Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, D‑80337 Munich, Germany.
Institute of Paidopathology, Pediatric Tumor Registry, Christian‑Albrecht's‑University Kiel, D‑24105 Kiel, Germany.
Int J Oncol. 2019 May;54(5):1853-1863. doi: 10.3892/ijo.2019.4741. Epub 2019 Mar 5.
Hepatoblastoma (HB) is the most common liver tumor in children under the age of 3 years worldwide. While many patients achieve good outcomes with surgical resection and conventional chemotherapy, there is still a high‑risk population that exhibits a poor treatment response and unfavorable prognosis, which warrants the search for novel treatment options. In recent years, it has become clear that genetic events alone are not sufficient to explain the aggressive phenotype of this embryonal malignancy. Instead, epigenetic modifications and aberrant gene expression seem to be key drivers of HB. In the present study, expression analyses such as reverse transcription‑quantitative polymerase chain reaction revealed that the oncogene, MYCN proto‑oncogene basic‑helix‑loop‑helix transcription factor (MYCN) was upregulated in HB and other pediatric liver tumors, due to the transcriptional activity of its antisense transcript MYCN opposite strand (MYCNOS). Pyrosequencing demonstrated the hypomethylated regions in the promoter of MYCN and MYCNOS, suggesting that an epigenetic mechanism may underlie the induction of aberrant expression. Transient MYCN knockdown in HB cells resulted in growth inhibition over time. In addition, treating HB cells with the MYCN inhibitors JQ1 and MLN8237 led to the significant downregulation of MYCN either at the mRNA or protein levels, respectively. The underlying mechanism of action of the two inhibitors was revealed to be associated with the induction of dose‑dependent growth arrest, by arresting cells at either the G1/G0 or G2 phase. Furthermore, MLN8237 and JQ1 were able to cause spindle disturbances and/or apoptosis in HB cells. The present results suggest that MYCN may be a promising biomarker for HB and a potential therapeutic target in patients with tumors overexpressing MYCN.
肝细胞瘤(HB)是全球 3 岁以下儿童中最常见的肝脏肿瘤。虽然许多患者通过手术切除和常规化疗获得了良好的结果,但仍有一部分高危人群治疗反应差、预后不良,因此需要寻找新的治疗方法。近年来,人们已经清楚地认识到,仅遗传事件不足以解释这种胚胎性恶性肿瘤的侵袭性表型。相反,表观遗传修饰和异常基因表达似乎是 HB 的关键驱动因素。在本研究中,逆转录定量聚合酶链反应等表达分析显示,癌基因 MYCN 原癌基因基本螺旋环螺旋转录因子(MYCN)在 HB 和其他小儿肝脏肿瘤中上调,这是由于其反义转录本 MYCN 反义链(MYCNOS)的转录活性所致。焦磷酸测序显示 MYCN 和 MYCNOS 启动子中的低甲基化区域,表明表观遗传机制可能是导致异常表达的原因。HB 细胞中 MYCN 的瞬时敲低导致随着时间的推移生长抑制。此外,用 MYCN 抑制剂 JQ1 和 MLN8237 处理 HB 细胞分别导致 MYCN 在 mRNA 或蛋白水平的显著下调。两种抑制剂的作用机制被揭示与诱导剂量依赖性生长停滞有关,使细胞分别停滞在 G1/G0 或 G2 期。此外,MLN8237 和 JQ1 能够引起 HB 细胞的纺锤体紊乱和/或凋亡。这些结果表明,MYCN 可能是 HB 的一个有前途的生物标志物,也是表达过量 MYCN 的肿瘤患者的潜在治疗靶点。