In multiple myeloma (MM) osteolytic lesions rarely heal because of persistent suppressed osteoblast differentiation resulting in a high fracture risk. Herein, chromatin immunoprecipitation analyses reveal that MM cells induce repressive epigenetic histone changes at the Runx2 locus that prevent osteoblast differentiation. The most pronounced MM-induced changes were at the Runx2-P1 promoter, converting it from a poised bivalent state to a repressed state. Previously it was observed that MM induce the transcription repressor GFI1 in osteoblast precursors, which correlates with decreased Runx2 expression. Thus, prompting detailed characterization of the MM and TNFα-dependent GFI1-response element within the Runx2-P1 promoter. Further analyses reveal that MM-induced GFI1 binding to Runx2 in osteoblast precursors and recruitment of the histone modifiers HDAC1, LSD1, and EZH2 is required to establish and maintain Runx2 repression in osteogenic conditions. These GFI1-mediated repressive chromatin changes persist even after removal of MM. Ectopic GFI1 is sufficient to bind to Runx2, recruit HDAC1 and EZH2, increase H3K27me3 on the gene, and prevent osteogenic induction of endogenous Runx2 expression. Gfi1 knockdown in MC4 cells blocked MM-induced recruitment of HDAC1 and EZH2 to Runx2, acquisition of repressive chromatin architecture, and suppression of OB differentiation. Importantly, inhibition of EZH2 or HDAC1 activity in pre-osteoblasts after MM exposure in vitro or in osteoblast precursors from MM patients reversed the repressive chromatin architecture at Runx2 and rescued osteoblast differentiation.
Implications
This study suggests that therapeutically targeting EZH2 or HDAC1 activity may reverse the profound MM-induced osteoblast suppression and allow repair of the lytic lesions.