Sepsis Induces Hematopoietic Stem Cell Exhaustion and Myelosuppression through Distinct Contributions of TRIF and MYD88

Toll-like receptor 4 (TLR4) plays a central role in host responses to bacterial infection, but the precise mechanism(s) by which its downstream signaling components coordinate the bone marrow response to sepsis is poorly understood. Using mice deficient in TLR4 downstream adapters MYD88 or TRIF, we demonstrate that both cell-autonomous and non-cell-autonomous MYD88 activation are major causes of myelosuppression during sepsis, while having a modest impact on hematopoietic stem cell (HSC) functions. In contrast, cell-intrinsic TRIF activation severely compromises HSC self-renewal without directly affecting myeloid cells. Lipopolysaccharide-induced activation of MYD88 or TRIF contributes to cell-cycle activation of HSC and induces rapid and permanent changes in transcriptional programs, as indicated by persistent downregulation of Spi1 and CebpA expression after transplantation. Thus, distinct mechanisms downstream of TLR4 signaling mediate myelosuppression and HSC exhaustion during sepsis through unique effects of MyD88 and TRIF. [Display omitted] •Activation of TLR4 by LPS causes HSC injury, myelosuppression, and neutropenia•LPS-induced MYD88 activation leads to apoptosis and myelosuppression•LPS causes HSC damage and exhaustion by TRIF activation•HSC retain long-term memory of LPS injury In this article, Carlesso and colleagues investigate the role of the TLR4 downstream adapters, MyD88 and TRIF, in the regulation of bone marrow response to sepsis. Their work shows that MyD88 activation is a major cause of myelosuppression during sepsis while having a modest impact on HSC, whereas cell-intrinsic TRIF activation compromises HSC self-renewal without directly affecting myeloid cells. Cell-intrinsic activation in HSC results in HSC exhaustion and transcriptional changes persisting over the long term even when the endotoxic environment is removed.