P733: DHX9 HELICASE DYSFUNCTION CONTRIBUTES TO DISEASE PROGRESSION IN PATIENTS WITH MYELODYSPLASTIC SYNDROMES

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Background:DHX9 is a member of the DEAH (Asp-Glu-Ala-His) helicase family, and participates in regulating DNA replication and RNA processing. DHX9 dysfunction promotes tumorigenesis in several solid cancers. However, the role of DHX9 in myelodysplastic syndromes (MDS) is still unknown. Aims: to investigate the role of DHX9 in the pathogenesis of myelodysplastic syndromes. Methods:DHX9 expression was analyzed in 120 MDS patients and 42 non-MDS benign controls by quantitative PCR. Clinical significance of changes in DHX9 expression was investigated in disease progression and survival. Lentivirus-mediated DHX9 knockdown experiments were performed to investigate its biological function. The mechanistic involvement of DHX9 in MDS development was explored in cell functional assays, gene microarray and pharmacological intervention. Considering the importance of DHX9 in regulation of R-loop, we also investigated the role of DHX9 and R-loop in MDS. Results: We found that overexpression of DHX9 is frequent in MDS patients, and associated with poor survival and high risk of AML transformation. Cell functional assays showed that DHX9 is essential for the maintenance of malignant proliferation of leukemia cells, and knockdown of DHX9 results in increased cell apoptosis and growth inhibition. Gene expression profile and bioinformatics analysis reveal that DHX9 may be involved in PI3K-AKT signaling pathways. Validating experiments show that DHX9 is indispensable for the activation of PI3K-AKT signaling as knockdown of DHX9 inactivates the PI3K-AKT signaling, reduces the expression of anti-apoptosis genes such as CCND2, MYC and BCL2. In addition, we found that DHX9 knockdown leads to R-loop accumulation in MDS cells, and induces R-Loop-dependent DNA damage through ATR-Chk1 activation. It suggests that overexpressed DHX9 could counteract cell growth defect caused by R-Loop which is quite common in MDS patients especially in those with splicing genes mutations. Summary/Conclusion: Our data suggest that DHX9 contributes to disease progression by activation of PI3K-AKT signaling and correcting R-loop-mediated growth defect in MDS, and may serve as a novel prognostic marker for AML transformation and therapeutic target in MDS.