Pathogenesis of Myeloproliferative Neoplasms: Role and Mechanisms of Chronic Inflammation

Mediators Inflamm. 2015:2015:145293. doi: 10.1155/2015/145293. Epub 2015 Oct 11.

Abstract

Myeloproliferative neoplasms (MPNs) are a heterogeneous group of clonal diseases characterized by the excessive and chronic production of mature cells from one or several of the myeloid lineages. Recent advances in the biology of MPNs have greatly facilitated their molecular diagnosis since most patients present with mutation(s) in the JAK2, MPL, or CALR genes. Yet the roles played by these mutations in the pathogenesis and main complications of the different subtypes of MPNs are not fully elucidated. Importantly, chronic inflammation has long been associated with MPN disease and some of the symptoms and complications can be linked to inflammation. Moreover, the JAK inhibitor clinical trials showed that the reduction of symptoms linked to inflammation was beneficial to patients even in the absence of significant decrease in the JAK2-V617F mutant load. These observations suggested that part of the inflammation observed in patients with JAK2-mutated MPNs may not be the consequence of JAK2 mutation. The aim of this paper is to review the different aspects of inflammation in MPNs, the molecular mechanisms involved, the role of specific genetic defects, and the evidence that increased production of certain cytokines depends or not on MPN-associated mutations, and to discuss possible nongenetic causes of inflammation.

Publication types

  • Review

MeSH terms

  • Calreticulin / genetics
  • Cytokines / metabolism
  • Genetic Predisposition to Disease
  • Humans
  • Hypereosinophilic Syndrome / genetics
  • Hypereosinophilic Syndrome / physiopathology
  • Inflammation / genetics
  • Inflammation / physiopathology*
  • Janus Kinase 2 / genetics
  • Leukemia
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / physiopathology
  • Mastocytosis / genetics
  • Mastocytosis / physiopathology
  • Mutation
  • Myeloproliferative Disorders / genetics
  • Myeloproliferative Disorders / physiopathology*
  • Neoplasms / physiopathology*
  • Phenotype
  • Polycythemia Vera / genetics
  • Polycythemia Vera / physiopathology
  • Primary Myelofibrosis / genetics
  • Primary Myelofibrosis / physiopathology
  • Receptors, Thrombopoietin / genetics
  • Thrombocythemia, Essential / genetics
  • Thrombocythemia, Essential / physiopathology

Substances

  • CALR protein, human
  • Calreticulin
  • Cytokines
  • Receptors, Thrombopoietin
  • MPL protein, human
  • JAK2 protein, human
  • Janus Kinase 2

Supplementary concepts

  • Pdgfra-Associated Chronic Eosinophilic Leukemia