Abstract

Pediatric gliomas comprise a broad range of brain tumors derived from glial cells. While high-grade gliomas are often resistant to therapy and associated with a poor outcome, children with low-grade gliomas face a better prognosis. However, the treatment of low-grade gliomas is often associated with severe long-term adverse effects. This shows that there is a strong need for improved treatment approaches. Here, we highlight the potential for repurposing disulfiram to treat pediatric gliomas. Disulfiram is a drug used to support the treatment of chronic alcoholism and was found to be effective against diverse cancer types in preclinical studies. Our results show that disulfiram efficiently kills pediatric glioma cell lines as well as patient-derived glioma stem cells. We propose a novel mechanism of action to explain disulfiram’s anti-oncogenic activities by providing evidence that disulfiram induces the degradation of the oncoprotein MLL. Our results further reveal that disulfiram treatment and MLL downregulation induce similar responses at the level of histone modifications and gene expression, further strengthening that MLL is a key target of the drug and explaining its anti-oncogenic properties.

Highlights

  • Aberrant epigenetic landscapes are prevalent in cancer cells and contribute strongly to cancer development and maintenance

  • Since HOXA9 and HOXA10 have been associated with temozolomide resistance in pediatric glioma [9], we hypothesized that MLL proteins might have a functional role in pediatric glioma

  • Expression of MLL2 is consistent in all five cell lines, while MLL1 expression differs widely over the different cells lines with the highest expression being detected for the high-grade SF188 cells (Fig. 1A)

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Summary

Introduction

Aberrant epigenetic landscapes are prevalent in cancer cells and contribute strongly to cancer development and maintenance. The idea of epigenetic therapy is to interfere with the epigenetic machinery in cancer cells to reverse aberrant patterns and to reestablish the epigenetic landscapes of healthy cells. The methyltransferases play a crucial role in the regulation of multiple processes during development and are implicated in the maintenance of Hox cluster gene expression [2]. MLL1 was found to enable cancer stem cell features and to promote cell growth and tumorigenicity in adult glioblastoma [3, 4]. Aberrant expression of multiple Hox cluster genes was detected in gliomas [6,7,8], and a Hox signature was associated with resistance to the chemotherapeutic agent temozolomide in pediatric glioblastoma [9]

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