ASXL1 mutations accelerate bone marrow fibrosis via EGR1-TNFA axis-mediated neoplastic fibrocyte generation in myeloproliferative neoplasms

Haematologica. 2023 May 1;108(5):1359-1373. doi: 10.3324/haematol.2021.280320.

Abstract

Apart from the central role of the activated JAK/STAT signaling pathway, ASXL1 mutations are the most recurrent additional mutations in myeloproliferative neoplasms and occur much more commonly in myelofibrosis than in essential thrombocythemia and polycythemia vera. However, the mechanism of the association with ASXL1 mutations and bone marrow fibrosis remains unknown. Here, integrating our own data from patients with myeloproliferative neoplasms and a hematopoietic-specific Asxl1 deletion/Jak2V617F mouse model, we show that ASXL1 mutations are associated with advanced myeloproliferative neoplasm phenotypes and onset of myelofibrosis. ASXL1 mutations induce skewed monocyte/macrophage and neoplastic monocyte-derived fibrocyte differentiation, consequently they enhance inflammation and bone marrow fibrosis. Consistently, the loss of ASXL1 and JAK2V617F mutations in hematopoietic stem and progenitor cells leads to enhanced activation of polycomb group target genes, such as EGR1. The upregulation of EGR1, in turn, accounts for increased hematopoietic stem and progenitor cell commitment to the monocyte/macrophage lineage. Moreover, EGR1 induces the activation of TNFA and thereby further drives the differentiation of monocytes to fibrocytes. Accordingly, combined treatment with a TNFR antagonist and ruxolitinib significantly reduces fibrocyte production in vitro. Altogether, these findings demonstrate that ASXL1 mutations accelerate fibrocyte production and inflammation in myeloproliferative neoplasms via the EGR1-TNFA axis, explaining the cellular and molecular basis for bone marrow fibrosis and the proof-ofconcept for anti-fibrosis treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Marrow Neoplasms*
  • Early Growth Response Protein 1 / genetics
  • Janus Kinase 2 / genetics
  • Mice
  • Mutation
  • Myeloproliferative Disorders* / genetics
  • Polycythemia Vera* / genetics
  • Primary Myelofibrosis* / genetics
  • Repressor Proteins / genetics

Substances

  • Asxl1 protein, mouse
  • Early Growth Response Protein 1
  • Egr1 protein, mouse
  • Janus Kinase 2
  • Repressor Proteins
  • tumor necrosis factor alpha (36-68)

Grants and funding

Funding: This study was supported in part by National Natural Science funds (N. 81530008, 81870104 and 82170139 to ZJX, 82070134 and 81600098 to BL, 81770129 to GH, and 81772676 and 31970579 to XDW), the National Key Research and Development Program (N. 2017YFA0504102 to XDW), Tianjin Natural Science funds (N. 18JCZDJC34900 to ZJX, 18JCJQJC48200 to XDW, and 19JCQNJC09400 to BL), the PUMC Youth Fund and Fundamental Research Funds for Central Universities (N. 3332019093 to JQL), CAMS Initiative Fund for Medical Sciences (N. 2016-I2M-1-001 and 2020-I2M-C&T-A-020 to ZJX, and 2020-I2M-C&T-B-090 to ZFX), and the Haihe Laboratory of Cell Ecosystem Innovation Fund (N. HH22KYZX0033 to ZJX).