Review Article

The Role of Methylation in Chronic Lymphocytic Leukemia and Its Prognostic and Therapeutic Impacts in the Disease: A Systematic Review

Table 10

MAPK/Erk pathway.

Gene nameRelated pathwayFindings in CLLRef.

ZAP70NFAT, TCR signaling, Rho GTPases signaling, NF-kB, Erk signalingNegative prognostic marker in CLL methylation of a CpG site downstream of transcriptional start site correlated with IGVH-mutated and favorable prognosis[114118]
ANGPT2MIF-mediated glucocorticoid regulation, TGF-β pathway, Erk, PI3K-Akt signalingHigher methylation levels of gene promoter in the IGVH-mutated cases, lower degree of methylation associated with particularly poor prognosis, methylation of its promoter leads to gene silencing[14, 119121]
ROR1GPCR signaling, Erk, signaling by WNTROR1 expression was upregulated; hypomethylation in the promoter as well as in the body region was demonstrated[37, 122]
DAPK1Programmed cell death dimerization of procaspase-8, MAPK-ErkPromoter hypermethylation associated with the downregulation of DAPK1 expression[123]
ADAM12Cell-to-cell and cell-to-matrix interactions, fertilization, muscle tissue development, and neurogenesis EGFR, MAPK-Erk pathway48% of the samples were partially methylated and 52% were reported to be unmethylated compared to 20% and 80.6%, respectively, in healthy individuals, an association statistically significant[124]
AIRERegulated by the MAPK pathwayMethylated gene body was observed in IGVH-mutated cells[26, 125]
RASGRP3RAF/MAPK cascade regulation of activated PAK-2Methylated gene body correlated with the IGVH-mutated status[26, 126128]
PPP1R3ABeta-adrenergic signalingMethylated gene body was observed in IGVH-mutated cases[26, 129]

CLL: chronic lymphocytic leukemia, Ref.: reference, ZAP70: zeta chain of T-cell receptor-associated protein kinase 70, ANGPT2: angiopoietin 2, ROR1: receptor tyrosine kinase-like orphan receptor 1, DAPK1: death-associated protein kinase 1, ADAM12: disintegrin and metalloproteinase domain-containing protein 12, AIRE: autoimmune regulator, RASGRP3: rat sarcoma guanyl releasing protein 3, PPP1R3A: protein phosphatase 1 regulatory subunit 3A, NFAT: nuclear factor of activated T cells, TCR: T-cell receptor, NF-kB: nuclear factor kappa-beta, MAPK: mitogen-activated protein kinase, Erk: extracellular signal-regulated kinase, MIF: macrophage migration inhibitory factor, TGF-β: transforming growth factor beta, PI3K-Akt: phosphatidylinositol-3-kinase—protein kinase B, GPCR: G protein-coupled receptor, WNT: wingless-related integration site, RAF: rapidly accelerated fibrosarcoma, EGFR: epidermal growth factor receptor, PAK-2: p21 activated kinase 2, IGVH: immunoglobulin variable heavy chain gene.