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Pyruvate kinase deficiency modifies sickle hemoglobin carrier and sickle cell disease phenotypes in mice
Xunde Wang, Meghann Smith, Sayuri Kamimura, Quan Li, Niharika Shah, Martha Quezado, Luis E.F. Almeida, Sebastian Vogel, Mickias B. Tegegn, Kevin Y. Sun, Rafael Villasmil, Chengyu Liu, William A. Eaton, Swee Lay Thein, Zenaide M.N. Quezado
Xunde Wang, Meghann Smith, Sayuri Kamimura, Quan Li, Niharika Shah, Martha Quezado, Luis E.F. Almeida, Sebastian Vogel, Mickias B. Tegegn, Kevin Y. Sun, Rafael Villasmil, Chengyu Liu, William A. Eaton, Swee Lay Thein, Zenaide M.N. Quezado
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Research Article Genetics Hematology

Pyruvate kinase deficiency modifies sickle hemoglobin carrier and sickle cell disease phenotypes in mice

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Abstract

Growing evidence indicates that PKLR, the gene for pyruvate kinase (PK), is a genetic modifier of the sickle cell phenotype. Coinheritance of specific PKLR variants is associated with increased pain-related hospitalization and can trigger sickle cell disease (SCD) phenotypes in asymptomatic carriers. PK deficiency disrupts RBC glycolysis, leading to ATP deficits and accumulation of 2,3-diphosphoglycerate, which exacerbates sickling in SCD. Using CRISPR-Cas9, we generated null mutations in Pklr [Pklr(13ntdel/13ntdel) or Pklr(246ntdel/246ntdel)] specific for the RBC isoform (PKR) in Townes mice that were homozygous (SS) or heterozygous (AS) for the human sickle globin gene, or homozygous for human hemoglobin A (AA, controls), to investigate the effect of PKR deficiency on the sickle phenotype in mice. PKR-deficient AA and AS mice developed severe anemia, reticulocytosis, and substantial spleen and liver iron deposits. Unlike what is observed in humans, PKR deficiency in AS and SS mice surprisingly decreased sickling, but it was also associated with increased extramedullary hematopoiesis and mitochondrial retention in mature RBCs. These results demonstrate the differential effect of Pklr mutations on the phenotype of both AS and SS mouse models, offering insights into the complex role of PKR deficiency in SCD pathology.

Authors

Xunde Wang, Meghann Smith, Sayuri Kamimura, Quan Li, Niharika Shah, Martha Quezado, Luis E.F. Almeida, Sebastian Vogel, Mickias B. Tegegn, Kevin Y. Sun, Rafael Villasmil, Chengyu Liu, William A. Eaton, Swee Lay Thein, Zenaide M.N. Quezado

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Figure 8

Coinheritance of Pklr-null mutations [Pklr(13ntdel/13ntdel) or Pklr(246ntdel/246ntdel)] specific for the RBC pyruvate kinase isoform (PKR) differentially affects liver and spleen histopathology in AA, AS, and SS mice.

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Coinheritance of Pklr-null mutations [Pklr(13ntdel/13ntdel) or Pklr(246n...
Each panel shows representative H&E-stained sections of liver and spleen from Pklr(WT/WT)and Pklr(246ntdel/246ntdel). Yellow arrows indicate hemosiderin pigmentation in macrophages, green arrows lymphocytic infiltration (inflammation), black arrow necrosis, and white arrows extramedullary hematopoiesis. Mice with Pklr(13ntdel/13ntdel) and Pklr(246ntdel/246ntdel) had similar histopathology; for simplicity, we only display representative images for Pklr(246ntdel/246ntdel) mice. Compared with AAPklr(WT/WT) (A) and ASPklr(WT/WT) (C), and SSPklr(WT/WT) (E) mice displayed marked hepatic inflammation (lymphocytes and macrophage infiltration), necrosis, and iron deposition (hemosiderin pigmentation in macrophages). PKR-deficient AA (B and H) and AS mice (D and J) developed substantial liver and spleen iron deposition, as well as marked hepatic inflammation, and increased extramedullary hematopoiesis compared with AAPklr(WT/WT) (A and G) or ASPklr(WT/WT) (C and I). In contrast, PKR-deficient SS (F and L) showed no significant changes in liver or spleen histopathology compared with SSPklr(WT/WT mice (E and K). Liver and spleen histopathology from 5 to 12 mice per each genotype were examined.

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