Phosphorylation of heat shock protein 20 (Hsp20) by protein kinase A (PKA) is now recognized as an important regulatory mechanism modulating contractile activity in the human myometrium. Thus agonists that stimulate cyclic AMP production may cause relaxation with resultant beneficial effects on pathologies that affect this tissue such as the onset of premature contractions prior to term. Here we describe for the first time that acetylation of Hsp20 is also a potent post-translational modification that can affect human myometrial activity. We show that histone deacetylase 8 (HDAC8) is a non-nuclear lysine deacetylase (KDAC) that can interact with Hsp20 to affect its acetylation. Importantly, use of a selective linkerless hydroxamic acid HDAC8 inhibitor increases Hsp20 acetylation with no elevation of nuclear-resident histone acetylation nor marked global gene expression changes. These effects are associated with significant inhibition of spontaneous and oxytocin-augmented contractions of ex vivo human myometrial tissue strips. A potential molecular mechanism by which Hsp20 acetylation can affect myometrial activity by liberating cofilin is described and further high-lights the use of specific effectors of KDACs as therapeutic agents in regulating contractility in this smooth muscle.In developed countries premature birth prior to 37 weeks gestation accounts for nearly 75% of newborn deaths and is related to a high risk for survivors of long-term physical or mental disability (1). There are still no effective and safe therapeutic treatments for decreasing the incidence of premature deliveries. Accordingly, an increased understanding of the molecular mechanisms underlying myometrial activity is required to aid in the development of new strategies for the treatment of premature labor. To this end, recent evidence indicates a novel role for post-translational modification by acetylation in regulating myometrial activity. This was first highlighted by the class I/II histone deacetylase inhibitors (HDACIs) 3 TSA, VPA, and SBHA effecting relaxations of ϳ60% to spontaneously or oxytocin-mediated contracting human myometrial tissues ex vivo (2). Potential epigenetic events resulting from increased histone acetylation seem to be excluded due to the comparatively short time period observed for contractile inhibition of 20 -60 min. This pointed to the above HDACIs having non-epigenetic effects involving increased acetylation of lysine residues of protein components of the myometrial contractile machinery. This possibility is supported by recent proteomic findings of Kim et al. (3) and Choudhary et al. (4). They, respectively, showed that administration of the HDACIs TSA/Sirtinol to HeLa or SAHA/MS-275 to leukemia MV4 -11 cell cultures resulted in acetylation of a range of non-nuclear proteins. Importantly, proteins involved in regulating the cytoskeletal/filamentous architecture of cells were observed to be acetylated. These included actin, cofilin, 14-3-3 as well as the heat shock family protein member Hsp27.

Intrachromosomal amplification of chromosome 21 is a heterogeneous chromosomal rearrangement occurring in 2% of cases of childhood precursor B-cell acute lymphoblastic leukemia. These abnormalities are too complex to engineer faithfully in animal models and are unrepresented in leukemia cell lines. As a resource for future functional and preclinical studies, we have created xenografts from the leukemic blasts of patients with intrachromosomal amplification of chromosome 21 and characterized them by in-vivo and ex-vivo luminescent imaging, flow immunophenotyping, and histological and ultrastructural analyses of bone marrow and the central nervous system. Investigation of up to three generations of xenografts revealed phenotypic evolution, branching genomic architecture and, compared with other B-cell acute lymphoblastic leukemia genetic subtypes, greater clonal diversity of leukemia-initiating cells. In support of intrachromosomal amplification of chromosome 21 as a primary genetic abnormality, it was always retained through generations of xenografts, although we also observed the first example of structural evolution of this rearrangement. Clonal segregation in xenografts revealed convergent evolution of different secondary genomic abnormalities implicating several known tumor suppressor genes and a region, containing the B-cell adaptor, PIK3AP1, and nuclear receptor co-repressor, LCOR, in the progression of B-cell acute lymphoblastic leukemia. Tracking of mutations in patients and derived xenografts provided evidence for co-operation between abnormalities activating the RAS pathway in B-cell acute lymphoblastic leukemia and for their aggressive clonal expansion in the xeno-environment. Bi-allelic loss of the CDKN2A/B locus was recurrently maintained or emergent in xenografts and also strongly selected as RNA sequencing demonstrated a complete absence of reads for genes associated with the deletions.

A common problem in the study of human malignancy is the elucidation of cancer driver mechanisms associated with recurrent deletion of regions containing multiple genes. Taking B-cell acute lymphoblastic leukaemia (B-ALL) and large deletions of 6q [del(6q)] as a model, we integrated analysis of functional cDNA clone tracking assays with patient genomic and transcriptomic data, to identify the transcription factors FOXO3 and PRDM1 as candidate tumour suppressor genes (TSG). Analysis of cell cycle and transcriptomic changes following overexpression of FOXO3 or PRDM1 indicated that they co-operate to promote cell cycle exit at the pre-B cell stage. FOXO1 abnormalities are absent in B-ALL, but like FOXO3, FOXO1 expression suppressed growth of TCF3::PBX1 and ETV6::RUNX1 B-ALL in-vitro. While both FOXOs induced PRDM1 and other genes contributing to late pre-B cell development, FOXO1 alone induced the key transcription factor, IRF4, and chemokine, CXCR4. CRISPR-Cas9 screening identified FOXO3 as a TSG, while FOXO1 emerged as essential for B-ALL growth. We relate this FOXO3-specific leukaemia-protective role to suppression of glycolysis based on integrated analysis of CRISPR-data and gene sets induced or suppressed by FOXO1 and FOXO3. Pan-FOXO agonist Selinexor induced the glycolysis inhibitor TXNIP and suppressed B-ALL growth at low dose (ID50 < 50 nM).

Insight into the role of recurrent genomic changes arising in leukemia has depended largely on the functional analysis of cell lines and transgenic animals. However not all acquired abnormalities are represented in available cell lines and a few are too complex to be faithfully engineered in animal models. One such abnormality is intrachromosomal amplification of chromosome 21 (iAMP21), a heterogeneous cytogenetic rearrangement, with a distinct clinical profile, occurring in 2% of childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The most highly amplified segment of iAMP21 varies in size and copy number but has always included a 5.1 Mb common region of amplification (CRA). Regions flanking the most highly amplified segment have profiles that may be step-like, or more complex combinations of lower level amplification, normal copy number and deletion. Abnormalities at other chromosomal locations such as deletions of IKZF1, CDKN2A/B or RB1 and rearrangements activating CRLF2 co-occur with iAMP21 but have never been shown to precede its formation. To investigate clonal evolution and to provide a resource for future functional studies, we established xenografts from three cases of iAMP21 BCP-ALL in NOD.Cg-PrkdcscidIl2rgtm1Wjl/SzJ (NSG) mice. Signs of disease were seen between 6 and 8 months after intrafemoral injection and autopsy revealed marked splenomegaly in all cases. Cells isolated from the bone marrow and spleen, were positive for human B cell markers CD19 and CD10. Disease onset was more rapid (3-6 months) when primografts were transplanted and cells from these secondary mice were used to establish leukemia in a third generation. Whole body imaging of mice transplanted with xenograft cells, transduced with a lentivirus expressing luciferase, revealed the rapid spread of disease from the injection site to the contralateral femur, sternum, pelvis, ribs, spine and skull, with the spleen becoming the major site of engraftment at late stage disease. Comparison of SNP 6.0 array profiles of presentation and xenografts samples revealed several examples of post-transplant genomic progression which, with the exception of a biallelic deletion of the CDKN2A/B locus, had not previously been reported in iAMP21 patients. Additional copies of chromosomes 9 and 12 in patient samples were lost in xenografts resulting in copy number neutral loss of heterozygosity (CNN-LOH) for chromosome 12 but not 9. Analysis of further primary iAMP21 BCP-ALL cases identified two with CNN-LOH for part of the long arm of chromosome 12, suggesting involvement of an imprinted locus in this region. iAMP21 chromosomes were retained in all xenografts, supporting evidence that it is a primary abnormality. However, as these rearrangements have been considered to be stable once formed, we were surprised to observe acquisition of a non–contiguous deletion of chromosome 21 in one secondary mouse and all of its tertiary recipients. The deletion was proximal to the CRA and resulted in extension of pre-existing haploinsufficient regions by 6.6 Mb. Evolution of this iAMP21 chromosome was confirmed by fluorescence in-situ hybridisation (FISH) using probes targeting the deletion, with loss of signal observed in all cells from mice carrying the deletion but in no cells from the presentation sample or unaffected mice. Although we cannot rule out that the deletion arose in response to adaptive pressure specific to the xeno-environment, opportunities to observe similar progression in patients have been limited because FISH analysis has generally targeted only the CRA and few paired presentation/relapse samples have been analysed by genomic array. While it remains likely that overrepresentation of oncogenes within the CRA acts as a primary driver of iAMP21 BCP-ALL, the additional deletion may highlight the position of tumour suppressor genes involved in leukemia progression. As these patients are treated as a single clinical entity, an important implication of these data is that the position and extent of deletions in iAMP21 rearrangements may influence response to therapy. In conclusion, xenografts of iAMP21 BCP-ALL closely resemble human primary disease and will make valuable pre-clinical models for basic and translational research. As models for the study of clonal evolution they support previous evidence that iAMP21 is a primary abnormality and have revealed novel forms of clonal progression. Disclosures: No relevant conflicts of interest to declare.

Deletions of the short arm of chromosome 12 (12p) are found in around 6% of acute myeloid leukaemia (AML). Particularly in paediatric AML they often occur as the sole cytogenetic change and impart a poor prognosis (Harrison et al J Clin Oncol 2010). Despite multiple deletion mapping studies, a single gene has not been identified from this region that is responsible for driving leukaemic progression, thus it is clear that a functional approach is required. This study aimed to functionally implicate a significant gene through the use of a competitive selection assay. Publicly available array data from 8 studies were used to determine copy number from AML patient samples to define a minimal region of 12p deletion (MRD). Data were obtained from 866 samples, which had been analysed on either the Affymetrix SNP Array 6.0 or the Affymetrix GeneChip 500K Array platforms. Data files from matched remission samples were also analysed in 576 cases. In total 58 samples (6.7%) were found to have deletions of 12p and were used to determine the MRD. Multiplex ligation dependent probe amplification, a polymerase chain reaction based technique to determine copy number was utilised to further define the MRD. A set of probes targeted to genes from within the MRD was designed and 75 karyotypically normal AML patients were screened. 5 samples (6.6%) were found to have deletions of the MRD region, and these were confirmed by fluorescence in situ hybridisation. AML cell lines with deletions of 12p (NKM-1 and GDM-1) were selected to investigate the functional relevance of the genes within the MRD. Both were used in vitro and in immunocompromised mouse models, where leukaemia was established by intrafemoral injection and monitored by luminescent imaging of luciferase expression constructs. Taking a pooled approach, genes within the MRD were expressed from integrated lentiviral vectors in these cell lines. To evaluate effects of expression on leukaemia growth or survival, changes in construct copy number after cell line expansion in vitro and in vivo were determined by targeted high throughput sequencing on the Illumina MiSeq platform. The effects on growth of 11 candidate genes were assessed. Demonstrating a strong anti leukaemic effect for expression of this gene, a construct for cyclin dependent kinase inhibitor 1B (CDKN1B) was rapidly selected against in the assay. Expression levels of CDKN1B were measured in a range of AML cell lines and patient samples with and without 12p deletion, and the downstream effects of high and low CDKN1B protein levels were investigated. Overexpression of CDKN1B in AML cell lines carrying a 12p deletion was shown to inhibit growth through G1 phase cell cycle arrest. The sensitivity of AML cell lines to treatment with the cyclin dependent kinase inhibitor Flavopiridol was assessed and low expression levels of CDKN1B were found to moderately correlate with increased sensitivity to Flavopiridol (n = 8, Spearman’s rho = 0.4048). Data obtained from this project provide valuable insight into the mechanisms giving rise to this complex disease and represent the initial step towards developing novel targeted therapies specifically tailored to individual patients with high risk AML. These assays may also be used to study other regions of interest as well as other cancers. Disclosures No relevant conflicts of interest to declare.