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Kaastrup K, Gillberg L, Mikkelsen SU, Ørskov AD, Schöllkopf C, Mortensen BK, Porse B, Hansen JW, Grønbæk K. LEP promoter methylation in the initiation and progression of clonal cytopenia of undetermined significance and myelodysplastic syndrome. Clin Epigenetics 2023; 15:91. [PMID: 37237325 DOI: 10.1186/s13148-023-01505-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Idiopathic non-clonal cytopenia (ICUS) and clonal cytopenia (CCUS) are common in the elderly population. While these entities have similar clinical presentations with peripheral blood cytopenia and less than 10% bone marrow dysplasia, their malignant potential is different and the biological relationship between these disorders and myeloid neoplasms such as myelodysplastic syndrome (MDS) is not fully understood. Aberrant DNA methylation has previously been described to play a vital role in MDS and acute myeloid leukemia (AML) pathogenesis. In addition, obesity confers a poorer prognosis in MDS with inferior overall survival and a higher rate of AML transformation. In this study, we measured DNA methylation of the promoter for the obesity-regulated gene LEP, encoding leptin, in hematopoietic cells from ICUS, CCUS and MDS patients and healthy controls. We investigated whether LEP promoter methylation is an early event in the development of myeloid neoplasms and whether it is associated with clinical outcome. RESULTS We found that blood cells of patients with ICUS, CCUS and MDS all have a significantly hypermethylated LEP promoter compared to healthy controls and that LEP hypermethylation is associated with anemia, increased bone marrow blast percentage, and lower plasma leptin levels. MDS patients with a high LEP promoter methylation have a higher risk of progression, shorter progression-free survival, and inferior overall survival. Furthermore, LEP promoter methylation was an independent risk factor for the progression of MDS in a multivariate Cox regression analysis. CONCLUSION In conclusion, hypermethylation of the LEP promoter is an early and frequent event in myeloid neoplasms and is associated with a worse prognosis.
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Affiliation(s)
- Katja Kaastrup
- The Epi-/Genome Lab, Department of Hematology, Rigshospitalet, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation for Stem Cell Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Linn Gillberg
- The Epi-/Genome Lab, Department of Hematology, Rigshospitalet, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Stine U Mikkelsen
- The Epi-/Genome Lab, Department of Hematology, Rigshospitalet, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation for Stem Cell Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andreas D Ørskov
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | | | - Bo K Mortensen
- Department of Hematology, Herlev Hospital, Herlev, Denmark
| | - Bo Porse
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation for Stem Cell Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Finsen Laboratory, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob W Hansen
- The Epi-/Genome Lab, Department of Hematology, Rigshospitalet, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation for Stem Cell Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Grønbæk
- The Epi-/Genome Lab, Department of Hematology, Rigshospitalet, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark.
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark.
- The Novo Nordisk Foundation for Stem Cell Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Urup T, Gillberg L, Kaastrup K, Lü MJS, Michaelsen SR, Andrée Larsen V, Christensen IJ, Broholm H, Lassen U, Grønbaek K, Poulsen HS. Angiotensinogen promoter methylation predicts bevacizumab treatment response of patients with recurrent glioblastoma. Mol Oncol 2020; 14:964-973. [PMID: 32133779 PMCID: PMC7191184 DOI: 10.1002/1878-0261.12660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/30/2019] [Accepted: 03/02/2020] [Indexed: 11/07/2022] Open
Abstract
Patients with recurrent glioblastoma achieving response to bevacizumab combined with chemotherapy have clinical improvement and prolonged survival. High gene expression of angiotensinogen (AGT) is associated with a poor bevacizumab response. Because AGT expression is epigenetically regulated, we aimed to investigate whether AGT promoter methylation in tumor tissue predicts response to bevacizumab combination therapy in patients with recurrent glioblastoma. The study included 159 patients with recurrent glioblastoma, treated with bevacizumab combination treatment (training cohort, n = 77; validation cohort, n = 82). All patients could be evaluated for treatment response and biomarkers. DNA methylation of 4 CpG sites in the AGT promoter was measured using pyrosequencing. A model for nonresponse was established using logistic regression analysis. In the training cohort, lower methylation of each of the four CpG sites in the AGT promoter was significantly associated with nonresponse (all P < 0.05). Moreover, the mean methylation level of all four CpG sites was associated with an increased likelihood of not achieving response to bevacizumab combination therapy (twofold decrease: odds ratio = 3.01; 95% confidence interval: 1.41-6.44; P = 0.004). We developed a model for nonresponse in the training cohort, where a threshold of mean AGT promoter methylation levels was set to below 12%. The model could predict bevacizumab nonresponse with 96% specificity. Importantly, this predictor was also significantly associated with nonresponse in the validation cohort (P = 0.037). Taken together, our findings suggest that low AGT promoter methylation in tumor tissue predicts nonresponse to bevacizumab combination treatment in patients with recurrent glioblastoma. We have, thus, established and successfully validated a predictor for nonresponse that can be used to identify patients who will not benefit from bevacizumab combination therapy.
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Affiliation(s)
- Thomas Urup
- Department of Radiation Biology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark.,Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Linn Gillberg
- Department of Hematology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark.,Biotech Research and Innovation Centre (BRIC), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Katja Kaastrup
- Department of Hematology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark.,Biotech Research and Innovation Centre (BRIC), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maya Jeje Schuang Lü
- Department of Radiation Biology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Signe Regner Michaelsen
- Department of Radiation Biology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Vibeke Andrée Larsen
- Department of Radiology, Center of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | | | - Helle Broholm
- Department of Neuropathology, Center of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Lassen
- Department of Radiation Biology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark.,Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Grønbaek
- Department of Hematology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark.,Biotech Research and Innovation Centre (BRIC), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Skovgaard Poulsen
- Department of Radiation Biology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark.,Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
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Urup T, Gillberg L, Kaastrup K, Schuang Lü M, Regner Michaelsen S, Larsen VA, Jarle Christensen I, Broholm H, Lassen U, Grønbæk K, Skovgaard Poulsen H. PATH-28. ANGIOTENSINOGEN PROMOTER METHYLATION TO PREDICT BEVACIZUMAB RESPONSE IN RECURRENT GLIOBLASTOMA PATIENTS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Recurrent glioblastoma patients achieving response to bevacizumab combination therapy have clinical improvement and prolonged survival. High gene-expression of angiotensinogen (AGT) is associated with a poor response to bevacizumab combination therapy. Because AGT gene-expression is epigenetically regulated, we investigate if lower AGT promoter methylation in tumor tissue predicts a poor response to bevacizumab combination therapy in recurrent glioblastoma patients. Methods: Patients were assessed for eligibility using our clinical database comprising all recurrent glioblastoma patients consecutively treated with bevacizumab combination therapy at our center. The study included 159 response and biomarker evaluable patients: A training cohort of 77 patients and a validation cohort of 82 patients treated in the period between year 2005–2011 and 2012–2015. DNA methylation of 4 CpG sites in the AGT promoter was measured using pyrosequencing. Using logistic regression analysis, a predictive model for non-response was established. Results: In the training cohort, lower methylation of each of the four CpG sites was significantly associated with non-response (p < 0.05). Lower mean methylation of the AGT promoter was significantly associated with non-response (2-fold decrease: OR &eq; 3.01; 95% CI:1.41–6.44; p &eq; 0.004). A predictive model able to predict bevacizumab non-response in clinical practice was established. This predictor was significantly associated with non-response in the validation cohort (p &eq; 0.037). Conclusion: AGT promoter methylation is lower in tumor tissue from non-responsive recurrent glioblastoma patients treated with bevacizumab combination therapy. A predictive model for non-response was established and successfully validated. This model can be used to identify patients who will not benefit from bevacizumab combination therapy.
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Affiliation(s)
- Thomas Urup
- Department of Radiation Biology and Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Linn Gillberg
- Biotech Research and Innovation Centre (BRIC), Grønbæk Group, University of Copenhagen and Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Katja Kaastrup
- Biotech Research and Innovation Centre (BRIC), Grønbæk Group, University of Copenhagen and Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Maja Schuang Lü
- Department of Radiation Biology and Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Vibeke A Larsen
- Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ib Jarle Christensen
- Department of Gastroenterology, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
| | - Helle Broholm
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark
| | - Ulrik Lassen
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten Grønbæk
- Biotech Research and Innovation Centre (BRIC), Grønbæk Group, University of Copenhagen and Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Hans Skovgaard Poulsen
- Department of Radiation Biology and Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Kaastrup K, Gillberg L, Aslan D, Kristensen LS, Ørskov AD, Hansen JW, Grønbæk K. TERT PROMOTER METHYLATION AS A POTENTIAL PROGNOSTIC BIOMARKER FOR PROGRESSION OF UNEXPLAINED CYTOPENIA TO MDS AND AML. Hemasphere 2019. [DOI: 10.1097/02014419-201906001-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Radical polymerization reactions initiated by light can be used to provide signal amplification in molecular binding assays.
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Affiliation(s)
| | - H. D. Sikes
- Department of Chemical Engineering
- USA
- Program in Polymers and Soft Matter
- Massachusetts Institute of Technology
- Cambridge
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Kaastrup K, Sikes HD. Investigation of dendrimers functionalized with eosin as macrophotoinitiators for polymerization-based signal amplification reactions. RSC Adv 2015. [DOI: 10.1039/c4ra14466j] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Water-soluble macrophotoinitiators with up to 24 eosin substituents and one protein per dendrimer were assessed in interfacial binding assays.
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Affiliation(s)
- K. Kaastrup
- Department of Chemical Engineering
- Massachusetts Institute of Technology
- Cambridge
- USA
| | - H. D. Sikes
- Department of Chemical Engineering
- Massachusetts Institute of Technology
- Cambridge
- USA
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