Epigenetic Regulation of the Expression of T Cell Stimulatory and Inhibitory Factors by Histone H3 Lysine Modification Enzymes and Its Prognostic Roles in Glioblastoma
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3346/jkms.2023.38.e258
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Sang Hyuk LEE
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Seung Hwan KIM
			        		
			        		;
		        		
		        		
		        		
			        		Taek Min NAM
			        		
			        		;
		        		
		        		
		        		
			        		Ji Hwan JANG
			        		
			        		;
		        		
		        		
		        		
			        		Kyu Hong KIM
			        		
			        		;
		        		
		        		
		        		
			        		Young-Sam LEE
			        		
			        		;
		        		
		        		
		        		
			        		Minseok S. KIM
			        		
			        		;
		        		
		        		
		        		
			        		Mee-Seon KIM
			        		
			        		;
		        		
		        		
		        		
			        		Sung Yup JIN
			        		
			        		;
		        		
		        		
		        		
			        		Moonok LEE
			        		
			        		;
		        		
		        		
		        		
			        		Sung-Hun LEE
			        		
			        		;
		        		
		        		
		        		
			        		Young Zoon KIM
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
            
            
            	- From:Journal of Korean Medical Science
	            		
	            		 2023;38(33):e258-
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Background:This study aimed to identify the specific T cell co-stimulatory and co-inhibitory factors that play prognostic roles in patients with glioblastoma. Additionally, the unique histone H3 modification enzymes that regulate the expression levels of these specific costimulatory and co-inhibitory factors were investigated. 
				        	
				        
				        	Methods:The medical records of 84 patients newly diagnosed with glioblastoma at our institution from January 2006 to December 2020 were retrospectively reviewed.Immunohistochemical (IHC) staining for T cell co-stimulatory factors (CD27, CD28, CD137, OX40, and ICOS), T cell co-inhibitory factors (CTLA4, PD1, PD-L1, TIM3, and CD200R), and histone H3 lysine modification enzymes (MLL4, RIZ, EZH1, NSD2, KDM5c, JMJD1a, UTX, and JMJD5) was performed on archived paraffin-embedded tissues obtained by biopsy or resection. Quantitative real time-polymerase chain reaction (qRT-PCR) was performed for specific factors, which demonstrated causal relationships, in order to validate the findings of the IHC examinations. 
				        	
				        
				        	Results:The mean follow-up duration was 27.5 months (range, 4.1–43.5 months). During this period, 76 patients (90.5%) died, and the mean OS was 19.4 months (95% confidence interval, 16.3–20.9 months). Linear positive correlations were observed between the expression levels of CD28 and JMJD1a (R2 linear = 0.982) and those of CD137 and UTX (R2 linear = 1.528). Alternatively, significant negative correlations were observed between the expression levels of CTLA4 and RIZ (R2 linear = −1.746) and those of PD-L1 and EZH1 (R2 linear = −2.118); relationships were confirmed by qRT-PCR. In the multivariate analysis, increased expression levels of CD28 (P = 0.042), and CD137 (P = 0.009), and decreased expression levels of CTLA4 (P = 0.003), PD-L1 (P = 0.020), and EZH1 (P = 0.040) were significantly associated with longer survival. 
				        	
				        
				        	Conclusion:These findings suggest that the expression of certain T cell co-stimulatory factors, such as CD28 and CD 137, and co-inhibitory factors, such as CTLA4 and PD-L1 are associated with prognosis of glioblastoma patients.