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Query: UMLS:C0032463 (
polycythemia vera
)
3,374
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Increasing evidence for pathological erythroid clones and availability of additional diagnostic criteria suggest to reconsider the classification of polycythemia, with particular regard to the separation between primary proliferative polycythemia (PPP) or
polycythemia vera
, and other conditions in which the excessive red cell mass is not due to a myeloproliferative disorder. The characteristics of the abnormal erythropoietic clone in PPP are reviewed, with special reference to the in vitro growth of Epo-independent clones and the response to Epo and other growth factors. Traditional PPP diagnostic criteria are thus integrated with more recent parameters and the clinical features are considered; the main features of idiopathic erythrocytosis (IE) are also reviewed, as well as those of other forms, like familial, secondary and apparent polycythemia. It is pointed out that previously obscure forms are now being elucidated, with the decisive help from molecular biology investigations, allowing the discovery of genetic defects. It is thus becoming apparent that basic science acquisitions, as in the field of erythropoietic initiators (Epo receptor,
GATA-1
transcription factor and so on) are eventually helping our understanding of clinical problems in this area, with relevant consequences on diagnosis and treatment of various forms of polycythemia.
...
PMID:Polycythemia: from clones to clinic. 817 29
The abnormal megakaryocytopoiesis associated with idiopathic myelofibrosis (IM) plays a role in its pathogenesis. Because mice with defective expression of transcription factor GATA-1 (
GATA-1
(low) mutants) eventually develop myelofibrosis, we investigated the occurrence of
GATA-1
abnormalities in IM patients. CD 34(+) cells were purified from 12 IM patients and 8 controls; erythroblasts and megakaryocytes were then obtained from unilineage cultures of CD 34(+) cells. Purified CD 61(+), GPA(+), and CD 34(+) cells from IM patients contained levels of
GATA-1
, GATA-2, and FOG-1 mRNA, as well as of GATA-2 protein, that were similar to controls. In contrast, CD 61(+) cells from IM patients contained significantly reduced
GATA-1
protein. Furthermore, 45% of megakaryocytes in biopsies from IM patients did not stain with anti-
GATA-1
antibody, as compared to controls (2%), essential thrombocythemia (4%), or
polycythemia vera
(11%) patients. Abnormalities in immunoreactivity for FOG-1 were not found, and no mutations in
GATA-1
coding sequences were found. The presence of
GATA-1
(neg) megakaryocytes in bone marrow biopsies was independent of the Val 617 Phe JAK 2 mutation, making it unlikely that a downstream functional relationship exists. We conclude that megakaryocytes from IM patients have reduced
GATA-1
content, possibly contributing to disease pathogenesis as in the
GATA-1
(low) mice and also representing a novel IM-associated marker.
...
PMID:Abnormalities of GATA-1 in megakaryocytes from patients with idiopathic myelofibrosis. 1612 62
Polycythemia Vera
(PV) is a myeloproliferative disorder (MPD) that is commonly characterized by mutant JAK2 (JAK2V617F) signaling, erythrocyte overproduction, and a propensity for thrombosis, progression to myelofibrosis, or acute leukemia. In this study, JAK2V617F expression by human hematopoietic progenitors promoted erythroid colony formation and erythroid engraftment in a bioluminescent xenogeneic immunocompromised mouse transplantation model. A selective JAK2 inhibitor, TG101348 (300 nM), significantly inhibited JAK2V617F+ progenitor-derived colony formation as well as engraftment (120 mg/kg) in xenogeneic transplantation studies. TG101348 treatment decreased
GATA-1
expression, which is associated with erythroid-skewing of JAK2V617F+ progenitor differentiation, and inhibited STAT5 as well as GATA S310 phosphorylation. Thus, TG101348 may be an effective inhibitor of JAK2V617F+ MPDs in clinical trials.
...
PMID:Selective inhibition of JAK2-driven erythroid differentiation of polycythemia vera progenitors. 1839 55
BCR-ABL is a causative tyrosine kinase (TK) of chronic myelogenous leukemia (CML). In CML patients, although myeloid cells are remarkably proliferating, erythroid cells are rather decreased and anemia is commonly observed. This phenotype is quite different from that observed in
polycythemia vera
(PV) caused by JAK2 V617F, whereas both oncogenic TKs activate common downstream molecules at the level of hematopoietic stem cells (HSCs). To clarify this mechanism, we investigated the effects of BCR-ABL and JAK2 V617F on erythropoiesis. Enforced expression of BCR-ABL but not of JAK2 V617F in murine LSK (Lineage(-)Sca-1(hi)CD117(hi)) cells inhibited the development of erythroid cells. Among several signaling molecules downstream of BCR-ABL, an active mutant of N-Ras (N-RasE12) but not of STAT5 or phosphatidylinositol 3-kinase (PI3-K) inhibited erythropoiesis, while N-RasE12 enhanced the development of myeloid cells. BCR-ABL activated Ras signal more intensely than JAK2 V617F, and inhibition of Ras by manumycin A, a farnesyltransferase inhibitor, ameliorated erythroid colony formation of CML cells. As for the mechanisms of Ras-induced suppression of erythropoiesis, we found that
GATA-1
, an erythroid-specific transcription factor, blocked Ras-mediated mitogenic signaling at the level of MEK through the direct interaction. Furthermore, enforced expression of N-RasE12 in LSK cells derived from p53-, p16(INK4a)/p19(ARF)-, and p21(CIP1/WAF1)-null/wild-type mice revealed that suppressed erythroid cell growth by N-RasE12 was restored only by p21(CIP1/WAF1) deficiency, indicating that a cyclin-dependent kinase (CDK) inhibitor, p21(CIP1/WAF1), plays crucial roles in Ras-induced suppression of erythropoiesis. These data would, at least partly, explain why respective oncogenic TKs cause different disease phenotypes.
...
PMID:BCR-ABL but not JAK2 V617F inhibits erythropoiesis through the Ras signal by inducing p21CIP1/WAF1. 2066 70
Essentials The BCR-ABL negative myeloproliferative neoplasms are subjected to unknown phenotypic modifiers.
GATA-1
is upregulated in ET patients, regardless of treatment regimen or mutational status. Myelofibrosis (MF) megakaryocytes displayed decreased
GATA-1
staining.
GATA-1
may have utility as a diagnostic marker in ET and in its differential diagnosis from MF. ABSTRACT: Background The BCR-ABL-negative myeloproliferative neoplasms, i.e.,
polycythemia vera
, essential thrombocythemia (ET), and myelofibrosis (MF), are characterized by mutations in JAK2, CALR, or MPL. However, an as yet unknown factor drives the precise disease phenotype. The hematopoietic transcription factor
GATA-1
and its downstream targets NFE2 and FLI1 are responsible for determining erythroid and megakaryocyte lineages during hematopoietic stem cell differentiation. Previous studies have demonstrated a low level of
GATA-1
expression in megakaryocytes from patients with MF. Objectives and methods The expression of
GATA-1
, NFE2 and FLI1 was studied for changes in the peripheral blood (PB) of ET patients. Peripheral blood samples were obtained from 36 ET patients, 14 MF patients, and seven healthy control donors. Total RNA from PB mononuclear cells (PBMCs) was extracted, and quantitative polymerase chain reaction was used to determine relative changes in gene expression. Protein levels of
GATA-1
were also determined in bone marrow sections from ET and MF patients. Results
GATA-1
mRNA was upregulated in ET patients, regardless of treatment regimen or mutational status. FLI1 expression was significantly downregulated, whereas NFE2 expression was unaffected by changes in
GATA-1
mRNA levels. Megakaryocytes from ET patients showed increased protein levels of
GATA-1
as compared with those from MF patients. Conclusions Our results confirmed, in PB, our previous data demonstrating elevated levels of
GATA-1
mRNA in total bone marrow of ET patients.
GATA-1
mRNA levels are independent of cytoreductive therapies, and may have utility as a diagnostic marker in ET and in its differential diagnosis from MF.
...
PMID:GATA-1: A potential novel biomarker for the differentiation of essential thrombocythemia and myelofibrosis. 3088 3