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Molecular Biology and Genetics |
Kanematsu Laboratories, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia [J. R. M., P. C. V., S. J. C.]; Faculty of Medicine, University of Sydney, New South Wales 2006, Australia [J. R. M., P. C. V., S. J. C.]; and CSIRO, Molecular Science, Sydney Laboratory, P. O. Box 184, North Ryde, New South Wales 1670, Australia [S. J. C.]
| ABSTRACT |
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| INTRODUCTION |
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To understand further the process of aberrant hypermethylation in cancer, we have chosen to study DNA methylation patterns in leukemia. We have demonstrated previously that the levels of DNA MTase in leukemia are elevated 45-fold (6)
. In addition, DNA methylation patterns are known to be altered in leukemia; a generalized hypomethylation has been reported for B-cell chronic lymphocytic leukemia (11)
, as well as specific regions of hypomethylation such as in the Bcl-2 oncogene (12)
, and tumor necrosis factor
and ß genes (13)
. In contrast, hypermethylation of the calcitonin gene has been observed in acute and chronic leukemias and lymphomas (14
, 15)
and in patients with myelodysplastic syndrome (16
, 17)
. Hypermethylation is also seen in the cyclin-dependent kinase inhibitor gene p15 in patients with acute leukemias (18
, 19)
. The ER gene is hypermethylated in acute and chronic leukaemias, as well as in lymphomas (20)
. The HIC1 gene also has been reported to be frequently methylated in acute lymphoblastic leukemia but infrequently methylated in AMLs. Therefore, there is mounting evidence that a number of individual genes can be abnormally methylated in leukemia. However, most of the previous studies were performed in separate patient groups by restriction enzyme analysis, and consequently, the methylation data are limited to a few CpG sites in individual genes. Hence, the extent of hypermethylation measured previously in leukemia may not have been representative.
The mechanism responsible for abnormal methylation in cancer is unclear. In this study, we address whether aberrant methylation is limited to single target genes that provide the cell with a growth advantage, similar to a random mutation, or whether multiple genes are susceptible to hypermethylation in the same cell, thereby implying a general deregulation of CpG island methylation in cancer. We have used sodium bisulfite genomic sequencing (21, 22, 23) to re-examine in more detail the patterns of aberrant de novo methylation in leukemia from the same patient cohort. In comparison to Southern analysis or MSP (24) , bisulfite sequencing permits analysis of every cytosine in the CpG-rich promoter regions of each target gene. In particular, we address whether critical CpG sites are commonly hypermethylated and whether CpG island methylation is confined to a single locus or multiple loci in the one cohort of patients.
| }MATERIALS AND METHODS |
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Methylation Analysis.
DNA was isolated using TriZOL Reagent (Life Technologies, Inc.) from bone marrow cells that had been lysed in hypotonic lysis buffer. Bisulfite genomic sequencing was used to analyze the methylation patterns. The bisulfite reaction was carried out for 16 h at 55°C on 12 µg of HindIII-digested patient DNA, under conditions described by Clark et al. (22)
. After bisulfite conversion, the DNA was ethanol precipitated, dried, resuspended in 100 µl of TE buffer [10 mM Tris-HCl (pH 8) and 1 mM EDTA] and stored at -20°C. The primers used for amplification of sodium bisulfite-converted DNA are summarized in Table 1
. Where direct sequencing was to be performed, the (-21)M13 universal primer sequence was incorporated into the 5' end of inner primer 2. Nested PCR amplifications were performed on 13 µl of bisulfite-treated genomic DNA in a reaction mix containing 200 µM of each of the four deoxynucleotide triphosphates and 2 units of AmpliTaq DNA polymerase (Perkin-Elmer). The reactions were performed in either 25 µl of reaction mixtures containing 50 mM KCl, 10 mM Tris-HCl (pH 8.3), and 100 ng of each primer or in 50-µl reactions containing 67 mM Tris, 16.6 mM ammonium sulfate, 1.7 mg/ml BSA, and 10 mM ß-mercaptoethanol in TE buffer and 300 ng of each primer. The volume of the PCR for each gene is as noted in Table 1
. Reactions were cycled in a Hybaid DNA Thermal Cycler with variable MgCl2 concentrations as detailed in Table 1
. The standard PCR reaction was performed by the following cycling conditions: 96°C/3 min for 1 cycle; 95°C/1 min, a1°C/2 min, 72°C/3 min, for 5 cycles; 95°C/1 min, a2°C/2 min, 72°C/2 min, for 23 cycles; and 72°C/4 min for 1 cycle, where a1 and a2 are annealing temperatures 1 and 2, respectively, described in Table 1
. All of the primers used were shown to amplify methylated and unmethylated DNA without major bias under these PCR conditions (25)
.
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RESULTS
We have used bisulfite genomic sequencing to characterize the overall methylation profile of the CpG islands associated with calcitonin, ER, E-cadherin, p15, p16, Rb, GST-pi, and HIC1 in the bone marrow of patients with AML. We have shown previously that the expression of DNA MTase was increased in a number of the AML patients analyzed in this study (6)
. Twenty patients with de novo AML, spanning ages 2288 years, and nine normal controls, spanning ages 1974 years, were assayed. The bone marrow from the AML patients contained >70% blast cells. Therefore, due to the low amount of normal cell contamination, the methylation levels that are presented represent minimal values. The genes that we sequenced were selected on the basis of being hypermethylated either in leukemia or other cancers or on the basis on our preliminary Southern analysis data that indicated the genes were hypermethylated in the AML samples (data not shown). We chose to analyze the methylation data by direct PCR sequencing because this provides a semiquantitative estimate of the methylation levels in the sample, and individual CpG sites could be assessed in the one reaction. A summary of the genomic sequencing results for each of the eight individual genes analyzed is presented below, followed by an overall summary of the methylation state of the genes for each patient.
Calcitonin Gene.
It has been well established that the calcitonin gene, which lies on chromosome 11p15.2, is a "hot spot" for methylation in leukemia. The CpG rich 5' region of the calcitonin gene was found previously to be methylated in 7895% of acute leukemias by Southern analysis (16
, 26)
or genomic sequencing (27)
. To correlate the methylation profile of the calcitonin gene in AML with the methylation profile of the other target genes, we used bisulfite genomic sequencing. Fig. 1
shows the sequence map of the 19 CpG sites in the central CpG rich island close to the transcription start site that were sequenced. There was a low level (<25%) of methylation at one to two CpG sites in approximately half the normal bone marrow samples, and these methylated sites were localized downstream to the start of transcription. In contrast, 12 of 17 (71%) of the AML patients had substantial methylation across the entire CpG-rich region. However, the methylation patterns in the AML samples was heterogeneous, varying from extensive methylation at high levels (e.g., R76 and R86) to low level methylation at four to six CpG sites (e.g., R94 and R125). The remaining AML patients (5 of 17, 29%) displayed methylation profiles similar to the normal patterns (e.g., R63 and R79). There does not appear to be any critical sites that are exclusively methylated in each patient; however, the region encompassing CpG sites 16, which are the sites closest to the transcription start site, were found to be the most heavily methylated (50100%). Of the 19 CpG sites studied, only one site (CpG 15) encompassed an informative site for Southern analysis (HpaII site). However, this site was only methylated in 5 of 17 (29%) of the samples, 1 of which (R63) had a normal methylation profile. Therefore, using bisulfite sequencing enabled a more detailed and informative description of the methylation profile of the calcitonin gene.
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To enable a more complete analysis of these genes, we determined the methylation status of 47 CpG sites that encompass the transcription start site and exon 1 of p15 (Fig. 4)
. This sequence also includes the region where hypermethylation has been associated with transcriptional silencing (31)
. We found in some of the normal bone marrow samples a low level of methylation (<25%) at one to five CpG sites downstream to the start of transcription. In comparison, we found hypermethylation of the p15 gene in 13 of 19 (68%) of AML patients studied. Again, the methylation patterns are heterogeneous, ranging from no methylation (R79 and R94) to sparse methylation (R59 and R60) and to methylation encompassing the entire region (R38 and R102). In general, methylation spanned the entire region analyzed but was highly mosaic in the individual patients. A similar finding of variegation in the methylation profile of p15 was also found in AML by Dodge et al. (19)
. As for calcitonin, the level of methylation was often high (75100%) at individual CpG sites, indicating that either both alleles were methylated or that one allele was heavily methylated and the other lost.
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Concurrent Hypermethylation.
By studying the methylation profile of a number of target genes from the same cohort of patients, we have been able to assess whether hypermethylation is limited to single target genes or whether multiple genes are susceptible to hypermethylation in the one cell. Fig. 7A
summarizes the methylation patterns for the eight target genes studied in the normal and AML bone marrow samples. To aid in the interpretation of the results, we scored the gene as significantly methylated only if the samples were methylated at any one CpG site at levels >25% or if the samples were methylated in at least 25% of determinable sites. It is clear that except for methylation in the calcitonin gene that was found in one normal sample (N47) and HIC1 which showed differential methylation in exon 2, the rest of the genes studied from normal bone marrow samples were essentially unmethylated in the CpG-rich island regions analyzed. In contrast, the methylation profile in the AML patients was extensive. Moreover, hypermethylation was not limited to a single target gene but often was found in multiple genes in each patient studied. In fact, 15 of 20 (75%) AML patients displayed concordant methylation in at least two genes. Interestingly, the subset of genes methylated varied in each patient. For example, in R128, only p15 was methylated; in R103, p15 and ER were both methylated; and in R14, p15 and calcitonin were both methylated. There are also patients with multiple genes methylated; for example in R36, calcitonin, E-cadherin, p15, p16, and HIC1 were methylated, and in R38, all of the genes tested were methylated except for GST-Pi and Rb. In fact, GST-Pi and Rb were not methylated in any of the AML samples tested. Fig. 7B
shows that >50% of the patients were methylated in the calcitonin, E-cadherin, ER, p15, and HIC1 genes, and >80% of the patients were methylated in HIC1. However, it is of interest to note that no single gene was always methylated.
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| DISCUSSION |
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The main conclusion from our study is that aberrant methylation is not confined to single target genes in AML but rather can occur concurrently across many different genes spanning different chromosomes in an individual patient. The HIC1 gene (spanning intron 2) was the most commonly methylated, with >80% of the AML samples tested showing hypermethylation. Calcitonin, E-cadherin, ER, and p15 were also commonly methylated, with >50% of the AML samples showing hypermethylation. In comparison, p16 was less frequently methylated, and Rb and GST-Pi were found to be never methylated in the AML samples tested. Interestingly, the methylation portfolio of each AML patient was remarkably different from each other, with quite a variation in the combination of genes selected. In addition, there was no obvious correlation between ages of the patients with AML and the number of genes or subset of genes methylated. In particular, the methylation of the ER did not appear to be age specific in either the normal or cancer samples, as reported by Issa et al. (42) and Ahuja et al. (43) for colon cancer. This difference may be due to the fact that different tissues were examined in the latter study, or our sample size was limited. However, we have taken care to ensure that the median ages between normal and AML samples were matched to differentiate AML-specific methylation from age-related methylation.
It is clear from our results that, although there is a heterogeneity in the profile of genes methylated within the AML patients, there also appears to be cancer cell type-specific differences. For example, Rb and GST-Pi were both found to be unmethylated in the AML patients, whereas these genes are frequently methylated in retinoblastoma tumors and prostate tumors, respectively (38
, 39 , 44)
. p16 was also methylated at a low level in
30% of samples in this study, but p16 is frequently methylated in lung cancer and melanoma (45)
. Liang et al. (46)
, using a genome scanning analysis of three different tumors, also reported tissue-specific variation in the methylation patterns between the tumors. The fact that multiple genes are frequently methylated in cancer suggests that the mechanism that normally protects CpG islands from methylation is defective in the cancer cell. The fact that different combinations of a subset of genes can be methylated in the one cell type suggests that methylation is stochastic. The set of genes that are commonly methylated possibly reflects the genes that, when silenced, provide the cell with a selective growth advantage in different cell types. However, the cancer specificity observed may reflect the different set of tissue-specific factors found in the different cell types.
The mechanism that protects CpG islands from methylation is unclear, and what triggers hypermethylation in cancer is still unresolved. An increase in DNA MTase was proposed to be important in the initiation and progression of cancer and in establishing altered DNA methylation patterns (3, 4, 5 , 9) . However, it is clear from our results that simply an increase in DNA MTase is insufficient to explain the altered methylation patterns. The AML samples screened had DNA MTase levels 2.510-fold higher than normal bone marrow (6) , but the methylation patterns of these patients were variable and bore no obvious relationship to the level of DNA MTase in the cell. It is, however, possible that other methylation enzymes, such as dnmt3a and dnmt3b (47) , may play a role in abnormal methylation in leukemia.
Active transcription also has been proposed as a mechanism to protect CpG islands from methylation (48) . It is possible that in the cancer cell, a subset of CpG island promoters are silenced, permitting subsequent de novo methylation. This is an attractive hypothesis and may help to explain how hypermethylation appears to be stochastic but also limited to a specific subset of genes for the different cancer types. Unfortunately, because the samples we tested contained a low level of normal cell contamination, it was not possible to accurately quantitate the level of expression for each gene in the sample and demonstrate that the genes were indeed silenced. It is also unclear from our results whether the variable methylation patterns we observed influenced the level of gene transcription within the individual genes tested. However methylation, as determined by Southern analysis, has been associated with inactivation of expression in many of the genes we analyzed (28 , 30 , 32, 33, 34, 35 , 42 , 49) . We suggested previously that transient CpNpG methylation of Sp1 sites in the promoter regions of CpG islands may be one mechanism that may lead to gene silencing and subsequent de novo methylation of CpG islands (50) . However, in this analysis, we found no evidence of CpNpG methylation at detectable levels. Because our data were obtained by direct PCR sequencing, methylation levels <15% are difficult to assess above background.
We chose to analyze the individual methylation patterns for each gene by sequencing to gain an insight into the mechanism responsible for the specific methylation profiles. We found that for each gene, the methylation profile across the CpG island was heterogeneous, and no one CpG site appeared to be always methylated. This is similar to our previous findings of mosaic methylation found in both cancer and normal cells (38 , 39 , 51 , 52) . It therefore appears that the de novo methylation process is stochastic and supports the hypothesis that it is the density of methylation across a region that is important rather than methylation of individual target sites. Interestingly, for the HIC1 gene, we did note a marked boundary of methylation that occurred between intron 2 and exon 3 in the normal cell that was lacking in the cancer cell. The existence of such a methylation boundary, which is clearly lost in the cancer cell, may provide clues in the future as to the mechanism that normally protects sequences from methylation in the normal cell (53) .
The results of this study have allowed us to answer some important questions about de novo DNA methylation in cancer cells: (a) although a deregulation of the methylation machinery is implicated in abnormal hypermethylation, an increase in DNA MTase alone is not sufficient to mediate this hypermethylation; (b) hypermethylation in AML is not confined to a single locus but rather is a multiple loci event covering CpG-rich gene regions; and (c) the aberrant de novo methylation found in AML appears to be a stochastic process acting at individual CpG sites within different CpG islands combined with a cell type selectivity. Moreover, the cancer specificity may reflect the different set of factors found in different cell types. The next step is to determine what the factors are protecting CpG islands from methylation in the normal cell and what triggers the breakdown of the protective process in the malignant cell.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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1 J. R. M. is the recipient of the Anthony Rothe Memorial Trust postgraduate scholarship. ![]()
2 To whom requests for reprints should be addressed, at CSIRO, Molecular Science, Sydney Laboratory, P. O. Box 184, North Ryde, New South Wales 1670, Australia. Phone: (612) 94905148; Fax: (612) 94905005; E-mail: susan.clark{at}molsci.csiro.au ![]()
3 The abbreviations used are: MTase, methyltransferase; ER, estrogen receptor; AML, acute myeloblastic leukemia; MSP, methylation-specific PCR. ![]()
Received 1/25/99. Accepted 6/ 2/99.
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P. G. Corn, B. D. Smith, E. S. Ruckdeschel, D. Douglas, S. B. Baylin, and J. G. Herman E-Cadherin Expression Is Silenced by 5' CpG Island Methylation in Acute Leukemia Clin. Cancer Res., November 1, 2000; 6(11): 4243 - 4248. [Abstract] [Full Text] [PDF] |
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J. R. Melki, P. C. Vincent, R. D. Brown, and S. J. Clark Hypermethylation of E-cadherin in leukemia Blood, May 15, 2000; 95(10): 3208 - 3213. [Abstract] [Full Text] [PDF] |
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A. Aggerholm, P. Hokland, P. Guldberg;, and J. G. Herman DAP-kinase CpG island methylation in acute myeloid leukemia: methodology versus biology? Blood, May 1, 2000; 95(9): 2997 - 2999. [Full Text] [PDF] |
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T. Ueki, M. Toyota, T. Sohn, C. J. Yeo, J.-P. J. Issa, R. H. Hruban, and M. Goggins Hypermethylation of Multiple Genes in Pancreatic Adenocarcinoma Cancer Res., April 1, 2000; 60(7): 1835 - 1839. [Abstract] [Full Text] |
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B. S. Parker, S. M. Cutts, and D. R. Phillips Cytosine Methylation Enhances Mitoxantrone-DNA Adduct Formation at CpG Dinucleotides J. Biol. Chem., May 4, 2001; 276(19): 15953 - 15960. [Abstract] [Full Text] [PDF] |
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D. S. Millar, C. L. Paul, P. L. Molloy, and S. J. Clark A Distinct Sequence (ATAAA)n Separates Methylated and Unmethylated Domains at the 5'-End of the GSTP1 CpG Island* J. Biol. Chem., August 4, 2000; 275(32): 24893 - 24899. [Abstract] [Full Text] [PDF] |
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R. S. Gitan, H. Shi, C.-M. Chen, P. S. Yan, and T. H.-M. Huang Methylation-Specific Oligonucleotide Microarray: A New Potential for High-Throughput Methylation Analysis Genome Res., January 1, 2002; 12(1): 158 - 164. [Abstract] [Full Text] [PDF] |
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