Importantly, GDF11 is a secreted factor, and its protein dosage could be modulated using recombinant protein to increase dosage (for RTT or GDF11 haploinsufficiency) or using a neutralizing antibody to decrease dosage (for MDS) (Morvan et al., 2017; Ozek et al., 2018; Zhang et al., 2018). This evidence concerns the gene GDF11 and myelodysplastic syndrome.