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Etude de l'implication de mécanismes épigénétiques dans la physiopathologie du myélome multiple et dans la différenciation plasmocytaire normale

Abstract : Epigenetic mechanisms play an essential role in gene expression regulation. EZH2, the catalytic sub-unit of PRC2, is able to trimethylate the lysine 27 of histone H3 (H3K27me3) and is involved in the regulation of numerous normal processes, such as development and cell differentiation. Plasma cells (PCs) play a major role in the defense of the host organism against pathogens, by producing antigen-specific antibodies. B cell differentiation into PC is mediated by a fine-tuned regulatory network of cell specific transcription factors involved in B and plasma cell identity. Although numerous key actors involved in plasma cell differentiation (PCD) have been described, most of the epigenetic mechanisms associated with this process are yet to be unveiled. Using an in vitro model of PCD developed in our laboratory, we showed that EZH2 is upregulated in the preplasmablast stage (prePB) of the PCD. By analyzing DNA sequences associated with EZH2 and H3K27me3 in this cell type, we highlighted that EZH2 is recruited to and represses through H3K27me3 a subset of genes involved in B cell and plasma cell identity. Interestingly, in prePBs and PBs, EZH2 was also found to be recruited to H3K27me3-free promoters of transcriptionally active genes known to regulate cell proliferation and DNA repair. Inhibition of EZH2 catalytic activity resulted in B to PC transcriptional changes associated with PC maturation induction together with higher immunoglobulin secretion. Altogether, our data suggests that EZH2 is involved in the maintenance of prePBs/PBs transitory immature proliferative state through H3K27me3-dependent and independent gene regulation supporting their amplification. Moreover, while EZH2 overexpression was previously shown to inhibit PCD in mice, this study highlights for the first time that EZH2 inhibition can accelerate normal human PCD by prematurely inducing a plasma cell transcriptional program.EZH2 mutations or abnormal expression were shown to be involved in numerous hematological malignancies and solid tumors. Multiple Myeloma (MM) is a malignant plasma cell disease with a poor survival, characterized by the accumulation of myeloma cells (MMCs) within the bone marrow. We identified a significant upregulation of the Polycomb Repressive Complex 2 (PRC2) core genes in MM cells in association with proliferation. We used EPZ-6438, a specific small molecule inhibitor of EZH2 methyltransferase activity, to evaluate its effects on MM cells phenotype and gene expression profile. PRC2 targeting results in cell growth inhibition due to cell cycle arrest and apoptosis together with Polycomb, DNA methylation, TP53 and RB1 target genes induction. EZH2 inhibitor induced toxicity was heterogeneous in human myeloma cell lines and primary MM cells from patients. Interestingly, we found that MM cell resistance to EZH2 inhibitor could be mediated by DNA methylation of PRC2 target genes. We established a gene expression-based EZ-score allowing to identify poor prognosis patients that could benefit from EZH2 inhibitor treatment. We also demonstrated a synergistic effect of EPZ-6438 and Lenalidomide, a conventional drug used for MM treatment, through the activation of B cell transcription factors and tumor suppressor gene expression in concert with MYC repression. Moreover, EPZ-6438 pre-treatment was able to overcome MM cells resistance to lenalidomide. These data suggest that PRC2 targeting could have a therapeutic interest in MM patients characterized by high-risk EZ-score values, reactivating B cell transcription factors and tumor suppressor genes. EZH2 inhibitor could also re-sensitize MM patients to chemotherapies based on immunomodulatory agents.
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Laurie Herviou. Etude de l'implication de mécanismes épigénétiques dans la physiopathologie du myélome multiple et dans la différenciation plasmocytaire normale. Médecine humaine et pathologie. Université Montpellier, 2018. Français. ⟨NNT : 2018MONTT019⟩. ⟨tel-02401492⟩

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