Secreted-frizzled related proteins (SFRPs) are modulators of the Wnt signaling pathway that is closely involved in normal and malignant hematopoiesis. Epigenetic deregulation of Wnt modulators leading to aberrant signaling has been reported in adult patients with acute myeloid leukemia (AML), but its occurrence in childhood patients with AML and the role of individual modulators are unclear. In this study, we examined SFRP1, SFRP2, SFRP4, and SFRP5 promoter methylation in 83 patients with AML (59 children and 24 adults) and found preferential SFRP1 methylation and mRNA down-regulation in the prognostically favorable subgroup of AML with t(8;21) translocation. Among the 4 genes, SFRP1 methylation independently predicted prolonged event-free and relapse-free survivals in childhood patients with nonacute promyelocytic leukemia with nonadverse cytogenetics. Mechanistically, we further demonstrated that RUNX1-ETO, the t(8;21) fusion product, specifically bound the SFRP1 promoter and repressed its transcription via a consensus RUNX binding site. In t(8;21)-leukemia cells, SFRP1 selectively inhibited canonical Wnt signaling and cellular proliferation that were associated with concomitant down-regulation of Wnt/-catenin target genes, including CCND1 and MYC. Taken
IntroductionThe Wnt signaling pathway is an important regulator of hematopoietic cell fate and growth. 1,2 Deregulation of this pathway has been implicated in human leukemogenesis. 3 Wnt signaling comprises the canonical pathway with -catenin as a central mediator and noncanonical pathways primarily involving Ca 2ϩ ions and planar cell polarity. 4 Signal transduction by Wnts is tightly regulated by several families of extracellular modulators, among which secreted frizzled-related proteins (SFRPs) are the largest family. 4 SFRPs are generally regarded as Wnt antagonists. However, they can also activate Wnt signaling and interfere with other signaling pathways through Wnt-independent mechanisms. 4 In humans, 5 SFRP genes (SFRP1, SFRP2, SFRP3, SFRP4, and SFRP5) have been identified, and 4 of these genes except SFRP3 contain dense CpG islands around their promoter regions. Interestingly, previous studies reported that SFRP1, SFRP2, SFRP4, SFRP5, and other Wnt modulators were silenced by promoter hypermethylation in different cancers, including acute myeloid leukemia (AML), and this epigenetic silencing was associated with aberrant Wnt activation. [5][6][7][8] Moreover, in AML, the Wnt signaling can also be activated by mutant fms-like tyrosine kinase 3 (FLT3) and common translocationassociated fusion proteins. 9,10 Collectively, these findings indicate that Wnt signaling aberration involves multiple mechanisms and is a common molecular feature in different biologic subtypes of AML.t(8;21)(q22;q22) is the most frequent karyotypic abnormality in AML, representing ϳ 15% of total cases, and is associated with the French-American-British (FAB) M2 subtype. 11 t(8;21) fuses the N-terminal portion of RUNX1, including its Runt domain, to most of the eight-twenty-one (E...