Abstract
The fibrosis associated with idiopatic myelofibrosis (IM) is thought to be a reactive process mediated by cytokines released by abnormal megakaryocytes (MKs) in the microenviroment. The biochemical details of this process are, however, still not known. GATA-1low mice develop with age myelofibrosis, a syndrome very similar to IM, that manifests itself with thrombocytopenia, anemia and teardrop poikilocytes in the blood and marrow and spleen fibrosis at 12-month of age. From 15-month-on, extramedullary hematopoiesis is observed in the liver. Electron microscopy studies have shown that MKs from GATA-1low mutants are blocked between stage I and II of maturation. The block includes failure to organize the α-granules, abnormal P-selectin localization on the Demarcation Membrane System (DMS), and pathological neutrophil emperipolesis. The neutrophils embedded in the MKs release proteases that are thought to mediate release of TGF-β in the microenviroment through the canaliculi of the DMS. TGF- β is supposed, then, to activate the fibroblasts to produce fibers (
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