Aspects cytologiques et immunophénotypiques des syndromes lymphoprolifératifs chroniques

Cytological analysis of peripheral blood smears and immunophenotyping of the tumoral cell population represent diagnostic tools which are essential for the identification of chronic lymphoid leukemias and of small cell lymphomas in leukaemic phase. Schematically, two main categories are described: chronic lymphoproliferative disorders from B origin and those from T origin. Among B lymphoproliferative disorders, chronic lymphocytic leukemia is the most frequent and may be difficult to distinguish from small B-cell lymphomas: mantle cell lymphoma or follicular lymphoma. Hairy cell leukemia and splenic lymphoma with villous lymphocytes are generally easily identified thanks to their characteristic morphology. The marginal splenic B-cell lymphoma constitutes a recently described entity, yet ill-defined, which presents frequently at onset in leukaemic phase and has to be distinguished from B-CLL. T-cell chronic lymphoid disorders, less frequent, are recognized by their well defined cytological features, their specific phenotypic profile and/or their suggestive clinical presentation: T prolymphocytic leukemia, leukemia with LGL (large granular leukaemia), adult T cell leukemia/lymphoma, and Sezary syndrome.     

Virus epstein-barr et proliférations lymphoïdes B

EBV driven B-cell lymphoid proliferations occur after the dysfunction of the immune control and they appear in primary or acquired immunodeficiencies. In primary immunodeficiencies, combined variable immune deficiency (CVID), X linked lymphoproliferative disorder (XLP), severe combined immune deficiency (SCID) and Wiskott-Aldrich syndrome (WAS) are frequently associaterd with EBV associated B-cell lymphoproliferative disorders or lymphomas. In acquired immunodeficiency after organ or bone marrow transplantation, the occurrence of lymphoid proliferation is one of the most serious complications. They are B-cell, polymorphic or monomorphic and EBV related in almost all cases in early proliferations after the graft. In HIV infection, EBV associated B-cell lymphoma are mostly observed in profound immunosuppressed patients. They are localised in brain or in other extra nodal sites. They are diffuse large B cell lymphoma having the features of immunoblastic subcategory. HIV related Burkitt lymphoma is associated with EBV in 30 to 70 % of cases. The role of EBV in such lymphoma where oncogenic events are predominant remain to be elucidated as well as in the Burkitt lymphoma occurring in immunocompetent patients (children or adults) where EBV is present in about 15 % of non endemic cases.     

Analysis of the coding genome of diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most common form of human lymphoma. Although a number of structural alterations have been associated with the pathogenesis of this malignancy, the full spectrum of genetic lesions that are present in the DLBCL genome, and therefore the identity of dysregulated cellular pathways, remains unknown. By combining next-generation sequencing and copy number analysis, we show that the DLBCL coding genome contains, on average, more than 30 clonally represented gene alterations per case. This analysis also revealed mutations in genes not previously implicated in DLBCL pathogenesis, including those regulating chromatin methylation (MLL2; 24% of samples) and immune recognition by T cells. These results provide initial data on the complexity of the DLBCL coding genome and identify novel dysregulated pathways underlying its pathogenesis.     

Le virus epstein-barr : structure et cycle biologique

The Epstein-Barr virus (EBV) is an oncogene virus which is widely spread in the human populations. Following infection, EBV establishes a latent infection which allows its persistence during the entire life of the infected host. Most often viral persistence is asymptomatic. Nevertheless Epstein-Barr virus is also associated with various malignancies of epithelial (nasopharygeal carcinoma) and B-cell origin (Burkitt's lymphoma, B-cell lymphomas and lymphoproliferative diseases of immunocompromised patients). An important part of our current knowledge provides from studies which have been conducted on EBV-infected cell lines. This review aimed at presenting these data and will most especially stress on various aspects of the biological cycle of the virus and its ability to transform cells.     

Genetics of gene expression in primary immune cells identifies cell type-specific master regulators and roles of HLA alleles

Trans-acting genetic variants have a substantial, albeit poorly characterized, role in the heritable determination of gene expression. Using paired purified primary monocytes and B cells, we identify new predominantly cell type-specific cis and trans expression quantitative trait loci (eQTLs), including multi-locus trans associations to LYZ and KLF4 in monocytes and B cells, respectively. Additionally, we observe a B cell-specific trans association of rs11171739 at 12q13.2, a known autoimmune disease locus, with IP6K2 (P = 5.8 × 10(-15)), PRIC285 (P = 3.0 × 10(-10)) and an upstream region of CDKN1A (P = 2 × 10(-52)), suggesting roles for cell cycle regulation and peroxisome proliferator-activated receptor γ (PPARγ) signaling in autoimmune pathogenesis. We also find that specific human leukocyte antigen (HLA) alleles form trans associations with the expression of AOAH and ARHGAP24 in monocytes but not in B cells. In summary, we show that mapping gene expression in defined primary cell populations identifies new cell type-specific trans-regulated networks and provides insights into the genetic basis of disease susceptibility.     

Intérêt de la cytogénétique dans les syndromes lymphoprolifératifs chroniques

Chronic B-cell lymphoid proliferations are characterised by the presence of multiple recurrent chromosomal aberrations. A certain number of these chromosomal anomalies have been found to represent disease-specific tumour markers : the t(11;14) in mantle cell lymphoma, the t(14;18) in follicular lymphoma and the t(11;18) in lowgrade MALT lymphoma, for instance. These tumour-specific genetic markers are not only useful in patient diagnosis and follow-up, but can also have great prognostic significance. Recent prospective studies in chronic lymphocytic leukaemias have shown that in multivariate analysis, 17p and 11q deletions are the two strongest independant predictors of survival followed by age and RAI stage.The occurrence of common genetic changes in different categories of chronic lymphoid disorders is suggestive of common disease mechanisms in these apparently distinct disease entities. Therefore, it is to be expected that further multidisciplinary studies on these lymphomas would identify other potentially disease- or progression-specific chromosomal aberrations useful for accurate classification.Finally, cytogenetic studies coupled with FISH mapping have already proved instrumental in identifying hot spots of rearrangement in human cancer which in turn have served as chromosomal guides for the cloning of new genes important in oncogenesis or tumour progression.     

Interacting loci cause severe iris atrophy and glaucoma in DBA/2J mice

Glaucomas are a major cause of blindness. Visual loss typically involves retinal ganglion cell death and optic nerve atrophy subsequent to a pathologic elevation of intraocular pressure (IOP). Some human glaucomas are associated with anterior segment abnormalities such as pigment dispersion syndrome (PDS) and iris atrophy with associated synechiae. The primary causes of these abnormalities are unknown, and their aetiology is poorly understood. We recently characterized a mouse strain (DBA/2J) that develops glaucoma subsequent to anterior segment changes including pigment dispersion and iris atrophy. Using crosses between mouse strains DBA/2J (D2) and C57BL/6J (B6), we now show there are two chromosomal regions that contribute to the anterior segment changes and glaucoma. Progeny homozygous for the D2 allele of one locus on chromosome 6 (called ipd) develop an iris pigment dispersion phenotype similar to human PDS. ipd resides on a region of mouse chromosome 6 with conserved synteny to a region of human chromosome 7q that is associated with human PDS. Progeny homozygous for the D2 allele of a different locus on chromosome 4 (called isa) develop an iris stromal atrophy phenotype (ISA). The Tyrpl gene is a candidate for isa and likely causes ISA via a mechanism involving pigment production. Progeny homozygous for the D2 alleles of both ipd and isa develop an earlier onset and more severe disease involving pigment dispersion and iris stromal atrophy.     

Application of comparative functional genomics to identify best-fit mouse models to study human cancer

Genetically modified mice have been extensively used for analyzing the molecular events that occur during tumor development. In many, if not all, cases, however, it is uncertain to what extent the mouse models reproduce features observed in the corresponding human conditions. This is due largely to lack of precise methods for direct and comprehensive comparison at the molecular level of the mouse and human tumors. Here we use global gene expression patterns of 68 hepatocellular carcinomas (HCCs) from seven different mouse models and 91 human HCCs from predefined subclasses to obtain direct comparison of the molecular features of mouse and human HCCs. Gene expression patterns in HCCs from Myc, E2f1 and Myc E2f1 transgenic mice were most similar to those of the better survival group of human HCCs, whereas the expression patterns in HCCs from Myc Tgfa transgenic mice and in diethylnitrosamine-induced mouse HCCs were most similar to those of the poorer survival group of human HCCs. Gene expression patterns in HCCs from Acox1(-/-) mice and in ciprofibrate-induced HCCs were least similar to those observed in human HCCs. We conclude that our approach can effectively identify appropriate mouse models to study human cancers.     

Spatial proximity of translocation-prone gene loci in human lymphomas

Cancer cells frequently have disease-specific chromosome rearrangements. It is poorly understood why translocations between chromosomes recur at specific breakpoints in the genome. Here we provide evidence that higher-order spatial genome organization is a contributing factor in the formation of recurrent translocations. We show that MYC, BCL and immunoglobulin loci, which are recurrently translocated in various B-cell lymphomas, are preferentially positioned in close spatial proximity relative to each other in normal B cells. Loci in spatial proximity are non-randomly positioned towards the nuclear interior in normal B cells. This locus proximity is the consequence of higher-order genome structure rather than a property of individual genes. Our results suggest that the formation of specific translocations in human lymphomas, and perhaps other tissues, is determined in part by higher-order spatial organization of the genome.     

New genes involved in cancer identified by retroviral tagging

Retroviral insertional mutagenesis in BXH2 and AKXD mice induces a high incidence of myeloid leukemia and B- and T-cell lymphoma, respectively. The retroviral integration sites (RISs) in these tumors thus provide powerful genetic tags for the discovery of genes involved in cancer. Here we report the first large-scale use of retroviral tagging for cancer gene discovery in the post-genome era. Using high throughput inverse PCR, we cloned and analyzed the sequences of 884 RISs from a tumor panel composed primarily of B-cell lymphomas. We then compared these sequences, and another 415 RIS sequences previously cloned from BXH2 myeloid leukemias and from a few AKXD lymphomas, against the recently assembled mouse genome sequence. These studies identified 152 loci that are targets of retroviral integration in more than one tumor (common retroviral integration sites, CISs) and therefore likely to encode a cancer gene. Thirty-six CISs encode genes that are known or predicted to be genes involved in human cancer or their homologs, whereas others encode candidate genes that have not yet been examined for a role in human cancer. Our studies demonstrate the power of retroviral tagging for cancer gene discovery in the post-genome era and indicate a largely unrecognized complexity in mouse and presumably human cancer.     

Chromosome stability, in the absence of apoptosis, is critical for suppression of tumorigenesis in Trp53 mutant mice

The p53 protein integrates multiple upstream signals and functions as a tumor suppressor by activating distinct downstream genes. At the cellular level, p53 induces apoptosis, cell cycle arrest and senescence. A rare mutant form of p53 with the amino acid substitution R175P, found in human tumors, is completely defective in initiating apoptosis but still induces cell cycle arrest. To decipher the functional importance of these pathways in spontaneous tumorigenesis, we used homologous recombination to generate mice with mutant p53-R172P (the mouse equivalent of R175P in humans). Mice inheriting two copies of this mutation (Trp53(515C/515C)) escape the early onset of thymic lymphomas that characterize Trp53-null mice. At 7 months of age, 90% of Trp53-null mice had died, but 85% of Trp53(515C/515C) mice were alive and tumor-free, indicating that p53-dependent apoptosis was not required for suppression of early onset of spontaneous tumors. The lymphomas and sarcomas that eventually developed in Trp53(515C/515C) mice retained a diploid chromosome number, in sharp contrast to aneuploidy observed in tumors and cells from Trp53-null mice. The ability of mutant p53-R172P to induce a partial cell cycle arrest and retain chromosome stability are crucial for suppression of early onset tumorigenesis.     

Gene-target recognition among members of the myc superfamily and implications for oncogenesis

Myc and Mad family proteins regulate multiple biological processes through their capacity to influence gene expression directly. Here we show that the basic regions of Myc and Mad proteins are not functionally equivalent in oncogenesis, have separable E-box-binding activities and engage both common and distinct gene targets. Our data support the view that the opposing biological actions of Myc and Mxi1 extend beyond reciprocal regulation of common gene targets. Identification of differentially regulated gene targets provides a framework for understanding the mechanism through which the Myc superfamily governs the growth, proliferation and survival of normal and neoplastic cells.     

Diagnostic histopathologique de la mononucléose infectieuse

Infectious mononucleosis corresponds to the clinical syndrome of primary infection by Epstein-Barr virus (EBV). When diagnosis has not been achieved, pathologists may have to analyze lymph node biopsy, tonsil sample or spleen. In all cases, the diagnosis is based on a massive proliferation of infected B cells and cytotoxic T cells. Tissue architecture is preserved, sometimes masked by the polymorphic cellular infiltration, comprising many cells with plasmacytic differentiation. Immunohistochemistry shows the mixture of B and T immunoblasts, the polytypic phenotype of cells with plasmacytic differentiation and numerous cytotoxic T cells. EBV is evidenced by in situ hybridization (EBER-1 probe) or by immunohistochemistry with detection of latent viral proteins (LMP-1, EBNA-2). Differential diagnosis can be difficult with some lymphomas (Hodgkin's disease, Diffuse large B cell lymphomas…) as well as with other infectious chronic lymphadenopathies.     

HNPCC-like cancer predisposition in mice through simultaneous loss of Msh3 and Msh6 mismatch-repair protein functions.

Cancer predisposition in hereditary non-polyposis colon cancer (HNPCC) is caused by defects in DNA mismatch repair (MMR). Mismatch recognition is attributed to two heterodimeric protein complexes: MutSalpha (refs 2, 3, 4, 5), a dimer of MutS homologues MSH2 and MSH6; and MutSbeta (refs 2,7), a dimer of MSH2 and MSH3. These complexes have specific and redundant mismatch recognition capacity. Whereas MSH2 deficiency ablates the activity of both dimers, causing strong cancer predisposition in mice and men, loss of MSH3 or MSH6 (also known as GTBP) function causes a partial MMR defect. This may explain the rarity of MSH6 and absence of MSH3 germline mutations in HNPCC families. To test this, we have inactivated the mouse genes Msh3 (formerly Rep3 ) and Msh6 (formerly Gtmbp). Msh6-deficient mice were prone to cancer; most animals developed lymphomas or epithelial tumours originating from the skin and uterus but only rarely from the intestine. Msh3 deficiency did not cause cancer predisposition, but in an Msh6 -deficient background, loss of Msh3 accelerated intestinal tumorigenesis. Lymphomagenesis was not affected. Furthermore, mismatch-directed anti-recombination and sensitivity to methylating agents required Msh2 and Msh6, but not Msh3. Thus, loss of MMR functions specific to Msh2/Msh6 is sufficient for lymphoma development in mice, whereas predisposition to intestinal cancer requires loss of function of both Msh2/Msh6 and Msh2/Msh3.