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MYELODYSPLASTIC NEOPLASM

SLIT2 promoter hypermethylation-mediated SLIT2-IT1/miR-218 repression drives leukemogenesis and predicts adverse prognosis in myelodysplastic neoplasm

Abstract

Epigenetic modifications have been found to play crucial roles in myelodysplastic neoplasm (MDS) progression. Previously, we investigated genome-wide DNA methylation alterations during MDS evolution to acute myeloid leukemia (AML) by next-generation sequencing (NGS). Herein, we further determined the role and clinical implications of an evident methylation change in CpG islands at the SLIT2 promoter identified by NGS. First, increased SLIT2 promoter methylation was validated in 11 paired MDS/AML patients during disease evolution. Additionally, SLIT2 promoter methylation was markedly increased in MDS/AML patients compared with controls and was correlated with poor clinical phenotype and outcome. Interestingly, SLIT2 expression was particularly upregulated in AML patients and was not correlated with SLIT2 promoter methylation. However, the SLIT2-embedded genes SLIT2-IT1 and miR-218 were downregulated in AML patients, which was negatively associated with SLIT2 promoter methylation and further validated by demethylation studies. Functionally, SLIT2-IT1/miR-218 overexpression exhibited antileukemic effects by affecting cell proliferation, apoptosis and colony formation in vitro and in vivo. Mechanistically, SLIT2-IT1 may function as a competing endogenous RNA by sponging miR-3156-3p to regulate BMF expression, whereas miR-218 may directly target HOXA1 in MDS progression. In summary, our findings demonstrate that SLIT2 promoter hypermethylation is associated with disease evolution in MDS and predicts poor prognoses in both MDS and AML. Epigenetic inactivation of SLIT2-IT1/miR-218 by SLIT2 promoter hypermethylation could be a promising therapeutic target in MDS.

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Fig. 1: SLIT2 promoter methylation was significantly increased during MDS progression and correlated with poor clinical outcome.
Fig. 2: Transcriptional regulatory effects of SLIT2 promoter methylation on noncoding RNAs SLIT2-IT1/miR-218 expression in leukemogenesis.
Fig. 3: SLIT2-IT1 exerted antileukemic effects in vitro and in vivo.
Fig. 4: SLIT2-IT1 may function as a competing endogenous RNA by “sponging” miR-3156-3p to regulate BMF expression in leukemogenesis.
Fig. 5: MiR-218 elaborated antileukemic effects in vitro and in vivo by targeting HOXA1.
Fig. 6: The schematic diagram of the regulatory mechanism and role of SLIT2 promoter hypermethylation during MDS transformation.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Cazzola M. Myelodysplastic syndromes. N. Engl J Med. 2020;383:1358–74.

    Article  CAS  PubMed  Google Scholar 

  2. Khoury JD, Solary E, Abla O, Akkari Y, Alaggio R, Apperley JF, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia. 2022;36:1703–19.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Goel H, Rahul E, Gupta I, Chopra A, Ranjan A, Gupta AK, et al. Molecular and genomic landscapes in secondary & therapy related acute myeloid leukemia. Am J Blood Res. 2021;11:472–97.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Martínez-Cuadrón D, Megías-Vericat JE, Serrano J, Martínez-Sánchez P, Rodríguez-Arbolí E, Gil C, et al. Treatment patterns and outcomes of 2310 patients with secondary acute myeloid leukemia: a PETHEMA registry study. Blood Adv. 2022;6:1278–95.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Palomo L, Meggendorfer M, Hutter S, Twardziok S, Ademà V, Fuhrmann I, et al. Molecular landscape and clonal architecture of adult myelodysplastic/myeloproliferative neoplasms. Blood. 2020;136:1851–62.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Garcia-Manero G, Chien KS, Montalban-Bravo G. Myelodysplastic syndromes: 2021 update on diagnosis, risk stratification and management. Am J Hematol. 2020;95:1399–420.

    Article  PubMed  Google Scholar 

  7. Menssen AJ, Walter MJ. Genetics of progression from MDS to secondary leukemia. Blood 2020;136:50–60.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Dan C, Chi J, Wang L. Molecular mechanisms of the progression of myelodysplastic syndrome to secondary acute myeloid leukaemia and implication for therapy. Ann Med. 2015;47:209–17.

    Article  CAS  PubMed  Google Scholar 

  9. Bravo GM, Lee E, Merchan B, Kantarjian HM, García-Manero G. Integrating genetics and epigenetics in myelodysplastic syndromes: advances in pathogenesis and disease evolution. Br J Haematol. 2014;166:646–59.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Heuser M, Yun H, Thol F. Epigenetics in myelodysplastic syndromes. Semin Cancer Biol. 2018;51:170–9.

    Article  CAS  PubMed  Google Scholar 

  11. Ye F, Li N. Role of p15(INK4B) methylation in patients with myelodysplastic syndromes: a systematic meta-analysis. Clin Lymphoma Myeloma Leuk. 2019;19:e259–e265.

    Article  PubMed  Google Scholar 

  12. Zhang TJ, Xu ZJ, Gu Y, Wen XM, Ma JC, Zhang W, et al. Identification and validation of prognosis-related DLX5 methylation as an epigenetic driver in myeloid neoplasms. Clin Transl Med. 2020;10:e29.

    PubMed  PubMed Central  Google Scholar 

  13. Zhou JD, Wang YX, Zhang TJ, Li XX, Gu Y, Zhang W, et al. Identification and validation of SRY-box containing gene family member SOX30 methylation as a prognostic and predictive biomarker in myeloid malignancies. Clin Epigenetics. 2018;10:92.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Zhou JD, Zhang TJ, Li XX, Ma JC, Guo H, Wen XM, et al. Epigenetic dysregulation of ID4 predicts disease progression and treatment outcome in myeloid malignancies. J Cell Mol Med. 2017;21:1468–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Zhou JD, Lin J, Zhang TJ, Ma JC, Yang L, Wen XM, et al. GPX3 methylation in bone marrow predicts adverse prognosis and leukemia transformation in myelodysplastic syndrome. Cancer Med. 2017;6:267–74.

    Article  CAS  PubMed  Google Scholar 

  16. Zhou JD, Zhang TJ, Xu ZJ, Deng ZQ, Gu Y, Ma JC, et al. Genome-wide methylation sequencing identifies progression-related epigenetic drivers in myelodysplastic syndromes. Cell Death Dis. 2020;11:997.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Blockus H, Chédotal A. Slit-Robo signaling. Development. 2016;143:3037–44.

    Article  CAS  PubMed  Google Scholar 

  18. Tong M, Jun T, Nie Y, Hao J, Fan D. The role of the slit/robo signaling pathway. J Cancer. 2019;10:2694–705.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Gara RK, Kumari S, Ganju A, Yallapu MM, Jaggi M, Chauhan SC. Slit/Robo pathway: a promising therapeutic target for cancer. Drug Disco Today. 2015;20:156–64.

    Article  CAS  Google Scholar 

  20. Jiang Z, Liang G, Xiao Y, Qin T, Chen X, Wu E, et al. Targeting the SLIT/ROBO pathway in tumor progression: molecular mechanisms and therapeutic perspectives. Ther Adv Med Oncol. 2019;11:1758835919855238.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Xu F, Wu LY, Chang CK, He Q, Zhang Z, Liu L, et al. Whole-exome and targeted sequencing identify ROBO1 and ROBO2 mutations as progression-related drivers in myelodysplastic syndromes. Nat Commun. 2015;6:8806.

    Article  CAS  PubMed  Google Scholar 

  22. Yang D, Zhang T, Wang Y, Yao D, Yang L, Zhou J, et al. Decreased miR-218 expression predicts unfavorable prognosis in de novo acute myeloid leukemia. Int J Clin Exp Pathol. 2016;9:8318–26.

    CAS  Google Scholar 

  23. Papaemmanuil E, Gerstung M, Malcovati L, Tauro S, Gundem G, Van Loo P, et al. Clinical and biological implications of driver mutations in myelodysplastic syndromes. Blood. 2013;122:3616–27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Jiang Y, Dunbar A, Gondek LP, Mohan S, Rataul M, O’Keefe C, et al. Aberrant DNA methylation is a dominant mechanism in MDS progression to AML. Blood 2009;113:1315–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Narayan G, Goparaju C, Arias-Pulido H, Kaufmann AM, Schneider A, Dürst M, et al. Promoter hypermethylation-mediated inactivation of multiple Slit-Robo pathway genes in cervical cancer progression. Mol Cancer. 2006;5:16.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tseng RC, Lee SH, Hsu HS, Chen BH, Tsai WC, Tzao C, et al. SLIT2 attenuation during lung cancer progression deregulates beta-catenin and E-cadherin and associates with poor prognosis. Cancer Res. 2010;70:543–51.

    Article  CAS  PubMed  Google Scholar 

  27. Mohamed G, Talima S, Li L, Wei W, Rudzki Z, Allam RM, et al. Low expression and promoter hypermethylation of the tumour suppressor SLIT2, are associated with adverse patient outcomes in diffuse large b cell lymphoma. Pathol Oncol Res. 2019;25:1223–31.

    Article  CAS  PubMed  Google Scholar 

  28. Mitra S, Mazumder-Indra D, Mondal RK, Basu PS, Roy A, Roychoudhury S, et al. Inactivation of SLIT2-ROBO1/2 pathway in premalignant lesions of uterine cervix: clinical and prognostic significances. PLoS One. 2012;7:e38342.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Tseng RC, Chang JM, Chen JH, Huang WR, Tang YA, Kuo IY, et al. Deregulation of SLIT2-mediated Cdc42 activity is associated with esophageal cancer metastasis and poor prognosis. J Thorac Oncol. 2015;10:189–98.

    Article  CAS  PubMed  Google Scholar 

  30. Lin CJ, Huang WR, Wu CZ, Tseng RC. Changes in SLIT2 expression are associated with the migration of human ovarian clear cell carcinoma cells. Oncol Lett. 2021;22:551.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Huang Y, Xie Y, Abel PW, Wei P, Plowman J, Toews ML, et al. TGF-beta1-induced miR-424 promotes pulmonary myofibroblast differentiation by targeting Slit2 protein expression. Biochem Pharm. 2020;180:114172.

    Article  CAS  PubMed  Google Scholar 

  32. Dong Y, Fan G, Li Y, Zhou Q. TUG1 represses apoptosis, autophagy, and inflammatory response by regulating miR-27a-3p/SLIT2 in lipopolysaccharide-treated vascular endothelial cells. J Surg Res. 2020;256:345–54.

    Article  CAS  PubMed  Google Scholar 

  33. Shen X, Li L, He Y, Lv X, Ma J. Raddeanin A inhibits proliferation, invasion, migration and promotes apoptosis of cervical cancer cells via regulating miR-224-3p/Slit2/Robo1 signaling pathway. Aging. 2021;13:7166–79.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Weinhäuser I, Pereira-Martins DA, Ortiz C, Silveira DR, Simões LAA, Bianco TM, et al. Reduced SLIT2 is associated with increased cell proliferation and arsenic trioxide resistance in acute promyelocytic leukemia. Cancers. 2020;12:3134.

    Article  PubMed Central  Google Scholar 

  35. Gołos A, Jesionek-Kupnicka D, Gil L, Braun M, Komarnicki M, Robak T, et al. The expression of the SLIT-ROBO family in adult patients with acute myeloid leukemia. Arch Immunol Ther Exp. 2019;67:109–23.

    Article  Google Scholar 

  36. Tavora B, Mederer T, Wessel KJ, Ruffing S, Sadjadi M, Missmahl M, et al. Tumoural activation of TLR3-SLIT2 axis in endothelium drives metastasis. Nature 2020;586:299–304.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Lu YF, Zhang L, Waye MM, Fu WM, Zhang JF. MiR-218 mediates tumorigenesis and metastasis: Perspectives and implications. Exp Cell Res. 2015;334:173–82.

    Article  CAS  PubMed  Google Scholar 

  38. Díaz-Beyá M, Navarro A, Ferrer G, Díaz T, Gel B, Camós M, et al. Acute myeloid leukemia with translocation (8;16)(p11;p13) and MYST3-CREBBP rearrangement harbors a distinctive microRNA signature targeting RET proto-oncogene. Leukemia. 2013;27:595–603.

    Article  PubMed  Google Scholar 

  39. Wang Y, Sun HH, Sui MH, Ma JJ. miR-218 inhibits acute promyelocytic leukemia cell growth by targeting BMI-1. Oncol Lett. 2017;14:8078–83.

    PubMed  PubMed Central  Google Scholar 

  40. Li Y, Liu S, Sun H, Yang Y, Qi H, Ding N, et al. MiR-218 inhibits erythroid differentiation and alters iron metabolism by targeting ALAS2 in K562 cells. Int J Mol Sci. 2015;16:28156–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Chen LL. Linking long noncoding RNA localization and function. Trends Biochem Sci. 2016;41:761–72.

    Article  CAS  PubMed  Google Scholar 

  42. Schmitt AM, Chang HY. Long noncoding RNAs in cancer pathways. Cancer Cell. 2016;29:452–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Bartel DP. MicroRNAs: genomics, biogenesis, mechanism, and function. Cell 2004;116:281–97.

    Article  CAS  PubMed  Google Scholar 

  44. Handschuh L, Wojciechowski P, Kazmierczak M, Lewandowski K. Transcript-level dysregulation of BCL2 family genes in acute myeloblastic leukemia. Cancers 2021;13:3175.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Chen SL, Qin ZY, Hu F, Wang Y, Dai YJ, Liang Y. The role of the HOXA gene family in acute myeloid leukemia. Genes. 2019;10:621.

    Article  CAS  PubMed Central  Google Scholar 

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Funding

The work was supported by National Natural Science Foundation of China (81900166, 81900163, 81970118), Zhenjiang Clinical Research Center of Hematology (SS2018009), Social Development Foundation of Zhenjiang (SH2020055, SH2021052), Medical Field of Zhenjiang “Jin Shan Ying Cai” Project, Medical Education Collaborative Innovation Fund of Jiangsu University (JDY2022011), Scientific Research Foundation of Affiliated People’s Hospital of Jiangsu University for PhD (KFB202002, KFB202202).

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JQ and J-DZ conceived and designed the experiments; T-JZ and X-MW performed the experiments; Z-JX analyzed the data and provided bioinformatics analysis; YG and QY collected the clinical data; J-CM and JL provided the technical and financial supports; T-JZ wrote the manuscript; J-DZ revised the manuscript; All authors read and approved the final manuscript.

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Correspondence to Jiang Lin, Jing-dong Zhou or Jun Qian.

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The present study approved by the Ethics Committee of the Affiliated People’s Hospital of Jiangsu University. Written informed consents were obtained from all enrolled individuals prior to their participation.

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Zhang, Tj., Xu, Zj., Wen, Xm. et al. SLIT2 promoter hypermethylation-mediated SLIT2-IT1/miR-218 repression drives leukemogenesis and predicts adverse prognosis in myelodysplastic neoplasm. Leukemia 36, 2488–2498 (2022). https://doi.org/10.1038/s41375-022-01659-1

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