Regulation of N-methyladenosine modification in erythropoiesis and thalassemia.

In eukaryotic RNA, N-methyladenosine (mA) is a prevalent form of methylation modification. The mA modification process is reversible and dynamic, written by mA methyltransferase complex, erased by mA demethylase, and recognized by mA binding proteins. Through mediating RNA stability, decay, alternative splicing, and translation processes, mA modification regulates gene expression at the post-transcriptional level. Erythropoiesis is the process of hematopoietic stem cells undergoing proliferation, a series of differentiation and maturation to form red blood cells (RBCs). Thalassemia is a common monogenic disease characterized by excessive production of ineffective RBCs in the peripheral circulation, resulting in hemolytic anemia. Increasing evidence suggests that mA modification plays a crucial role in erythropoiesis. In this review, we comprehensively summarize the function of mA modification in erythropoiesis and further generalize the mechanism of mA modification regulating ineffective erythropoiesis and fetal hemoglobin expression. The purpose is to improve the understanding of the pathogenesis of erythroid dysplasia and offer new perspectives for the diagnosis and treatment of thalassemia.