Published online 16 July 2009
Haematologica, Vol 94, Issue 8, 1170-1174 doi:10.3324/haematol.2009.007260
Copyright © 2009 by Ferrata Storti Foundation
Mutational analysis of TP53, PTEN, PIK3CA and CTNNB1/β-catenin genes in human herpesvirus 8-associated primary effusion lymphoma
Emmanuelle Boulanger1,
Agnès Marchio2,
Saw-See Hong3,
Pascal Pineau2
1 Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris;
2 Nuclear Organization and Oncogenesis Unit, INSERM U579, Institut Pasteur, Paris and
3 Laboratory of Virology and Vectorology, CNRS FRE 3011, Faculté de Médecine RTH Laënnec, Université Lyon I, Lyon, France
Correspondence: Emmanuelle Boulanger, Laboratory of Thymus research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Ave, Brasil 4365, Manguinhos, 21045-900, Rio de Janeiro, RJ, Brazil. E-mail:emmaboul{at}ioc.fiocruz.br.

ABSTRACT
Human herpesvirus 8 (HHV-8)-associated primary effusion lymphoma
is a rare non-Hodgkins lymphoma often associated with
Epstein-Barr virus (EBV) infection. Mutations in
TP53,
PTEN,
PIK3CA,
CTNNB1/β-catenin genes and deletion of CDKN2A-ARF
(p14
ARF-p16
NK4a I ) locus were investigated in sixteen primary
primary effusion lymphoma tumors and seven primary effusion
lymphoma cell lines using PCR and sequencing.
TP53 mutations
were detected in one primary primary effusion lymphoma tumor
(6.2%) and two primary effusion lymphoma cell lines (28.6%).
BC-3 and BCP-1 cell lines showed
PTEN gene mutations, associated
with a loss of PTEN protein expression in both cases. No mutations
were detected in
PIK3CA and
CTNNB1/β-catenin hotspot sequences.
Only BC-3 contained a homozygous deletion of CDKN2A-ARF locus.
Although detected at a higher frequency in primary effusion
lymphoma cell lines than in primary primary effusion lymphoma
tumors,
TP53 and/or
PTEN mutations, as well as deletion of CDKN2A-ARF
locus are uncommon in primary effusion lymphoma, and are found
to correlate with the EBV-negative status of primary effusion
lymphoma tumors.
Key words: human herpesvirus 8, non-Hodgkins lymphoma, primary effusion lymphoma, tumor suppressor gene, mutations.

Introduction
Somatic mutations of tumor suppressor genes and oncogenes are
among the most common genetic alterations found in human malignancies.
Moreover, single nucleotide polymorphisms (SNP) in genes involved
in apoptosis or cell cycle regulation have been shown to correlate
with an increased risk of cancer development, an accelerated
cancer onset, a poor response to treatment or a shorter survival.
In this setting, a common SNP (rs1042522) in exon 4 of the
TP53 gene, resulting in either Arginine or Proline at codon 72 of
the proline-rich domain, has been reported to influence the
ability of TP53 protein to induce apoptosis, the Arg72 variant
being the most efficient apoptosis inducer.
1 The SNP309 t/g
(rs2279744) polymorphism identified in the promoter of MDM2
oncogene, which encodes the negative regulator of TP53, has
been shown to influence DNA binding affinity of the transcriptional
activator Sp1, leading to changes in MDM2 expression levels
and attenuation of TP53 response. In sporadic cancers, including
diffuse large B-cell lymphomas (DLBCL), the SNP309 g/g genotype
has been found to correlate with an earlier age of tumor onset
in female patients.
2 In other studies however, neither MDM2
SNP309 nor TP53 SNP72 have been found to be associated with
survival or age of tumor onset in patients with non-Hodgkins
lymphoma (NHL).
3,4
Primary effusion lymphoma (PEL) is a rare NHL which usually develops as lymphomatous effusions in the serous cavities of immunocompromised patients, especially Human Immunodeficiency Virus type-1 (HIV-1)-infected individuals and solid organ transplant recipients.5,6 PEL tumor cells display pleiomorphic morphology and frequently lack B-cell lineage antigen expression, despite their B-cell monoclonal origin. These cells are latently infected with HHV-8, and are in most cases co-infected with Epstein-Barr virus (EBV).7,8 The phosphatidylinositol 3-kinase (PI3K)/AKT cascade has been identified as constitutively activated in PEL and critical for cell survival.9 This pathway is negatively regulated by the non-redondant lipid phosphatase PTEN (phosphatase and tensin homolog deleted on chromosome 10). Among the best known genetic alterations leading to the constitutive activation of PI3K/AKT cascade, the loss of PTEN tumor suppressor gene and the activating mutations of the p110 catalytic subunit of PI3K (PIK3CA) have been reported in many cancers including NHL.10–13 PEL tumor cells have been shown to express high levels of β-catenin, which is a downstream activator of the Wnt signaling pathway.14 Mutations in exon 3 of the CTNNB1/β-catenin gene resulting in the accumulation of β-catenin in the cytoplasm, have been found in several cancer types, including lymphoproliferative disorders developed in renal transplant recipients.15 A loss of CDKN2A/p16NK4a I protein expression has been reported in all primary PEL isolates analyzed. However, the molecular events leading to CDKN2A/p16INK4a gene silencing have only been identified in a few PEL cell lines.16 Since mutations of PTEN, PIK3CA, CTNNB1/β-catenin genes and deletion of CDKN2A-ARF (p14ARF-p16INK4a) locus had not been previously investigated in primary PEL tumors, we performed an extensive molecular analysis of mutations and SNP in a large series of PEL samples.

Design and Methods
The study included seven PEL cell lines and sixteen primary
tumor samples (seven pleural effusions, eight ascites, one pericardial
effusion) collected from 12 HIV-1-infected patients, 2 HIV-1-negative
elderly individuals and 2 renal transplant recipients with HHV-8-associated
PEL. All patients samples (
Tables 1 and
2) were collected in
accordance with the ethical regulations of our institution,
as indicated in our previous studies.
5,6 The clinical data were
collected from the patients records by the same examiner
(
EB). Human acute lymphoblastic leukemia (ALL) cell lines of
T (CEM) and B [DAUDI, RAJI, REH, RS(4;11)] cell lineage origins,
and peripheral blood mononuclear cells (PBMCs) from Caucasian
healthy donors, were used as controls. Mutations of
TP53 (exons
4–11),
PTEN (exons 1–9),
PIK3CA (exons 9 and 20),
CTNNB1/β-catenin (exon 3) genes and deletion of CDKN2A-ARF
(p14
ARF-p16
INK4a) locus were detected by PCR and direct sequencing.
SNP in several genes involved in apoptosis and cell cycle regulation
including SNP72 and ins16bp in TP53, SNP309 in MDM2, S31R and
3'UTR (c70t) in CDKN1A/p21
Cip1, V109G and 5'UTR (c79t) in CDKN1B/p27
Kip1,
g870a in CCND1/cyclin D1, A259S in CCND3/cyclin D3, F31I (t91a)
in STK15/aurora A, R70C in CDC25C, A655V in CDC2L1 and I441V
in
CDC6 genes, were assessed by PCR.

Results and Discussion
As previously observed,
7,8 the frequency of
TP53 gene mutations
in PEL was found to be low, as they were detected in only one
out of sixteen (6.2%) tumor samples and in two out of seven
cell lines (28.6%,
Table 1). In accordance with previous reports,
17 BCBL-1 was found to harbor a heterozygous M246I mutation of
TP53. BCP-1 contained two missense mutations leading to single
nucleotide changes (M246V and D259N) in both alleles of exon
7. Only BC-3 contained a homozygous deletion of CDKN2A-ARF locus,
in agreement with previous reports.
16 No mutations were found
in PIK3CA and CTNNB1/β-catenin hotspot sequences. PTEN
gene alterations were identified in two PEL cell lines (
Table 1).
BC-3 carried a monoallelic 2 bp-deletion in exon 7 leading to
a frameshift at codon 247 followed by a stop at codon 250, whereas
BCP-1 harbored a homozygous deletion of PTEN exons 6 through
9. In both cases, these mutations resulted in the loss of PTEN
protein expression (
Figure 1). Approximately 20% of high-grade
B-cell NHL have TP53 mutations
18 whereas the reported rates
of
PTEN and
PIK3CA mutations are around 5%
10,11 and from 1 to
8%,
12,13 respectively. By contrast,
CTNNB1/β-catenin gene
mutations occur more frequently in T-cell or NK/T-cell NHL from
Asian patients than in B-cell NHL.
15 Our results indicated that
these genetic alterations occur at a lower frequency in PEL
than in other subtypes of B-cell NHL, and suggested that other
mechanisms may be relevant in activating oncogenic pathways.
Among HHV-8 lytic proteins with transforming potential, G-protein
coupled receptor (vGPCR)
19 and K1
20 have been shown to constitutively
activate the PI3K/AKT pathway, and viral interferon regulatory
factor 1 (vIRF1) to inhibit TP53 function.
21 LANA-1, which is
constitutively expressed in tumor PEL cells, is able to suppress
TP53 function and to induce β-catenin accumulation by trapping
the glycogen synthase kinase-3b (GSK-3b) into the nucleus.
14 Beside genetic alterations of coding sequences, additional mechanisms
might participate in the loss of tumor suppressor gene function
such as epigenetic silencing. In BCBL-1, BCP-1 and ISI-1 cell
lines, gene hypermethylation has been identified as underlying
the loss of CDKN2A/p16
INK4a locus expression.
16 Post-translational
modifications like phosphorylation can lead to PTEN inactivation,
as observed in Hodgkins lymphoma cell lines.
22 Because
K1 expression has been shown to increase PTEN phosphorylation
in transfected BJAB cells, it might contribute to the constitutive
activation of PI3K/AKT pathway observed in PEL.
20 Like in DLBCL
and Burkitts lymphomas, TP53 and PTEN gene alterations
occurred at a higher frequency in PEL cell lines (3/7) than
in primary tumors (1/16). Considering both PEL cell lines and
primary PEL tumors, the mutation rate was found to be significantly
higher in EBV-negative PEL (4/11) compared to EBV-positive PEL
(0/12,
p=0.037, Fishers test). However, this difference
was not significant when only the primary PEL cases were analyzed.
A similar correlation between the presence of TP53 gene mutations
and the absence of EBV has been reported in Hodgkins
lymphomas,
23 although this result could not be confirmed by
further studies.
24
Considering the 16 patients with PEL (Table 2), the CDKN1A/p21Cip1 S31R, CDKN1B/p27Kip1 V109G and CDC2L1 A655V polymorphims were found to be significantly associated with an African origin (p=0.033, 0.002 and 0.007, respectively), the CDKN1A/p21Cip1 c70t polymorphism with the presence of an HHV-8-associated multicentric Castleman disease (p=0.015) and the CCND3 A259S polymorphism with HIV-1 infection and EBV status of PEL (p=0.001 and 0.015, respectively). However, no correlation could be found between these SNP, the age of patients at the time of PEL diagnosis and their survival from the date of PEL diagnosis.
Our results confirm that mutations of TP53 and PTEN tumor suppressor genes, as well as deletion of CDKN2A-ARF locus, are uncommon in PEL, although they were detected at a higher frequency in PEL cell lines than in primary PEL tumors. Moreover, these genetic alterations were found to be restricted to EBV-negative PEL tumors. No mutations were detected in PIK3CA and CTNNB1/β-catenin hotspot sequences, suggesting that other mechanisms are involved in the pathogenesis of HHV-8-associated PEL.

Acknowledgments
the authors would like to thank Dr. Félix Agbalika (Service
de Microbiologie, Hôpital Saint-Louis and EA3963, Université
Paris 7, Paris, France), Dr. Chris Boshoff (Wolfson Institute
for Biomedical Research, University College London, UK), Dr.
Renaud Mahieux (Unité d'Epidémiologie et de Physiopathologie
des Virus Oncogènes, Institut Pasteur, Paris, France)
and Dr. Elizabeth Macintyre (Laboratoire dHématologie,
Hôpital Necker Enfants Malades, Paris, France) for providing
us with ISI-1, BCP-1, BC-2, BC-3, BCBL-1, BBG-1, CRA-BCBL, CEM,
DAUDI, RAJI, RS(4;11) and REH cell lines. We would also like
to thank Prof. Pierre Boulanger (Faculté de Médecine
Laennec, Lyon, France) for critical reading of our manuscript.

Footnotes
Authorship and Disclosures
EB was the principal investigator and takes primary responsibility for the paper. EB recruited the patients. EB, AM, SSH and PP performed the laboratory work for the study. EB and PP performed the statistical analyses and wrote the paper.
The authors reported no potential conflicts of interest.
Funding: this work was supported by a grant from the French Ligue Nationale contre le Cancer. EB was supported by the French Association pour la Recherche sur le Cancer (ARC).
Received for publication February 10, 2009.
Revision received March 7, 2009.
Accepted for publication March 16, 2009.

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