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Blood, 1 May 2001, Vol. 97, No. 9, pp. 2777-2783
NEOPLASIA
Survivin is expressed on CD40 stimulation and interfaces
proliferation and apoptosis in B-cell chronic lymphocytic
leukemia
Luisa Granziero,
Paolo Ghia,
Paola Circosta,
Daniela Gottardi,
Giuliana Strola,
Massimo Geuna,
Licia Montagna,
Paola Piccoli,
Marco Chilosi, and
Federico Caligaris-Cappio
From the Department of Biomedical Sciences and Human
Oncology, University of Torino, Italy; IRCC, Institute for Cancer
Research and Treatment, Candiolo, Italy; and University Division of
Clinical Immunology and Hematology, Ospedale Mauriziano Umberto I,
Torino, Italy; and the Department of Pathology, University of Verona,
Policlinico Borgo Roma, Italy.
In B-cell chronic lymphocytic leukemia (B-CLL), defective apoptosis
causes the accumulation of mature CD5+ B cells in lymphoid
organs, bone marrow (BM), and peripheral blood (PB). These cells are
the progeny of a proliferating pool that feeds the accumulating
compartment. The authors sought to determine which molecular mechanisms
govern the proliferating pool, how they relate to apoptosis, and what
the role is of the microenvironment. To begin to resolve these
problems, the expression and modulation of the family of inhibitor of
apoptosis proteins (IAPs) were investigated, with consideration given
to the possibility that physiological stimuli, such as CD40 ligand
(CD40L), available to B cells in the microenvironment, might modulate
IAP expression. The in vitro data on mononuclear cells from PB or BM of
30 patients demonstrate that B-CLL cells on CD40 stimulation express
Survivin and that Survivin is the only IAP whose expression is induced by CD40L. Through immunohistochemistry, in vivo Survivin expression in
lymph node (LN) and BM biopsies was evaluated. In reactive LN, Survivin
was detected only in highly proliferating germinal center cells. In LN
from patients with B-CLL, Survivin was detected only in
pseudofollicles. Pseudofollicle Survivin+ cells were
actively proliferating and, in contrast to Survivin+ B
cells found in normal GC, were Bcl-2+. In B-CLL BM
biopsies, CD5+, Survivin+ cells were observed
in clusters interspersed with T cells. These findings establish that
Survivin controls the B-CLL proliferative pool interfacing apoptosis
and that its expression may be modulated by microenvironmental stimuli.

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