Lipid metabolism transcriptomic signature of defective erythropoiesis in Diamond Blackfan anemia syndrome.

Analysis of Diamond Blackfan anemia syndrome (DBAS) cohorts and animal models has not revealed a potential mechanism for the variable anemia phenotype, a key feature of this disease. Here, we used an established Rpl5Skax23-Jus/+ murine DBAS model to study this dynamic erythropoiesis deficiency. These haploinsufficient mice exhibit variably penetrant craniofacial and cardiac defects mimicking the phenotypes of patients with DBAS bearing RPL5 mutations. We additionally discovered that this specific heterozygous splicing mutation is pathogenic and leads to partial intron retention. By examining the transcriptome of fetal liver erythroid progenitors at embryonic day 12.5 (E12.5), we demonstrate downregulation of erythroid differentiation pathways consistent with the DBAS phenotype. We also identified dysregulated transcription of lipid metabolism genes with significant reduction in Scd1 expression in the subset of E12.5 mutant embryos at risk for erythroid failure. Stearoyl-coenzyme A desaturase 1, a key enzyme that converts saturated to monounsaturated fatty acids, has not been previously linked to erythropoiesis or DBAS. When anemia was induced in adult Rpl5Skax23-Jus/+ mice, mutant mice exhibited delayed erythroid recovery, whereas pretreatment with an stearoyl-coenzyme A desaturase 1 inhibitor resulted in improved erythropoiesis in both wild-type and mutant mice. This analysis suggests a potential role of lipid metabolism in the variable anemia penetrance in DBAS and highlights a previously unappreciated pathway that requires further study as a potential target for drug development.