YAP1 regulates thrombopoiesis by binding to MYH9 in immune thrombocytopenia

Immune thrombocytopenia (ITP) is a complicated bleeding disease characterized by sharp platelet reduction. As a dominating element involved in ITP, megakaryocytes (MKs) are responsible for thrombopoiesis. However, the mechanism underlying the dysregulation of thrombopoiesis that occurs in ITP remains unidentified. In this study, we examined the role of yes-associated protein 1 (YAP1) in thrombopoiesis during ITP. We observed a reduced YAP1 expression with cytoskeletal actin misalignment in MKs from ITP patients. By using an experimental ITP mouse model, we showed that reduced YAP1 expression induced aberrant MK distribution, reduced the percentage of late MKs among total MKs, and caused submaximal platelet recovery. Mechanistically, YAP1 upregulation by binding of GATA binding protein 1 (GATA1) to its promoter promoted MK maturation. Phosphorylated YAP1 promoted cytoskeletal activation by binding of its WW2 domain to myosin heavy chain 9 (MYH9), facilitating thrombopoiesis. Targeting YAP1 by its activator XMU-MP-1 was sufficient to rescue cytoskeletal defects and thrombopoiesis dysregulation in YAP1+/- mice with ITP and patients. Taken together, these results demonstrate a crucial role for YAP1 in thrombopoiesis, providing a potential for the development of diagnostic markers and therapeutic options for ITP.