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Blood, 1 November 2001, Vol. 98, No. 9, pp. 2720-2725
HEMATOPOIESIS
Interleukin-6 stimulates thrombopoiesis through
thrombopoietin: role in inflammatory thrombocytosis
Arthur Kaser,
Gerald Brandacher,
Wolfgang Steurer,
Susanne Kaser,
Felix A. Offner,
Heinz Zoller,
Igor Theurl,
Walter Widder,
Clemens Molnar,
Othmar Ludwiczek,
Michael B. Atkins,
James W. Mier, and
Herbert Tilg
From the Divisions of Gastroenterology and Hepatology
and of General Internal Medicine, the Department of Medicine, and the
Department of Transplant Surgery, University Hospital Innsbruck,
Austria; the Department of Pathology, Academic Teaching Hospital
Feldkirch, Austria; and the Department of Medicine, Division of
Hematology and Oncology, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA.
Baseline platelet production is dependent on thrombopoietin (TPO).
TPO is constitutively produced and primarily regulated by
receptor-mediated uptake by platelets. Inflammatory thrombocytosis is
thought to be related to increased interleukin-6 (IL-6) levels. To
address whether IL-6 might act through TPO to increase platelet counts,
TPO was neutralized in vivo in C57BL/10 mice treated with IL-6,
and hepatic TPO mRNA expression and TPO plasma levels were studied.
Transcriptional regulation of TPO mRNA was studied in the
hepatoblastoma cell line HepG2. Furthermore, TPO plasma levels were
determined in IL-6-treated cancer patients. It is shown that IL-6-induced thrombocytosis in C57BL/10 mice is accompanied by enhanced hepatic TPO mRNA expression and elevated TPO plasma levels. Administration of IL-6 to cancer patients results in a corresponding increase in TPO plasma levels. IL-6 enhances TPO mRNA transcription in
HepG2 cells. IL-6-induced thrombocytosis can be abrogated by neutralization of TPO, suggesting that IL-6 induces thrombocytosis through TPO. A novel pathway of TPO regulation by the inflammatory mediator IL-6 is proposed, indicating that the number of platelets by
themselves might not be the sole determinant of circulating TPO levels
and thus of thrombopoiesis. This regulatory pathway might be of
relevance for the understanding of reactive thrombocytosis.

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