered that
AML blast-secreted TNFα down-regulates miR-126 in Sca-1+ ECs and causes a loss of arteriolar
vessels. This results in a decreased supply of miR-126 to LSCs, which then engage the cell cycle
and induce leukemia growth. We also made the “key” observation that forcing miR-126 down-
regulation below the already decreased levels in the BM leukemic niche (hereafter referred to as
“miR-126 deprivation”), leads to further loss of arterioles which harms LSCs but not normal HSCs.
Restoring BM arteriolar vascularization in AML mice by neutralization of TNFα favors quiescent
LSC expansion rather than having an antileukemic effect by increasing endothelial miR-126
supply to these cells. Thus, the central hypothesis of this proposal is that the understanding of
the cellular and molecular basis of TNFα-induced miR-126 downregulation and its impact on BM
vascular remodeling in AML will allow us to design novel miR-126 deprivation-based treatments
that will eliminate homeostatic support to LSCs, rendering them vulnerable to anti-leukemic
therapies. Therefore, we propose the following Specific Aims (SAs): SA#1: To prove the central
role of the TNFα/miR-126 axis in vascular remodeling of the BM leukemic niche in AML. SA#2:
Define the molecular mechanisms of the TNFα/miR-126 axis in the vascular remodeling of the
BM leukemic niche in AML. SA#3: Therapeutic targeting of the leukemic vascular niche by a miR-
126 inhibitor in combination with commonly used antileukemic therapies.

## Key facts

- **NIH application ID:** 10817034
- **Project number:** 5R01CA248475-05
- **Recipient organization:** BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
- **Principal Investigator:** GUIDO MARCUCCI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $485,048
- **Award type:** 5
- **Project period:** 2020-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817034

## Citation

> US National Institutes of Health, RePORTER application 10817034, Vascular Remodeling in the Bone Marrow Leukemic Niche: A Therapeutic Target? (5R01CA248475-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10817034. Licensed CC0.

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