Sex-Biased ZRSR2 Mutations in Myeloid Malignancies Impair Plasmacytoid Dendritic Cell Activation and Apoptosis

Katsuhiro Togami, Sun Sook Chung, Vikas Madan, Christopher A.G. Booth, Christopher M. Kenyon, Lucia Cabal-Hierro, Justin Taylor, Sunhee S. Kim, Gabriel K. Griffin, Mahmoud Ghandi, Jia Li, Yvonne Y. Li, Fanny Angelot-Delettre, Sabeha Biichle, Michael Seiler, Silvia Buonamici, Scott B. Lovitch, Abner Louissaint, Elizabeth A. Morgan, Fabrice JardinPier Paolo Piccaluga, David M. Weinstock, Peter S. Hammerman, Henry Yang, Marina Konopleva, Naveen Pemmaraju, Francine Garnache-Ottou, Omar Abdel-Wahab, H. Phillip Koeffler, Andrew A. Lane

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive leukemia of plasmacytoid dendritic cells (pDC). BPDCN occurs at least three times more frequently in men than in women, but the reasons for this sex bias are unknown. Here, studying genomics of primary BPDCN and modeling disease-associated mutations, we link acquired alterations in RNA splicing to abnormal pDC development and inflammatory response through Toll-like receptors. Loss-offunction mutations in ZRSR2, an X chromosome gene encoding a splicing factor, are enriched in BPDCN, and nearly all mutations occur in males. ZRSR2 mutation impairs pDC activation and apoptosis after inflammatory stimuli, associated with intron retention and inability to upregulate the transcription factor IRF7. In vivo, BPDCN-associated mutations promote pDC expansion and signatures of decreased activation. These data support a model in which male-biased mutations in hematopoietic progenitors alter pDC function and confer protection from apoptosis, which may impair immunity and predispose to leukemic transformation.

Original languageEnglish (US)
Pages (from-to)522-541
Number of pages20
JournalCancer discovery
Volume12
Issue number2
DOIs
StatePublished - Feb 1 2022

ASJC Scopus subject areas

  • Oncology

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