- Research article
- Open Access
TET2 is upregulated during erythroid differentiation of CD34+ cells from healthy donors and myelodysplastic syndrome patients
Applied Cancer Research volume 37, Article number: 38 (2017)
Tet methylcytosine dioxygenase 2 (TET2) is frequently mutated and/or downregulated in myeloid neoplasm, including myelodysplastic syndromes. Despite the extensive studies, the specific contribution of TET2 in disease phenotype of myeloid neoplasms is not fully elucidated. Recent findings have grown attention on the role of TET2 in normal and malignant erythropoiesis.
In the present study, we investigated TET2 mRNA levels by quantitative PCR during erythropoietin-induced erythroid differentiation CD34+ cells from healthy donor and myelodysplastic syndrome patients. Statistical analyses were performed using the ANOVA and Bonferroni post hoc test and a p-value <0.05 was considered statically significant.
TET2 expression is upregulated during erythroid differentiation of CD34+ cells from healthy donor and myelodysplastic syndrome patients.
Our findings corroborate that TET2 is involved in the erythrocyte differentiation.
Myelodysplastic syndromes (MDS) are clonal hematopoietic neoplasms characterized by bone marrow dysplasia and peripheral blood cytopenias . In MDS, ineffective erythropoiesis leads to anemia, which has a prognostic impact (e.g. Revised International Prognostic Scoring System ). Tet methylcytosine dioxygenase 2 (TET2; also know as Ten-Eleven-Translocation 2) is a methyl cytosine dioxygenase frequently mutated and/or downregulated in myeloid neoplasm, including MDS [3–5]. Experiments in loss-of-function of TET2 using human hematopoietic stem cells and murine models indicate that this protein contributes to myeloid transformation [6, 7]. Despite extensive studies, the specific contribution of TET2 in disease phenotype of myeloid neoplasms is not fully elucidated. Recent findings have brought attention to the role of TET2 in normal and malignant erythropoiesis [8, 9].
To provide additional evidence of TET2 enrolment in erythropoiesis, we investigate TET2 mRNA levels in CD34+ cells from healthy donor and MDS patients during erythropoietin-induced erythroid differentiation.
Bone marrow samples were collected from seven MDS patients (refractory cytopenia with multilineage dysplasia n = 6 and refractory anemia with ringed sideroblasts n = 1, according to the Word Health Organization (WHO) 2008 classification ). Bone marrow (n = 3) or buffy coat preparation from peripheral blood samples (n = 6) were obtained from nine healthy donors. The study was approved by the Ethics Committee of the University of Campinas and informed written consent was obtained from healthy donors and MDS patients. Patients’ characteristics are described in Table 1.
Erythroid cell differentiation
CD34+ cells were separated using MIDI-MACS immunoaffinity columns (Miltenyi Biotec, Auburn, CA, USA) and submitted to erythroid differentiation, as previously described [11, 12]. In brief, CD34+ cells were plated in methylcellulose medium containing 3 U/mL erythropoietin (EPO), 50 ng/mL stem cell factor, and 30 ng/mL interleukin 3, and cultured for 6 days (cell expansion period). The resulting cells (BFU-E and CFU-E derived colony cells and proerythroblasts) were then transferred to alpha MEM (Gibco BR, Carisbad, CA, USA) containing 30% fetal bovine serum (Sigma, St. Louis, MO, USA), 10−5 M 2-mercaptoethanol (Sigma), 2 U/mL EPO, 300 mg/mL holotransferrin (Sigma), and 1% bovine serum albumin (Calbiochem, Darmstadt, Germany) for an additional 6 days (cell differentiation period). Cells were submitted to RNA extraction followed by quantitative PCR (qPCR) on days 6, 8 and 12 or to immunophenotyping on days 6 and 12. The experimental design is illustrated in Fig. 1.
Total RNA was extracted from cells using the illustra RNAspin Mini Kit (GE Healthcare Bio-Sciences, Piscataway, NJ, USA) according manufacture’s instruction. The reverse transcription reaction was performed using RevertAid™ First Strand cDNA Synthesis Kit (MBI Fermentas, St. Leon-Rot, Germany). TET2 mRNA level was detected by Maxima Sybr green qPCR master mix (MBI Fermentas) in the ABI 7500 Sequence Detection System (Thermo Fisher Scientific, Fairlawn, NJ, USA) using specific primers. HPRT1 (hypoxanthine phosphoribosyltransferase 1) was used as the reference gene. Primers sequences and concentration are described in Table 2. The relative quantification value was calculated using the eq. 2-ΔΔCT . Undifferentiated cells after culture expansion period (day 6) were used as calibrator sample for each experiment. A negative ‘No Template Control’ was included for each primer pair. The dissociation protocol was performed at the end of each run to check for non-specific amplifications. Three replicas were run on the same plate for each sample.
Statistical analyses were performed using the ANOVA and Bonferroni post hoc test and GraphPad Prism 5 software (GraphPad Software, Inc., San. Diego, CA, USA). A p-value <0.05 was considered statistically significant.
TET2 mRNA levels increases during erythroid differentiation
In order to provide additional evidence of TET2 participation during normal and myelodysplastic human erythropoiesis, we investigated TET2 expression during erythropoietin-induced erythroid differentiation in CD34+ cells from healthy donor and MDS patients. As previously described, the number of cells derived from BFU-E and CFU-E, as well as the pattern of erythroid differentiation did not differ among CD34+ cells from healthy donors and MDS patients [11, 12].
In the present study, qPCR experiments evidenced that TET2 transcripts were significantly increased on day 12 of erythroid differentiation in normal CD34+ cells (median: 2.05-fold (minimum: 0.47 – maximum: 9.28), p < 0.05; Fig. 2a) and in MDS CD34+ cells (median: 3.59-fold (minimum: 0.63 – maximum: 11.09) p < 0.05; Fig. 2b).
Herein, we demonstrated that TET2 expression increases during erytroid differentiation of primary hematopoietic progenitors from healthy donors and MDS patients. Pronier et al.  demonstrated that the TET2 silencing increased granulomonocytic differentiation in detriment of erythroid differentiation in normal CD34+ cells. Yan et al. , similarly demonstrated that TET2 inhibition led to MDS-like dyserythropoiesis. Of note, TET2 deletion leads to erythroid dysplasia and anemia in zebrafish model , suggesting a conserved function for TET2 in erythrocytes production.
Recently, Guo and colleagues  reported that TET2 mRNA levels was increased in mature erythroid cells from murine fetal liver, and in MEL and K562 cell lines upon chemically-induced erythroid differentiation. Using functional assays, the authors also established that TET2 plays a cytoprotective function in iron homeostasis against oxidative stress during erythropoiesis. In contrast, Inokura and colleagues , using cell sorting of murine bone marrow erythroid populations, observed that Tet2 mRNA levels is reduced at latter erythroid differentiation stages. However, the researchers observed that Tet2 knockdown mice present mild normocytic anemia, and downregulation/methylation of heme biosynthesis and iron metabolism-related genes , corroborating the hypothesis that TET2 plays a key role during normal erythropoiesis.
Taken together, our findings corroborate the data that TET2 is involved in erythrocyte differentiation and further mechanistic studies are necessary to elucidate the importance of TET2 for dyserythropoiesis in MDS.
Erythroid burst-forming units
Colony forming unit-erythrocyte
Hypoxanthine phosphoribosyltransferase 1
Quantitative polymerase chain reaction
Tet methylcytosine dioxygenase 2
Word Health Organization
Visconte V, Tiu RV, Rogers HJ. Pathogenesis of myelodysplastic syndromes: an overview of molecular and non-molecular aspects of the disease. Blood Res. 2014;49:216–27.
Greenberg PL, Tuechler H, Schanz J, Sanz G, Garcia-Manero G, Sole F, et al. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012;120:2454–65.
Tefferi A, Lim KH, Abdel-Wahab O, Lasho TL, Patel J, Patnaik MM, et al. Detection of mutant TET2 in myeloid malignancies other than myeloproliferative neoplasms: CMML, MDS. MDS/MPN and AML Leukemia. 2009;23:1343–5.
Lin Y, Lin Z, Cheng K, Fang Z, Li Z, Luo Y, et al. Prognostic role of TET2 deficiency in myelodysplastic syndromes: a meta-analysis. Oncotarget. 2017;
Scopim-Ribeiro R, Machado-Neto JA, Campos Pde M, Silva CA, Favaro P, Lorand-Metze I, et al. Ten-eleven-translocation 2 (TET2) is downregulated in myelodysplastic syndromes. Eur J Haematol. 2015;94:413–8.
Moran-Crusio K, Reavie L, Shih A, Abdel-Wahab O, Ndiaye-Lobry D, Lobry C, et al. Tet2 Loss leads to increased hematopoietic stem cell self-renewal and myeloid transformation. Cancer Cell. 2011;20:11–24.
Li Z, Cai X, Cai CL, Wang J, Zhang W, Petersen BE, et al. Deletion of Tet2 in mice leads to dysregulated hematopoietic stem cells and subsequent development of myeloid malignancies. Blood. 2011;118:4509–18.
Pronier E, Almire C, Mokrani H, Vasanthakumar A, Simon A, da Costa Reis Monte Mor B, et al. Inhibition of TET2-mediated conversion of 5-methylcytosine to 5-hydroxymethylcytosine disturbs erythroid and granulomonocytic differentiation of human hematopoietic progenitors. Blood. 2011;118:2551–5.
Yan H, Wang Y, Qu X, Li J, Hale J, Huang Y, et al. Distinct roles for TET family proteins in regulating human erythropoiesis. Blood. 2017;129:2002–12.
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of Tumours of Haematopoietic and lymphoid tissues. Fourth ed. Lyon: IARC; 2008.
Machado-Neto JA, Favaro P, Lazarini M, da Silva Santos Duarte A, Archangelo LF, Lorand-Metze I, et al. Downregulation of IRS2 in myelodysplastic syndrome: a possible role in impaired hematopoietic cell differentiation. Leuk Res. 2012;36:931–5.
Pereira JK, Traina F, Machado-Neto JA, Duarte Ada S, Lopes MR, Saad ST, et al. Distinct expression profiles of MSI2 and NUMB genes in myelodysplastic syndromes and acute myeloid leukemia patients. Leuk Res. 2012;36:1300–3.
Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(−Delta Delta C(T)) method. Methods. 2001;25:402–8.
Ge L, Zhang RP, Wan F, Guo DY, Wang P, Xiang LX, et al. TET2 Plays an essential role in erythropoiesis by regulating lineage-specific genes via DNA oxidative demethylation in a zebrafish model. Mol Cell Biol. 2014;34:989–1002.
Guo S, Jiang X, Wang Y, Chen L, Li H, Li X, et al. The protective role of TET2 in erythroid iron homeostasis against oxidative stress and erythropoiesis. Cell Signal. 2017;38:106–15.
Inokura K, Fujiwara T, Saito K, Iino T, Hatta S, Okitsu Y, et al. Impact of TET2 deficiency on iron metabolism in erythroblasts. Exp Hematol. 2017;49:56–67. e55
The authors would like to thank Andy Cumming for English review, and Tereza Salles for her valuable technical assistance.
This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).
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Ethics approval and consent to participate
The present study was approved by the ethics committee of the University of Campinas in accordance with the Helsinki Declaration. Written informed consent was obtained from all healthy donors and MDS patients who participated in this study.
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Scopim-Ribeiro, R., Machado-Neto, J.A., da Silva Santos Duarte, A. et al. TET2 is upregulated during erythroid differentiation of CD34+ cells from healthy donors and myelodysplastic syndrome patients. Appl Cancer Res 37, 38 (2017) doi:10.1186/s41241-017-0044-6
- Tet methylcytosine dioxygenase 2
- Myelodysplastic syndromes
- Erythroid differentiation