IntroductionParathyroid hormone (PTH) is a major regulator of calcium metabolism that defends against hypocalcemia, in part by stimulating bone resorption and thereby the release of calcium from the skeleton. However, when injected daily, a regimen known as intermittent PTH (iPTH) treatment, the hormone markedly stimulates bone formation, leading to improved bone microarchitecture and increased strength. 1 As a result, intermittent treatment with the 1-34 fragment of PTH is an FDA-approved treatment modality for postmenopausal osteoporosis. In addition, PTH has important effects on the hemopoietic system. PTH expands the hematopoietic stem and progenitor cell (HSPC) pool and regulates the activity of the HSPC niche, 2 the specialized microenvironment that maintains HSPCs. Accordingly, patients with primary hyperparathyroidism have an increased number of circulating BM-derived HSPCs in the peripheral blood. 3 Moreover, some PTH regimens increase the population that can later be mobilized by G-CSF, 4 whereas others induce mobilization of progenitor cells from the BM into the peripheral circulation, 5 thus mimicking the effects of G-CSF. Because of these properties, PTH has been investigated as a potential therapeutic agent to enhance HSPC mobilization. 6 However, the mechanism by which PTH increases the number of HSPCs has only been partially elucidated. Limited data 4 have addressed whether PTH regulates the most primitive long-term reconstituting subset of HSPCs (LT-HSPCs), or the short-term reconstituting subset of HSPCs (ST-HSPCs), a population that arises from LT-HSPCs and possess limited self-renewal activity. 7 A pivotal effect of PTH is that of increasing the HSPC pool through regulatory actions on the HSPC niche. The HSPC niche is composed of a variety of cells, including stromal cells (SCs) and osteoblasts (OBs). 8 Early studies had linked this activity of PTH to its capacity to increase the osteoblastic expression of the Notch ligand, Jagged1, leading to the activation of Notch signaling in HSPCs in vivo. 2 PTH directly up-regulates the expression of Jagged1 mRNA in OBs. 9 In addition, Jagged1 is up-regulated in SCs when canonical Wnt signaling is activated resulting in stabilization of -catenin, 10 a key effect of PTH in osteoblastic cells. 11 These and other reports have confirmed that Notch signaling plays a relevant role in regulating HSPC self-renewal, but the exact role of Notch signaling remains controversial because some studies suggest that Notch signaling may not be required for HSPC homeostasis. 12 Another intracellular system that regulates HSPC expansion is canonical Wnt signaling. 13-15 PTH activates Wnt signaling in SCs and OBs through multiple mechanisms, which include Wnt ligandindependent activation of the Wnt coreceptor LRP6, 16 increased production of Wnt ligands by bone and BM cells, 17 and suppression of sclerostin production. 18 Whereas SCs, OBs, and osteocytes represent the major targets of PTH in bone, [19][20][21] reports from our laboratory have disclosed that T lymphocytes p...