This is to our knowledge, the first study that comprehensively investigated the genetics of DCM in a large-scale cohort and across a broad gene panel of the known DCM genes. Our results underline the high analytical quality and feasibility of Next-Generation Sequencing in clinical genetic diagnostics and provide a sound database of the genetic causes of DCM.

SUMMARY We investigated the transcriptional and epigenetic repression of miR-29 by Myc, HDAC3, and EZH2 in mantle cell lymphoma and other Myc-associated lymphomas. We demonstrate that miR-29 is repressed by Myc through a co-repressor complex with HDAC3 and EZH2. Myc contributes to EZH2 upregulation via repression of the EZH2 targeting miR-26a, and EZH2 induces Myc via inhibition of the Myc targeting miR-494 to create positive feedback. Combined inhibition of HDAC3 and EZH2 cooperatively disrupted the Myc-EZH2-miR-29 axis, resulting in restoration of miR-29 expression, down-regulation of miR-29 targeted genes, and lymphoma growth suppression in vitro and in vivo. These findings define a Myc-mediated miRNA repression mechanism, shed light on Myc lymphomagenesis mechanisms and reveals promising therapeutic targets for aggressive B-cell malignancies.

The novel Bruton's tyrosine kinase inhibitor ibrutinib has demonstrated high response rates in B-cell lymphomas; however, a growing number of ibrutinib-treated patients relapse with resistance and fulminant progression. Using chemical proteomics and an organotypic cell-based drug screening assay, we determine the functional role of the tumour microenvironment (TME) in ibrutinib activity and acquired ibrutinib resistance. We demonstrate that MCL cells develop ibrutinib resistance through evolutionary processes driven by dynamic feedback between MCL cells and TME, leading to kinome adaptive reprogramming, bypassing the effect of ibrutinib and reciprocal activation of PI3K-AKT-mTOR and integrin-β1 signalling. Combinatorial disruption of B-cell receptor signalling and PI3K-AKT-mTOR axis leads to release of MCL cells from TME, reversal of drug resistance and enhanced anti-MCL activity in MCL patient samples and patient-derived xenograft models. This study unifies TME-mediated de novo and acquired drug resistance mechanisms and provides a novel combination therapeutic strategy against MCL and other B-cell malignancies.

The molecular mechanisms whereby CD8 T cells become "exhausted" in the tumor microenvironment remain unclear. Programmed death ligand-1 (PD-L1) is upregulated on tumor cells and PD-1-PD-L1 blockade has significant efficacy in human tumors; however, most patients do not respond, suggesting additional mechanisms underlying T cell exhaustion. B7 superfamily member 1 (B7S1), also called B7-H4, B7x, or VTCN1, negatively regulates T cell activation. Here we show increased B7S1 expression on myeloid cells from human hepatocellular carcinoma correlated with CD8 T cell dysfunction. B7S1 inhibition suppressed development of murine tumors. Putative B7S1 receptor was co-expressed with PD-1 but not T cell immunoglobulin and mucin-domain containing-3 (Tim-3) at an activated state of early tumor-infiltrating CD8 T cells, and B7S1 promoted T cell exhaustion, possibly through Eomes overexpression. Combinatorial blockade of B7S1 and PD-1 synergistically enhanced anti-tumor immune responses. Collectively, B7S1 initiates dysfunction of tumor-infiltrating CD8 T cells and may be targeted for cancer immunotherapy.

Highlights d Tox2 is highly expressed in Tfh cells and regulated by Bcl6 and STAT3 d Forced expression of Tox2 drives Tfh development d Tox2 directly binds to Tfh-associated genes, promoting chromatin accessibility d Combined deletion of Tox2 and Tox abrogates Tfh development