HSCs function to replenish the blood system and maintain hematopoietic homeostasis in response to either physiological or imposed stress demands
4–6. To explore the role of LKB1 in various aspects of HSC biology, we assessed the impact of somatic deletion of
Lkb1 in the mouse adult hematopoietic system using
Rosa26-CreERT2 deletor mice
7. In this model, the treatment of adult mice with tamoxifen results in complete deletion of
Lkb1 in hematopoietic organs (
Supplementary Fig. 1a), and associated reductions of phosphorylation of AMPK Thr172 and AMPK substrate Acetyl-CoA carboxylase (ACC) Ser79 (
Supplementary Fig. 1b). Strikingly, within 30
days
post completing tamoxifen
injection (DPI), all tamoxifen-treated
Lkb1 L/L, Rosa26-CreERT2 mice (hereafter designated
Lkb1 KO) exhibited constitutional signs of weight loss (
Supplementary Fig. 2a), lethargy, hunched posture, and ultimately death (); in contrast, tamoxifen-treated
Lkb1 +/+, Rosa26-CreERT2 or Lkb1 L/L mice (collectively hereafter designated
Lkb1 WT) remained viable and healthy ().
Somatic deletion of
Lkb1 led to pancytopenia within 1 week after tamoxifen treatment (7 DPI) – evidenced by reduced weight of spleen and thymus, and reduction of the absolute cell number of bone marrow, spleen and thymus (
Supplementary Figs. 2b–f).
Lkb1 KO mice also developed acute anemia as evidenced by marked decline in red blood cell, hemoglobin and hematocrit counts (
Supplementary Figs. 2g–i). While anemic,
Lkb1 KO mice had increased non-fasting blood glucose levels (
Supplementary Fig. 3), making unlikely that the
Lkb1 KO anemia phenotype derives from a profound systemic deficiencies in glucose availability. Further analysis revealed severe reductions in
Lkb1 KO Ter119
+ cells and erythroid progenitors at all developmental stages (,
Supplementary Figs. 4a–b). Consistent with the pancytopenia phenotype described above, we observed a decline of all hematopoietic lineages examined in the
Lkb1 KO mice, including platelets (
Supplementary Fig. 4c), Gr-1
+/Mac-1
+ cells ( and
Supplementary Fig. 4d), B cells ( and
Supplementary Fig. 4e), and T cells (
Supplementary Fig. 4f). To study the underlying mechanism of the multi-lineage defects associated with
Lkb1 deletion, we examined the cell survival status of various lineages in
Lkb1 WT and KO mice given the important role of LKB1 in the maintenance of cell survival under energy stress in other cellular contexts
8,9. Indeed we observed an increase of cleaved Caspase-3 in
Lkb1 KO bone marrow, spleen and thymus samples (
Supplementary Fig. 5). Further Annexin V/7AAD analysis revealed increased apoptosis in myeloid, erythroid and B cell populations in
Lkb1 KO bone marrow cells (). In summary,
Lkb1 deficiency leads to severe pancytopenia phenotype and impairs the cell survival of multiple lineages.
Next we examined HSC and hematopoietic progenitor populations in
Lkb1 KO mice. Compared with WT controls, serial analysis of
Lkb1 KO HSC-enriched LSK cells (Lin
−, Sca-1
+, c-Kit
+) and long-term HSCs (LT-HSCs; CD34
− Flt-3
− LSKs) in bone marrow showed an acute increase at 1 DPI, but a subsequent decrease in numbers from 4 DPI and thereafter (). BrdU labeling experiment revealed significantly increased percentage of BrdU positive cells in
Lkb1 KO LSK cells ( and
Supplementary Figs. 6a–b). Notably,
Lkb1 deletion increased cell proliferation only in LSK and LSK CD34
− cells, but not whole bone marrow and mature lineage cells (), suggesting an HSC-specific role for LKB1 in the regulation of cell quiescence. The more pronounced function of LKB1 in HSC compartment also aligns well with its more prominent expression levels in HSCs relative to other more committed compartments (
Supplementary Figs. 6c–d). Furthermore, 7-AAD/Annexin-V staining of LSK population showed increased apoptosis in
Lkb1 KO LSK cells (
Supplementary Figs. 6e–f). Together, our results suggest that LKB1 functions to maintain HSC quiescence and survival and that
Lkb1 inactivation leads to transient expansion, yet subsequent decline, of bone marrow HSCs.
We next performed competitive and noncompetitive transplantation assays to examine the impact of
Lkb1 deficiency on HSC repopulating capability
in vivo (
Supplementary Figs. 7a–b). In the competitive transplantation experiments, we observed that
Lkb1 KO transplants showed markedly diminished repopulating capability relative to WT controls (, and
Supplementary Figs. 8a–c). In the noncompetitive experiments, all recipient mice reconstituted with
Lkb1L/L, Rosa26-CreERT2 bone marrow cells died within 60 DPI (
Supplementary Fig. 8d) with anemia, pancytopenia defects (data not shown), and increased HSC cell cycle entry and subsequent decline (
Supplementary Figs. 8e–f). These data collectively indicate that LKB1 exerts a predominant cell-autonomous impact on hematopoietic repopulating potential and homeostasis.
To understand the mechanisms underlying LKB1-directed regulation of HSC homeostasis, we assessed the impact of pharmacological inhibition of mTORC1 signaling on the
Lkb1 KO phenotype, given that mTORC1 serves as a key downstream surrogate of LKB1-AMPK signaling
3 and also plays critical roles in the regulation of HSC homeostasis
10–14. Daily rapamycin or vehicle protocols were initiated to
Lkb1 or
Tsc1 WT and KO mice at the time of tamoxifen treatment
12. Rapamycin treatment significantly rescued multi-lineage defects, HSC cycling increase and expansion phenotypes in
Tsc1 KO mice, but had minimal effect on these phenotypes in
Lkb1 KO mice () despite confirmation of abolished S6 phosphorylation in sorted bone marrow B220
+ cells, Mac1
+ cells and CD34
− LSK cells from
Lkb1 KO mice (
Supplementary Fig. 9). Thus, unlike TSC1, LKB1 regulates hematopoiesis via an mTORC1-independent pathway. Finally, administration of metformin, a known AMPK activator, did not rescue bone marrow/thymus cellularity decline, LSK transient expansion/subsequent depletion phenotype and lineage defects in
Lkb1 KO mice (
Supplementary Fig. 10). These data, together with AMPK activator A-769662 treatment data from Gurumurthy et al and AMPK KO mice analyses from Nakada et al, suggest that either multiple AMPK-related kinases (including AMPK) cooperatively mediate LKB1 function in HSC homeostasis or non-AMPK dependent processes are operative.
The above observations prompted transcriptome analysis of sorted LSK cells from
Lkb1 WT and KO bone marrows at 1 DPI to gain further mechanistic insight of LKB1 regulation of HSC homeostasis (
Supplementary Fig. 11a). Ingenuity pathway analysis of 570 significantly differentially expressed genes revealed significant enrichment of genes involved in G1/S cell cycle checkpoint regulation (
Supplementary Fig. 11b, and Supplementary Table 1) including up-regulation of Cyclin D1, Cyclin D2, Cyclin E1, Cdc25A, E2F1, Cdk4 and Skp2, which would serve to synergistically promote cell cycling of
Lkb1 KO LSKs. Most notably, there was prominent representation of LXR/RXR, VDR/RXR and PPAR metabolism pathways (
Supplementary Fig. 11b). To identify key networks regulated by LKB1 in a TSC-mTORC1-independent manner, we further conducted comparative analysis of
Lkb1 and
Tsc1
12 HSC transcriptome datasets (
Supplementary Fig. 11a), which revealed that, although G1/S cell cycle checkpoint was enriched in both datasets, the LXR/RXR, VDR/RXR and PPAR metabolism pathways were distinctively enriched in the
Lkb1 transcriptome dataset (
Supplementary Fig. 11c). In addition, promoter analysis of
Lkb1 HSC transcriptome dataset identified E2F, nuclear respiratory factor 1 (NRF1) and PPARγ motifs as the most significantly enriched promoter binding elements in
Lkb1 LSK transcriptome dataset (1.4x, 2.1x and 1.4x, respectively). The link to PPARγ and NRF1 is notable given that peroxisome proliferator-activated receptor-coactivators, PGC-1α and PGC-1β, are the principal transcriptional coactivator for PPARγ and NRF1
15, and that the PGC-1s are regulated by LKB1
16.
Prompted by this observation, we next investigated whether
Lkb1 deletion impacted on PGC-1, a master transcriptional regulator of mitochondrial biogenesis
17, and its associated biological processes in the hematopoietic system. We found the expression levels of both PGC-1α and PGC-1 β were down-regulated in
Lkb1 KO LSKs (), which coincided with decreased mitochondrial membrane potential and DNA content in
Lkb1 KO LSKs at 4 DPI (). Interestingly, we observed increased mitochondrial DNA content in
Lkb1 KO LSKs at later time point (10 DPI), possibly reflecting compensatory (secondary) effects that occur in the wake of mitochondriopathy (). Finally, we found that the basal ATP levels in spleen and thymus were profoundly decreased in
Lkb1 KO mice (). Although our data raises the possibility that
Lkb1 deficiency and associated dysregulation of PGC-1 impair mitochondrial function, the presence of apoptosis in these
Lkb1−/− HSCs does not allow us to exclude the possibility that mitochondrial dysfunction reflects in part an ongoing apoptotic process caused by
Lkb1 deletion.
In conclusion, our results reveal an essential role of LKB1 in the maintenance of HSC homeostasis. Somatic deletion of Lkb1 in the hematopoietic system impairs HSC quiescence and survival and leads to metabolic catastrophe, resulting in pancytopenia and rapid animal death. Mechanistically, we propose that LKB1 maintains HSC homeostasis through multiple mechanisms governing mitochondrial function, cell survival, and cell cycle regulation via LKB1 regulation of AMPK and other AMPK-related kinases and their downstream effectors (including PGC-1). Our findings align with those of Nakada et al and Gurumurthy et al. and provide a broad framework to understand the integration of energy signaling and mitochondrial physiology in the maintenance of HSC homeostasis.