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NEOPLASIA
From the Abteilung "Organisation komplexer Genome,"
Deutsches Krebsforschungszentrum, Heidelberg, Germany; and Innere
Medizin III, University of Ulm, Ulm, Germany.
Loss of genomic material from chromosomal band 13q14.3 is the most
common genetic imbalance in B-cell chronic lymphocytic leukemia (B-CLL)
and mantle cell lymphoma, pointing to the involvement of this region in
a tumor suppressor mechanism. From the minimally deleted region, 3 candidate genes have been isolated, RFP2, BCMS, and BCMSUN. DNA sequence analyses have failed to detect
small mutations in any of these genes, suggesting a different
pathomechanism, most likely haploinsufficiency. We, therefore, tested
B-CLL patients for epigenetic aberrations by measuring expression of
genes from 13q14.3 and methylation of their promotor region.
RB1, CLLD7, KPNA3, CLLD6, and
RFP2 were down-regulated in B-CLL patients as compared with
B cells of healthy donors, with RFP2 showing the most
pronounced loss of expression. To test whether this loss of gene
expression is associated with methylation of CpG islands in the
respective promotor regions, we performed methylation-sensitive quantitative polymerase chain reaction analyses and bisulfite sequencing on DNA from B-CLL patients. No difference in the methylation patterns could be detected in any CpG island of the minimally deleted region. Down-regulation of genes within chromosomal
band 13q14.3 in B-CLL is in line with the concept of
haploinsufficiency, but this tumor-specific phenomenon is not
associated with DNA methylation.
(Blood. 2002;99:4116-4121) B-cell chronic lymphocytic leukemia (B-CLL), the
most frequent leukemia in the Western world, is cytogenetically well
characterized.1,2 There is a significant overlap between
the chromosomal alterations in B-CLL and mantle cell lymphoma
(MCL).3 The most frequent genomic imbalance is loss of
genetic material from chromosomal band 13q14, detected in more than
50% of B-CLL patients and almost 70% of MCL patients by fluorescence
in situ hybridization (FISH).3-5 It is, therefore, very
likely that this genomic region is involved in the pathogenesis of
B-CLL and MCL and harbors a tumor suppressor mechanism. In the search
for this tumor suppressor mechanism, several contigs of physically
overlapping DNA fragments have been constructed,5-9 and 3 candidate tumor suppressor genes were isolated: RFP2 (also
termed Leu5, CAR), BCMSUN (DLeu2,
t4, cDNA 1B4), and BCMS (Dleu1,
t5, cDNA 170C-70)5,7,9-12 (Figure
1 for overview ). Extensive mutation
analyses of the 3 candidate genes as well as the noncoding regions
failed to detect small genetic aberrations in B-CLL
patients10,13 (D.M. and S.W., unpublished
results, September 2001). Therefore, it has been considered
that the pathomechanism involving chromosomal band 13q14.3 in B-CLL and
MCL is based on haploinsufficiency and possibly is of epigenetic
nature; ie, it is not reflected in the primary sequence. Such a
mechanism has been shown, for example, in the CDNK2B/p15
gene in hematologic malignancies14-16: in many cases, no
point mutations are found in the CDKNB2/p15 gene, but gene
function is lost through genomic deletion or hypermethylation of both
alleles. The RB1 gene localized at chromosomal band
13q14.1-q14.2 can be inactivated in retinoblastoma by genomic deletion,
point mutation, or methylation.17 Silencing through
methylation has been detected for several other genes in a variety of
malignancies (for reviews, see Jones & Laird18 and Baylin
& Herman19). To test whether a similar mechanism of gene
repression with concomitant methylation is responsible for the proposed
tumor suppressor pathomechanism at chromosomal band 13q14.3 in B-CLL,
we analyzed the expression of the genes localized in this region and
the methylation of the respective CpG islands.
RNA isolation, reverse transcription, and real-time
polymerase chain reaction
Bisulfite conversion, real-time PCR, and
sequencing
Expression of the genes BCL2, RB1, CHC1L, KPNA3, RFP2,
BCMSUN, and BCMS (Figure 1) was measured by using
real-time quantitative PCR in patients with tumors that are biallelic
for the critical region at chromosomal band 13q14.3 (dis = disomic;
n = 6) or patients with loss of one allele (del; n = 16) assessed
by FISH. As internal standards, 12 housekeeping genes (18SrRNA,
RPLP0, ACTB, PPI, GAPD, PGK, B2M, GUSB, HPRT1, TBP, TFRC, and
LMNB1) were tested for expression in peripheral blood of a
healthy donor and 3 B-CLL patients. Expression of 18SrRNA and GAPD
varied substantially between the patients (Figure
2). In contrast, Lamin B1
(LMNB1; GDB ID 512 284), phosphoglycerokinase (PGK; CAA 23 835), and cyclophilin (PPI; EC
5.2.1.8) showed similar expression in all 4 patients (Figure 2) and
were, therefore, suitable as internal controls to normalize samples.
Expression of most genes at chromosomal band 13q14.3 varied
substantially among B-CLL cases (Figure
3). BCMS and BCMSUN
(exons B and 4, 5, and 7) are not significantly down-regulated in
B-CLL compared with sorted B cells of healthy donors. In contrast,
RB1, CLLD7, KPNA3, CLLD6, and RFP2 are
significantly down-regulated in B-CLL lymphocytes with loss of one
allele at chromosomal band 13q14.3 (Figure 3B). Expression of
RFP2 showed the most pronounced down-regulation (more than
10-fold less on average compared with control B cells). Of the genes
analyzed that are localized in the vicinity of the critical region,
RFP2 is the only gene that is down-regulated in all patients
disomic at chromosomal band 13q14.3 (more than 4-fold down-regulation
in B-CLL patients as compared with sorted B cells,
P < .0001; Figure 3B). Of the 3 genes, which are
localized within the minimally deleted region, only expression of
RFP2 is down-regulated in B-CLL patients. The correlation of
genetic aberrations with aberrant expression patterns in B-CLL points
at a pathomechanism in this region that is mediated by down-regulation
of gene expression. In addition, all investigated genes localized near
the minimally deleted region are significantly down-regulated in B-CLL
lymphocytes with loss of one allele at chromosomal band 13q14.3,
suggesting haploinsufficiency of this region as a pathomechanism
for B-CLL.
As loss of gene expression in neoplasia is often associated with
DNA methylation, we investigated the methylation pattern of the CpG
islands localized in the minimally deleted region and associated with
KPNA3, both localized in chromosomal band 13q14.3 as well as
the CpG island associated with BCL2, serving as
control.23 Of the methods for the detection of methylated
CpG islands,24,25 we chose a coupled bisulfite
quantitative PCR method that allows screening of a larger number of
patients and CpG islands26 (Figure 4A). By using nonconverted DNA,
bisulfite-converted DNA, and converted DNA pretreated with methylase,
methylation sensitivity of primers specific for the genes localized in
chromosomal band 13q14.3 could be shown (Figure 4B). Primers specific
for the ACTB and MYOD1 genes are methylation
insensitive and were used as internal controls.26
In 3 patient samples, 2 CpG islands were subjected to bisulfite sequencing to allow a detailed verification of the PCR approach.22 By using the coupled bisulfite quantitative PCR method, no significant
differences in methylation could be detected in B-CLL patients
(n = 23) compared with sorted B cells (n = 11) at any of the CpG
islands tested (see Figure 5 for
overview; results in Figure 6).
Even though the variability of DNA methylation is higher among B-CLL
patients compared with the sorted B cells, no methylation patterns
specific for B-CLL patients could be detected. Therefore, DNA
methylation in the critical region localized in chromosomal band
13q14.3 is not different in B-CLL lymphocytes compared with sorted B
cells (Figure 6B).
To verify this result and to rule out inhomogeneous methylation
patterns that cannot be detected in the PCR-based approach, the CpG
island associated with the RFP2 gene was completely
bisulfite sequenced in 3 B-CLL patients and partially in the
BCMS-associated CpG island (Figure 7 and data not shown).
Only clones carrying converted DNA inserts were analyzed for each PCR
product, and only 2 methylated cytosines could be detected in the
critical region at chromosomal band 13q14.3 (Figure
7), verifying that DNA-methylation
patterns of CpG islands localized in chromosomal band 13q14.3 do not
differ between normal B cells and B-CLL lymphocytes.
More than 50% of B-CLL and almost 70% of MCL patients show loss of genomic material from a critical region localized in chromosomal band 13q14.3.3,5,27 Therefore, this region is the prime candidate for containing genes that lead to the expansion of malignant B-cell clones in B-CLL and MCL patients. However, despite multiple efforts by several groups, no mutations were found in genes localized in this region in B-CLL patients5,10,13 that would fit the 2-hit model for tumor suppressor genes.28 This finding prompted us to search for epigenetic aberrations at chromosomal band 13q14.3 in B-CLL patients that could possibly identify the postulated tumor suppressor mechanism. Expression of the 3 genes located in the minimally deleted region was previously tested in B-CLL patients by Northern blot analysis: all patients showed RNA expression of BCMS and RFP2, whereas expression of the BCMSUN gene in B-CLL patients was below the detection limit of the analysis.13 However, our expression analysis of genes localized in the critical region and the near vicinity with the more sensitive quantitative real-time PCR method showed significant down-regulation of a number of genes in B-CLL patients with loss of one allele. Only RFP2 mRNA was significantly down-regulated in all B-CLL patients, including those disomic at 13q14. The RFP2 gene product is the homolog of the RET finger protein (RFP), which was cloned as the rearrangement partner of a tyrosine kinase, the RET protooncogene.29 The RFP protein has a tripartite motif: a RING-zinc-finger domain, which in other proteins has been shown to mediate ubiquitination (reviewed in Joazeiro & Weissman30), a B-box domain, and a coiled-coil domain, which were shown to interact with the enhancer of Polycomb (E(Pc)) and thus strongly repress gene expression.31 To further elucidate the expression pattern of the respective region within 13q13.4, the mode of RFP2 down-regulation in B-CLL patients is of particular interest. Loss of expression has been shown in a variety of genes and tumors to be associated with methylation of the respective CpG islands (for review, see Jones & Laird18 and Baylin & Herman19). In B-CLL, genome-wide hypomethylation32 and hypomethylation of the BCL2 gene, an inhibitor of apoptosis, have been reported together with up-regulation of the BCL2 protein.23 We used real-time PCR to measure methylation of a small set of CpG dinucleotides localized in chromosomal band 13q14.3 in a larger group of patients combined with qualitative screening by bisulfite sequencing of 2 CpG islands in the minimally deleted region of 3 selected patients. No consistent B-CLL-specific methylation patterns were detected with either method. However, methylation of small regions within CpG islands that escapes detection by the methylation-specific PCR cannot be strictly excluded. Furthermore, it cannot be ruled out that the 3 B-CLL patients might not represent the entire range of alterations in B-CLL, or methylation occurs outside of the sequenced DNA segments. However, the data we present strongly argue for an involvement of RFP2 in the pathomechanism of B-CLL because of the frequent loss of genetic material harboring the gene in B-CLL patients and its significant down-regulation in B-CLL patients without detectable loss of the gene as compared with the other genes localized in the vicinity of the critical region that are not down-regulated in these patients. The down-regulation of RFP2 gene expression is independent of methylation in the minimally deleted region. It is intriguing that the majority of the genes localized in the vicinity of the minimally deleted region have homologs, which are involved in regulation of chromatin condensation, such as the homolog of the RFP2 gene, RFP,31 CHC1L,33 CLLD7 and 8,34 and KPNA3.35 Genes involved in the regulation of chromatin condensation have been found defective in acute lymphocytic leukemia (MLL alias HRX36 alias ALL137), a disease with genomic translocations near the BCMS gene,38 and in MCL (BMI-139). Clustering of genes involved in chromatin condensation near the minimally deleted region in B-CLL suggests the existence of a functional unit localized at 13q14.3. If this is the case, loss of expression of RFP2 could be an early event, which is enhanced in B-CLL patients by later genetic loss of the remaining functional unit. For functional analysis of the pathomechanism involving the critical region localized at chromosomal band 13q14.3, it might, therefore, be worthwhile to investigate the chromatin status of this genomic region.
We thank Frank Lyko and Ruthild G. Weber for helpful discussions and Christian Korz as well as Armin Pscherer for support.
Submitted September 6, 2001; accepted January 25, 2002.
Supported by grants 01KW9935, 01KW9937, and 01SF9903/3 from the Bundesministerium für Bildung und Forschung (BMBF) and by the European Union (EU) QLG1-CT-2000-00687.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: Peter Lichter, Abteilung "Organisation komplexer Genome" (H0700), Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany; e-mail: p.lichter{at}dkfz-heidelberg.de.
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© 2002 by The American Society of Hematology.
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