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Myelodysplastic syndrome

PRC2 insufficiency causes p53-dependent dyserythropoiesis in myelodysplastic syndrome


EZH1 and EZH2 are enzymatic components of polycomb repressive complex (PRC) 2, which catalyzes histone H3K27 tri-methylation (H3K27me3) to repress the transcription of PRC2 target genes. We previously reported that the hematopoietic cell-specific Ezh2 deletion (Ezh2Δ/Δ) induced a myelodysplastic syndrome (MDS)-like disease in mice. We herein demonstrated that severe PRC2 insufficiency induced by the deletion of one allele Ezh1 in Ezh2-deficient mice (Ezh1+/−Ezh2Δ/Δ) caused advanced dyserythropoiesis accompanied by a differentiation block and enhanced apoptosis in erythroblasts. p53, which is activated by impaired ribosome biogenesis in del(5q) MDS, was specifically activated in erythroblasts, but not in hematopoietic stem or progenitor cells in Ezh1+/−Ezh2Δ/Δ mice. Cdkn2a, a major PRC2 target encoding p19Arf, which activates p53 by inhibiting MDM2 E3 ubiquitin ligase, was de-repressed in Ezh1+/−Ezh2Δ/Δ erythroblasts. The deletion of Cdkn2a as well as p53 rescued dyserythropoiesis in Ezh1+/−Ezh2Δ/Δ mice, indicating that PRC2 insufficiency caused p53-dependent dyserythropoiesis via the de-repression of Cdkn2a. Since PRC2 insufficiency is often involved in the pathogenesis of MDS, the present results suggest that p53-dependent dyserythropoiesis manifests in MDS in the setting of PRC2 insufficiency.

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Fig. 1: Ezh1+/−Ezh2Δ/Δ mice exhibited dyserythropoiesis.
Fig. 2: p53 activation and de-repressed Cdkn2a in Ezh1+/−Ezh2Δ/Δ erythroblasts.
Fig. 3: Reductions in H3K27me3 levels in Ezh1+/−Ezh2Δ/Δ erythroblasts.
Fig. 4: Deletion of p53 and Cdkn2a rescued dyserythropoiesis in Ezh1+/−Ezh2Δ/Δ mice.
Fig. 5: Deletion of Cdkn2a inhibited p53 activation in Ezh1+/−Ezh2Δ/Δ erythroblasts.
Fig. 6: Proposed model for PRC2 insufficiency-induced dyserythropoiesis.


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Ezh1 constitutive knockout mice were generated at the Research Institute of Molecular Pathology (Vienna, Austria) in 2000 by Donal O’Carroll (Laboratory Thomas Jenuwein) with the help of Maria Sibilia (Laboratory Erwin Wagner). Ezh2fl/fl and p53fl/fl mice were kindly provided by Haruhiko Koseki (RIKEN, Japan) and by Anton Berns (Netherlands Cancer Institute), respectively. The authors thank Yuko Yamagata for her technical help and Chikako Furuta and Mohamed Rizk for critical review of our paper. The super-computing resource was provided by the Human Genome Center, The Institute of Medical Science, The University of Tokyo. This work was supported in part by Grants-in-Aid for Scientific Research (#19H05653) and Scientific Research on Innovative Areas “Stem Cell Aging and Disease” (#26115002) and “Replication of Non-Genomic Codes” (#19H05746) from MEXT, Japan.

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KA and DS performed the experiments, analyzed results, made the figures, and actively wrote the paper; ES, YN-T, MO, SK, OR, SS, ST, and GS assisted with experiments; and AI conceived of and directed the project, secured funding, and actively wrote the paper.

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Correspondence to Kazumasa Aoyama or Atsushi Iwama.

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Aoyama, K., Shinoda, D., Suzuki, E. et al. PRC2 insufficiency causes p53-dependent dyserythropoiesis in myelodysplastic syndrome. Leukemia 35, 1156–1165 (2021).

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