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Updated: Aug 9, 2025

Engineering Oncogenic Heterozygous Gain-of-Function Mutations in Human Hematopoietic Stem and Progenitor Cells
Published on: March 10, 2023
Human gene-engineered calreticulin mutant stem cells recapitulate MPN hallmarks and identify targetable
Johannes Foßelteder1, Gabriel Pabst1,2,3, Tommaso Sconocchia1
1Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria.
Abstract:
Calreticulin (CALR) mutations present the main oncogenic drivers in JAK2 wildtype (WT) myeloproliferative neoplasms (MPN), including essential thrombocythemia and myelofibrosis, where mutant (MUT) CALR is increasingly recognized as a suitable mutation-specific drug target. However, our current understanding of its mechanism-of-action is derived from mouse models or immortalized cell lines, where cross-species differences, ectopic over-expression and lack of disease penetrance are hampering translational research. Here, we describe the first human gene-engineered model of CALR MUT MPN using a CRISPR/Cas9 and adeno-associated viral vector-mediated knock-in strategy in primary human hematopoietic stem and progenitor cells (HSPCs) to establish a reproducible and trackable phenotype in vitro and in xenografted mice. Our humanized model recapitulates many disease hallmarks: thrombopoietin-independent megakaryopoiesis, myeloid-lineage skewing, splenomegaly, bone marrow fibrosis, and expansion of megakaryocyte-primed CD41+ progenitors. Strikingly, introduction of CALR mutations enforced early reprogramming of human HSPCs and the induction of an endoplasmic reticulum stress response. The observed compensatory upregulation of chaperones revealed novel mutation-specific vulnerabilities with preferential sensitivity of CALR mutant cells to inhibition of the BiP chaperone and the proteasome. Overall, our humanized model improves purely murine models and provides a readily usable basis for testing of novel therapeutic strategies in a human setting.
Insights
Researchers developed a humanized model for CALRETICULIN (CALR) mutation-driven myeloproliferative neoplasms (MPN). This model reveals new drug targets by showing CALR mutations sensitize cells to chaperone and proteasome inhibition.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Calreticulin (CALR) mutations are key drivers in JAK2 wildtype myeloproliferative neoplasms (MPN).
- Current models using cell lines or mice have limitations in translational research due to cross-species differences and ectopic expression.
- Mutant CALR is a recognized drug target, but understanding its mechanism requires better models.
Purpose of the Study:
- To create the first human gene-engineered model of CALR mutation-positive MPN.
- To establish a reproducible and trackable in vitro and in vivo model using human cells.
- To identify novel therapeutic vulnerabilities associated with CALR mutations.
Main Methods:
- CRISPR/Cas9 and adeno-associated viral vector-mediated knock-in in primary human hematopoietic stem and progenitor cells (HSPCs).
- Establishment of a humanized model in vitro and in xenografted mice.
- Analysis of cellular reprogramming, endoplasmic reticulum stress response, and chaperone expression.
Main Results:
- The humanized model recapitulated key MPN hallmarks: thrombopoietin-independent megakaryopoiesis, myeloid skewing, splenomegaly, and bone marrow fibrosis.
- CALR mutations induced early reprogramming of human HSPCs and endoplasmic reticulum stress.
- Compensatory chaperone upregulation identified mutation-specific vulnerabilities.
Conclusions:
- This humanized model overcomes limitations of murine models for studying CALR-mutant MPN.
- The model demonstrates that CALR mutations confer sensitivity to BiP chaperone and proteasome inhibition.
- It provides a valuable platform for testing new therapeutic strategies in a human context.
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