[EZH inhibitors in lymphoma therapy].

Kenji Ishitsuka
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Abstract

Enhancer of zeste homolog (EZH), a subunit of polycomb repressive complex 2 (PRC2), suppresses gene expression by methylation of H3K27. EZH is closely associated with B-cell development and pathogenesis of certain malignant lymphomas. In follicular lymphoma (FL), gain-of-function mutation and upregulation of EZH2 are observed in approximately 30% and 15% of cases, respectively. Moreover, one-third of diffuse large B-cell lymphomas carry an EZH2 mutation, mostly co-existing with translocation involving Bcl-2. Genome-wide trimethylation of H3K27 is a unique characteristic induced by upregulation of both EZH2 and EZH1, and is responsible for more than half of the gene suppression that occurs in adult T-cell leukemia/lymphoma (ATL). Inhibition of EZH can reduce H3K27 methylation and subsequently restore epigenetically suppressed genes. Currently, an EZH2 inhibitor and dual EZH1/2 inhibitor have been clinically used to treat relapsed/refractory FL and ATL, respectively. EZH-targeted treatment for lymphoma has only just begun, and further development of these drugs for various other malignancies, both alone and in combination with other therapeutics, is ongoing.

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[EZH抑制剂在淋巴瘤治疗中的应用]
zeste同源增强子(Enhancer of zeste homolog, EZH)是多梳抑制复合体2 (polycomb suppressicomplex 2, PRC2)的一个亚基,通过H3K27的甲基化抑制基因表达。EZH与某些恶性淋巴瘤的b细胞发育和发病机制密切相关。在滤泡性淋巴瘤(FL)中,大约30%和15%的病例分别观察到EZH2的功能获得性突变和上调。此外,三分之一的弥漫性大b细胞淋巴瘤携带EZH2突变,大多数与涉及Bcl-2的易位共存。H3K27全基因组三甲基化是EZH2和EZH1上调诱导的独特特征,是成人t细胞白血病/淋巴瘤(ATL)中超过一半的基因抑制的原因。抑制EZH可以降低H3K27甲基化,随后恢复表观遗传抑制基因。目前,一种EZH2抑制剂和双EZH1/2抑制剂已分别用于临床治疗复发/难治性FL和ATL。针对ezh的淋巴瘤治疗才刚刚开始,这些药物用于其他各种恶性肿瘤的进一步开发,无论是单独使用还是与其他治疗方法联合使用,都在进行中。
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