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[EZH抑制剂在淋巴瘤治疗中的应用]

[EZH inhibitors in lymphoma therapy].

作者信息

Ishitsuka Kenji

机构信息

Department of Hematology and Rheumatology, Kagoshima University.

出版信息

Rinsho Ketsueki. 2023;64(7):665-669. doi: 10.11406/rinketsu.64.665.

Abstract

Enhancer of zeste homolog (EZH), a subunit of polycomb repressive complex 2 (PRC2), suppresses gene expression by methylation of H3K27. EZH is closely associated with B-cell development and pathogenesis of certain malignant lymphomas. In follicular lymphoma (FL), gain-of-function mutation and upregulation of EZH2 are observed in approximately 30% and 15% of cases, respectively. Moreover, one-third of diffuse large B-cell lymphomas carry an EZH2 mutation, mostly co-existing with translocation involving Bcl-2. Genome-wide trimethylation of H3K27 is a unique characteristic induced by upregulation of both EZH2 and EZH1, and is responsible for more than half of the gene suppression that occurs in adult T-cell leukemia/lymphoma (ATL). Inhibition of EZH can reduce H3K27 methylation and subsequently restore epigenetically suppressed genes. Currently, an EZH2 inhibitor and dual EZH1/2 inhibitor have been clinically used to treat relapsed/refractory FL and ATL, respectively. EZH-targeted treatment for lymphoma has only just begun, and further development of these drugs for various other malignancies, both alone and in combination with other therapeutics, is ongoing.

摘要

zeste同源增强子(EZH)是多梳抑制复合物2(PRC2)的一个亚基,通过H3K27甲基化抑制基因表达。EZH与B细胞发育及某些恶性淋巴瘤的发病机制密切相关。在滤泡性淋巴瘤(FL)中,分别约有30%和15%的病例观察到EZH2功能获得性突变和上调。此外,三分之一的弥漫性大B细胞淋巴瘤携带EZH2突变,大多与涉及Bcl-2的易位共存。H3K27全基因组三甲基化是EZH2和EZH1上调诱导的独特特征,并且是成人T细胞白血病/淋巴瘤(ATL)中发生的超过一半的基因抑制的原因。抑制EZH可减少H3K27甲基化,随后恢复表观遗传抑制的基因。目前,一种EZH2抑制剂和双EZH1/2抑制剂已分别在临床上用于治疗复发/难治性FL和ATL。针对淋巴瘤的EZH靶向治疗才刚刚开始,这些药物针对各种其他恶性肿瘤的进一步开发,无论是单独使用还是与其他疗法联合使用,都在进行中。

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