1 6693 128 VARIABLE INDUCTION OF PRDM1 AND DIFFERENTIATION IN CHRONIC LYMPHOCYTIC LEUKEMIA IS ASSOCIATED WITH ANERGY. DESPITE ANTIGEN ENGAGEMENT AND INTACT B-CELL-RECEPTOR (BCR) SIGNALING, CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) CELLS FAIL TO UNDERGO TERMINAL DIFFERENTIATION. WE HYPOTHESIZED THAT SUCH FAILURE MAY BE DUE TO ANERGY, AS CLL CELLS EXHIBIT VARIABLE LEVELS OF NONRESPONSIVENESS TO SURFACE IGM STIMULATION THAT IS REVERSIBLE IN VITRO. MOREOVER, ANERGY IS ASSOCIATED WITH REDUCED DIFFERENTIATION CAPACITY IN NORMAL B CELLS. WE INVESTIGATED RESPONSES OF CLL CELLS TO TWO POTENT DIFFERENTIATION-PROMOTING AGENTS, IL-21 AND CYTOSINE GUANINE DINUCLEOTIDE-ENRICHED OLIGO-DEOXYNUCLEOTIDES. THE INDUCTION OF PR DOMAIN-CONTAINING PROTEIN 1 (PRDM1; ALSO KNOWN AS BLIMP-1), A CRITICAL REGULATOR OF PLASMACYTIC DIFFERENTIATION, BY THESE AGENTS WAS CLOSELY CORRELATED BUT VARIED BETWEEN INDIVIDUAL CASES, DESPITE FUNCTIONALLY INTACT IL-21 RECEPTOR- AND TOLL-LIKE RECEPTOR 9-MEDIATED SIGNAL TRANSDUCER AND ACTIVATOR OF TRANSCRIPTION 3, AND NUCLEAR FACTOR-KAPPAB PATHWAYS. PRDM1 INDUCTION WAS INVERSELY CORRELATED WITH THE EXTENT OF ANERGY AS MEASURED BY THE ABILITY TO MOBILIZE INTRACELLULAR CA(2+) FOLLOWING BCR CROSSLINKING. PRDM1 RESPONSIVENESS WAS ASSOCIATED WITH OTHER MARKERS OF DIFFERENTIATION AND PROLIFERATION BUT NOT WITH DIFFERENCES IN APOPTOSIS. THE ABILITY TO INDUCE PRDM1 DID CORRELATE WITH DIFFERENTIAL TRANSCRIPTIONAL AND EPIGENETIC REGULATION OF THE PRDM1 GENE. THESE STUDIES EXTEND OUR UNDERSTANDING OF CLL PATHOBIOLOGY, DEMONSTRATING THAT REDUCED DIFFERENTIATION CAPACITY MAY BE A CONSEQUENCE OF ANERGY. EPIGENETIC DRUGS MAY OFFER POSSIBILITIES TO REACTIVATE PRDM1 EXPRESSION AS PART OF NOVEL DIFFERENTIATION THERAPY APPROACHES. 2014 2 5223 40 PRIMARY MURINE CD4+ T CELLS FAIL TO ACQUIRE THE ABILITY TO PRODUCE EFFECTOR CYTOKINES WHEN ACTIVE RAS IS PRESENT DURING TH1/TH2 DIFFERENTIATION. CONSTITUTIVE RAS SIGNALING HAS BEEN SHOWN TO AUGMENT IL-2 PRODUCTION, REVERSE ANERGY, AND FUNCTIONALLY REPLACE MANY ASPECTS OF CD28 CO-STIMULATION IN CD4+ T CELLS. THESE DATA RAISE THE POSSIBILITY THAT INTRODUCTION OF ACTIVE RAS INTO PRIMARY T CELLS MIGHT RESULT IN IMPROVED FUNCTIONALITY IN PATHOLOGIC SITUATIONS OF T CELL DYSFUNCTION, SUCH AS CANCER OR CHRONIC VIRAL INFECTION. TO TEST THE BIOLOGIC EFFECTS OF ACTIVE RAS IN PRIMARY T CELLS, CD4+ T CELLS FROM COXSACKIE-ADENOVIRUS RECEPTOR TRANSGENIC MICE WERE TRANSDUCED WITH AN ADENOVIRUS ENCODING ACTIVE RAS. AS EXPECTED, ACTIVE RAS AUGMENTED IL-2 PRODUCTION IN NAIVE CD4+ T CELLS. HOWEVER, WHEN CELLS WERE CULTURED FOR 4 DAYS UNDER CONDITIONS TO PROMOTE EFFECTOR CELL DIFFERENTIATION, ACTIVE RAS INHIBITED THE ABILITY OF CD4+ T CELLS TO ACQUIRE A TH1 OR TH2 EFFECTOR CYTOKINE PROFILE. THIS DIFFERENTIATION DEFECT WAS NOT DUE TO DEFICIENT STAT4 OR STAT6 ACTIVATION BY IL-12 OR IL-4, RESPECTIVELY, NOR WAS IT ASSOCIATED WITH DEFICIENT INDUCTION OF T-BET AND GATA-3 EXPRESSION. IMPAIRED EFFECTOR CYTOKINE PRODUCTION IN ACTIVE RAS-TRANSDUCED CELLS WAS ASSOCIATED WITH DEFICIENT DEMETHYLATION OF THE IL-4 GENE LOCUS. OUR RESULTS INDICATE THAT, DESPITE AUGMENTING ACUTE ACTIVATION OF NAIVE T CELLS, CONSTITUTIVE RAS SIGNALING INHIBITS THE ABILITY OF CD4+ T CELLS TO PROPERLY DIFFERENTIATE INTO TH1/TH2 EFFECTOR CYTOKINE-PRODUCING CELLS, IN PART BY INTERFERING WITH EPIGENETIC MODIFICATION OF EFFECTOR GENE LOCI. ALTERNATIVE STRATEGIES TO POTENTIATE RAS PATHWAY SIGNALING IN T CELLS IN A MORE REGULATED FASHION SHOULD BE CONSIDERED AS A THERAPEUTIC APPROACH TO IMPROVE IMMUNE RESPONSES IN VIVO. 2014 3 5058 36 PHENOTYPIC ALTERATION OF CD8+ T CELLS IN CHRONIC LYMPHOCYTIC LEUKEMIA IS ASSOCIATED WITH EPIGENETIC REPROGRAMMING. IMMUNOSUPPRESSION IS A PREVALENT CLINICAL FEATURE IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) PATIENTS, WITH MANY PATIENTS DEMONSTRATING INCREASED SUSCEPTIBILITY TO INFECTIONS AS WELL AS INCREASED FAILURE OF AN ANTITUMOR IMMUNE RESPONSE. HOWEVER, MUCH IS CURRENTLY NOT UNDERSTOOD REGARDING THE PRECISE MECHANISMS THAT ATTRIBUTE TO THIS IMMUNOSUPPRESSIVE PHENOTYPE IN CLL. TO PROVIDE FURTHER CLARITY TO THIS PARTICULAR PHENOMENON, WE ANALYZED THE T-CELL PROFILE OF CLL PATIENT SAMPLES WITHIN A LARGE COHORT AND OBSERVED THAT PATIENTS WITH AN INVERTED CD4/CD8 RATIO HAD A SHORTER TIME TO FIRST TREATMENT AS WELL AS OVERALL SURVIVAL. THESE OBSERVATIONS COINCIDED WITH HIGHER EXPRESSION OF THE IMMUNE CHECKPOINT RECEPTOR PD-1 IN CLL PATIENT CD8+ T CELLS WHEN COMPARED TO AGE-MATCHED HEALTHY DONORS. INTERESTINGLY, WE DISCOVERED THAT INCREASED PD-1 EXPRESSION IN CD8+ T CELLS CORRESPONDS WITH DECREASED DNA METHYLATION LEVELS IN A DISTAL UPSTREAM LOCUS OF THE PD-1 GENE PDCD1. FURTHER ANALYSIS USING LUCIFERASE REPORTER ASSAYS SUGGESTS THAT THE IDENTIFIED PDCD1 DISTAL UPSTREAM REGION ACTS AS AN ENHANCER FOR PDCD1 TRANSCRIPTION AND THIS REGION BECOMES DEMETHYLATED DURING ACTIVATION OF NAIVE CD8+ T CELLS BY ANTI-CD3/ANTI-CD28 ANTIBODIES AND IL2. FINALLY, WE CONDUCTED A GENOME-WIDE DNA METHYLATION ANALYSIS COMPARING CD8+ T CELLS FROM CLL PATIENTS AGAINST HEALTHY DONORS AND IDENTIFIED ADDITIONAL DIFFERENTIALLY METHYLATED GENES WITH KNOWN IMMUNE REGULATORY FUNCTIONS INCLUDING CCR6 AND KLRG1. TAKEN TOGETHER, OUR FINDINGS REVEAL THE OCCURRENCE OF EPIGENETIC REPROGRAMMING TAKING PLACE WITHIN CLL PATIENT CD8+ T CELLS AND HIGHLIGHT THE POTENTIAL MECHANISM OF HOW IMMUNOSUPPRESSION IS ACCOMPLISHED IN CLL. 2016 4 5477 31 RESTORING THE FUNCTIONAL IMMUNOGENICITY OF CHRONIC LYMPHOCYTIC LEUKEMIA USING EPIGENETIC MODIFIERS. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS A MALIGNANCY ARISING FROM IMMUNE CELLS (B-LYMPHOCYTES) ENDOWED WITH INTRINSIC ANTIGEN-PRESENTING CAPABILITIES. SUCH A FUNCTION HOWEVER IS LOST DURING MALIGNANT TRANSFORMATION AND CLL CELLS ARE WELL KNOWN FOR THEIR INABILITY TO PROCESS AND PRESENT ANTIGENS TO THE T-CELL ARM OF THE IMMUNE SYSTEM. INSTEAD, MALIGNANT CLL CELLS ELICIT A VAST ARRAY OF IMMUNE REGULATORY MECHANISMS CONDUCIVE TO T-CELL DYSFUNCTION AND IMMUNOSUPPRESSION. PREVIOUSLY, WE HAVE SHOWN THAT TREATMENT OF CLL CELLS WITH THE DEMETHYLATING AGENT 5-AZA-2'-DEOXYCYTIDINE UNLEASHED TARGET ANTIGEN EXPRESSION. HERE WE SHOW FOR THE FIRST TIME THAT COMBINING TWO EPIGENETIC MODIFIERS, 5-AZA-2'-DEOXYCYTIDINE AND THE HISTONE DEACETYLASE INHIBITOR LAQ824 EFFECTIVELY RESTORES THE IMMUNOGENICITY OF CLL CELL LINES AS WELL AS PRIMARY CELLS OBTAINED FROM CLL PATIENTS. INDEED, SUCH A COMBINATION INDUCES THE EXPRESSION OF NOVEL AND HIGHLY ANTIGENIC CANCER-TESTIS ANTIGENS (CTAS) AND COSTIMULATORY MOLECULES. THESE CHANGES FACILITATE THE FORMATION OF ROBUST SUPRAMOLECULAR ACTIVATION COMPLEXES (SMAC) BETWEEN CLL CELLS AND RESPONDER T-CELLS LEADING TO INTRACELLULAR SIGNALING, LYTIC GRANULE MOBILIZATION, AND POLARIZATION OF FUNCTIONAL AND RELEVANT T-CELL RESPONSES. THIS CASCADE OF T-CELL ACTIVATING EVENTS TRIGGERED BY CLL CELLS WITH RESTORED APC FUNCTION, POINTS TO COMBINED EPIGENETIC MODIFIER TREATMENT AS A POTENTIAL IMMUNOTHERAPEUTIC STRATEGY FOR CLL PATIENTS. 2011 5 1976 28 EPIGENETIC ALTERATIONS IN A MURINE MODEL FOR CHRONIC LYMPHOCYTIC LEUKEMIA. EARLY STAGES IN THE DEVELOPMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) HAVE NOT BEEN EXPLORED MAINLY DUE TO THE INABILITY TO STUDY NORMAL B-CELLS EN ROUTE TO TRANSFORMATION. IN ORDER TO DETERMINE SUCH EARLY EVENTS OF LEUKEMOGENESIS, WE HAVE USED A WELL ESTABLISHED MOUSE MODEL FOR CLL. OVER-EXPRESSION OF HUMAN TCL1, A KNOWN CLL ONCOGENE IN MURINE B-CELLS LEADS TO THE DEVELOPMENT OF MATURE CD19+/CD5+/IGM+ CLONAL LEUKEMIA WITH A DISEASE PHENOTYPE SIMILAR TO THAT SEEN IN HUMAN CLL. HEREIN, WE REVIEW OUR RECENT STUDY USING THIS TCL1-DRIVEN MOUSE MODEL FOR CLL AND CORRESPONDING HUMAN CLL SAMPLES IN A CROSS-SPECIES EPIGENOMICS APPROACH TO ADDRESS THE TIMING AND RELEVANCE OF EPIGENETIC EVENTS OCCURRING DURING LEUKEMOGENESIS. WE DEMONSTRATED THAT THE MOUSE MODEL RECAPITULATES THE EPIGENETIC EVENTS THAT HAVE BEEN REPORTED FOR HUMAN CLL, AFFIRMING THE POWER AND VALIDITY OF THIS MOUSE MODEL TO STUDY EARLY EPIGENETIC EVENTS IN CANCER PROGRESSION. EPIGENETIC ALTERATIONS ARE DETECTED AS EARLY AS THREE MONTHS AFTER BIRTH, FAR BEFORE DISEASE MANIFESTS AT ABOUT 11 MONTHS OF AGE. THESE MICE UNDERGO NFKAPPAB REPRESSOR COMPLEX MEDIATED INACTIVATION OF THE TRANSCRIPTION FACTOR FOXD3, WHOSE TARGETS BECOME ABERRANTLY METHYLATED AND SILENCED IN MOUSE AND HUMAN CLL. OVERALL, OUR DATA SUGGEST THE ACCUMULATED EPIGENETIC ALTERATIONS DURING CLL PATHOGENESIS AS A CONSEQUENCE OF GENE SILENCING THROUGH TCL1 AND NFKAPPAB REPRESSOR COMPLEX, SUGGESTING THE RELEVANCE FOR NFKAPPAB AS A THERAPEUTIC TARGET IN CLL. 2009 6 1533 27 DNA METHYLATION DYNAMICS DURING B CELL MATURATION UNDERLIE A CONTINUUM OF DISEASE PHENOTYPES IN CHRONIC LYMPHOCYTIC LEUKEMIA. CHARTING DIFFERENCES BETWEEN TUMORS AND NORMAL TISSUE IS A MAINSTAY OF CANCER RESEARCH. HOWEVER, CLONAL TUMOR EXPANSION FROM COMPLEX NORMAL TISSUE ARCHITECTURES POTENTIALLY OBSCURES CANCER-SPECIFIC EVENTS, INCLUDING DIVERGENT EPIGENETIC PATTERNS. USING WHOLE-GENOME BISULFITE SEQUENCING OF NORMAL B CELL SUBSETS, WE OBSERVED BROAD EPIGENETIC PROGRAMMING OF SELECTIVE TRANSCRIPTION FACTOR BINDING SITES COINCIDENT WITH THE DEGREE OF B CELL MATURATION. BY COMPARING NORMAL B CELLS TO MALIGNANT B CELLS FROM 268 PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), WE SHOWED THAT TUMORS DERIVE LARGELY FROM A CONTINUUM OF MATURATION STATES REFLECTED IN NORMAL DEVELOPMENTAL STAGES. EPIGENETIC MATURATION IN CLL WAS ASSOCIATED WITH AN INDOLENT GENE EXPRESSION PATTERN AND INCREASINGLY FAVORABLE CLINICAL OUTCOMES. WE FURTHER UNCOVERED THAT MOST PREVIOUSLY REPORTED TUMOR-SPECIFIC METHYLATION EVENTS ARE NORMALLY PRESENT IN NON-MALIGNANT B CELLS. INSTEAD, WE IDENTIFIED A POTENTIAL PATHOGENIC ROLE FOR TRANSCRIPTION FACTOR DYSREGULATION IN CLL, WHERE EXCESS PROGRAMMING BY EGR AND NFAT WITH REDUCED EBF AND AP-1 PROGRAMMING IMBALANCES THE NORMAL B CELL EPIGENETIC PROGRAM. 2016 7 5030 36 PERSPECTIVES ON PRECISION MEDICINE IN CHRONIC LYMPHOCYTIC LEUKEMIA: TARGETING RECURRENT MUTATIONS-NOTCH1, SF3B1, MYD88, BIRC3. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS HIGHLY HETEROGENEOUS, WITH EXTREMELY VARIABLE CLINICAL COURSE. THE CLINICAL HETEROGENEITY OF CLL REFLECTS DIFFERENCES IN THE BIOLOGY OF THE DISEASE, INCLUDING CHROMOSOMAL ALTERATIONS, SPECIFIC IMMUNOPHENOTYPIC PATTERNS AND SERUM MARKERS. THE APPLICATION OF NEXT-GENERATION SEQUENCING TECHNIQUES HAS DEMONSTRATED THE HIGH GENETIC AND EPIGENETIC HETEROGENEITY IN CLL. THE NOVEL MUTATIONS COULD BE PHARMACOLOGICALLY TARGETED FOR INDIVIDUALIZED APPROACH IN SOME OF THE CLL PATIENTS. POTENTIAL NEUROGENIC LOCUS NOTCH HOMOLOG PROTEIN 1 (NOTCH1) SIGNALLING TARGETING MECHANISMS IN CLL INCLUDE SECRETASE INHIBITORS AND SPECIFIC ANTIBODIES TO BLOCK NOTCH LIGAND/RECEPTOR INTERACTIONS. IN VITRO STUDIES CHARACTERIZING THE EFFECT OF THE SPLICING INHIBITORS RESULTED IN INCREASED APOPTOSIS OF CLL CELLS REGARDLESS OF SPLICING FACTOR 3B SUBUNIT 1 (SF3B1) STATUS. SEVERAL THERAPEUTIC STRATEGIES HAVE BEEN ALSO PROPOSED TO DIRECTLY OR INDIRECTLY INHIBIT THE TOLL-LIKE RECEPTOR/MYELOID DIFFERENTIATION PRIMARY RESPONSE GENE 88 (TLR/MYD88) PATHWAY. ANOTHER POTENTIAL APPROACH IS TARGETING NUCLEAR FACTOR KAPPA-LIGHT-CHAIN-ENHANCER OF ACTIVATED B CELLS (NF-KAPPAB) AND INHIBITION OF THIS PROSURVIVAL PATHWAY. NEWLY DISCOVERED MUTATIONS AND THEIR SIGNALLING PATHWAYS PLAY KEY ROLES IN THE COURSE OF THE DISEASE. THIS OPENS NEW OPPORTUNITIES IN THE MANAGEMENT AND TREATMENT OF CLL. 2021 8 3822 28 INVESTIGATING EPIGENETIC EFFECTS OF ACTIVATION-INDUCED DEAMINASE IN CHRONIC LYMPHOCYTIC LEUKEMIA. ACTIVATION INDUCED DEAMINASE (AID) HAS TWO DISTINCT AND WELL DEFINED ROLES, BOTH RELYING ON ITS DEOXYCYTIDINE (DC) DEAMINATING FUNCTION: ONE AS A DNA MUTATOR AND ANOTHER IN DNA DEMETHYLATION. IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), AID WAS PREVIOUSLY SHOWN TO BE AN INDEPENDENT NEGATIVE PROGNOSTIC FACTOR. WHILE THERE IS SUBSTANTIAL IMPACT ON DNA MUTATIONS, EFFECTS OF AID ON GENE EXPRESSION BY PROMOTER DEMETHYLATION OF DISEASE RELATED TARGET GENES IN LEUKEMIA HAS NOT BEEN ADDRESSED. TO SHED LIGHT ON THIS QUESTION, WE AIMED AT DETERMINING GENOME WIDE METHYLATION CHANGES AS WELL AS GENE EXPRESSION CHANGES IN RESPONSE TO AID EXPRESSION IN CLL. ALTHOUGH WE FOUND MINOR DIFFERENCES IN INDIVIDUAL METHYLATION VARIABLE POSITIONS FOLLOWING AID EXPRESSION, WE COULD NOT FIND RECURRENT METHYLATION CHANGES OF SPECIFIC TARGET SITES OR CHANGES IN GLOBAL METHYLATION. 2018 9 4695 36 NF-KAPPAB ACTIVATION IN CHRONIC LYMPHOCYTIC LEUKEMIA: A POINT OF CONVERGENCE OF EXTERNAL TRIGGERS AND INTRINSIC LESIONS. THE NUCLEAR FACTOR-KAPPAB (NF-KAPPAB) PATHWAY IS CONSTITUTIVELY ACTIVATED IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) PATIENTS, AND HENCE PLAYS A MAJOR ROLE IN DISEASE DEVELOPMENT AND EVOLUTION. IN CONTRAST TO MANY OTHER MATURE B-CELL LYMPHOMAS, ONLY A FEW RECURRENTLY MUTATED GENES INVOLVED IN CANONICAL OR NON-CANONICAL NF-KAPPAB ACTIVATION HAVE BEEN IDENTIFIED IN CLL (I.E. BIRC3, MYD88 AND NFKBIE MUTATIONS) AND OFTEN AT A LOW FREQUENCY. ON THE OTHER HAND, CLL B CELLS SEEM 'ADDICTED' TO THE TUMOR MICROENVIRONMENT FOR THEIR SURVIVAL AND PROLIFERATION, WHICH IS PRIMARILY MEDIATED BY INTERACTION THROUGH A NUMBER OF CELL SURFACE RECEPTORS, E.G. THE B-CELL RECEPTOR (BCR), TOLL-LIKE RECEPTORS AND CD40, THAT IN TURN ACTIVATE DOWNSTREAM NF-KAPPAB. THE IMPORTANCE OF CELL-EXTRINSIC TRIGGERING FOR CLL PATHOPHYSIOLOGY WAS RECENTLY ALSO HIGHLIGHTED BY THE CLINICAL EFFICACY OF NOVEL DRUGS TARGETING MICROENVIRONMENTAL INTERACTIONS THROUGH THE INHIBITION OF BCR SIGNALING. IN OTHER WORDS, CLL CAN BE CONSIDERED A PROTOTYPE DISEASE FOR STUDYING THE INTRICATE INTERPLAY BETWEEN EXTERNAL TRIGGERS AND INTRINSIC ABERRATIONS AND THEIR COMBINED IMPACT ON DISEASE EVOLUTION. IN THIS REVIEW, WE WILL DISCUSS THE CURRENT UNDERSTANDING OF MECHANISMS UNDERLYING NF-KAPPAB DEREGULATION IN CLL, INCLUDING MICRO-ENVIRONMENTAL, GENETIC AND EPIGENETIC EVENTS, AND SUMMARIZE DATA GENERATED IN MURINE MODELS RESEMBLING HUMAN CLL. FINALLY, WE WILL ALSO DISCUSS DIFFERENT STRATEGIES UNDERTAKEN TO INTERVENE WITH THE NF-KAPPAB PATHWAY AND ITS UPSTREAM MEDIATORS. 2016 10 1068 29 CLL INTRACLONAL FRACTIONS EXHIBIT ESTABLISHED AND RECENTLY ACQUIRED PATTERNS OF DNA METHYLATION. INTRACLONAL SUBPOPULATIONS OF CIRCULATING CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) CELLS WITH DIFFERENT PROLIFERATIVE HISTORIES AND RECIPROCAL SURFACE EXPRESSION OF CXCR4 AND CD5 HAVE BEEN OBSERVED IN THE PERIPHERAL BLOOD OF CLL PATIENTS AND NAMED PROLIFERATIVE (PF), INTERMEDIATE (IF), AND RESTING (RF) CELLULAR FRACTIONS. HERE, WE FOUND THAT THESE INTRACLONAL CIRCULATING FRACTIONS SHARE PERSISTENT DNA METHYLATION SIGNATURES LARGELY ASSOCIATED WITH THE MUTATION STATUS OF THE IMMUNOGLOBULIN HEAVY CHAIN LOCUS (IGHV) AND THEIR ORIGINS FROM DISTINCT STAGES OF DIFFERENTIATION OF ANTIGEN-EXPERIENCED B CELLS. INCREASED LEUKEMIC BIRTH RATE, HOWEVER, SHOWED A VERY LIMITED IMPACT ON DNA METHYLATION OF CIRCULATING CLL FRACTIONS INDEPENDENT OF IGHV MUTATION STATUS. ADDITIONALLY, DNA METHYLATION HETEROGENEITY INCREASED AS LEUKEMIC CELLS ADVANCED FROM PF TO RF IN THE PERIPHERAL BLOOD. THIS FREQUENTLY CO-OCCURRED WITH HETEROCHROMATIN HYPOMETHYLATION AND HYPERMETHYLATION OF POLYCOMB-REPRESSED REGIONS IN THE PF, SUGGESTING ACCUMULATION OF LONGEVITY-ASSOCIATED EPIGENETIC FEATURES IN RECENTLY BORN CELLS. ON THE OTHER HAND, TRANSCRIPTIONAL DIFFERENCES BETWEEN PAIRED INTRACLONAL FRACTIONS CONFIRMED THEIR PROLIFERATIVE EXPERIENCE AND FURTHER SUPPORTED A LINEAR ADVANCEMENT FROM PF TO RF IN THE PERIPHERAL BLOOD. SEVERAL OF THESE DIFFERENTIALLY EXPRESSED GENES SHOWED UNIQUE ASSOCIATIONS WITH CLINICAL OUTCOME NOT EVIDENT IN THE BULK CLONE, SUPPORTING THE PATHOLOGICAL AND THERAPEUTIC RELEVANCE OF STUDYING INTRACLONAL CLL FRACTIONS. WE CONCLUDE THAT INDEPENDENT METHYLATION AND TRANSCRIPTIONAL LANDSCAPES REFLECT BOTH PREEXISTING CELL-OF-ORIGIN FINGERPRINTS AND MORE RECENTLY ACQUIRED HALLMARKS ASSOCIATED WITH THE LIFE CYCLE OF CIRCULATING CLL CELLS. 2020 11 2380 28 EPIGENETIC REGULATION OF WNT SIGNALING IN CHRONIC LYMPHOCYTIC LEUKEMIA. CERTAIN WNT AND WNT NETWORK TARGET GENES ARE EXPRESSED AT HIGHER OR LOWER LEVELS IN CHRONIC LYMPHOCYTIC LEUKEMIA COMPARED WITH NORMAL B-CELLS. THIS INCLUDES UPREGULATION OF NUCLEAR COMPLEX GENES, AS WELL AS GENES FOR CYTOPLASMIC PROTEINS AND WNT LIGANDS AND THEIR COGNATE RECEPTORS. IN ADDITION, EPIGENETIC SILENCING OF SEVERAL NEGATIVE REGULATORS OF THE WNT PATHWAY HAVE BEEN IDENTIFIED. THE BALANCE BETWEEN EPIGENETIC DOWNREGULATION OF NEGATIVE EFFECTOR GENES AND INCREASED EXPRESSION OF POSITIVE EFFECTOR GENES DEMONSTRATE THAT THE EPIGENETIC DOWNREGULATION OF WNT ANTAGONISTS IS ONE MECHANISM, PERHAPS THE MAIN MECHANISM, THAT IS PERMISSIVE TO ACTIVE WNT SIGNALING IN CHRONIC LYMPHOCYTIC LEUKEMIA. MOREOVER, CONSTITUTIVE ACTIVATION OF THE WNT NETWORK AND TARGET GENES IS LIKELY TO IMPACT ON ADDITIONAL INTERACTING SIGNALING PATHWAYS. BASED ON PUBLISHED STUDIES, WE PROPOSE A MODEL OF WNT SIGNALING THAT INVOLVES MAINLY PERMISSIVE EXPRESSION, AND SOMETIMES OVEREXPRESSION, OF POSITIVE EFFECTORS AND DOWNREGULATION OF NEGATIVE REGULATORS IN THE NETWORK. IN THIS MODEL, DNA METHYLATION, HISTONE MODIFICATIONS AND ALTERED EXPRESSION OF MICRORNA MOLECULES INTERACT TO ALLOW CONTINUOUS WNT SIGNALING. 2010 12 2114 33 EPIGENETIC HETEROCHROMATIN MARKERS DISTINGUISH TERMINALLY DIFFERENTIATED LEUKOCYTES FROM INCOMPLETELY DIFFERENTIATED LEUKEMIA CELLS IN HUMAN BLOOD. OBJECTIVE: DURING TERMINAL CELL DIFFERENTIATION, NUCLEAR CHROMATIN BECOMES CONDENSED AND THE REPERTOIRE OF EPIGENTIC HETEROCHROMATIN PROTEINS RESPONSIBLE FOR CHROMATIN CONDENSATION IS DRAMATICALLY CHANGED. IN ORDER TO IDENTIFY THE CHROMATIN REGULATORY FACTORS ASSOCIATED WITH INCOMPLETE CELL DIFFERENTIATION AND IMPAIRED CHROMATIN CONDENSATION IN HEMATOLOGICAL MALIGNANCIES, WE EXAMINED EXPRESSION LEVELS OF MAJOR HETEROCHROMATIN PROTEINS IN NORMAL BLOOD CELLS AND CELLS DERIVED FROM A NUMBER OF CHRONIC AND ACUTE MYELOID LEUKEMIA PATIENTS EXHIBITING DIFFERENT DEGREES OF DIFFERENTIATION. METHODS: WE USED IMMUNOBLOTTING AND IMMUNOFLUORESCENCE TO EXAMINE THE LEVELS AND LOCALIZATION OF EPIGENETIC HETEROCHROMATIN FACTORS IN ISOLATED CELL NUCLEI AND FRACTIONATED PERIPHERAL BLOOD CELLS. RESULTS: WHILE THE MAJOR EPIGENETIC HETEROCHROMATIN FACTOR, HISTONE H3 METHYLATED AT LYSINE 9, IS PRESENT IN ALL CELL TYPES, ITS MAIN COUNTERPARTS, NONHISTONE PROTEINS, HETEROCHROMATIN PROTEINS 1 (HP1) ALPHA, BETA, AND GAMMA, ARE DRAMATICALLY REDUCED IN PERIPHERAL BLOOD LEUKOCYTES OF NORMAL DONORS AND CHRONIC MYELOID LEUKEMIA PATIENTS, BUT ARE SUBSTANTIALLY INCREASED IN THE BLOOD OF ACCELERATED PHASE AND BLAST CRISIS PATIENTS. IN THE TERMINALLY DIFFERENTIATED CELLS, NUCLEAR CHROMATIN ACCUMULATES A NUCLEOCYTOPLASMIC SERPIN, MONOCYTE AND NEUTROPHIL ELASTASE INHIBITOR (MNEI). HP1 AND MNEI LEVELS INVERSELY CORRELATE IN A NUMBER OF NORMAL AND LEUKEMIA MYELOID CELLS AND SHOW STRIKINGLY OPPOSITE COORDINATED CHANGES DURING DIFFERENTIATION OF U937 CELL LINE INDUCED BY RETINOIC ACID. CONCLUSIONS: OUR RESULTS SUGGEST THAT REPRESSION OF HP1 AND ACCUMULATION OF MNEI ARE LINKED TO TERMINAL CELL DIFFERENTIATION AND THAT THEIR LEVELS MAY BE MONITORED IN BLOOD CELL POPULATIONS TO DETECT TRANSITIONS IN CELL DIFFERENTIATION ASSOCIATED WITH LEUKEMIA PROGRESSION AND TREATMENT. 2006 13 206 33 ACTIVATION OF NOTCH AND MYC SIGNALING VIA B-CELL-RESTRICTED DEPLETION OF DNMT3A GENERATES A CONSISTENT MURINE MODEL OF CHRONIC LYMPHOCYTIC LEUKEMIA. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS CHARACTERIZED BY DISORDERED DNA METHYLATION, SUGGESTING THESE EPIGENETIC CHANGES MIGHT PLAY A CRITICAL ROLE IN DISEASE ONSET AND PROGRESSION. THE METHYLTRANSFERASE DNMT3A IS A KEY REGULATOR OF DNA METHYLATION. ALTHOUGH DNMT3A SOMATIC MUTATIONS IN CLL ARE RARE, WE FOUND THAT LOW DNMT3A EXPRESSION IS ASSOCIATED WITH MORE AGGRESSIVE DISEASE. A CONDITIONAL KNOCKOUT MOUSE MODEL SHOWED THAT HOMOZYGOUS DEPLETION OF DNMT3A FROM B CELLS RESULTS IN THE DEVELOPMENT OF CLL WITH 100% PENETRANCE AT A MEDIAN AGE OF ONSET OF 5.3 MONTHS, AND HETEROZYGOUS DNMT3A DEPLETION YIELDS A DISEASE PENETRANCE OF 89% WITH A MEDIAN ONSET AT 18.5 MONTHS, CONFIRMING ITS ROLE AS A HAPLOINSUFFICIENT TUMOR SUPPRESSOR. B1A CELLS WERE CONFIRMED AS THE CELL OF ORIGIN OF DISEASE IN THIS MODEL, AND DNMT3A DEPLETION RESULTED IN FOCAL HYPOMETHYLATION AND ACTIVATION OF NOTCH AND MYC SIGNALING. AMPLIFICATION OF CHROMOSOME 15 CONTAINING THE MYC GENE WAS DETECTED IN ALL CLL MICE TESTED, AND INFILTRATION OF HIGH-MYC-EXPRESSING CLL CELLS IN THE SPLEEN WAS OBSERVED. NOTABLY, HYPERACTIVATION OF NOTCH AND MYC SIGNALING WAS EXCLUSIVELY OBSERVED IN THE DNMT3A CLL MICE, BUT NOT IN THREE OTHER CLL MOUSE MODELS TESTED (SF3B1-ATM, IKZF3, AND MDR), AND DNMT3A-DEPLETED CLL WERE SENSITIVE TO PHARMACOLOGIC INHIBITION OF NOTCH SIGNALING IN VITRO AND IN VIVO. CONSISTENT WITH THESE FINDINGS, HUMAN CLL SAMPLES WITH LOWER DNMT3A EXPRESSION WERE MORE SENSITIVE TO NOTCH INHIBITION THAN THOSE WITH HIGHER DNMT3A EXPRESSION. ALTOGETHER, THESE RESULTS SUGGEST THAT DNMT3A DEPLETION INDUCES CLL THAT IS HIGHLY DEPENDENT ON ACTIVATION OF NOTCH AND MYC SIGNALING. SIGNIFICANCE: LOSS OF DNMT3A EXPRESSION IS A DRIVING EVENT IN CLL AND IS ASSOCIATED WITH AGGRESSIVE DISEASE, ACTIVATION OF NOTCH AND MYC SIGNALING, AND ENHANCED SENSITIVITY TO NOTCH INHIBITION. 2021 14 4254 36 METHYLOME-BASED CELL-OF-ORIGIN MODELING (METHYL-COOM) IDENTIFIES ABERRANT EXPRESSION OF IMMUNE REGULATORY MOLECULES IN CLL. BACKGROUND: IN CANCER, NORMAL EPIGENETIC PATTERNS ARE DISTURBED AND CONTRIBUTE TO GENE EXPRESSION CHANGES, DISEASE ONSET, AND PROGRESSION. THE CANCER EPIGENOME IS COMPOSED OF THE EPIGENETIC PATTERNS PRESENT IN THE TUMOR-INITIATING CELL AT THE TIME OF TRANSFORMATION, AND THE TUMOR-SPECIFIC EPIGENETIC ALTERATIONS THAT ARE ACQUIRED DURING TUMOR INITIATION AND PROGRESSION. THE PRECISE DISSECTION OF THESE TWO COMPONENTS OF THE TUMOR EPIGENOME WILL FACILITATE A BETTER UNDERSTANDING OF THE BIOLOGICAL MECHANISMS UNDERLYING MALIGNANT TRANSFORMATION. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) ORIGINATES FROM DIFFERENTIATING B CELLS, WHICH UNDERGO EXTENSIVE EPIGENETIC PROGRAMMING. THIS POSES THE CHALLENGE TO PRECISELY DETERMINE THE EPIGENOMIC GROUND STATE OF THE CELL-OF-ORIGIN IN ORDER TO IDENTIFY CLL-SPECIFIC EPIGENETIC ABERRATIONS. METHODS: WE DEVELOPED A LINEAR REGRESSION MODEL, METHYLOME-BASED CELL-OF-ORIGIN MODELING (METHYL-COOM), TO MAP THE CELL-OF-ORIGIN FOR INDIVIDUAL CLL PATIENTS BASED ON THE CONTINUUM OF EPIGENOMIC CHANGES DURING NORMAL B CELL DIFFERENTIATION. RESULTS: METHYL-COOM ACCURATELY MAPS THE CELL-OF-ORIGIN OF CLL AND IDENTIFIES CLL-SPECIFIC ABERRANT DNA METHYLATION EVENTS THAT ARE NOT CONFOUNDED BY PHYSIOLOGIC EPIGENETIC B CELL PROGRAMMING. FURTHERMORE, METHYL-COOM UNMASKS ABNORMAL ACTION OF TRANSCRIPTION FACTORS, ALTERED SUPER-ENHANCER ACTIVITIES, AND ABERRANT TRANSCRIPT EXPRESSION IN CLL. AMONG THE ABERRANTLY REGULATED TRANSCRIPTS WERE MANY GENES THAT HAVE PREVIOUSLY BEEN IMPLICATED IN T CELL BIOLOGY. FLOW CYTOMETRY ANALYSIS OF THESE MARKERS CONFIRMED THEIR ABERRANT EXPRESSION ON MALIGNANT B CELLS AT THE PROTEIN LEVEL. CONCLUSIONS: METHYL-COOM ANALYSIS OF CLL IDENTIFIED DISEASE-SPECIFIC ABERRANT GENE REGULATION. THE ABERRANTLY EXPRESSED GENES IDENTIFIED IN THIS STUDY MIGHT PLAY A ROLE IN IMMUNE-EVASION IN CLL AND MIGHT SERVE AS NOVEL TARGETS FOR IMMUNOTHERAPY APPROACHES. IN SUMMARY, WE PROPOSE A NOVEL FRAMEWORK FOR IN SILICO MODELING OF REFERENCE DNA METHYLOMES AND FOR THE IDENTIFICATION OF CANCER-SPECIFIC EPIGENETIC CHANGES, A CONCEPT THAT CAN BE BROADLY APPLIED TO OTHER HUMAN MALIGNANCIES. 2020 15 1479 27 DIVERSE TARGETS OF THE TRANSCRIPTION FACTOR STAT3 CONTRIBUTE TO T CELL PATHOGENICITY AND HOMEOSTASIS. STAT3, AN ESSENTIAL TRANSCRIPTION FACTOR WITH PLEIOTROPIC FUNCTIONS, PLAYS CRITICAL ROLES IN THE PATHOGENESIS OF AUTOIMMUNITY. DESPITE RECENT DATA LINKING STAT3 WITH INFLAMMATORY BOWEL DISEASE, EXACTLY HOW IT CONTRIBUTES TO CHRONIC INTESTINAL INFLAMMATION IS NOT KNOWN. USING A T CELL TRANSFER MODEL OF COLITIS, WE FOUND THAT STAT3 EXPRESSION IN T CELLS WAS ESSENTIAL FOR THE INDUCTION OF BOTH COLITIS AND SYSTEMIC INFLAMMATION. STAT3 WAS CRITICAL IN MODULATING THE BALANCE OF T HELPER 17 (TH17) AND REGULATORY T (TREG) CELLS, AS WELL AS IN PROMOTING CD4(+) T CELL PROLIFERATION. WE USED CHROMATIN IMMUNOPRECIPITATION AND MASSIVE PARALLEL SEQUENCING (CHIP-SEQ) TO DEFINE THE GENOME-WIDE TARGETS OF STAT3 IN CD4(+) T CELLS. WE FOUND THAT STAT3 BOUND TO MULTIPLE GENES INVOLVED IN TH17 CELL DIFFERENTIATION, CELL ACTIVATION, PROLIFERATION, AND SURVIVAL, REGULATING BOTH EXPRESSION AND EPIGENETIC MODIFICATIONS. THUS, STAT3 ORCHESTRATES MULTIPLE CRITICAL ASPECTS OF T CELL FUNCTION IN INFLAMMATION AND HOMEOSTASIS. 2010 16 2928 26 GENERATION OF IPSCS FROM CULTURED HUMAN MALIGNANT CELLS. INDUCED PLURIPOTENT STEM CELLS (IPSCS) CAN BE GENERATED FROM VARIOUS DIFFERENTIATED CELL TYPES BY THE EXPRESSION OF A SET OF DEFINED TRANSCRIPTION FACTORS. SO FAR, IPSCS HAVE BEEN GENERATED FROM PRIMARY CELLS, BUT IT IS UNCLEAR WHETHER HUMAN CANCER CELL LINES CAN BE REPROGRAMMED. HERE WE DESCRIBE THE GENERATION AND CHARACTERIZATION OF IPSCS DERIVED FROM HUMAN CHRONIC MYELOID LEUKEMIA CELLS. WE SHOW THAT, DESPITE THE PRESENCE OF ONCOGENIC MUTATIONS, THESE CELLS ACQUIRED PLURIPOTENCY BY THE EXPRESSION OF 4 TRANSCRIPTION FACTORS AND UNDERWENT DIFFERENTIATION INTO CELL TYPES DERIVED OF ALL 3 GERM LAYERS DURING TERATOMA FORMATION. INTERESTINGLY, ALTHOUGH THE PARENTAL CELL LINE WAS STRICTLY DEPENDENT ON CONTINUOUS SIGNALING OF THE BCR-ABL ONCOGENE, ALSO TERMED ONCOGENE ADDICTION, REPROGRAMMED CELLS LOST THIS DEPENDENCY AND BECAME RESISTANT TO THE BCR-ABL INHIBITOR IMATINIB. THIS FINDING INDICATES THAT THE THERAPEUTIC AGENT IMATINIB TARGETS CELLS IN A SPECIFIC EPIGENETIC DIFFERENTIATED CELL STATE, AND THIS MAY CONTRIBUTE TO ITS INABILITY TO FULLY ERADICATE DISEASE IN CHRONIC MYELOID LEUKEMIA PATIENTS. 2010 17 2494 22 EPIGENETICS AND CHRONIC LYMPHOCYTIC LEUKEMIA. THE DNA METHYLATION LEVEL IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA IS GENERALLY LOWER THAN HEALTHY INDIVIDUALS. ALTHOUGH DNA METHYLATION IS GLOBALLY DECREASED, REGIONAL HYPERMETHYLATION OF GENE PROMOTERS LEADS TO GENE SILENCING. MANY OF THESE GENES HAVE TUMOR SUPPRESSOR PHENOTYPES. UNLIKE MUTATIONS OR DELETIONS, HYPERMETHYLATION IS POTENTIALLY REVERSIBLE AFTER INHIBITION WITH DNA METHYLATION MODULATORS. MYELODYSPLASTIC SYNDROME HAS BEEN A MODEL DISEASE IN WHICH TREATMENT OF PATIENTS RESULTS IN DEMETHYLATION OF SPECIFIC GENES. THE STORY IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA IS SLOWLY UNRAVELING AS EPIGENETIC MODIFICATIONS LIKELY ALSO PLAY AN IMPORTANT ROLE. ONGOING CLINICAL TRIALS CORRELATING CLINICAL RESPONSE TO GENE EXPRESSION AFTER TREATMENT WITH DNA METHYLATION INHIBITORS WILL ULTIMATELY ALLOW US TO BETTER RISK STRATIFY AND PREDICT THE SUBGROUP OF PATIENTS WHO WILL BENEFIT FROM TREATMENT WITH THIS CLASS OF DRUGS. 2006 18 3523 29 IL-10-PRODUCING B CELLS ARE CHARACTERIZED BY A SPECIFIC METHYLATION SIGNATURE. AMONG THE FAMILY OF REGULATORY B CELLS, THE SUBSET ABLE TO PRODUCE INTERLEUKIN-10 (IL-10) IS THE MOST STUDIED, YET ITS BIOLOGY IS STILL A MATTER OF INVESTIGATION. THE DNA METHYLATION PROFILING OF THE IL-10 GENE LOCUS REVEALED A NOVEL EPIGENETIC SIGNATURE CHARACTERIZING MURINE B CELLS READY TO RESPOND THROUGH IL-10 SYNTHESIS: A DEMETHYLATED REGION LOCATED 4.5 KB FROM THE TRANSCRIPTION STARTING SITE (TSS), THAT WE NAMED EARLY IL10 REGULATORY REGION (EIL10RR). THIS FEATURE ALLOWS TO DISTINGUISH B CELLS THAT ARE IMMEDIATELY PRONE AND DEVELOPMENTALLY COMMITTED TO IL-10 PRODUCTION FROM THOSE THAT REQUIRE A PERSISTENT STIMULATION TO EXERT AN IL-10-MEDIATED REGULATORY FUNCTION. THESE LATE IL-10 PRODUCERS ARE INSTEAD CHARACTERIZED BY A DELAYED IL10 REGULATORY REGION (DIL10RR), A PARTIALLY DEMETHYLATED DNA PORTION LOCATED 9 KB UPSTREAM FROM THE TSS. A DEMETHYLATED REGION WAS ALSO FOUND IN HUMAN IL-10-PRODUCING B CELLS AND, VERY INTERESTINGLY, IN SOME B-CELL MALIGNANCIES, SUCH AS CHRONIC LYMPHOCYTIC LEUKEMIA AND MANTLE CELL LYMPHOMA, CHARACTERIZED BY AN IMMUNOSUPPRESSIVE MICROENVIRONMENT. OUR FINDINGS DEFINE MURINE AND HUMAN REGULATORY B CELLS AS AN EPIGENETICALLY CONTROLLED FUNCTIONAL STATE OF MATURE B CELL SUBSETS AND OPEN A NEW PERSPECTIVE ON IL-10 REGULATION IN B CELLS IN HOMEOSTASIS AND DISEASE. 2019 19 3918 29 LINKING ABERRANT CHROMATIN FEATURES IN CHRONIC LYMPHOCYTIC LEUKEMIA TO TRANSCRIPTION FACTOR NETWORKS. IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), A DIVERSE SET OF GENETIC MUTATIONS IS EMBEDDED IN A DEREGULATED EPIGENETIC LANDSCAPE THAT DRIVES CANCEROGENESIS. TO ELUCIDATE THE ROLE OF ABERRANT CHROMATIN FEATURES, WE MAPPED DNA METHYLATION, SEVEN HISTONE MODIFICATIONS, NUCLEOSOME POSITIONS, CHROMATIN ACCESSIBILITY, BINDING OF EBF1 AND CTCF, AS WELL AS THE TRANSCRIPTOME OF B CELLS FROM CLL PATIENTS AND HEALTHY DONORS. A GLOBALLY INCREASED HISTONE DEACETYLASE ACTIVITY WAS DETECTED AND HALF OF THE GENOME COMPRISED TRANSCRIPTIONALLY DOWNREGULATED PARTIALLY DNA METHYLATED DOMAINS DEMARCATED BY CTCF CLL SAMPLES DISPLAYED A H3K4ME3 REDISTRIBUTION AND NUCLEOSOME GAIN AT PROMOTERS AS WELL AS CHANGES OF ENHANCER ACTIVITY AND ENHANCER LINKAGE TO TARGET GENES. A DNA BINDING MOTIF ANALYSIS IDENTIFIED TRANSCRIPTION FACTORS THAT GAINED OR LOST BINDING IN CLL AT SITES WITH ABERRANT CHROMATIN FEATURES. THESE FINDINGS WERE INTEGRATED INTO A GENE REGULATORY ENHANCER CONTAINING NETWORK ENRICHED FOR B-CELL RECEPTOR SIGNALING PATHWAY COMPONENTS. OUR STUDY PREDICTS NOVEL MOLECULAR LINKS TO TARGETS OF CLL THERAPIES AND PROVIDES A VALUABLE RESOURCE FOR FURTHER STUDIES ON THE EPIGENETIC CONTRIBUTION TO THE DISEASE. 2019 20 2389 32 EPIGENETIC REPOLARIZATION OF T LYMPHOCYTES FROM CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS USING 5-AZA-2'-DEOXYCYTIDINE. T CELL IMMUNE DYSFUNCTION HAS AN IMPORTANT ROLE IN THE PROFOUND IMMUNE SUPPRESSION THAT CHARACTERIZES CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). IMPROPER POLARIZATION OF T CELLS HAS BEEN PROPOSED AS ONE OF THE MECHANISM INVOLVED. MOUNTING DATA IMPLICATES CHROMATIN REGULATION, NAMELY PROMOTER METHYLATION, IN THE PLASTICITY OF NAIVE HUMAN T CELLS. RECENT IN VITRO EVIDENCE INDICATES THAT THIS PLASTICITY MAY BE PHENOTYPICALLY ALTERED BY USING METHYLATION INHIBITORS WHICH ARE APPROVED FOR CLINICAL USE IN CERTAIN TYPES OF CANCER. THESE RESULTS BEG THE QUESTION: CAN THE INEFFECTIVE POLARIZATION OF T LYMPHOCYTES IN THE CONTEXT OF CLL BE EFFECTIVELY MODULATED USING METHYLATION INHIBITORS IN A SUSTAINABLE THERAPEUTIC FASHION? TO ANSWER THIS QUESTION OUR LABORATORY HAS STUDIED THE EFFECTS OF 5-AZA-2'-DEOXYCYTIDINE (5A2) IN HELPER AND CYTOTOXIC T LYMPHOCYTES FROM HEALTHY DONORS AND CLL PATIENTS IN WELL CHARACTERIZED MOLECULAR AND EPIGENETIC SIGNALING PATHWAYS INVOLVED IN EFFECTIVE POLARIZATION. MOREOVER, WE SOUGHT TO INVESTIGATE THE CONSEQUENCES OF METHYLATION INHIBITOR TREATMENT ON LYMPHOCYTE SURVIVAL, ACTIVATION INTENSITY, AND NAIVE CELL POLARIZATION. OUR DATA INDICATES THAT 5A2 TREATMENT CAN DEPOLARIZE TH2 CELLS TO EFFECTIVELY SECRETE INTERFERON GAMMA, SIGNAL VIA T-BET, AND ACHIEVE DEMETHYLATION OF CRITICAL TH1 SPECIFIC PROMOTERS. MOREOVER, WE DEMONSTRATE THAT 5A2 CAN FORCE TH1 POLARIZATION OF NAIVE T CELLS DESPITE A STRONG IL-4 STIMULI AND A LACK OF IL-12. IN CONCLUSION OUR DATA SEEKS TO DEFINE A MODALITY IN WHICH IMPROPER OR INEFFECTIVE T CELL POLARIZATION CAN BE ALTERED BY 5AZA AND COULD BE INCORPORATED IN FUTURE THERAPEUTIC INTERVENTIONS. 2011