Hyperglycemia cooperates with Tet2 heterozygosity to induce leukemia driven by proinflammatory cytokine–induced lncRNA Morrbid
Zhigang Cai, … , Laura Haneline, Reuben Kapur
Zhigang Cai, … , Laura Haneline, Reuben Kapur
Published October 22, 2020
Citation Information: J Clin Invest. 2021;131(1):e140707. https://doi.org/10.1172/JCI140707.
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Concise Communication Hematology Inflammation

Hyperglycemia cooperates with Tet2 heterozygosity to induce leukemia driven by proinflammatory cytokine–induced lncRNA Morrbid

Abstract

Diabetes mellitus (DM) is a risk factor for cancer. The role of DM-induced hyperglycemic (HG) stress in blood cancer is poorly understood. Epidemiologic studies show that individuals with DM are more likely to have a higher rate of mutations in genes found in pre-leukemic hematopoietic stem and progenitor cells (pre-LHSPCs) including TET2. TET2-mutant pre-LHSPCs require additional hits to evolve into full-blown leukemia and/or an aggressive myeloproliferative neoplasm (MPN). Intrinsic mutations have been shown to cooperate with Tet2 to promote leukemic transformation. However, the extrinsic factors are poorly understood. Using a mouse model carrying Tet2 haploinsufficiency to mimic the human pre-LHSPC condition and HG stress, in the form of an Ins2Akita/+ mutation, which induces hyperglycemia and type 1 DM, we show that the compound mutant mice developed a lethal form of MPN and/or acute myeloid leukemia (AML). RNA-Seq revealed that this was due in part to upregulation of proinflammatory pathways, thereby generating a feed-forward loop, including expression of the antiapoptotic, long noncoding RNA (lncRNA) Morrbid. Loss of Morrbid in the compound mutants rescued the lethality and mitigated MPN/AML. We describe a mouse model for age-dependent MPN/AML and suggest that hyperglycemia acts as an environmental driver for myeloid neoplasms, which could be prevented by reducing expression levels of the inflammation-related lncRNA Morrbid.

Authors

Zhigang Cai, Xiaoyu Lu, Chi Zhang, Sai Nelanuthala, Fabiola Aguilera, Abigail Hadley, Baskar Ramdas, Fang Fang, Kenneth Nephew, Jonathan J. Kotzin, Adam Williams, Jorge Henao-Mejia, Laura Haneline, Reuben Kapur

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Figure 3

A “feed-forward loop” model for cooperation between Tet2+/– preleukemic mutation and HG stress.

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A “feed-forward loop” model for cooperation between Tet2+/– preleukemic ...
Tet2 heterozygosity (Tet2+/–) defines a preleukemic condition in HSCs and intrinsically promotes HSC self-renewal and myeloid skewing under normal physiological conditions. Consequently, Tet2+/– mice develop a low-grade MPN. Extrinsic stress induced by HG exacerbates systematic inflammation and cooperates with Tet2 heterozygosity to perpetuate myeloid skewing/myelogenesis, chronic inflammation, and production of proinflammatory cytokines such as IL-6 and G-CSF. The myeloid-specific survival regulator lncRNA Morrbid mediates myelogenesis and chronic inflammation and also functions as a downstream effector of IL-6 and G-CSF. Consequently, loss of Morrbid mitigates the feed-forward loop observed in compound mutant mice.