Nature Communications (May 2024)

TFPI from erythroblasts drives heme production in central macrophages promoting erythropoiesis in polycythemia

  • Jun-Kai Ma,
  • Li-Da Su,
  • Lin-Lin Feng,
  • Jing-Lin Li,
  • Li Pan,
  • Qupei Danzeng,
  • Yanwei Li,
  • Tongyao Shang,
  • Xiao-Lin Zhan,
  • Si-Ying Chen,
  • Shibo Ying,
  • Jian-Rao Hu,
  • Xue Qun Chen,
  • Qi Zhang,
  • Tingbo Liang,
  • Xin-Jiang Lu

DOI
https://doi.org/10.1038/s41467-024-48328-8
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 16

Abstract

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Abstract Bleeding and thrombosis are known as common complications of polycythemia for a long time. However, the role of coagulation system in erythropoiesis is unclear. Here, we discover that an anticoagulant protein tissue factor pathway inhibitor (TFPI) plays an essential role in erythropoiesis via the control of heme biosynthesis in central macrophages. TFPI levels are elevated in erythroblasts of human erythroblastic islands with JAK2 V617F mutation and hypoxia condition. Erythroid lineage-specific knockout TFPI results in impaired erythropoiesis through decreasing ferrochelatase expression and heme biosynthesis in central macrophages. Mechanistically, the TFPI interacts with thrombomodulin to promote the downstream ERK1/2-GATA1 signaling pathway to induce heme biosynthesis in central macrophages. Furthermore, TFPI blockade impairs human erythropoiesis in vitro, and normalizes the erythroid compartment in mice with polycythemia. These results show that erythroblast-derived TFPI plays an important role in the regulation of erythropoiesis and reveal an interplay between erythroblasts and central macrophages.