Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal stem cell hematologic malignancies characterized by cytopenias as a result of ineffective hematopoiesis and a propensity to progress to acute myeloid leukemia. In low-risk MDS, a characteristic finding in the bone marrow is that of increased apoptosis. The most common structural genomic aberration observed in MDS is the interstitial deletion of the long arm of chromosome 5. MDS with isolated del(5q) is a subtype of MDS characterized by severe anemia and variable neutropenia, but normal or high platelet counts with dysplastic megakaryocytes. MicroRNAs (miRNAs) are short noncoding RNAs capable of exerting their effects by postranscriptionally regulating numerous mRNA targets. We have shown that deletion of chromosome 5q correlates with loss miR-145 and miR-146a that are abundant in hematopoietic stem/progenitor cells (HSPC). Genes involved in innate immune signaling are significantly overrepresented when predicted targets of these two miRNas are surveyed. Specifically, Toll-interleukin-1 receptor domain-containing adaptor protein (TIRAP) and tumor necrosis factor receptor-associated factor-6 (TRAF6) are targets of miR-145 and miR-16a, respectively. Knockdown of miR-145 and miR-146a together or enforced expression of TRAF6, to activate innate immune signaling in mouse HSPC, results in thrombocytosis, mild neutropenia and megakaryocytic dysplasia. A subset of mice transplanted with TRAF6-expressing marrow, in order to aberrantly activate innate immune signaling, progress either to marrow failure or acute myeloid leukemia. Loss of these miRNAs and consequent inappropriate immune signaling results in suppression of HSPC with a relatively greater effect on normal HSPC. Thus, inappropriate activation of innate immune signaling in HSPC phenocopies several general clinical features of low-risk MDS and of del(5q) MDS in particular. Recent work from our group defines additional cytokine pathways that are dysregulated by loss of miR-143 and miR-145. The impact of cytokine dysregulation on HSPC and the marrow microenvironment will be discussed.


Karsan:Celgene: Research Funding.

Author notes


Asterisk with author names denotes non-ASH members.

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