Acute Leukemia Clinical Trial
Official title:
Expression of TET1 Gene in Acute Leukaemia
The aim of the present study is to detect the expression of TET 1 gene in patients with acute leukemia and its correlation with clinical and pathological criteria of the patients.
"Acute leukemia" is defined by the World Health organization standards, in which greater than
20% of the cells in the bone marrow are blasts (Kabuto et al., 2006). Cure is a realistic
goal and is achieved in more than 80% of affected children, although only 20-40% of adults
are cured(Rose-Inman and Kuehl, 2014).
There are two major forms of acute leukaemias—acute lymphoblastic leukaemia (ALL) and acute
myeloid leukaemia (AML) Acute lymphoblastic leukemia (ALL) is an acute form of
leukemiacharacterized by the overproduction and accumulation of cancerous, immature white
blood cells, known as lymphoblasts(Rose-Inman and Kuehl, 2014).
Internationally, ALL is more common in Caucasians than in Africans; it is more common in
Hispanics and in Latin America(Greer, 2014; Urayama and Manabe, 2014).About 6,000 cases are
reported in the United States every year(Inaba et al., 2013).
Acute Myeloid leukemia (AML)Acute Myeloid Leukemia is a cancer of leukemic stem cells (LSCs)
with a rapid progression. It is characterized by overproduction of immature myeloid cells in
bone marrow which crowds out normal hematopoietic stem cells (HSC) (Indian J Hematol Blood
Transfus. 2017).
DNA methylation is a covalent modification that is critical for the regulation of gene
expression in a wide variety of biological contexts (Jaenisch and Bird, 2003; Bergman and
Cedar, 2013). Methylation of DNA on cytosines is an important mechanism for silencing gene
expression, and cytosine demethylation is required for gene activation (Ito et al., 2011; He
et al., 2011). DNA methylation plays important roles in a variety of cellular processes,
including genomic imprinting , X-chromosome inactivation and regulation of gene expression
(Bird 2002).
The ten-eleven translocation (Tet) family of methylcytosine dioxygenases, which includes
Tet1, Tet2, and Tet3 enzymes, has been recently implicated in DNA demethylation it converts
5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) as well as to 5-formylcytosine and
5-carboxylcytosine (Tahiliani et al., 2009; Ito et al., 2010; Guo et al., 2011a). 5hmC has
been proposed to act as an intermediate in demethylation and the base-excision repair
machinery (Guo et al., 2011a).
Tet proteins contain several conserved domains (Tahiliani et al. 2009), including a CXXC
domain that has high affinity for clustered unmethylated CpG dinucleotides and a catalytic
domain that is typical of Fe(II)- and 2-oxoglutarate (2OG)-dependent dioxygenases (Loenarz
and Schofield 2011) ), mutation of iron-binding sites of Tet proteins abolishes their
enzymatic activities (Tahiliani et al. 2009; Ito et al. 2010). In addition,
2-hydroxyglutarate (2-HG), a competitive inhibitor of 2OG-dependent dioxygenases, suppresses
the catalytic activity of Tet proteins (W Xu et al. 2011).Both fully methylated and
hemimethylated DNA in a CG or non-CG context can serve as substrates for TET1 (Tahiliani et
al. 2009; Ficz et al. 2011; Pastor et al. 2011). In tumor cells, the normal pattern of DNA
methylation is often altered, resulting in global hypomethylation of the genome in
conjunction with hypermethylation at CpG islands within the promoters of critical genes such
as tumor suppressors (Esteller, 2008).
The TET1 gene, was initially identified in acute myeloid leukemia (AML) as a fusion partner
of the histone H3 Lys 4 (H3K4) methyltransferase MLL (mixed-lineage leukemia) (Ono et al.
2002; Lorsbach et al. 2003). TET1 is significantly upregulated and plays an oncogenic role in
MLL-rearranged leukemia, rendering TET1 as a potential target for treating this form of
hematopoietic malignancy ( Huang et al., 2013). Tet1 is abundantly expressed in hematopoietic
stem/progenitor cells (HSC/HPCs) and differentiated lineages such as B cells and myeloid
cells (Huang et al., 2013; Li et al., 2011 ; Moran-Crusio et al., 2011)
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