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      Novel Regenerative Peptide TP508 Mitigates Radiation-Induced Gastrointestinal Damage By Activating Stem Cells and Preserving Crypt Integrity

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          Abstract

          In recent years, increasing threats of radiation exposure and nuclear disasters have become a significant concern for the United States and countries worldwide. Exposure to high doses of radiation triggers a number of potentially lethal effects. Among the most severe is the gastrointestinal (GI) toxicity syndrome caused by the destruction of the intestinal barrier, resulting in bacterial translocation, systemic bacteremia, sepsis and death. The lack of effective radioprotective agents capable of mitigating radiation-induced damage has prompted a search for novel countermeasures that can mitigate the effects of radiation post-exposure, accelerate tissue repair in radiation-exposed individuals, and prevent mortality. We report that a single injection of regenerative peptide TP508 (rusalatide acetate, Chrysalin®) 24h after lethal radiation exposure (9Gy, LD 100/15) appears to significantly increase survival and delay mortality by mitigating radiation-induced intestinal and colonic toxicity. TP508 treatment post-exposure prevents the disintegration of gastrointestinal crypts, stimulates the expression of adherens junction protein E-cadherin, activates crypt cell proliferation, and decreases apoptosis. TP508 post-exposure treatment also up-regulates the expression of DCLK1 and LGR5 markers of stem cells that have been shown to be responsible for maintaining and regenerating intestinal crypts. Thus, TP508 appears to mitigate the effects of GI toxicity by activating radioresistant stem cells and increasing the stemness potential of crypts to maintain and restore intestinal integrity. These results suggest that TP508 may be an effective emergency nuclear countermeasure that could be delivered within 24h post-exposure to increase survival and delay mortality, giving victims time to reach clinical sites for advanced medical treatment.

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          Most cited references77

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          Molecular regulation of stem cell quiescence.

          Subsets of mammalian adult stem cells reside in the quiescent state for prolonged periods of time. This state, which is reversible, has long been viewed as dormant and with minimal basal activity. Recent advances in adult stem cell isolation have provided insights into the epigenetic, transcriptional and post-transcriptional control of quiescence and suggest that quiescence is an actively maintained state in which signalling pathways are involved in maintaining a poised state that allows rapid activation. Deciphering the molecular mechanisms regulating adult stem cell quiescence will increase our understanding of tissue regeneration mechanisms and how they are dysregulated in pathological conditions and in ageing.
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            The intestinal stem cell markers Bmi1 and Lgr5 identify two functionally distinct populations.

            The small intestine epithelium undergoes rapid and continuous regeneration supported by crypt intestinal stem cells (ISCs). Bmi1 and Lgr5 have been independently identified to mark long-lived multipotent ISCs by lineage tracing in mice; however, the functional distinctions between these two populations remain undefined. Here, we demonstrate that Bmi1 and Lgr5 mark two functionally distinct ISCs in vivo. Lgr5 marks mitotically active ISCs that exhibit exquisite sensitivity to canonical Wnt modulation, contribute robustly to homeostatic regeneration, and are quantitatively ablated by irradiation. In contrast, Bmi1 marks quiescent ISCs that are insensitive to Wnt perturbations, contribute weakly to homeostatic regeneration, and are resistant to high-dose radiation injury. After irradiation, however, the normally quiescent Bmi1(+) ISCs dramatically proliferate to clonally repopulate multiple contiguous crypts and villi. Clonogenic culture of isolated single Bmi1(+) ISCs yields long-lived self-renewing spheroids of intestinal epithelium that produce Lgr5-expressing cells, thereby establishing a lineage relationship between these two populations in vitro. Taken together, these data provide direct evidence that Bmi1 marks quiescent, injury-inducible reserve ISCs that exhibit striking functional distinctions from Lgr5(+) ISCs and support a model whereby distinct ISC populations facilitate homeostatic vs. injury-induced regeneration.
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              Interconversion between intestinal stem cell populations in distinct niches.

              Intestinal epithelial stem cell identity and location have been the subject of substantial research. Cells in the +4 niche are slow-cycling and label-retaining, whereas a different stem cell niche located at the crypt base is occupied by crypt base columnar (CBC) cells. CBCs are distinct from +4 cells, and the relationship between them is unknown, though both give rise to all intestinal epithelial lineages. We demonstrate that Hopx, an atypical homeobox protein, is a specific marker of +4 cells. Hopx-expressing cells give rise to CBCs and all mature intestinal epithelial lineages. Conversely, CBCs can give rise to +4 Hopx-positive cells. These findings demonstrate a bidirectional lineage relationship between active and quiescent stem cells in their niches.
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                Author and article information

                Journal
                0376617
                5462
                Lab Invest
                Lab. Invest.
                Laboratory investigation; a journal of technical methods and pathology
                0023-6837
                1530-0307
                17 October 2015
                17 August 2015
                November 2015
                01 May 2016
                : 95
                : 11
                : 1222-1233
                Affiliations
                [1 ]Department of Biochemistry and Molecular Biology, UTMB, Galveston, TX.
                [2 ]Department of Medicine, University of Oklahoma Health Sciences Center, OK.
                [3 ]Department of Molecular and Integrative Physiology, University of Kansas Medical Center, KS.
                [4 ]Department of Radiation Oncology, UTMB, Galveston, TX.
                [5 ]Department of Neuroscience and Cell Biology, UTMB, Galveston, TX.
                [6 ] Chrysalis BioTherapeutics, Inc., Galveston, TX.
                Author notes
                [*]

                Co-corresponding authors

                Correspondence: Darrell Carney, Ph.D., Adjunct Professor, Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, 6.136 Medical Research Building, 301 University Blvd, Route 1079, Galveston, TX 77555-1079, dcarney@ 123456utmb.edu , Office: 409-772-1910
                Article
                NIHMS706507
                10.1038/labinvest.2015.103
                4626368
                26280221
                71891cb7-3bc4-4a4f-9a28-66fc4cdebc73

                Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms

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                Article

                Pathology
                tp508,gastrointestinal crypts,radioprotector,mitigator,stem cells,dclk1,lgr5
                Pathology
                tp508, gastrointestinal crypts, radioprotector, mitigator, stem cells, dclk1, lgr5

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