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M Fontenay-Roupie, E Dupuy, E Berrou, G Tobelem and M Bryckaert
Laboratoire de Physiopathologie cellulaire et moleculaire des cellules du
sang et du vaisseau, Inserm U 348, Paris, France.
Pachydermoperiostosis or primary hypertrophic osteoarthropathy (HOA) is a
rare congenital growth disorder of connective tissue. We report a case of
severe myelofibrosis in a patient with HOA. When cultured in vitro, patient
bone marrow-derived fibroblasts displayed a high proliferative potential
with a shortened doubling time (24 hours v 36 to 48 hours for normal
fibroblasts). The role of platelet-derived growth factor (PDGF), previously
implicated in the pathogenesis of secondary acquired myelofibrosis, was
studied. HOA fibroblasts expressed an increased number of PDGF-BB binding
sites (300,000 sites/cell v 200,000 sites/cell for normal fibroblasts)
without any modification of affinity. The increased expression of PDGF-R
beta appeared to result from an accelerated rate of PDGF-R beta resynthesis
with normal kinetics of endocytosis. As a consequence, a several-fold
increase of PDGF-R beta tyrosine kinase activity was observed. No autocrine
mechanism of growth was suspected as neither spontaneous PDGF- R beta
autophosphorylation nor mitogenic activity in HOA fibroblast- conditioned
medium was detected. Patient serum and platelet lysate were less potent
than controls in inducing [3H]thymidine incorporation into HOA fibroblasts.
This was inconsistent with a paracrine mechanism of growth. In vitro, human
serum or PDGF-BB were not more mitogenic for HOA than normal fibroblasts.
High levels of cyclin D1, a putative oncogene, were detected in
serum-deprived HOA fibroblasts. Cyclin D1 overexpression could be
implicated in the accelerated growth of these cells. Our results suggest
that the mechanism of fibroblastic proliferation observed in this case of
myelofibrosis might differ from those reported in other acquired
myeloproliferative syndromes and could be associated with an intrinsic
abnormality of HOA fibroblast growth.
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| Copyright © 1995 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||