Somatic mutations in the gene encoding transcription factor GATA-1 are associated with acute megakaryoblastic leukemia (AMKL) in children with Down syndrome (DS, trisomy 21), although the mechanisms underlying this genetic interaction are unknown. In preliminary studies, I demonstrated that trisomy 21 itself increases the proliferative capacity of human erythroid and megakaryocyte progenitors. In parallel murine studies, I used genetically manipulated embryonic stem cells to show that loss of GATA-1 promotes the expansion of bipotential megakaryocyte-erythroid precursors (MEPs), a population that resembles AMKL blasts. Through genetic complementation of the mutant MEPs, I discovered that GATA-1 represses a program of myeloid differentiation, in part by inhibiting transcription of the proto- oncogene PU.1/Sfpi1. This effect is attenuated by AMKL-associated GATA1 mutations. Together, my findings generate two related hypotheses: First, GATA1 mutations and trisomy 21 produce distinct effects on hematopoiesis, which act together to promote leukemia. Second, GATA-1 promotes normal hematopoiesis by repressing PU.1/Sfpi1 transcription and this process may become dysregulated through genetic alterations associated with DS-AMKL. This application is to support a mentored research experience to elucidate how GATA-1 controls normal hematopoiesis and how dysregulated GATA-1 and DS synergize in leukemogenesis. I will extend my studies in DS fetal hematopoiesis to understand the mechanisms by which trisomy 21 expand erythroid and megakaryocytic progenitors (Aim 1). I will examine functional interactions between altered GATA-1 and trisomy 21 in human hematopoietic progenitors in vitro and in mice (Aim 2). Lastly, I will study the mechanisms by which wild type and AMKL-associated mutant forms of GATA-1 repress PU. 1/SfpH oncogene transcription (Aim 3). If successful, my research will provide insights into the transcriptional control of normal erythro- megakaryocytic development and how this process becomes disturbed in AMKL. The broader impact of this research is to better understand how a lineage-specific transcription factor functions in normal tissue development and cancer. Combined with my training and structured mentoring in this application, I believe that the proposed research will provide novel new insights into normal and malignant hematopoiesis and provide a strong foundation to establish my career as a pediatric physician-scientist.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Clinical Investigator Award (CIA) (K08)
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Special Emphasis Panel (ZHL1-CSR-O (M1))
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Welniak, Lisbeth A
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Children's Hospital of Philadelphia
United States
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Byrska-Bishop, Marta; VanDorn, Daniel; Campbell, Amy E et al. (2015) Pluripotent stem cells reveal erythroid-specific activities of the GATA1 N-terminus. J Clin Invest 125:993-1005
Zaslavsky, Alexander; Chou, Stella T; Schadler, Keri et al. (2013) The calcineurin-NFAT pathway negatively regulates megakaryopoiesis. Blood 121:3205-15
Malinge, Sébastien; Chlon, Tim; Doré, Louis C et al. (2013) Development of acute megakaryoblastic leukemia in Down syndrome is associated with sequential epigenetic changes. Blood 122:e33-43
Chou, Stella T; Byrska-Bishop, Marta; Tober, Joanna M et al. (2012) Trisomy 21-associated defects in human primitive hematopoiesis revealed through induced pluripotent stem cells. Proc Natl Acad Sci U S A 109:17573-8
Chou, Stella T; Khandros, Eugene; Bailey, L Charles et al. (2009) Graded repression of PU.1/Sfpi1 gene transcription by GATA factors regulates hematopoietic cell fate. Blood 114:983-94