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Chemistry & Biology Review Small Molecule Control of Chromatin Remodeling Aidan Finley1 and Robert A. Copeland1,* 1Epizyme, Inc., 400 Technology Square, 4th Floor, Cambridge, MA 02139, USA *Correspondence: [email protected] http://dx.doi.org/10.1016/j.chembiol.2014.07.024 Control of cellular transcriptional programs is based on reversible changes in chromatin conformation that affect access of the transcriptional machinery to specific gene promoters. Chromatin conformation is in turn controlled by the concerted effects of reversible, covalent modification of the DNA and histone components of chromatin, along with topographical changes in DNA-histone interactions; all of these chromatin-modifying reactions are catalyzed by specific enzymes and are communicated to the transcriptional machinery by proteins that recognize and bind to unique, covalent modifications at specific chromatin sites (so-called reader proteins). Over the past decade, considerable progress has been made in the discovery of potent and selective small molecule modulators of specific chromatin-modifying proteins. Here we review the progress that has been made toward small molecule control of these mechanisms and the potential clinical applications of such small molecule modulators of chromatin remodeling. All somatic cells within multicellular organisms contain the full complement of DNA that constitutes the genome of that organism. Nevertheless, beyond early embryonic development, multicellular organisms are distinguished from single cell and colony-forming organisms by the presence of a broad spectrum of fit-for-purpose cells that have differentiated themselves from their common progenitors. Cellular differentiation depends on precise control of gene transcription programs, such that certain genes are transcriptionally active whereas others are repressed, depending on the cell type, cell cycle stage, and timing relative to cellular division. The regulatory system used to control transcriptional programs is commonly referred to as epigenetics (Allis et al., 2007; Holliday, 1990), but is more correctly referred to as chromatin remodeling (Ptashne, 2013). At the molecular level, chromatin remodeling involves controlling the local structure of chromatin at specific gene promoters by the concerted action of a spectrum of chromatin-modifying proteins (CMPs) (Arrowsmith et al., 2012; Copeland et al., 2009; Wilkins et al., 2014). Chromatin is the amalgam of DNA and histone proteins that make up chromosomes. Chromosomal DNA exists as stretches of unassociated, double-stranded DNA, interspersed with nucleosomes—loci of 140–150 base-pair stretches of DNA coiled twice around a spool-like octamer core of histones, consisting of two copies each of four core histone proteins (H2A, H2B, H3, and H4). The coiling of DNA around the histone core provides a mechanism for compaction of the ca. 2 m of DNA that needs to be fit into the small volume of a cell nucleus. Fully compacted chromatin is referred to a heterochromatin. This conformational state, however, severely limits steric access of gene promoter regions to transcription factors, polymerases and the rest of the transcriptional machinery. A more relaxed (i.e., less compacted) state of chromatin, referred to as euchromatin, also exists; in this latter state, the gene promoter region is readily accessible to the transcriptional machinery (Figure 1). Methylation of CpG islands of chromosomal DNA directly affects gene transcription, whereas the conformational switch between euchromatin and heterochromatin states in proximity to particular gene locations is effected by modifications to the histone proteins; these modifications involve a collection of highly specific enzymes and associated recognition proteins, as detailed next. CMPs Three major categories of chromatin modifications work in concert to effect transcriptional regulation. These are: (1) methylation of chromosomal DNA, (2) posttranslational modifications of specific amino acids on histones, and (3) ATP hydrolysisdependent alteration of DNA-histone interactions. Methylation of chromosomal DNA is catalyzed by the DNA methyltransferases (DNMTs) and methylation is reversed by the ten-eleven translocation (TET) proteins (Figure 2). DNA methylation results in transcriptional silencing of genes, including a number of tumor suppressors (Baylin, 2005). The DNMTs have been targeted for small molecule inhibitors as cancer therapeutics; indeed, two DNMT-targeted drugs have been approved as treatments for myelodysplastic syndrome, decitibine (Dacogen) and azacitidine (Vidaza). DNA methylation and the drugs targeting this modification have been extensively reviewed in the literature (see, for example, Baylin, 2005 and Dhe-Paganon et al., 2011). Among the covalent modifications of histone proteins, the protein kinases that phosphorylate histones and their inhibitors have also been extensively reviewed in the recent literature (see, for example, Rossetto et al., 2012 and Suganuma and Workman, 2012). Hence, we shall focus our attention for the remainder of the current review on the various CMPs involved in histone acetylation/ deacetylation and methylation/demethylation reactions and on the CMPs involved in ATP hydrolysis-dependent chromatin remodeling. Posttranslational Modification of Histone Proteins Site-specific covalent modification of histones can affect the conformation of chromatin by altering interactions between the histones and the nucleosomal DNA (Arrowsmith et al., 2012; Copeland et al., 2009). These modifications include covalent attachment of small proteins, such as ubiquitin and SUMO, to 1196 Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved Chemistry & Biology Review Figure 1. Cartoon of the Conformational Transition of Chromatin from the More Open, Uncondensed Euchromatin State to the More Condensed Heterochromatin State Purple and red spheres represent individual histone proteins comprising the nucleosome core around which the DNA (turquoise) is wrapped. Small circles are meant to represent covalent modifications to the DNA and histones. specific lysines, as well as covalent attachment of chemical groups to specific amino acids; these latter reactions include lysine/arginine methylation, lysine acetylation, and serine/ threonine/tyrosine phosphorylation. All of these modifications affect chromatin structure, hence gene transcription. The enzymes involved in placement of acetyl and methyl groups on histones (referred to as writers) and the enzymes involved in the specific removal of these chemical groups (referred to as erasers) have been the most studied and are enzymes for which small molecule modulators have been reported. As stated above, we shall focus the remainder of our discussion on these enzymes and the reactions catalyzed by them, together with the proteins that recognize and bind to specific histone modifications (referred to as readers) as initiating events in transcriptional control. Histone Acetylation. Histone lysine residues are acetylated by the histone acetyltransferases (HATs). HATs acetylate lysine residues using acetyl-CoA as a common acetyl group donor. This results in charge neutralization of the lysine side chain, altering the electrostatic interactions that can be made with the negatively charged DNA (Figure 3A). Histone acetylation generally results in exposure of gene promoter sites to transcriptional machinery and activation of gene transcription (Rice and Allis, 2001). Acetylation also creates a locus for bromodomains to recognize ‘‘transcription ready’’ chromatin, and thus recruitment of transcriptional machinery (Dey et al., 2003). There are 18 human HATs, divided into distinct families based on sequence homology and structure. Type A (nuclear) HATs are divided into three subfamilies, GNAT, p300/CB, and MYST (Hodawadekar and Marmorstein, 2007; Andreoli et al., 2013). Type B HATs are found in the cytoplasm and acetylate histones prior to incorporation into chromatin (Andreoli et al., 2013). MYST and p300/CPB enzymes also acetylate nonhistone proteins (Friedmann and Marmorstein, 2013). HATs are large proteins with multiple domains, and the complexity of structure is important for substrate targeting and catalytic function (Lee and Workman, 2007). Structures of several HAT catalytic domains have been solved (Andreoli et al., 2013) and feature a conserved core binding to acetyl-CoA despite low sequence conservation and differing surrounding structures (Liu et al., 2008; Hodawadekar and Marmorstein, 2007; Marmorstein, 2001). This structural understanding is bolstered by detailed kinetic and biochemical studies of the HAT reaction mechanism. GCN5 family members require a ternary complex (enzyme * acetyl-CoA * H3 histone) before catalysis can occur, and this is conserved for the human and yeast enzymes. The catalytic mechanism is, however, likely specific to each HAT family/subfamily, as kinetic mechanisms are different among the P300/CBP, MYST, and GNAT subfamilies and tool inhibitory peptides specific for PCAF (another type A HAT that associates with p300/CBP) were unable to inhibit P300/CBP (Roth et al., 2001; Hodawadekar and Marmorstein, 2007). Deacetylation of lysine is catalyzed by the histone deacetylases (HDACs). There are 18 human HDACs and these are subdivided into four subclasses (Gregoretti et al., 2004). Class I contains the enzymes HDAC 1, 2, 3, and 8. Class IIa consists of HDACs 4, 5, 7, and 9. Class IIb contains HDACs 6 and 10. Class III is made up of the Sirtuins 1–7, whereas class IV contains a single enzyme, HDAC 11. With the exception of the Sirtuins, all of these enzymes use an active site zinc atom to active a coordinated water molecule that, together with active site histidine and aspartate side chains facilitate nucleophilic catalysis on the acetyl-lysine substrate (Lombardi et al., 2011; Figure 3B). The Sirtuins, on the other hand, use a distinct mechanism of catalysis involving NAD+ attack of the bound acetyl-lysine substrate (Walsh, 2006; Milne and Denu, 2008). For both the metal-utilizing HDACs and the Sirtuins, substrate specificity is moderate and is conferred by recognition elements outside the catalytic active site of these enzymes. Bromodomains (BRDs) are protein domains of approximately 110 amino acids in length with a predominantly a-helical structure (Haynes et al., 1992) configured as a left-handed up-anddown helical bundle. Bromodomain-containing proteins are found across several phyla from fruit flies to man, and in humans there are 61 different BRD structures (Filippakopoulos et al., 2012). Although the bromodomain family, including the bromodomain and extra-terminal domain (BET) proteins is large and relatively diverse, with low overall sequence homology, all bromodomain proteins are defined by a well-ordered, deep, hydrophobic pocket into which the acetyl-lysine side chain binds (Filippakopoulos and Knapp, 2014). Surface residues in the variable loop regions contribute to substrate recognition, allowing for considerable diversity in binding partners. In contrast to the surface residues, the binding site for the acetylated lysine is well conserved, with critical hydrophobic and aromatic residues (Owen et al., 2000). These residues interact with the aliphatic side chain of the lysine while a conserved asparagine residue forms a key hydrogen bond with the acetyl carbonyl. Water molecules in the binding pocket also bridge interactions between the acetylated lysine and the protein (Owen et al., 2000; Mujtaba et al., 2007). These common features notwithstanding, BRDs display considerable diversity of amino acid composition within the binding pocket and this has provided a basis for the development of domain-selective BRD inhibitors, as discussed below. Histone Methylation. Lysine and arginine residues within histones are methylated by the protein methyltransferases (PMTs; Copeland et al., 2009). This enzyme class bifurcates into families (Richon et al., 2011): the protein lysine methyltransferases (PKMTs) and the protein arginine methyltransferases (PRMTs). Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved 1197 Chemistry & Biology Review Figure 2. Reversible Methylation of Cytosine within CpG Islands of DNA Methylation is catalyzed by the DNMT class of enzymes and reversed, in a multistep process, by the TET class of enzymes. See text for further details. SAM, S-adenosyl methionine; SAH, S-adenosyl homocysteine; a-KG, alphaketoglutarate. All PMTs use SAM as a universal methyl donor and perform protein methylation via a SN2 reaction mechanism, involving formation of a ternary enzyme-SAM-protein complex prior to direct methyl transfer from SAM to the nitrogen atom of the lysine or arginine side chain (Figures 4A and 4B). Despite the common chemical reaction catalyzed by these enzymes, the active site architecture varies considerably among them, thus providing a structural basis for substrate specificity. As discussed below, the structural diversity of PMT active sites also provides a basis for potent and selective modulation of these enzymes by small molecule ligands (Basavapathruni et al., 2012). Substrate permissiveness varies among the PMT enzymes, as does the degree of enzyme redundancy for methylation of a particular histone site (Copeland, 2013; Copeland et al., 2009; Richon et al., 2011). For example, the enzyme DOT1L is the only human enzyme known to methylate histone H3 at lysine 79 (H3K79) and this position is the only site methylated by DOT1L. Likewise, the multi-protein complex polycomb repressive complex 2 (PRC2), containing the catalytic subunits EZH1 or EZH2, represent the only H3K27 methyltransferases in humans; PRC2 is also known to methylate only H3K27. On the other hand, some histone sites are methylated by several PMTs (e.g., H3K36). While the PKMTs tend to demonstrate a high degree of substrate specificity, the PRMTs tend to display greater permissiveness of substrate utilization, sometimes methylating multiple arginine residues on multiple proteins. The transcriptional consequences of histone methylation depend on the specific site being methylated and also on the number of methyl groups placed on the amino acid. Lysine can accept 1, 2 or 3 methyl groups and arginine can be monomethylated on one nitrogen, symmetrically dimethylated, or asymmetrically dimethylated (Figure 4B); each of these states of methylation can confer different biological consequences. Methylation of histone sites can be transcriptionally activating or repressive, depending on the site of the methylation. For example, trimethylation at H3K27 suppresses gene transcription, whereas trimethylation of H3K79 is transcriptionally activating (Copeland, 2013; Copeland et al., 2009). Methyl groups are oxidatively released from lysine by the lysine demethylases (KDMs; Arrowsmith et al., 2012; Forneris et al., 2005; Tsukada et al., 2006). The KDM class clusters into two families: the lysine-specific demethylase (LSD) family and the Jumonji domain-containing family (JmjC; Arrowsmith et al., 2012). Two flavin-dependent enzymes comprise the LSD family, LSD1 and LSD2 (Figure 4C). The JmjCs constitute a larger family of 27 enzymes that all use iron and 2-oxoglutarate to oxygenate the methyl group (Figure 4D). KDMs act primarily on histones, but can also demethylate nonhistone proteins. At least one JmJC family KDM, JMJD6, has been reported to directly demethylate methyl-arginine residues (Chang et al., 2007) and the protein arginine deiminases (PADs) can also lead to demethylation of arginine via conversion of arginine to citrulline (Cuthbert et al., 2004; Wang et al., 2004). Methyl-lysine is an abundant histone modification, and a diversity of methyl-lysine reader domains exist (Wigle and Copeland, 2013). Over 200 methyl-lysine reader domains have been described to date (James and Frye, 2013). The methyl-lysine readers (KMe readers) are divided into two families: PHD zinc finger domains, and the ‘‘Royal Family,’’ comprising Tudor, Agenet, MBT, CHROMO domain, WD40 repeats (WDR5 and EED) and PWWP domains (Wigle and Copeland, 2013; James and Frye, 2013). Recently, another protein domain, the bromo adjacent homology (BAH) domain of the ORC1 protein has been shown to also be a KMe reader specific to H4K20 dimethylation (Kuo et al., 2012). The KMe reader domains are typically comprised of less than 100 residues and fold to form pockets that contain an electron-rich cage of two to four aromatic residues (the aromatic cage) that interact with the lysine through p-cation, hydrogen bonding, and van der Waals interactions. The methylation state of the lysine is recognized by the presence of from zero to two acidic amino acids, at the base of the pocket, that interact with the nitrogen of the lysine side-chain. ATP Hydrolysis-Dependent Changes to DNA-Histone Interactions ATP hydrolysis-dependent chromatin remodeling is exemplified by the SWI/SNF complexes (Shain and Pollack, 2013; Wang et al., 2014; Wilson and Roberts, 2011). These complexes are composed of 9–12 protein subunits in humans; the exact composition of subunits defines the specific complex and its gene targets. Subunits of the SWI/SNF complex consist of: (1) one of two mutually exclusive ATP-hydrolyzing subunits known as BRM (also known as SMARCA2) or BRG1 (also known as SMARCA4), (2) a set of highly conserved core subunits, such as SNF5 (also known as SMARCB5), INI1, and BAF47, and (3) a variable set of subunits involved in targeting, assembly and cell lineage-specific functions. SWI/SNF complexes remodel chromatin by catalyzing sliding and ejection or insertion of histone octamer cores (Wilson and Roberts, 2011). Sliding refers to the following sequence of steps. First, the SWI/SNF complex binds at a specific position on nucleosomal DNA. Disruption of key contacts between the DNA and histone proteins then ensues. This is followed by translocation of the DNA, using the energy derived from ATP hydrolysis. A 1198 Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved Chemistry & Biology Review Figure 3. The Chemistry of Histone Acetylation (A) Reaction mechanism for the histone acetyltransferases (HATs). (B) Reaction mechanism for the metal-dependent histone deacetylases (HDACs). (C) Reaction mechanism for the Sirtuin histone deacetylases. Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved 1199 Chemistry & Biology Review A B C D Figure 4. The Chemistry of Histone Methylation (A) The common methyl group donor SAM is converted to SAH by all protein methyltransferases (PMTs). (B) Stepwise methylation of the ε-nitrogen of lysine side chains by the protein lysine methyltransferases (PKMTs) and of the side chain guanidino group of arginine by the protein arginine methyltransferases (PRMTs). (C) Reaction mechanism for the flavin-dependent lysine demethylases (LSDs). (D) Reaction mechanism for the iron-dependent lysine demethylases (JmjC). DNA loop is thus formed and this can be propagated around the nucleosome to create sites of increased access to DNA binding factors. Thus, transcription factors and the like can bind to specific gene promoter locations because of SWI/SNF catalysis. The SWI/SNF complex is also known to catalyze the ejection and insertion of histone octamers into nucleosomes, although the mechanistic details of these reactions are not well understood. For the pedagogic purposes of this review, we have described the various mechanisms of chromatin modification as discrete reactions, each with unique biochemical and biological consequences. It is important, however, to recognize that there can be considerable interplay and crosstalk between these varied mechanisms. For example, it is clear that DNA methylation affects the degree and location of histone post-translational modifications and that the two work in concert to control transcription (Collings et al., 2013; Rivera et al., 2014). Also, methylation of histone H3 at lysine 79 (H3K79) by DOT1L appears to depend critically on ubiquitylation of the nucleosome on histone H2B (Wang et al., 2013). Histone methylation at sites H3K36 and H3K27 appear to be antagonistic to one another, so that methylation at one site diminishes the ability of the alternative site to be methylated (Zheng et al., 2012) The activity of the SWI/SNF complex may be modulated by acetylation/deacetylation by HATs/ HDACs and chromatin modification by the SWI/SNF complex is antagonistically related to methylation of the H3K27 site by PRC2 (Knutson et al., 2013; Wilson et al., 2010). Finally, there are several examples of proteins that contain domains leading to multiple forms of chromatin interaction and remodeling. For example, the SWI/SNF complex not only contains an ATPhydrolysis subunit, but also contains bromodomains that are critical for recognition of acetyl-lysines and at least one CHROMO domain; these histone mark-recognition elements of SWI/SNF likely play an important role in homing of the complex to specific gene locations that have been appropriately marked by acetylation and (perhaps) methylation (Tang et al., 2010; Wilson et al., 2014). Thus, the various forms of chromatin modification work not as isolated biochemical reactions, but rather in concert with one another to provide a combinatorial, chemical ‘‘code’’ that regulates chromatin structure, hence gene transcription. Chromatin Modification and Human Disease CMPs are genetically altered in a number of human diseases, most notably in various human cancers. Hence, the development of small molecule modulators of specific CMPs as therapeutics has become a focal point for drug discovery research. The genetic alterations of CMPs in human disease and their pathogenic significance have been reviewed a number of times in the recent literature (Arrowsmith et al., 2012; Baylin and Jones, 2011; Campbell and Tummino, 2014; Copeland, 2013; Copeland et al., 2009, 2010, 2013; Helin and Dhanak, 2013; Wigle and Copeland, 2013). Table 1 summarizes some examples of pathogenic genetic alterations of CMPs. The reader is referred to the review articles cited above for additional information on this topic. Small Molecule Modulators of Chromatin-Modifying Proteins The importance of chromatin modification in human diseases has spurred significant interest in the discovery of small molecule modulators of CMPs. A pivotal start for the field was provided by 1200 Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved Chemistry & Biology Review Table 1. Genetic Alterations of Chromatin-Modifying Proteins in Human Diseases Target Genetic Alteration or Disease Association Indication Key Referencea heterozygous activating mutations occurring at Y641, A677 and A687 that result in hypertrimethylation of H3K27 lymphoma (1–3) PMT PRC2 (EZH2) PRC2 (EZH2, SUZ12, EED, RBBP4) DOT1L deletion of miR-101 leads to EZH2 overexpression prostate cancer deletion of SNF5 leads to EZH2 dependency malignant rhabdoid tumors heterozygous mutations at Y153, H694Y, and P132S Weaver syndrome SUZ12 fusion protein (JJAZ1/JAZF1) endometrial stromal sarcoma SUZ12 Inactivating mutations T cell precursor acute lymphoblastic leukemia (ALL) (4–6) EED Inactivating mutations acute myeloid leukemia (AML) 11q23 chromosomal translocations fusing MLL1 (without its catalytic SET domain) to DOT1L binding partners such as AF4, AF9, AF-10, and ENL leading to aberrant H3K79 methylation acute leukemia (both ALL and AML) (7) AML (9, 10) CALM-AF10 and SET-NUP214 fusions are known to mistarget DOT1L NSD1 NSD2 (WHSC1/MMSET) t(5;11)(q35;p15.5) translocation create NSD1-NUP98 fusions exon 22 mutations (p.Asp2119Valfs*31) Sotos syndrome t(4:14)(p16;q32) chromosomal translocations that places WHSC1 gene under the control of the IGH promoter and results in the overexpression of WHSC1 multiple myeloma (8, 97) Glu1099-to-Lys (E1099K) variant is hyperactivating ALL t(8;11)(p11.2;p15) chromosomal translocations fuses WHSC1L1 to NUP98 AML 8p11–12 focal amplifications breast cancer, squamous cell lung cancer SETDB1 1q21 amplifications melanoma (13) SMYD2 1q32 amplifications esophageal squamous cell carcinoma (14) EHMT2 (G9A) H3K9 gene silencing required for apoptotic hair cell death sensorineural hearing loss (15, 16) NSD3 (WHSC1L1) SETD2 (HYPB, KMT3A) regulates HoxA9 transcription AML mutations Sotos-like overgrowth syndrome (11,12) (98, 99) clear cell renal cell carcinoma (ccRCC) SETD7 SMYD3 Type 1 PRMT (1,2,3, 6,8) polymorphisms Type 1 Diabetes (T1D) and diabetic complications (17) (18–20,100) upregulation prostate cancer tandem repeat polymorphisms in promoter region (VNTR) esophageal squamous cell carcinoma tandem repeat polymorphisms in E2F-1 binding element (CCGCC) colorectal cancer and hepatocellular carcinoma (HCC) PRMT1 methylates SRSF1, upregulated in ALL pediatric ALL PRMT1 upregulated in asthma asthma PRMT1 methylation of FUS is linked to heritable ALS ALS PRMT8 upregulated prostate cancer (18, 21, 22) (Continued on next page) Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved 1201 Chemistry & Biology Review Table 1. Continued Target CARM1 (PRMT4) Genetic Alteration or Disease Association Indication Key Referencea (23–25) methylates SWI/SNF core subunit BAF155 colon, breast, and prostate cancer necessary for AR function glycogen storage diseases necessary for glycogen gene expression program in skeletal muscle acute coronary syndrome involved in chemokine activation (IP-10, MCP-1, IL-8) Type II PRMTs (5,7) PRMT5 overexpression glioblastoma (15, 26) ovarian cancer Putative PMT NSUN2 METTL1 5p amplification breast cancer homozygous truncating mutation (Q227X) mental retardation (27, 28, 102) SNPs multiple sclerosis 101 9p23–24 amplifications esophageal squamous cell carcinoma, squamous cell lung cancer (12, 29, 30, 39–41) t(9;14)(9p24.1q32) translocations creating fusions to IGH overexpression medulloblastoma, basal breast cancer KDM KDM4C (JMJD2C, GASC1) SNPs KDM1B (LSD2, AOF1) 6p22 amplifications urothelial carcinomas (31) KDM6 (UTX) inactivating mutations of UTX lead to pro-oncogenic hypertrimethylation of H3K27 and dependence on EZH2 multiple blood and solid cancers (32) (103, 33–35) KDM1A (LSD1) KDM4A (JMJD2A) overexpression AML hypomorphic allele (point mutations in tower domain) heart development defects mRNA overexpression ovarian cancer SNPs (rs671357, rs587168) HCC, salt-sensitive hypertension site-specific copy gain/re-replication ovarian cancer overexpression breast cancer (36–38) lung cancer KDM6B (JMJD3) overexpression driven by EBV oncogene Hodgkin’s lymphoma (42) KDM5A (JARID1A) amplifications breast cancer (104, 48, 49) t(11;21;12)(p15;p13;p13) translocations create fusions AML of JARID1A PHD domain and NUP98 KDM2B (FBXL10, JHDM1B, PCCX2) overexpression pancreatic cancer 105 SNPs rheumatoid arthritis (43–45) overexpression breast cancer PAD PADI2 PADI4 SNPs cutaneous basal cell carcinoma (46, 47) rheumatoid arthritis Methyl Reader PHF23 t(11;17)(p15;13) translocations create fusions of PHF23’s PHD domain to NUP98 AML (48, 50) PHF1 t(1;6)(p34;p21) translocation create MEAF6-PHF1 fusions, which may misdirect HAT activity toward PHF1 targets endometrial stromal sarcoma (51) SFMBT1 copy number loss ventriculomegaly (52) increase in occupancy at regulated promoters spinocerebellar ataxia type 7 (SCA7) (53, 54) loss of function retinopathy HAT (A) GCN5 (KAT2A) (Continued on next page) 1202 Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved Chemistry & Biology Review Table 1. Continued Target (A) PCAF (KAT2B) (A) P300 (KAT3B) (A) CBP (CREBBP) (A) TIP60 (KAT5) (A) MOZ (MYST3) (A) MORF (MYST4, KAT6B) Genetic Alteration or Disease Association Indication Key Referencea (55, 56) Asn386Ser polymorphism HCC promoter methylation esophageal squamous cell carcinoma C-terminal truncations without catalytic HAT activity diffuse large B-cell lymphoma (DLBCL) inactivating mutations cervical cancer fusion with MLL (t(11;22)(q23;q13) serous endometrial tumors frameshift mutation AML, Rubinstein-Taybi syndrome, Cornelia de Lange syndrome translocations (t(11;16)(q23;p13.3) with MLL AML translocations t(8;16) with MOZ Rubinstein-Taybi syndrome point mutations including truncating protein product duplication (16p13.3) mental retardation, DLBCL (57–59) (60–63) C-terminal truncations without catalytic HAT activity relapsed ALL sequence or deletion mutations in HAT domain adenoid cystic carcinoma monoallelic loss Point mutation (Y327F) lymphoma, H&N, and mammary carcinomas (64, 65) fusion gene (inv(8)(p11q13) with TIF2 AML (66, 67) homozygous (C-terminal deletion) and heterozygous (deletion of exons 3-7) mutations of Moz DiGeorge syndrome MORF/CBP fusion gene—t(10;16)(q22;p13) AML heterozygous mutations (nonsense, truncating, frameshift) Ohdo syndrome SBBYS variant (68–70) genitopatellar syndrome HDAC HDAC 1,2,3,8 (class I) HDAC8 loss of function Cornelia de Lange syndrome HDAC 4,5,7,9 (Class IIa) HDAC4 point mutations brachydactyly-mental retardation HDAC9 amplification CNS lymphoma (71, 72) X-linked intellectual disability HDAC 6, 10 (Class IIb) Sirtuins 1-7 (Class III) (73, 74) HDAC6 point mutation adult-onset Alexander disease HDAC6 SNP (c.281A > T) X-linked dominant chondrodysplasia SIRT1 polymorphisms cardiovascular disease (75) (76–78) Type 1 diabetes (T1D) Parkinson’s disease BRD BRD4 balanced translocation (t15:19) NUT midline carcinoma localization to N-terminal domain of AR castration-resistant prostate cancer transcriptional pause release heart failure (79, 80, 106) SWI/SNF SWI/SNF (ARID1A, ARID1B, ADNP mutation SMARCA4, SMARCC1, AIRD1B (truncating mutations) SMARCC2, SMARCD1, SMARCD2, SMARCD3, SMARCB1 mutations (biallelic) ACTL6A, ACTL6B) PBRM1, ARID1A (truncating), SMARCA4 mutations autism spectrum disorder (81–85) intellectual disability (Coffin Siris syndrome) rhabdoid tumors ccRCC AIRD1A, AIRD1B, PRBM1, SMARCA2, SMARCA4 Burkitt’s lymphoma, pancreatic (alterations, deletions, mutations, and rearrangements) cancer DNMT DNMT1 heterozygous mutations affecting DNMT1 folding autosomal dominant hereditary sensory neuropathy type IE (86, 87) autosomal dominant cerebellar ataxia, deafness, and narcolepsy (Continued on next page) Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved 1203 Chemistry & Biology Review Table 1. Target DNMT3A Continued Genetic Alteration or Disease Association Indication Key Referencea (88–90) somatic mutations (Arg883) AML somatic mutations (reduced enzymatic activity or aberrant affinity to histone H3) MDS heterozygous mutations (Arg882) chronic myelomonocytic polymorphisms (R271Q) leading to hypomethylation impaired spermatogenesis (91, 92) TET2 loss of function mutation overexpression systemic mastocytosis, MDS, AML, CLL (93–95) TET1 loss of function mutation AML (96) DNMT3L TET ALS, amyotrophic lateral sclerosis; TET, ten-eleven translocation; MDS, myelodysplastic syndromes; CLL, chronic lymphocytic leukemia. a Please see the Supplemental Information for key references associated with this table. the crystal structure of a HDAC with the early inhibitors trichostatin A and suberoylanilide hydroxamic acid (SAHA) bound in the active site (Finnin et al., 1999). Since then, the field has grown to see potent, selective inhibitors reported for several of the CMP classes discussed above. Moreover, inhibitors of HDACs and of DNMTs are now approved drugs for specific cancer indications and additional CMP inhibitors have recently entered human clinical trials for the treatment of specific cancers. Below we describe the current state of efforts toward identification of potent, selective small molecule modulators of CMPs, exemplified by the most advanced compounds for several of the CMP classes. A number of contemporary reviews have been published on protein kinase inhibitors [see, for example, (Kollareddy et al., 2012)] and DNMT hypomethylating agents (vide supra). Since these topics have been well covered within recent reviews, we shall not reiterate this information here. Instead, we focus our attention on small molecule modulators of histone acetylation and methylation. HAT Inhibitors Relatively few potent HAT inhibitors have been reported. Early examples of inhibitors were substrate mimetics and natural product derivatives of modest potency, selectivity and cell permeation. High throughput library screening has yielded isothiazolones and benzythiazine sulfonamide scaffolds as interesting starting points for inhibitor discovery. Recently, C646 (Figure 5A) a potent (Ki = 400 nM), selective pyrazolone-based inhibitor of the HAT p300/CBP was identified. Intracellular inhibition of p300/CBP by C646 led to cell growth inhibition, providing a clear rationale for further exploration of p300/CBP and other HATs as potential therapeutic targets (Bowers et al., 2010; Dekker et al., 2014). C646 provides a useful tool compound with some demonstration of intracellular activity. This compound, however, is not a pharmacologically tractable therapeutic agent. Hence, additional inhibitor discovery efforts are clearly needed for the HAT target class. HDAC Modulators Nonselective HDAC inhibitors have been reported that all act through chelation of the active site zinc atom of these enzymes. Two such compounds, vorinostat (SAHA, Zolinza) and romidepsin (Istodax) have been approved for the treatment of refractory cutaneous T cell lymphoma and peripheral T cell lymphoma (Prince et al., 2009). Vorinostat contains a hydroxamic acid as the zinc-chelating moiety (Finnin et al., 1999), wherease romidepsin is administered as a disulfide-containing, cyclic peptide prodrug (Furumai et al., 2002). Glutathione-mediated reduction of the disulfide bond of Istodax liberates a free thiol moiety that acts to chelate the active site zinc of HDACs (Figure 5B). Both drugs inhibit a broad spectrum of HDAC enzymes; vorinostat is reported to inhibit essentially all of the zinc-utilizing HDACs with similar potency, whereas romidepsin is somewhat more selective, inhibiting all class I HDACs. The utility of these drugs for cancers beyond T cell lymphomas has been limited in part due to a number of doselimiting adverse effects, such as thrombocytopenia and anemia (Mann et al., 2007). This has led to the suggestion that more enzyme-selective inhibitors may provide efficacy while minimizing adverse side effects, a hypothesis that has yet to be tested clinically. Additionally, selective HDAC inhibitors may also be effective therapeutics for indications beyond cancer, such as autoimmune diseases and schizophrenia (Bridle et al., 2013; Kurita et al., 2012). The most advanced, isozyme-selective compound to be reported to date is the HDAC6 selective inhibitor ACY-1215 (Figure 5B). This compound inhibits HDAC6 with a half-maximal inhibitory concentration (IC50) of 5 nM; it displays >10-fold selectivity with respect to HDAC1, 2, and 3 and shows no inhibitory activity against other HDACs (Santo et al., 2012). ACY-1215 is currently being tested in a phase I/II open-label, multicenter study as monotherapy and in combination with bortezomib and dexamethasone for the treatment of relapsed or relapsed/refractory multiple myeloma (http://clinicaltrials.gov, NCT01323751). Other examples of selective HDAC inhibitors include BRD8430, a HDAC1/2 selective inhibitor (IC50 = 69 and 560 nM for HDAC1 and 2, respectively) that induces differentiation in neuroblastoma (Frumm et al., 2013) and PCI-34051 (Balasubramanian et al., 2008), a selective HDAC8 inhibitor (Ki = 10 nM) being investigated for potential use in T cell lymphomas (Figure 5B). Bromodomain Inhibitors The BRD class includes a family of protein domains referred to as the bromodomain and BET proteins. The BET family contains the proteins BRD2, BRD3, BRD4, and BRDT (bromodomain testisspecific protein). The BRDs are defined by a well-ordered, deep, hydrophobic pocket into which the acetyl-lysine side chain binds. This pocket provides a highly favorable locus for small 1204 Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved Chemistry & Biology Review Figure 5. Small Molecule Modulators of Histone Acetylation A (A) Histone acetyltransferase (HAT) inhibitors. (B) Metal-dependent histone deacetylase (HDAC) inhibitors. (C) BET domain protein antagonists. B C molecule modulator binding; indeed all of the BRD modulators that have been reported bind within the pocket in a manner competitive with acetyl-lysine. A number of BRD binding molecules have been reported and several of these have been advanced into human clinical trials. The first BRD antagonist to enter clinical study was RVX-208 (Figure 5C), a preferential BRD2 inhibitor that was tested for use in atherosclerosis. RVX-208 was well tolerated in patients at the doses tested (Picaud et al., 2013). Optimization of the thienotriazolodiazepene core, first identified by Mitsubishi Tanabe scientists, led to JQ1 (Figure 5C). This compound selectively binds to BET family BRDs, such as BRD4, with minimal binding to non-BET family BRD proteins (Filippakopoulos et al., 2010). NUT midline carcinoma is a rare, genetically defined form of squamous carcinoma for which there is currently no effective treatment. Patients with NUT midline carcinoma are identified by the occurrence of a chromosomal translocation affecting the nuclear protein in testis (NUT) gene at the 15q14 location (French, 2010). In approximately two-thirds of patients, the translocation results in a fusion protein between NUT and BRD4 (Stelow, 2011). Preclinical studies with JQ1 have shown that the compound induces tumor regression and a significant survival advantage in a mouse model of NUT midline carcinoma involving the NUT-BRD4 fusion. Optimization efforts have led to the JQ1 analog TEN-010 (also known as JQ2; structure not available), which is currently in phase I clinical testing (http:// clinicaltrials.gov, NCT01987362). Contemporaneous work by the group at GlaxoSmithKline led to the identification of GSK I-BET762 (GSK525762; Figure 5C), a benzodiazepine that also selectively inhibits members of the BET-family of BRDs. GSK I-BET762 displays Ki values of 50–60 nM for BRD2, BRD3, and BRD4 with minimal effect on non-BET family BRDs (Mirguet et al., 2013). This compound is currently in phase I clinical testing for NUT midline carcinoma and other cancers (http:// clinicaltrials.gov, NCT01587703). A similar compound, OTX015 (Figure 5C) is also in phase I clinical testing in acute leukemia and other hematological malignancies (http://clinicaltrials.gov, NCT01713582). The sponsor of this trial (Oncoethix) recently reported preliminary results from their dose escalation studies. Thrombocytopenia was observed as a dose-limiting toxicity in patients with other hematological malignancies at a dose of 80 mg every day, but not when dosed at 40 mg twice daily, suggesting that the toxicity may be schedule dependent. Two complete responses and one partial response were observed in patients with leukemia or lymphoma and some evidence of response was observed in another four patients out of a total of 42 patients treated (see http://oncoethix.com). A fourth BETfamily selective BRD inhibitor, CPI-0610, has entered phase I clinical testing in patients with progressive lymphoma (http:// clinicaltrials.gov, NCT01949883); little additional information on this compound is currently available. All of the BET-family selective BRD inhibitors have also shown antiproliferative activity in a spectrum of solid tumor cell lines. These compounds also share the ability to silence MYCN expression; amplification of MYCN has been suggested to be a marker of BET-family selective BRD inhibitor sensitivity. Indeed, MYCN amplification is being used as a patient stratification biomarker within the GSK I-BET762 clinical trial. PMT Inhibitors Selective inhibitors of specific PMTs have been reported that bind within the SAM/SAH pocket, within the protein substrate pocket or within allosteric sites on these proteins (Copeland et al., 2013; Wigle and Copeland, 2013). Potent, selective, SAM-competitive inhibitors have been reported for several of the PKMT enzymes. Most notably, SAMcompetitive inhibitors of the enzymes DOT1L and EZH2 have advanced to human clinical trials in cancer indications (Copeland, 2013). DOT1L catalyzes the methylation of the H3K79 residue, leading to transcriptional activation of affected genes. In MLL-rearranged leukemia (MLL-r), DOT1L is aberrantly recruited to ectopic gene locations as a result of binding of the enzyme to the various MLL-fusion proteins that result from the 11q23 chromosomal translocation that is a universal hallmark of the disease. EPZ-4777 (Figure 6A) was the first potent, selective DOT1L inhibitor demonstrated to selectively kill leukemia cells bearing the 11q23 chromosomal translocation in cell culture and in a murine model of MLL-r (Daigle et al., 2011). Further optimization of the amino-nucleoside core of EPZ-4777 led to EPZ-5676 (Figure 6A), the first PMT inhibitor to enter human clinical trials. EPZ-5676 is a ca. 80 pM inhibitor of DOT1L that is >37,000fold selective against other human PMTs. In rat subcutaneous xenografts of human MLL-r cells, EPZ-5676 treatment led to essentially complete and durable tumor regression (Daigle Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved 1205 Chemistry & Biology Review A B C Figure 6. Small Molecule Modulators of Histone Methylation (A) Protein methyltransferase (PMT) inhibitors. (B) Lysine demethylase (KDM) inhibitors. (C) KMe reader domain protein antagonists. 1206 Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved Chemistry & Biology Review et al., 2013). EPZ-5676 is currently in a phase I study in advanced hematologic malignancies, including acute leukemia with rearrangement of the MLL gene (http://clinicaltrials.gov, NCT01684150). Earlier in 2014, the study sponsor (Epizyme) reported objective responses in MLL-r patients within the context of this ongoing trial. Several groups have reported potent, selective, SAM-competitive inhibitors of EZH2 (Figure 6A). Among these, EPZ-6438 (also known as E7438) is the first EZH2 inhibitor to enter human clinical trials as a single agent in subjects with advances solid tumors or with B cell lymphomas (http://clinicaltrials.gov, NCT01897571 (Knutson et al., 2013, 2014). More recently, a second EZH2 inhibitor, GSK2816126, has likewise entered clinical testing to investigate the safety, pharmacokinetics, pharmacodynamics, and clinical activity of the drug in subjects with relapsed/refractory diffuse large B cell and transformed follicular lymphoma (http:// clinicaltrials.gov, NCT02082977). Both of these compounds are nanomolar inhibitors of EZH2 with high selectivity against other human PMTs. In preclinical studies, both EPZ-6438 and GSK2816126 demonstrated robust tumor growth inhibition in xenograft models of lymphomas bearing mutations in EZH2 (Knutson et al., 2014; McCabe et al., 2012; Van Aller et al., 2014). EPZ-6438 is an orally bioavailable compound that is being administered orally twice per day, while GSK2816126 is being administered by intravenous infusion over 2 hours, twice weekly for 3 weeks of a 28-day dosing cycle. In addition to the nonHodgkin lymphoma indication, EZH2 inhibitors have been shown in preclinical models to effect tumor growth inhibition in INI-1deficient tumors, such as malignant rhabdoid tumors and have also been implicated in additional solid tumor malignancies (Knutson et al., 2013) Protein substrate-competitive inhibitors of the PKMTs EHMT1/2 (e.g., UNC0642 and A-366; Liu et al., 2013; Sweis et al., 2014), SMYD2 (e.g., AZ505; Ferguson et al., 2011) and SETD7 (e.g., PFI-2; Structural Genomics Consortium, Protein Data Bank code 4JLG), and of the PRMT CARM1 (e.g., Methylgene compound 7a; Allan et al., 2009) and BMS compound 7f (Huynh et al., 2009) have been reported (Figure 6A). None of these compounds, however, have yet been reported to demonstrated efficacy in animal models of disease. A final mechanism of selective PMT inhibitor binding is exemplified by the recently reported series of urea-containing allosteric inhibitor of PRMT3 (Figure 6A). These compounds bind at a PRMT3 dimer interface and cause structural rearrangements of the protein that are allosterically communicated to the enzyme active site. The most potent inhibitor in this series displays a Ki of 230 nM and is highly selective for PRMT3, owing to the unique nature of the compound binding pocket (Siarheyeva et al., 2012). Whether inhibitors of this type can be pharmacologically optimized and whether this approach can be more generally applied to the PMT enzyme class remains to be determined. KDM Inhibitors The active sites of the flavin-dependent LSDs bear considerable similarity to the FAD-dependent monoamino oxidases. Hence, covalent modifiers of the flavin cofactor of monoamine oxidases, such as tranylcypromine, also inactivate the LSDs by the same mechanism. This has been capitalized on to develop LSDselective inactivators. Two such compounds, ORY-1001 (Maes et al., 2013) and GSK2879552 (Kruger et al., 2013; Figure 6B), have entered human clinical trials for relapsed or refractory acute leukemia (ORY-1001) and for relapsed/refractory small cell lung carcinoma (GSK2879552; FAD-http://clinicaltrials.gov, NCT02034123). The JmjCs are likewise amenable to small molecule inhibition. In the case of these enzymes, all known inhibitors derive the majority of their binding energy from iron chelation (e.g., GSKJ1; Kruidenier et al., 2012; Figure 6B). Enzyme selectivity has been modest for JmJC inhibitors and no reported compounds have progressed beyond biochemical and cell culture assays. Nevertheless, the pathobiological relevance of the JmjCs makes them important targets for further inhibitor discovery and optimization. Methyl Reader Modulators The KMe reader domains (vide supra) have only recently become the focus of small molecule modulator discovery efforts. Only a few examples of KMe reader domain ligands have been reported (Wigle and Copeland, 2013), the most potent of which is UNC1215 (James et al., 2013), a substrate-competitive inhibitor of L3MBTL3 (Kd = 120 nM; Figure 6C). Future Directions Initiation of clinical trials for isozyme-selective HDAC inhibitors, BRD antagonists, LSD1 inhibitors, and PMT inhibitors ushers in an exciting period of testing the safety, pharmacokinetics, and ultimately the effectiveness of these novel therapeutic modalities. These will hopefully augment the existing CMP-targeted drugs approved for used in clinical oncology that today consists exclusively of DNMT hypomethylating agents and broad-spectrum HDAC inhibitors. It will be interesting to see how these CMP drugs, which display such promising effectiveness in preclinical animal models, affect disease as single agents in the context of human clinical settings. Beyond the use of these various CMP-targeted drugs as single agents, there is a growing body of data to suggest that these agents may be even more effective in treating human cancers when they are appropriately combined with other CMP modalities, existing standard of care drugs and even drugs that act to modulate allied intracellular signaling cascades (Johnston et al., 2013; Klaus et al., 2013). The power of such combinations of CMP modulators with other therapeutic agents is only beginning to be realized, and deserves considerably more preclinical and clinical exploration. Beyond the direct treatment of diseases, such as genetically defined cancers, small molecule CMP modulators show promise as constituents of mixed small molecule/macromolecule cocktails that are capable of inducing pluripotent stem cells (iPSCs) by reprogramming of differentiated, somatic cells. Reprogramming to iPSCs was first shown with a cocktail of four transcription factors: OCT4, SOX2, KLF4, and c-Myc (the Yamanaka factors). Several groups have demonstrated that small molecule modulators of the kinases ALK5 and MEK and of specific CMPs can replace individual Yamanaka factors to effect iPSC reprogramming. For example, the PMT inhibitor BIX-01294 can substitute for SOX2 and valproic acid, a pan-HDAC inhibitor, can substitute for c-Myc (Moschidou et al., 2012). More recently (Onder et al., 2012) the DOT1L inhibitor EPZ-4777 was shown to substitute for two Yamanaka Factors, KIF4 and c-Myc. This same group suggested that selective inhibitors of another PMT Chemistry & Biology 21, September 18, 2014 ª2014 Elsevier Ltd All rights reserved 1207 Chemistry & Biology Review enzyme, SUV39H1, would also be effective in promoting iPSC formation, based on results from shRNA studies. The ability to induce cellular reprogramming to form iPSCs using small, organic compounds that can be readily synthesized, in large scale and at reasonable costs, suggests a practical approach to the development of regenerative medicine applications. The continued discovery and development of potent, selective, small molecule modulators of CMPs may provide new avenues to novel therapeutic agents for a spectrum of human diseases. In addition to these clinical applications, the availability of such CMP modulators will continue to create new opportunities to interrogate the biological consequences of chromatin modification as well as revealing unanticipated interfaces between chromatin modification and other cellular signaling pathways. SUPPLEMENTAL INFORMATION Supplemental Information includes references for Table 1 and can be found with this article online at http://dx.doi.org/10.1016/j.chembiol.2014.07.024. ACKNOWLEDGMENTS The authors thank Drs. Edward Olhava, Tim Wigle, P. Ann Boriack-Sjodin, Robert Gould, and James E. Bradner for helpful discussions and comments on this work. Both authors are employees and stockholders of Epizyme, Inc. REFERENCES Allan, M., Manku, S., Therrien, E., Nguyen, N., Styhler, S., Robert, M.F., Goulet, A.C., Petschner, A.J., Rahil, G., Robert Macleod, A., et al. (2009). 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