In thalassemia and other iron loading anemias, ineffective erythropoiesis and erythroid signaling molecules are thought to cause inappropriate suppression of a small peptide produced by hepatocytes named hepcidin. Previously, it was reported that the erythrokine GDF15 is expressed at very high levels in thalassemia and suppresses hepcidin expression. In this study, erythroblast expression of a second molecule named twisted gastrulation (TWSG1) was explored as a potential erythroid regulator of hepcidin. Transcriptome analyses suggest TWSG1 is produced during the earlier stages of erythropoiesis. Hepcidin suppression assays demonstrated inhibition by TWSG1 as measured by quantitative polymerase chain reaction (PCR) in dosed assays (1-1000 ng/mL TWSG1). In human cells, TWSG1 suppressed hepcidin indirectly by inhibiting the signaling effects and associated hepcidin up-regulation by bone morphogenic proteins 2 and 4 (BMP2/BMP4). In murine hepatocytes, hepcidin expression was inhibited by murine Twsg1 in the absence of additional BMP. In vivo studies of Twsg1 expression were performed in healthy and thalassemic mice. Twsg1 expression was significantly increased in the spleen, bone marrow, and liver of the thalassemic animals. These data demonstrate that twisted gastrulation protein interferes with BMPmediated hepcidin expression and may act with GDF15 to dysregulate iron homeostasis in thalassemia syndromes. IntroductionSystemic iron homeostasis in mammals is largely maintained by the effects of hepcidin, 1 a small protein produced by hepatocytes. Hepcidin is regulated at the transcriptional and posttranscriptional levels by multiple extracellular signals related to iron homeostasis and inflammation. Erythropoiesis is also thought to regulate hepcidin expression through a variety of mechanisms including anemia-related hypoxia and erythropoietin production. ␤-Thalassemia syndromes are congenital anemias caused by mutations that reduce or abolish ␤-globin gene expression. Despite the common feature of decreased globin chain synthesis in all patients, there are prominent phenotypic variations in the disease that are not fully understood. 2 In so-called "iron-loading" anemias like thalassemia, the diseased erythron dysregulates iron homeostasis by inhibiting hepcidin expression even in the presence of severe iron overload. Humans with thalassemia syndromes express very high levels of a cytokine named GDF15, and GDF15 present in thalassemia patients' sera inhibited hepatic hepcidin expression ex vivo. 3 However, thalassemia sera also suppressed hepcidin expression to a lesser degree after immunoprecipitation of GDF15. 3 It was therefore hypothesized that GDF15 may act with other molecules to suppress hepcidin.In addition to clinical research in humans, murine models were developed for studies of thalassemia and hepcidin regulation. Mice with deletions of both the ␤ minor and ␤ major genes (th3 genotype) have a ␤-thalassemia intermedia phenotype in the heterozygous state. The homozygous deletion (th3/th3) results in death...

Lysyl oxidase (LOX), a matrix cross-linking protein, is known to be selectively expressed and to enhance a fibrotic phenotype. A recent study of ours showed that LOX oxidizes the PDGF receptor-␤ (PDGFR-␤), leading to amplified downstream signaling. Here, we examined the expression and functions of LOX in megakaryocytes (MKs), the platelet precursors. Cells committed to the MK lineage undergo mitotic proliferation to yield diploid cells, followed by endomitosis and acquisition of polyploidy. Intriguingly, LOX expression is detected in diploid-tetraploid MKs, but scarce in polyploid MKs. PDGFR-BB is an inducer of mitotic proliferation in MKs. LOX inhibition with ␤-aminopropionitrile reduces PDGFR-BB binding to cells and downstream signaling, as well as its proliferative effect on the MK lineage. Inhibition of LOX activity has no influence on MK polyploidy. We next rationalized that, in a system with an abundance of low ploidy MKs, LOX could be highly expressed and with functional significance. Thus, we resorted to GATA-1 low mice, where there is an increase in low ploidy MKs, augmented levels of PDGF-BB, and an extensive matrix of fibers. MKs from these mice display high expression of LOX, compared with control mice. Importantly, treatment of GATA-1 low mice with ␤-aminopropionitrile significantly improves the bone marrow fibrotic phenotype, and MK number in the spleen. Thus, our in vitro and in vivo data support a novel role for LOX in regulating MK expansion by PDGF-BB and suggest LOX as a new potential therapeutic target for myelofibrosis. Lysyl oxidase (LOX)3 is a copper-dependent amine oxidase that catalyzes the oxidative deamination of lysine and hydroxylysine residues on collagen and elastin precursors. The resulting semialdehydes form covalent cross-linkages, thus stabilizing the extracellular matrix fiber deposits (1). LOX is synthesized as a 50-kDa glycosylated precursor (pro-LOX), which is then secreted and undergoes proteolytic cleavage by pro-collagen C-proteinases, including bone morphogenetic protein 1, to release a catalytically active 30-kDa enzyme (LOX) and an 18-kDa propeptide (2, 3). LOX has been associated with various pathologies, including cardiovascular diseases (4), neurodegenerative disorders (5, 6), and tumor progression and metastasis (7-9). An interesting insight into the regulation of cellular proliferation by LOX came from a recent study, showing that LOX can oxidize and activate cell surface proteins, including PDGFR-␤, in rat aortic smooth muscle cells (10, 11). Nevertheless, the role of this oxidase in regulating megakaryocyte (MK) expansion and/or ploidy had not been explored.Megakaryocytes (MKs), the platelet precursors, undergo proliferation followed by endomitosis and polyploidy, prior to fragmenting into platelets (12, 13). In certain pathologies, the proliferation and ploidy of this lineage are deregulated, highlighting the need to further elucidate mechanisms of control of these processes (14, 15). Thrombopoietin (TPO) is the primary growth factor that stimulates the prolif...

Hepatitis C virus genotyping was assessed for 257 chronic hepatitis C patients with viral loads above 1,000 IU/ml. Twelve patients were coinfected with more than one genotype. Their median viral loads did not differ significantly from those observed for monoinfected patients, which in turn did not vary significantly among different genotypes.