UTX, MLL and Pathogenic Deregulation of Histone Methylation in Multiple Myeloma

Advances in genome sequencing revealed that recurrent mutations in chromatin regulators are a common feature in malignancy, including multiple myeloma (MM). Among these lesions, mutations in histone methyltransferases (HMTs) and histone demethylases are prominent. These mutations may yield global, genome-wide dysfunction of chromatin, strongly affecting gene regulation and possibly influencing other chromatin-dependent processes. The balance between histone 3 lysine 27 trimethylation (H3K27me3), associated with gene silencing and H3K4 methylation, linked to gene activation, is critical for normal gene expression. The PRC2 complex (Polycomb Repressive Complex 2) contains at its core a H3K27-specifc HMT, EZH2. Loss of function mutations of EZH2 or partner proteins such as ASXL1 lead to global loss of H3K27me3, while gain of function mutations of EZH2 in lymphoma increases H3K27me3. The importance of this residue was underscored by discovery of H3K27→M mutation in pediatric brain tumors, precluding histone modification 20 and blocking EZH2 action 21. Furthermore, we found that overexpression of MMSET, an H3K36-specific HMT, in MM causes a genome-wide decrease in H3K27me3. Gene activation requires the removal of the H3K27 mark and placement of the H3K4me modification at gene promoters and enhancers. This is accomplished by a multi-protein complex containing the H3K27-specific histone demethylase UTX, (Ubiquitously transcribed Tetratricopeptide repeat, X chromosome), members of the MLL (Mixed Lineage Leukemia) family of HMTs (including MLL2 and MLL3), histone acetyltransferases p300 and CREBBP, and members of the SWI/SNF chromatin remodeling machinery. Almost all members of these complexes can be mutated in lymphoid malignancies. Specifically, UTX (Official gene name KDM6A) is mutated or deleted in up to 30% of MM. Moreover, MLL2 and especially MLL3 display inactivating mutations in MM. We hypothesize that UTX and MLL3 mutations have a similar function in MM pathogenesis to cause an aberrant imbalance of H3K27me/H3K4me and suppression of critical target genes. Accordingly, an EZH2 inhibitor that decreases H3K27 methylation is in preclinical and early clinical development may be able to rebalance chromatin modifications and offer a new therapeutic approach. To test these ideas we propose the following specific Aims: 1) Determine the Importance of UTX and MLL3 in the Control of Chromatin Structure, Cell Growth and Homeostasis of MM and Lymphoid Cells 2) Determine the Genetic Targets and Pathways Affected by Loss of UTX and MLL3 in MM 3) Determine the Importance of UTX in B Cell Maturation and in the Development of MM