American Society of Hematology, Blood, 23(122), p. 3787-3797, 2013
DOI: 10.1182/blood-2013-06-501452
Full text: Download
The principal morbidity and mortality in patients with essential thrombocythaemia (ET) and polycythaemia vera (PV) stems from thrombotic events. Most patients with ET/PV harbor a JAK2V617F mutation but its role in the thrombotic diathesis remains obscure. Platelet function studies in patients are difficult to interpret because of inter-individual heterogeneity, reflecting variations in the proportion of platelets derived from the malignant clone, differences in the presence of additional mutations and the effects of medical treatments. To circumvent these issues we have studied a JAK2V617F knock-in mouse model of ET in which all megakaryocytes and platelets express JAK2V617F at a physiological level, equivalent to that present in human ET patients. We show that, in addition to increased differentiation, JAK2V617F positive megakaryocytes display greater migratory ability and proplatelet formation. We demonstrate in a range of assays that platelet reactivity to agonists is enhanced, with a concomitant increase in platelet aggregation in vitro and a reduced duration of bleeding in vivo. These data suggest that JAK2V617F leads to intrinsic changes in both megakaryocyte and platelet biology beyond an increase in cell number. In support of this hypothesis, we identify multiple differentially expressed genes in JAK2V617F megakaryocytes that may underlie the observed biological differences.