Epigenetics Meets Genetics in Acute Myeloid Leukemia: Clinical Impact of a Novel Seven-Gene Score
JOURNAL OF CLINICAL ONCOLOGY
Authors: Marcucci, Guido; Yan, Pearlly; Maharry, Kati; Frankhouser, David; Nicolet, Deedra; Metzeler, Klaus H.; Kohlschmidt, Jessica; Mrozek, Krzysztof; Wu, Yue-Zhong; Bucci, Donna; Curfman, John P.; Whitman, Susan P.; Eisfeld, Ann-Kathrin; Mendler, Jason H.; Schwind, Sebastian; Becker, Heiko; Baer, Constance; Carroll, Andrew J.; Baer, Maria R.; Wetzler, Meir; Carter, Thomas H.; Powell, Bayard L.; Kolitz, Jonathan E.; Byrd, John C.; Plass, Christoph; Garzon, Ramiro; Caligiuri, Michael A.; Stone, Richard M.; Volinia, Stefano; Bundschuh, Ralf; Bloomfield, Clara D.
Abstract
Purpose Molecular risk stratification of acute myeloid leukemia (AML) is largely based on genetic markers. However, epigenetic changes, including DNA methylation, deregulate gene expression and may also have prognostic impact. We evaluated the clinical relevance of integrating DNA methylation and genetic information in AML. Methods Next-generation sequencing analysis of methylated DNA identified differentially methylated regions (DMRs) associated with prognostic mutations in older ( 60 years) cytogenetically normal (CN) patients with AML (n = 134). Genes with promoter DMRs and expression levels significantly associated with outcome were used to compute a prognostic gene expression weighted summary score that was tested and validated in four independent patient sets (n = 355). Results In the training set, we identified seven genes (CD34, RHOC, SCRN1, F2RL1, FAM92A1, MIR155HG, and VWA8) with promoter DMRs and expression associated with overall survival (OS; P .001). Each gene had high DMR methylation and lower expression, which were associated with better outcome. A weighted summary expression score of the seven gene expression levels was computed. A low score was associated with a higher complete remission (CR) rate and longer disease-free survival and OS (P < .001 for all end points). This was validated in multivariable models and in two younger (< 60 years) and two older independent sets of patients with CN-AML. Considering the seven genes individually, the fewer the genes with high expression, the better the outcome. Younger and older patients with no genes or one gene with high expression had the best outcomes (CR rate, 94% and 87%, respectively; 3-year OS, 80% and 42%, respectively). Conclusion A seven-gene score encompassing epigenetic and genetic prognostic information identifies novel AML subsets that are meaningful for treatment guidance. (C) 2013 by American Society of Clinical Oncology
Transcriptome Analysis and Emerging Driver Identification of CD8+T Cells in Patients with Vitiligo
OXIDATIVE MEDICINE AND CELLULAR LONGEVITY
Authors: Deng, Qiancheng; Wei, Jingchao; Zou, Puyu; Xiao, Yangfan; Zeng, Zhuotong; Shi, Yaqian; Zhan, Yi; Zhang, Huiming; Tang, Bingsi; Zeng, Qinghai; Xiao, Rong
Abstract
Activated CD8+ T cells play important roles in the pathogenesis of vitiligo. However, driving factors about the activation and migration of CD8+ T cells remain obscure. In this study, we aim to identify differentially expressed genes (DEGs) and uncover potential factors that drive the disease in melanocyte-specific CD8+ T cells in vitiligo. A total of 1147 DEGs were found through transcriptome sequencing in CD8+ T cells from lesional skin of vitiligo patients and normal controls. Based on KEGG pathway enrichment analysis and PPI, 16 upregulated and 23 downregulated genes were identified. Ultimately, 3 genes were figured out after RT-qPCR verification. The mRNA and protein expression levels of PIK3CB, HIF-1 alpha, and F2RL1 were all elevated in CD8+ T cells from peripheral blood in vitiligo. HIF-1 alpha and PIK3CB were significantly increased in lesional skin of vitiligo. Two CpG sites of the HIF-1 alpha promoter were hypomethylated in vitiligo CD8+ T cells. In conclusion, HIF-1 alpha, F2RL1, and PIK3CB may act as novel drivers for vitiligo, which are all closely associated with reactive oxygen species and possibly contribute to the activation and/or migration of melanocyte-specific CD8+ T cells in vitiligo. In addition, we uncovered a potential role for DNA hypomethylation of HIF-1 alpha in CD8+ T cells of vitiligo.