Abstract Diffuse Midline Gliomas (DMGs) are highly aggressive pediatric cancers with no effective treatments. Over 80% of DMGs harbor histone mutations, particularly H3.1 K27M, H3.3 K27M, and H3.3 G34R/V. These mutations impair the function of the Polycomb Repressive Complex 2 (PRC2), leading to reduced levels of H3K27me3. Overexpression of the EZHIP has been identified in ependymomas and DMGs. EZHIP overexpression is marked by widespread H3K27me3 loss and is mutually exclusive with histone mutations. EZHIP overexpression mimics the effects of the H3K27M mutation by reducing H3K27me3 levels. It is believed to inhibit the catalytic activity of EZH2 by binding to its SET domain, similar to the K27M mutant. Expression of EZHIP is tightly regulated and typically absent in most cell types. The transcriptional regulation of EZHIP is poorly understood; however, promoter hypermethylation is likely involved in regulating its expression. We investigate EZHIP’s role in DMG tumorigenesis, focusing on its regulation, impact on histone modifications, and chromosomal stability. Initial analyses have revealed transcription factor binding sites within the EZHIP promoter, including EGR2, SOX2, and ICP4, indicating that various transcription factors and viral infections might directly affect EZHIP expression. Utilizing RNA-Seq, we have identified both shared and unique transcriptomic alterations in DMG cells related to EZHIP expression and H3.3 K27M mutations. To study the role of EZHIP in tumorigenesis, we developed a mouse model expressing EZHIP-HA p2A PDFGB in RCAS-Nestin TVA mice. EZHIP expression induces high-grade tumors and significantly reduces survival. Our ongoing research suggests that EZHIP functions similarly to H3.3 K27M mutations in driving tumor growth, not only by reducing K27me3 but also through chromosomal missegregation. We aim to elucidate the full extent of EZHIP’s role in epigenetic control, histone post-translational modifications, chromosomal accessibility, and instability. Our findings will provide critical insights into the mechanisms underlying DMG tumorigenesis and potential therapeutic targets.
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