The Role of PKM2 in the Activation of Myeloid Dendritic Cells from Patients with Severe Aplastic Anemia
Authors: Shao Zonghong , Liu Chunyan , Zheng Mengying , Wang Huaquan , Fu Rong 
Published: October 2019

Abstract
Severe aplastic anemia (SAA) is a hematologic disease characterized by severe bone marrow failure. The abnormal activation of myeloid dendritic cells (mDCs) in SAA might accelerate the polarization of Th0 cells to Th1 cells ,thus causing the over-function of T lymphocytes and apoptosis of hematopoietic cells. Hence, mDCs played an important role in the primary stage of the immune response.
Here, we analyze the protein components of mDC from SAA as well as normal control to explore the possible reason that activate mDC. The protein components of mDCs was detected by proteomics technology. Furtherly we applied both realtime PCR and western blot from a perspective of mRNA and protein to validate our discovery. Results revealed that expression of pyruvate kinase M2(PKM2) were enhanced in mDCs from SAA patients at an early stage of the onset. Concurrently, the level of PKM2 in mDCs of SAA patients was conspicuously higher than that in normal control not only at a protein level but also at the gene level.
To clarify the role of PKM2 in the activation of mDCs, we investigate the effect of targeted PKM2 siRNA -knockout in mDCs at the cellular level. We measured the levels of costimulatory molecules CD80 and CD86 on mDCs by flow cytometry and identified significantly higher expression of CD86 in the control group relative to the transfected group.
To quantify antigen uptake and processing capacities of mDCs, cells were treated with carboxylate-modified yellow-green (YG) microspheres and then analyzed by flow cytometry. The percentage of phagocytosis (PP) was determined by the following formula: PP = M1 + M2 + M3 + M4, where M1, M2, M3, and M4 correspond to the number of cells with one, two, three and four microspheres. Phagocytosis index(PI)=(intracellular cpms/ intracellular + extracellular cpms)x100%.After PKM2 siRNA transfection, we observed lower phagocytic ability of mDCs. Additionally, the level of PP of mDCs from control group was higher than that of PKM2 siRNA -knockout group. Through scanning electron microscopy (SEM), mDCs before siRNA transfection from SAA patients presented longer and more branched protrusions than those seen in PKM2 siRNA transfected mDCs.
Next, the effects of PKM2 on cytotoxic T cells(CTL) activation by mDCs from SAA patients were also determined. mDCs before and after PKM2 siRNA transfection were co cultured with CTL cells for 72 hours. After cell co culture, the mRNA expressions of perforin were identified significantly higher in the control group relative to the transfected group. Culture supernatant were collected for quantification of IFN-γ and IL-4 by commercial ELISA kits. The levels of IFN-γ and IL-4 in contral group were much higher than that of transfected group .Additionally, flow cytometry experiments assessing annexin V/propidium iodide staining showed that high PKM2 expression in mDCs was significantly associated with reduced apoptosis rate of CTLs. Therefore, the enhanced function of mDCs from SAA could activate the downstream CTL function and then enhance the killing effect to target cells.
Our findings demonstrated that elevated levels of PKM2 in mDCs play an important role in the activation of mDCs and thereby affecting the immune status of SAA by enhancing the function of mDCs and downstream CTLs.

Disclosures
No relevant conflicts of interest to declare.