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Shenoy N, Bhagat TD, Cheville J, Lohse C, Bhattacharyya S, Tischer A, Machha V, Gordon-Mitchell S, Choudhary G, Wong LF, Gross L, Ressigue E, Leibovich B, Boorjian SA, Steidl U, Wu X, Pradhan K, Gartrell B, Agarwal B, Pagliaro L, Suzuki M, Greally JM, Rakheja D, Thompson RH, Susztak K, Witzig T, Zou Y, Verma A. Ascorbic acid-induced TET activation mitigates adverse hydroxymethylcytosine loss in renal cell carcinoma. J Clin Invest 2019; 129:1612-1625. [PMID: 30702441 DOI: 10.1172/jci98747] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/24/2019] [Indexed: 12/31/2022] Open
Abstract
Although clear cell renal cell carcinoma (ccRCC) has been shown to result in widespread aberrant cytosine methylation and loss of 5-hydroxymethylcytosine (5hmC), the prognostic impact and therapeutic targeting of this epigenetic aberrancy has not been fully explored. Analysis of 576 primary ccRCC samples demonstrated that loss of 5hmC was strongly associated with aggressive clinicopathologic features and was an independent adverse prognostic factor. Loss of 5hmC also predicted reduced progression-free survival after resection of nonmetastatic disease. The loss of 5hmC in ccRCC was not due to mutational or transcriptional inactivation of ten eleven translocation (TET) enzymes, but to their functional inactivation by l-2-hydroxyglutarate (L2HG), which was overexpressed due to the deletion and underexpression of L2HG dehydrogenase (L2HGDH). Ascorbic acid (AA) reduced methylation and restored genome-wide 5hmC levels via TET activation. Fluorescence quenching of the recombinant TET-2 protein was unaffected by L2HG in the presence of AA. Pharmacologic AA treatment led to reduced growth of ccRCC in vitro and reduced tumor growth in vivo, with increased intratumoral 5hmC. These data demonstrate that reduced 5hmC is associated with reduced survival in ccRCC and provide a preclinical rationale for exploring the therapeutic potential of high-dose AA in ccRCC.
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Affiliation(s)
- Niraj Shenoy
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Tushar D Bhagat
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | | | | | | | | | | | - Gaurav Choudhary
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Li-Fan Wong
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | - Emily Ressigue
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | | | - Ulrich Steidl
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | - Kith Pradhan
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Benjamin Gartrell
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | | | - Masako Suzuki
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - John M Greally
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Dinesh Rakheja
- University of Texas Southwestern Medical School, Dallas, Texas, USA
| | | | - Katalin Susztak
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Yiyu Zou
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Amit Verma
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
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