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Epigenetic activation of EBV BGLF4 determines antiviral-based regimen response in EBV+CNS lymphoproliferative disease - PubMed

12 hours ago
  • #Epstein-Barr virus
  • #CNS Lymphoma
  • #Epigenetics
  • Epstein-Barr virus (EBV)-associated primary central nervous system lymphoproliferative diseases (EBV+PCNSL) are aggressive with poor prognoses.
  • Ganciclovir, azidothymidine, rituximab, and dexamethasone (GARD) treatment showed durable responses in PCNSL patients, linked to lytic viral protein kinases BGLF4 and BXLF1.
  • RNA expression in CNSL biopsies confirmed LMP1, BXLF1, and BGLF4 but not BZLF1, indicating an incomplete lytic EBV program.
  • Systemic PTLD cases showed significantly lower BXLF1 and BGLF4 expression compared to CNSL.
  • BGLF4 promoter methylation was significantly lower in CNSL vs systemic PTLD (P = .0006).
  • Luciferase reporter analysis identified 3 promoter activity regions in BGLF4 upstream sequence, with transcription start sites in EBV-infected cells and CNSL samples.
  • CNSL-specific DNA methylation loss occurred at single CpG dinucleotides, while surrounding EBV methylation remained high.
  • TET knockout and IDH1 mutant expression in a latent EBV model showed active demethylation is necessary for BGLF4 promoter activity.
  • Epigenetic activation of BGLF4 in CNSL via locus-specific promoter activation may determine GARD sensitivity.