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Molecular and Cellular Biology, June 2003, p. 3872-3883, Vol. 23, No. 11
0270-7306/03/$08.00+0 DOI: 10.1128/MCB.23.11.3872-3883.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Department of Molecular Medicine and Gene Therapy,1 Department of Pathology, Lund University Hospital, Lund, Sweden,2 Terry Fox Laboratory, British Columbia Cancer Agency,3 Department of Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1L3, Canada4
Received 4 September 2002/ Returned for modification 18 November 2002/ Accepted 2 March 2003
| ABSTRACT |
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| INTRODUCTION |
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Murine models have been generated where enforced expression of Hox genes is used to determine the effect of overexpression on self-renewal, differentiation, and other cell fate decisions during hematopoiesis (for reviews, see references 10 and 55). Such models include overexpression of HOXA10, as well as HOXA9, which both affected myelo- and lymphopoiesis and ultimately lead to myeloid leukemia (5, 9, 23, 52, 53). Expression of HOXB3 and HOXB4 is found in the primitive CD34+ population that is highly enriched for human hematopoietic stem cells (HSCs) but is rapidly downregulated as the cells differentiate into committed progenitors (44). Despite very similar expression pattern of HOXB3 and HOXB4, suggesting a common role or collaboration between these factors, the consequences from overexpressing these genes are very different. Although enforced expression of HOXB3 blocks both T- and B-cell development and causes a myeloproliferative disorder (46), overexpression of HOXB4 greatly enhances the regenerative capacity of HSCs in serial transplantation models and results in selective expansion of HOXB4-transduced cells without causing altered lineage decisions or malignant transformations (1, 45, 54). It is noteworthy that this expansion continues until the stem cell pool is normal in size (without overriding it), differing significantly from transplantation of untreated bone marrow (BM) cells, which can only regenerate up to 10% of the number of HSCs found in normal mice. Furthermore, a recent report demonstrates that an
40-fold net expansion of murine repopulating HSCs can be achieved by enforced expression of HOXB4 ex vivo for 10 to 14 days (2). This finding is in sharp contrast to ordinary cytokine induced cultures which can support maintenance of HSC numbers or at most expand by a factor of 2 to 4 (4, 12, 28). Less is known about the feasibility of using HOXB4 for human HSC expansion. Recent findings indicate that HOXB4 overexpression in human hematopoietic progenitors affects fate decisions in a concentration-dependent manner to determine whether self-renewal, differentiation, or a differentiation block ensues (7a, 8, 46a). These findings emphasize the importance of understanding the physiological effects of HOXB4 in HSCs in vivo. Interestingly, overexpression studies of HOXC4 also result in expansion of primitive human hematopoietic progenitors, suggesting a common role for paralog 4 genes on these progenitors (13).
Since HOXB3 and HOXB4 are expressed in the stem cell compartment and gain-of-function studies result in enhanced HSC regeneration, we wanted to further analyze the physiological role of these genes in controlling stem cell fate in a lack-of-function mouse model. Lack-of-function mouse models have generated important insight into the role of various transcription factors in hematopoiesis. These include targeting of genes such as GATA-2, SCL/tal-1, Rbtn2/Lmo2, AML1, PU.1/Spi1, Ikaros, Hoxb6, and Hoxa9 (reviewed in references 34 and 51). Hoxa9-deficient mice exhibit prominent defects in erythroid, myeloid, and lymphoid development, including early T-cell development, as well as apparent defects in HSC function, although these have not been fully described (20, 27, 27a). Hoxb6 deficiency mainly affects the erythroid development, increasing the numbers of erythroid progenitors (22). Here we describe a mouse model that is deficient in the contiguous Hoxb3 and Hoxb4 genes. All exons and intermediate sequences of these genes were excised by utilizing the Cre/LoxP technique (18, 43). Homozygous mice deficient in Hoxb3 and Hoxb4 (Hoxb3/b4-/-) were born at normal Mendelian ratios, showed no major abnormalities in skeletal structure, and remained healthy. However, the hematopoietic organs of Hoxb3/b4-deficient mice exhibited a significant reduction in cellularity and reduced numbers of primitive hematopoietic progenitors, in particular of the HSC pool in fetal livers (FLs) from 14.5-day-old embryos. The proliferative capacity of primitive hematopoietic progenitors from mutant mice was diminished in vitro and the regenerative capacity of Hoxb3/b4-/- HSCs was reduced after primary and secondary transplantation. The defects in repopulating abilities were not caused by aberrations in homing but were more likely due to diminished proliferation of HSCs. This is supported by studies after hematopoietic stress, which demonstrated that repopulating Hoxb3/b4-/- HSCs exhibited slower cell cycle kinetics and a larger proportion of resting stem cells. In summary, these findings show that Hoxb3/b4-deficient HSCs harbor a functional defect, impairing the proliferation capacity when rapid regeneration is required.
| MATERIALS AND METHODS |
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HindIII) and then opened with HindIII and blunted. Into this site the loxP flanked (floxed) neomycin expression cassette, a 1.3-kb XbaI/SalI fragment isolated from pl2neo, was ligated. To the 3' end of this subclone a 1-kb EagI/HindIII fragment (from pBS-ERI) was ligated, and this construct was then digested with PshAI/ClaI, resulting in a 7.2-kb targeting fragment (with 1.6-kb homologous arm upstream and 4.4-kb arm downstream of the neomycin cassette). The targeting fragment was ligated into a SmaI/ClaI-cut pBS, resulting in pBS-B4KO. The herpes simplex virus thymidine kinase (tk) gene driven by the PGK promoter was isolated from pPNT by EcoRI and HindIII digestion. The fragment was blunt ligated into the ClaI site in the 3' polylinker of pBS-B4KO, resulting in the final targeting construct, pBS-B4KOtk. For generation of the Hoxb3 targeting construct, a 1.7-kb XbaI fragment, located 3' of exon IV, was isolated from pSL-NheI and ligated into pBS. This subclone was digested with MscI and BamHI and blunted, and into this site the floxed neomycin cassette was ligated, generating pBS-b3lnl3'. pBS-b3lnl3' was then digested with SmaI, and a blunted 1.6-kb MscI fragment from pBS-ApaI was ligated in that site, resulting in pBS-b3lnl3'+ with a 3' homologous short arm of 1.6 kb. pBS-b3lnl3'+ was opened in the 5' polylinker with XbaI and NotI, and into this a 4.5-kb XbaI/NotI (where the NotI has replaced the endogenous Tth111I site) fragment from pSL-NheI was ligated, resulting in pBS-B3KO with a 5'homologous long arm of 4.5 kb. The tk fragment was blunt ligated into the ClaI site in the 3' polylinker of pBS-B3KO, resulting in the final targeting construct, pBS-B3KOtk.
Gene targeting in ES cells. The targeting constructs were linearized with NotI and purified. A total of 25 to 30 µg of DNA was electroporated (Bio-Rad; 0.26 kV, 500 µF) into ca. 107 RI embryonic stem (ES) cells that were grown according to standard procedure (56). The cells were then cultured in selective medium (300 to 500 µg of G418/ml and 4 µM ganciclovir [when appropriate]) for 7 to 9 days. To verify homologous recombination (HR) the surviving colonies were screened by PCR with the external primers B3L-ext (GCAGCATGGGCACTTCCACAAG) and B4U-ext (GAGGACAACATTGCCATGCCTAGAT) and the internal primers NeoU (TTGGCTGCAGGTCGCTTCGGTGTT) and NeoL (CTTCTTGACGAGTTCTTCTGAGGGGAT). Positive clones were further analyzed by Southern blot with external probes (data not shown). Southern blotting was also used to verify single integration of the targeting vectors. Genomic DNA was digested with either ApaLI or KpnI to screen Hoxb3 and Hoxb4 targeting, respectively, and then probed with a neomycin-specific probe (0.9-kb EcoRI fragment), resulting in a 8.5-kb band from the ApaLI digest and a 5.5-kb band from the KpnI digest (Fig. 1). Targeted clones were expanded and ca. 2 x 106 cells were electroporated with 15 µg of the plasmid pIC-Cre for excision of the neomycin gene. Resulting neomycin sensitive (Neos) clones were screened by PCR with the primers P2 (GAGTGTCACCAATGCCCTCCTGCT) and P6 (GCTTGCCCATTCTCCAGTCTCTCA) or the primers P1 (GTTGACATAAACACTCCGCTCATA) and P5 (ATGGCAACCTTATGTTTTCAGGGC) for the loxP sites at the Hoxb3 and Hoxb4 alleles, respectively (Fig. 1). For analysis of Cre-mediated total deletion of both the Hoxb3 and Hoxb4 genes, primers P1 and P2 were used (Fig. 1). Independently targeted clones of both the Hoxb3/b4-floxed and the Hoxb3/b4-deleted versions were injected into 3.5-day-old C57BL/6 blastocysts and transferred into pseudopregnant (C57BL/6 x CBA)F1 fostermothers by standard techniques (56). Chimeric males were mated to C57BL/6J females, resulting in offspring with a 129Sv/C57BL/6J genetic background. For screening of germ line offspring, DNA was isolated from tail biopsies and analyzed by PCR. Primers P3 (GGAAGCAAGAAAAGGAGGAAGAAAGGA) and P4 (CAAAGTGGGTACAGACAGGGAGGAAAG) were used to distinguish between homozygous and heterozygous offspring of Hoxb3/b4-deleted mice. Total RNA was isolated from the peripheral blood (PB) and BM (RNeasy; Qiagen) of Hoxb3/b4 mice and used for reverse transcription-PCR (RT-PCR) analysis to verify the presence or absence of the RNA transcripts.
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Proliferation recruitment. For single cell cultures, Lin- c-kit+ ScaI+ (LSK) cells were used. Briefly, BM cells were treated with ammonium chloride (NH4Cl; Stem Cell Technologies) and then incubated in a lineage antibody cocktail (CD4, CD8, CD5, Gr1, Mac1, B220, and TER119; all antibodies were from BD Pharmingen unless indicated otherwise). After washing and resuspending steps, sheep anti-rat immunoglobulin G (Fc)-conjugated immunomagnetic beads (Dynal) were added, and lineage-positive cells were removed with a magnetic particle concentrator (MPC-6; Dynal). Lin-/lo cells were stained with fluorescein isothiocyanate (FITC)-conjugated anti-ScaI (anti-E13-161.7) and allophycocyanin (APC)-conjugated anti-c-kit (anti-2B8). The cells were washed and stained with 7AAD (Sigma-Aldrich) to exclude dead cells. The LSK cells were sorted on a FACSVantage Cell Sorter (Becton Dickinson [BD]) and seeded into Terasaki plates (Nunc) at a concentration of one cell per well in 20 µl of serum free medium (X-vivo 15; BioWhittaker) supplemented with 1% bovine serum albumin (Stem Cell Technologies), 100 IU of penicillin and 100 µg of streptomycin (Gibco-BRL)/ml, 2 mM L-glutamine (Gibco-BRL), and 10-4 M 2-mercaptoethanol (Sigma). The following cytokines were used in various combinations (see Results): SCF (Amgen), TPO (Kirin), Flt-3 ligand (FL; Immunex), granulocyte-colony stimulating factor (G-CSF; Amgen), and granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-3 (Novartis).
Cell cycle analysis. Lin- cells were isolated as described above. The cells were then stained with c-kit-APC and ScaI-phycoerythrin (PE) and thereafter preserved in 0.4% formaldehyde (LabKemi) and 0.2% Triton-X (Sigma) overnight. The following day, the cells were labeled with Ki67-FITC and 7AAD (Sigma) and analyzed on a FACSCalibur (BD). When cyclophosphamide (Sendoxan; Asta Medica A.G.) treatment was included, the mice were injected intraperitoneally (200 mg/kg) at 96 h prior to BM harvest.
Transplantation experiments. For standard competitive transplantation experiments, 2 x 105 fresh BM cells from Hoxb3/b4-/- or control littermates (Ly5.2) were mixed together with 8 x 105 BM cells from B6.SJL (Ly5.1) cells. The mixture was injected into the tail vein of lethally irradiated B6.SJL recipient mice. To measure reconstitution of Ly5.2-derived cells, PB samples were taken at weeks 6 and 12 and when the mice were sacrificed at weeks 17 to 20. In some cases, 106 fresh BM cells from the primary recipients were further transplanted into secondary B6.SJL recipients. When 5-fluorouracil (5-FU; Nycomed AB) treatment was included in the transplantation study, Hoxb3/b4-/- and Hoxb3/b4+/+ littermates were injected with 5-FU (150 mg/kg) at days 1 and 5. On day 6, BM cells were harvested, and a 1/10 femur equivalent was mixed together with fresh 2 x 105 B6.SJL BM cells. This mixture was then injected intravenously (i.v.) into lethally irradiated B6.SJL recipients. For FL transplantation experiments, 2 x 105 Hoxb4-/- or Hoxb4+/+ cells (Ly5.2) derived from 14.5-day-old embryos were used in competition with 3 x 105 B6.SJL cells (Ly5.1) and transplanted into lethally irradiated (B6.SJL x C57BL/6)F1 recipients (express both Ly5.1/Ly5.2).
FACS analysis.
Hematopoietic cell suspensions (PB, BM, spleen, thymus, and lymph nodes) were treated with ammonium chloride (Stem Cell Technologies) prior to fluorescence-activated cell sorting (FACS) analysis. For lineage analysis, the cells were stained with FITC-conjugated anti-Mac1, anti-Gr1, anti-B220, and anti-CD4 antibodies, as well as PE-conjugated anti-CD3, anti-CD8, and anti-TER119 antibodies. For a more detailed analysis of B- and T-cell development, APC-conjugated anti-B220, FITC-anti-CD43, PE-(biotin)-anti-IgM, FITC-
ßTCR, and PE-
TCR were also used. For analysis of reconstitution in transplanted mice, PE-conjugated anti-CD45.1 (Ly5.1) and APC-(biotin-)-anti-CD45.2 (Ly5.2) antibodies were used. For estimation of LSK CD34lo/- (LSK CD34) cells, the cells were incubated in the lineage cocktail described above and then labeled with Tri-Color-conjugated goat F(ab')2 anti-rat immunoglobulin G (H+L; Caltag Laboratories) and ScaI-FITC, c-kit-PE, and CD34-(biotin)-APC. For evaluation of LSA (Lin- ScaI+ AA4.1+) cells from FL, the antibody against c-kit was replaced by an antibody to AA4.1. Analysis was done on FACSCalibur (BD), and the results were analyzed with CellQuest software (BD).
Homing assays. Fifteen million whole BM cells from four Ly5.2 Hoxb3/4-/- donors or four littermate control donors were injected into lethally irradiated Ly5.1 recipients. Recipients were sacrificed 24 h later for FACS analysis of viable (7AAD-) donor-derived cells in the BM and spleen by using a Tri-Color labeled lineage cocktail (CD4, CD8, CD5, Gr1, Mac1, B220, and TER119), PE-conjugated anti-Ly5.1, FITC-conjugated anti-Ly5.2, and APC-conjugated anti-c-kit. For analysis of CFU-S at day 12, 1/10 and 1/20 recipient spleen cells were injected into a second cohort of lethally irradiated Ly5.1 recipients (8 recipients per donor spleen), and the numbers of CFU-S were determined 12 days later by counting the visible colonies after fixation in Telleyesniczky's solution. To study the ability of the knockout BM to accept BM grafts, 15 x 106 whole BM cells from five Ly5.1 donors were injected into lethally irradiated Ly5.2 Hoxb3/4-/- or littermate control recipients (one Ly5.1 donor to one Ly5.2 knockout and one Ly5.2 control), and FACS analysis for engrafted Ly5.1 cells was performed 24 h later as described above.
Statistical analysis. Statistical analysis was performed by using the Student t test (either nonpaired or paired when applicable). A P value of <0.05 was considered significant.
| RESULTS |
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Hoxb3/b4-/- mice exhibit reduced cellularity in hematopoietic organs.
Pathological examination of hematopoietic tissues of the Hoxb3/b4-/- mice (BM, spleen, thymus, and lymph nodes) did not reveal any abnormalities. However, the mice displayed significantly reduced cellularity in hematopoietic organs (Table 2). The spleen weight and cellularity was reduced by 30% (P < 0.001) compared to normal littermates, and BM cellularity was reduced by ca. 25% (P < 0.003). A reduction in the red blood cell count and hemoglobin values was also observed, but the white blood cell count was normal. For comparative studies involving the knockout mice, littermate controls were used in all of our experiments. The observed reduction in cellularity led us to ask whether the reduction was restricted to a specific lineage or compartment within the hematopoietic hierarchy. FACS was performed on cells derived from PB, BM, spleen, and thymus with antibodies to Gr1, Mac1, CD4, CD8, B220, CD3, and TER119. The results did not show any significant difference in the lineage distribution of the hematopoietic cells derived from Hoxb3/b4-/- mice compared to Hoxb3/b4+/+ littermates (Fig. 2). In light of previously published data on the blocking effect of overexpression of Hoxb3 on B- and T-cell maturation (46), these populations were analyzed in more detail by FACS analysis. Antibodies to B220 were used in combination with CD43 and IgM for B-cell development, and CD4/CD8 were used in combination with
ßTCR or 
TCR for T-cell analysis; however, no difference was observed between Hoxb3/b4-/- cells and control cells (data not shown). Thus, the reduction observed in hematopoietic cell numbers suggested that the phenotype might arise from the primitive progenitor and stem cell compartment.
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Reduced proliferative capacity of primitive hematopoietic progenitors in vitro.
Due to the reduction in hematopoietic cellularity and a mild reduction in the hematopoietic progenitor cell pool caused by the loss of Hoxb3/b4, we sought to determine whether proliferation recruitment of primitive hematopoietic progenitors was affected in Hoxb3/b4-/- mice. LSK cells were sorted out from the BM and plated in serum-free medium in a single cell assay to evaluate survival and proliferation. The cells were plated out in medium containing either TPO or SCF alone and, on day 6, a multicytokine mix (SCF, FL, TPO, G-CSF, IL-3, and GM-CSF) was added to test the viability, which was found to be normal for the mutant cells. Recruitment into proliferation of single LSK cells was tested by supplementing the medium at day 1 with SCF alone, SCF-TPO, SCF-TPO-FL, or the multicytokine mixture described above. Low stimulatory growth conditions (few cytokines) did not give the mutant cells a proliferative disadvantage compared to control cells, but a significant difference in proliferation potential was detected between the Hoxb3/b4-/- and Hoxb3/b4+/+ littermates, when the multicytokine combination was used (Fig. 4 and data not shown). A significantly reduced number of LSK Hoxb3/b4-/- cell clones with high proliferative capacity (progeny cells cover
50% of the well) was observed compared to Hoxb3/b4+/+ littermates (P < 0.001). Similarly, there was a reduction in the total number of responding clones from the mutant cells, although this was not statistically significant (Fig. 4, P < 0.07). These results indicate that primitive LSK Hoxb3/b4-/- derived cells proliferate less effectively than their normal counterparts in vitro and that the effects due to lack of Hoxb3 and Hoxb4 are most prominent in settings in which there is extensive pressure for proliferation on this primitive cell population.
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| DISCUSSION |
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It is of interest to compare the findings presented here with those of previous reports that have used gain-of-function models to define the role of Hoxb4 and Hoxb3 in hematopoiesis. The loss of Hoxb3 expression did not affect B- or T-cell maturation and had no aberrant effects on the myeloid lineages, as reported by Sauvageau et al. in a retrovirally engineered overexpression study (46). This would indicate that Hoxb3 expression is redundant but that downregulation of this gene is important for normal differentiation. The loss of Hoxb3 and Hoxb4 does not seem to affect the hematopoietic lineage commitment pathways but rather reduces the proliferation capacity of stem cells, although the effects of deficiency are clearly not as dramatic as enforced HOXB4 expression resulting in 50-fold expansion of long-term repopulating HSCs (1, 45, 54). In a recent, elegant overexpression study, a new additional function of HOXB4 is suggested in promoting primitive HSCs, derived from yolk sac as well as from ES cells, to become definitive (26, 40). However, this promotion cannot entirely depend on Hoxb4 since the lack of this gene does not block the onset of definitive hematopoiesis. These effects could also be dose dependent, where exceeding a certain threshold-level changes the functional effect of the transcription factor, as has been seen for GATA-1, where the lineage outcome is correlated with the level of GATA-1 expression (25).
Given the functional complexity of the Hox gene clusters with regard to redundancy, as well as shared internal regulation, the deletion of a single gene might not give an accurate picture of its role since a neighboring or a paralog gene(s) might rescue the phenotype. Indeed, compound knockouts of paralog genes can display dose-dependent degrees of synergism in the homeotic transformations observed, based on the mutant combinations analyzed (19, 59). Surprisingly, in our double-knockout model, homozygous Hoxb3/b4-/- mice were born at a normal Mendelian ratios without signs of any life-threatening phenotype as reported for Hoxb4 mutants, which died at or around the time of birth due to a split sternum (38). The penetrance of this lethal phenotype was reported to be stronger (100%) in a pure 129SvEv genetic background but is still quite significant (50%) in the mixed C57BL/6J x 129SvEv background, which is the one that we have mainly used. The absence of this phenotype in our model is intriguing. A possible explanation could lie within the very different targeting strategies used since in the study by Ramirez-Solis et al., Hoxb4 mutants were generated either by disrupting the first exon by insertion of a double selection cassette and stop codons or by inserting a stop codon in the second exon. The split sternum phenotype was only observed in the first model (38). This might indicate that aberrant splice variants or the presence of a selection cassette driven by strong promoters within the complex regulated Hox cluster could affect the observed phenotype (i.e., see reference 6). In the present study, all exons and introns of Hoxb4 and Hoxb3 are completely removed, along with intermediate and flanking sequences containing specific and shared regulatory elements (i.e., see references 15, 16, 17, 31, and 47). This leaves no possibility for expression of abnormal splice variants or truncated proteins with aberrant function. However, the deletion brings Hoxb2 and Hoxb5 together, thereby possibly altering the sequential expression pattern of the Hoxb cluster during embryogenesis (as well as in hematopoiesis).
The mechanism by which Hox genes affect transcription remain largely unknown, as well as their target genes. In addition to classical transcriptional activities, including DNA binding or direct involvement in transcription complexes, recent studies suggest that these genes might also be involved in chromatin modulation by affecting the acetylation of histones, thereby either functioning as repressors or activators (14a, 42, 48). With regard to Hoxb4, cellular proliferation induced by Hoxb4 has been reported to cause increased activity of the AP-1 complex and higher levels of cyclin D1, both directly involved in cell cycle regulation (24). Hoxb4 has also been reported to bind to and participate in downregulation of c-myc, resulting in differentiation of a promyelocytic leukemic cell line (35, 36).
Regulating maintenance and expansion of the stem cell pool involves a very complex mixture of internal and external signals. In addition to Hoxb4, a number of other molecules have also been reported to have an important role in this scheme. Among these is the cyclin-dependent kinase inhibitor, p21cip1/waf1, which is necessary for maintaining stem cells in a quiescent state, and deficiency of this molecule leads to stem cell exhaustion (11). Interestingly, p21cip1/waf1 has been suggested to be a transcriptional target of another Hox transcription factor, namely, HOXA10 (7). Other factors important for maintenance of hematopoietic activity include molecules such as Pbx1 (14) and Rae28 (33), both with strong connections to Hox genes. A few candidate genes with the ability to expand stem cells have been reported. An example of this is HOXA9 (52); however, long-term overexpression of this gene leads to AML (23). Other examples include Hedgehog and Sonic hedgehog, which enhance proliferation of primitive human hematopoietic cells via BMP regulation (3), and Notch1 (57) and the homeobox gene Lhx2 (37), which have been successfully used to generate immortalized HSCs.
In summary, the data presented here suggest that proliferation, but not commitment of true stem cells, is negatively affected by Hoxb3/b4 deficiency. Furthermore, it appears that Hoxb3 and Hoxb4 are mainly important under conditions that call for a rapid proliferation response and are dispensable for normal, steady-state hematopoiesis. These findings are important for understanding the regulatory mechanisms that control fate, particularly self-renewal, of HSCs. Further studies are required to elucidate fully the mechanism of Hoxb4 action in HSCs in order to determine whether enforced expression of Hoxb4 can be used safely to generate or expand stem cells ex vivo for cell or gene therapy.
| ACKNOWLEDGMENTS |
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We thank C. Largman for providing the Hoxb4 probe, H. Gu for the pl2neo plasmid, R. Jaenish for the pNT, and R. Fässler for providing the RI ES cells. We also thank Per Levéen and Mary-Ann Sällström for help with blastocyst injections, Kristina Sundgren and Eva Gynnstam for expert animal care, Lilian Wittman for help with animal experiments, and Sten Eirik Jacobsen and members of The Department of Stem Cell Biology, Lund University, for helpful advice and discussions.
J.M.B. and N.L. contributed equally to this work.
| FOOTNOTES |
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