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Blood, 1 July 2007, Vol. 110, No. 1, pp. 345-353.
Prepublished online as a Blood First Edition Paper on March 20, 2007; DOI 10.1182/blood-2006-10-054502.
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Submitted October 26, 2006
Accepted March 16, 2007
Proteasome inhibitor bortezomib impairs both myelofibrosis and osteosclerosis induced by high thrombopoietin levels in mice
Orianne Wagner-Ballon, Didier F Pisani, Thomas Gastinne, Micheline Tulliez, Ronan Chaligne, Catherine Lacout, Frederic Aurade, Jean-Luc Villeval, Patrick Gonin, William Vainchenker, and Stephane Giraudier*
INSERM, U790, Universite Paris XI, Villejuif, France
Institut Gustave Roussy, Villejuif, France
AP-HP, Laboratoire d'Anatomo-pathologie, Hopital Cochin, Paris, France
Universite Paris XI, IFR54, Service Commun d'Experimentation Animale, Institute Gustave Roussy, Villejuif, France
AP-HP Laboratoire d'Hematologie, Hopital Henri Mondor, Creteil, France
* Corresponding author; email: stephane.giraudier{at}hmn.aphp.fr.
Myelofibrosis with myeloid metaplasia (MMM) is the most serious myeloproliferative disorder, characterized by clonal myeloproliferation associated with cytokine-mediated bone marrow stromal reaction including fibrosis and osteosclerosis. Current drug therapy remains mainly palliative. Since the NF- B pathway is implicated in the abnormal release of cytokines in MMM, the proteasome inhibitor bortezomib might be a potential therapy. In order to test its effect, we used the lethal murine model of myelofibrosis induced by thrombopoietin (TPO) overexpression. In this TPOhigh model, the development of the disease is related to a deregulated MPL signaling, as recently described in MMM patients. We first demonstrated that bortezomib was able to inhibit TPO-induced NF- B activation in vitro in murine megakaryocytes. It also inhibited NF- B activation in vivo in TPOhigh mice leading to decreased IL-1 plasma levels. After 4 weeks of treatment, bortezomib decreased TGF- 1 levels in marrow fluids and impaired marrow and spleen fibrosis development. After 12 weeks of treatment, bortezomib also impaired osteosclerosis development, through osteoprotegerin inhibition. Moreover, this drug reduced myeloproliferation induced by high TPO level. Finally, bortezomib dramatically improved TPOhigh mice survival (89% vs 8% at week 52). We conclude that bortezomib appears as a promising therapy for future treatment of MMM patients.

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