Model for the regulation of HSC self-renewal and proliferation by TET2 loss, JAK2V617F, and the combination of JAK2V617F and TET2 loss. TET2 loss increases the self-renewal of HSCs without significant effects on their proliferation, explaining that TET2-deficient HSCs outcompete normal HSCs and lead to clonal hematopoiesis. The effects of JAK2V617F on HSCs are dependent on the level of expression and yet-unknown parameters. At low levels of expression, JAK2V617F induces the proliferation of HSCs but slightly decreases self-renewal. The proliferation effect being predominant, JAK2V617F HSCs are capable of outcompeting wild-type HSCs. At high levels of expression, JAK2V617F may more profoundly alter the functions of HSCs. The TET2 loss restores the function of JAK2V617F by increasing self-renewal. The restoration is complete or incomplete depending on the defect of the JAK2V617F HSCs. Overall, TET2 loss increases the fitness of JAK2V617F to induce an MPN.

Model for the regulation of HSC self-renewal and proliferation by TET2 loss, JAK2V617F, and the combination of JAK2V617F and TET2 loss. TET2 loss increases the self-renewal of HSCs without significant effects on their proliferation, explaining that TET2-deficient HSCs outcompete normal HSCs and lead to clonal hematopoiesis. The effects of JAK2V617F on HSCs are dependent on the level of expression and yet-unknown parameters. At low levels of expression, JAK2V617F induces the proliferation of HSCs but slightly decreases self-renewal. The proliferation effect being predominant, JAK2V617F HSCs are capable of outcompeting wild-type HSCs. At high levels of expression, JAK2V617F may more profoundly alter the functions of HSCs. The TET2 loss restores the function of JAK2V617F by increasing self-renewal. The restoration is complete or incomplete depending on the defect of the JAK2V617F HSCs. Overall, TET2 loss increases the fitness of JAK2V617F to induce an MPN.

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