It has previously been reported that VEGF-A stimulates megakaryocyte (MK) maturation in vitro. Here we show that treatment of mice with the isoform VEGF-A 165 resulted in a significant increase in circulating numbers of platelets. Using specific VEGFR1 and VEGFR2 blocking mAbs and selective VEGFR1 and 2 agonists, PlGF-2 and VEGF-E, respectively, we show directly that stimulation of VEGFR1, but not VEGFR2, increases circulating platelet numbers in vivo. Using flow cytometric analysis of harvested MKs, we show that while PlGF does not change the absolute numbers of MKs present in the bone marrow and the spleen, it increases both their maturation and cell-surface expression of CXCR4 in the bone marrow. Histology of the bone marrow revealed a redistribution of MKs from the endosteal to the vascular niche in response to both VEGF-A 165 and PlGF-2 treatment in vivo. Antagonism of CXCR4 suppressed both the VEGFR1-stimulated redistribution of megakyocytes within the bone marrow compartment and the VEGF-A 165 -induced thrombocytosis. In conclusion, we define a novel proinflammatory VEGFR1-mediated pathway that stimulates the maturation and upregulation of CXCR4 on megakaryocytes, leading to their redistribution within the bone marrow environment, thereby enhancing platelet production in vivo. (Blood. 2012;120(14):2787-2795)
IntroductionUnder homeostatic conditions, megakaryopoiesis is driven primarily by thrombopoietin (TPO) and stem cell factor (SCF). 1,2 Patients suffering from congenital amegakaryocytic thrombocytopenia (a mutation to the TPO receptor: cMPL), and mice with genetic deletions of SCF and TPO, therefore exhibit a profound thrombocytopenia. 3,4 Within the bone marrow endosteal niche, TPO acts synergistically with other hematopoietic cytokines to stimulate stem cell differentiation toward the megakaryocyte lineage to create promegakaryoblasts. 5 Promegakaryoblasts then begin to increase their ploidy content via the process of endomitosis. This process driven by TPO is essential for normal maturation into megakaryocytes (MKs). 6,7 Mature MKs then migrate to within close proximity of the bone marrow sinusoidal endothelium to form preplatelet buds, eventually releasing platelets. 8,9 Studies of megakaryopoiesis in vitro using CD34 ϩ cell unilineage differentiation cultures have shown that the upregulation of the chemokine receptor CXCR4 is associated with the maturation of megakaryocytes. 10 Although CXCL12 (the ligand for CXCR4) acting alone does not stimulate MK development, it has been reported to act synergistically with TPO to enhance megakaryopoiesis and platelet formation in vitro and in vivo. [11][12][13] The original studies describing the expression of CXCR4 on MKs demonstrated that CXCL12 stimulated their migration in vitro. 8,14 More recent studies have shown that adenoviral delivery of CXCL12, resulting in a sustained elevation in plasma CXCL12 over 10 days, increased circulating numbers of platelets in TPO-and MPL-deficient mice. It was shown that platelet production was enhanced, as a result o...