Division of Hematology and Oncology, Department of Medicine, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.
Curr Hematol Malig Rep. 2019 Oct;14(5):439-450. doi: 10.1007/s11899-019-00541-9.
Emerging evidence has shown that epigenetic derangements might drive and promote tumorigenesis in various types of malignancies and is prevalent in both B cell and T cell lymphomas. The purpose of this review is to explain how the epigenetic derangements result in a chromatin-remodeled state in lymphoma and contribute to the biology and clinical features of these tumors.
Studies have explored on the functional role of epigenetic derangements in chromatin remodeling and lymphomagenesis. For example, the haploinsufficiency of CREBBP facilitates malignant transformation in mice and directly implicates the importance to re-establish the physiologic acetylation level. New findings identified 4 prominent DLBCL subtypes, including EZB-GC-DLBCL subtype that enriched in mutations of CREBBP, EP300, KMT2D, and SWI/SNF complex genes. EZB subtype has a worse prognosis than other GCB-tumors. Moreover, the action of the histone modifiers as well as chromatin-remodeling factors (e.g., SWI/SNF complex) cooperates to influence the chromatin state resulting in transcription repression. Drugs that alter the epigenetic landscape have been approved in T cell lymphoma. In line with this finding, epigenetic lesions in histone modifiers have recently been uncovered in this disease, further confirming the vulnerability to the therapies targeting epigenetic derangements. Modulating the chromatin state by epigenetic-modifying agents provides precision-medicine opportunities to patients with lymphomas that depend on this biology.
新兴证据表明,表观遗传失调可能驱动和促进多种恶性肿瘤的发生,并且在 B 细胞和 T 细胞淋巴瘤中都很普遍。本文旨在解释表观遗传失调如何导致淋巴瘤中染色质重塑状态,并促进这些肿瘤的生物学和临床特征。
研究已经探讨了表观遗传失调在染色质重塑和淋巴瘤发生中的功能作用。例如,CREBBP 的杂合性缺失促进了小鼠的恶性转化,并直接表明需要重新建立生理乙酰化水平。新的发现确定了 4 种主要的弥漫性大 B 细胞淋巴瘤亚型,包括 EZB-GC-DLBCL 亚型,该亚型富含 CREBBP、EP300、KMT2D 和 SWI/SNF 复合物基因的突变。EZB 亚型的预后比其他 GCB 肿瘤差。此外,组蛋白修饰剂和染色质重塑因子(如 SWI/SNF 复合物)的作用协同影响染色质状态,导致转录抑制。改变表观遗传景观的药物已在 T 细胞淋巴瘤中获得批准。与此发现一致,最近在该疾病中发现了组蛋白修饰剂中的表观遗传损伤,进一步证实了针对表观遗传失调的治疗方法的脆弱性。通过表观遗传修饰剂调节染色质状态为依赖这种生物学的淋巴瘤患者提供了精准医疗机会。