Thrombopoietin (TPO) acting via its receptor, the cellular homologue of the myeloproliferative leukemia virus oncogene (Mpl), is the major cytokine regulator of platelet number. To precisely define the role of specific hematopoietic cells in TPO-dependent hematopoiesis, we generated mice that express the Mpl receptor normally on stem/ progenitor cells but lack expression on megakaryocytes and platelets (Mpl
PF4cre/PF4cre). Mpl PF4cre/PF4cre mice displayed profound megakaryocytosis and thrombocytosis with a remarkable expansion of megakaryocyte-committed and multipotential progenitor cells, the latter displaying biological responses and a gene expression signature indicative of chronic TPO overstimulation as the underlying causative mechanism, despite a normal circulating TPO level. Thus, TPO signaling in megakaryocytes is dispensable for platelet production; its key role in control of platelet number is via generation and stimulation of the bipotential megakaryocyte precursors. Nevertheless, Mpl expression on megakaryocytes and platelets is essential to prevent megakaryocytosis and myeloproliferation by restricting the amount of TPO available to stimulate the production of megakaryocytes from the progenitor cell pool.bone marrow | essential thrombocythemia T hrombopoietin (TPO) is the principal hematopoietic cytokine that regulates platelet production at steady state and is required for rapid responses to platelet loss. TPO acts by binding to a specific cell surface receptor, the cellular homologue of the myeloproliferative leukemia virus oncogene (Mpl), leading to receptor dimerization, activation of intracellular signal transduction pathways, and responses of target cells. Mice lacking TPO or Mpl are severely thrombocytopenic and deficient in megakaryocytes and their progenitor cells, a phenotype consistent with a role for TPO in maintaining appropriate megakaryocyte numbers in vivo. In addition to its role in megakaryopoiesis, TPO is also an indispensible regulator of hematopoietic stem cells (HSC), essential for maintenance of quiescence and self-renewal (1).TPO is produced primarily in the liver (2) and upon binding to the Mpl receptor on target cells, is internalized and degraded. The prevailing model posits that circulating TPO concentration is inversely proportional to the "Mpl mass" contributed by the total number of megakaryocytes and platelets. In normal individuals, this model describes an effective feedback system to regulate TPO-driven megakaryocyte and platelet production according to need. The reciprocal relationship between platelet number and circulating TPO level is clearly evident in bone marrow transplant patients (1), and the key role of the TPO receptor is illustrated by the elevated circulating TPO in Mpl −/− mice (3) and the modest elevation of platelet counts in transgenic mice expressing low levels of Mpl (4, 5). However, the relationship between circulating TPO concentration and peripheral platelet counts is not always conserved in pathological states of thrombocytosis and thrombocyto...