title: The effects of DNA methylation and histone deacetylase inhibitors on human papillomavirus early gene expression in cervical cancer, an in vitro and clinical study.
abstract: BACKGROUND
  The methylation status at the human papilloma virus (HPV) genome found in pre-invasive and invasive cervical lesions suggests that neoplastic transformation can be suppressed by gene hypermethylation, whereas hypomethylation accompanies or causes cancer progression; hence, epigenetic therapy aimed at reactivating cellular suppressor-gene expression has the potential to act as a tumor promoter by enhancing HPV oncoprotein expression in HPV-related malignancies. The objective of this study was to determine the influence of hydralazine and valproate on HPV oncogene expression in cervical cancer cell lines and the primary tumors of patients undergoing treatment with hydralazine and valproate.
  
  
  RESULTS
  Overall, hydralazine and valproate either alone or combined exerted a growth inhibitory effect on cervical cancer cell lines. A cell line-specific up-regulating effect was observed on E6/E7 gene expression, which in general correlated with DNA hypomethylation and histone acetylation at the long control region (LCR). Nonetheless, E6/E7 expression was unchanged or decreased in the majority of patients with cervical cancer treated with hydralazine, valproate, or both. In some cervical cancer cell lines, these drugs led to increased transcription of p53, and increased its stabilization due to acetylation at lysines 273 and 282, which allowed a higher bax-protein transactivating effect.
  
  
  CONCLUSIONS
  The results of this study demonstrate that hydralazine and valproate can be safely administered to HPV-related malignancies such as cervical cancer because they do not increase viral oncoprotein expression. Most importantly, the antitumor effect of hydralazine and valproate in cervical cancer may at least partially depend on an up-regulating effect on p53 gene and on the valproate-induced hyperacetylation of p53 protein, protecting it from degradation by E6.
authors.affiliation: Unidad de Investigación Biomédica en Cáncer, Instituto de Investigaciones Biomédicas, UNAM/Instituto Nacional de Cancerología (IIB, UNAM/INCan), Mexico City, Mexico. qcerick2000@yahoo.com
authors.forename: Erick
authors.initials: E
authors.lastname: de la Cruz-Hernández
authors.forename: Enrique
authors.initials: E
authors.lastname: Pérez-Cárdenas
authors.forename: Adriana
authors.initials: A
authors.lastname: Contreras-Paredes
authors.forename: David
authors.initials: D
authors.lastname: Cantú
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mohar
authors.forename: Marcela
authors.initials: M
authors.lastname: Lizano
authors.forename: Alfonso
authors.initials: A
authors.lastname: Dueñas-González
mesh_terms: D000107:Acetylation; D052685:Alphapapillomavirus / Q000187:drug effects / Q000235:genetics*; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D045744:Cell Line, Tumor; D049109:Cell Proliferation; D019175:DNA Methylation; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D015870:Gene Expression; D015967:Gene Expression Regulation, Viral / Q000187:drug effects*; D016158:Genes, p53; D056572:Histone Deacetylase Inhibitors; D006657:Histones / Q000378:metabolism; D006801:Humans; D006830:Hydralazine / Q000494:pharmacology* / Q000627:therapeutic use; D009856:Oncogene Proteins, Viral / Q000096:biosynthesis / Q000235:genetics*; D012313:RNA / Q000032:analysis / Q000235:genetics; D012333:RNA, Messenger / Q000032:analysis / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014158:Transcription, Genetic; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000821:virology*; D014635:Valproic Acid / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D056572:Histone Deacetylase Inhibitors; D006657:Histones; D009856:Oncogene Proteins, Viral; D012333:RNA, Messenger; D016159:Tumor Suppressor Protein p53; D006830:Hydralazine; D014635:Valproic Acid; D012313:RNA