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      CpG methylation signature defines human temporal lobe epilepsy and predicts drug‐resistant

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          Abstract

          Aims

          Temporal lobe epilepsy (TLE) is the most common focal epilepsy syndrome in adults and frequently develops drug resistance. Studies have investigated the value of peripheral DNA methylation signature as molecular biomarker for diagnosis or prognosis. We aimed to explore methylation biomarkers for TLE diagnosis and pharmacoresistance prediction.

          Methods

          We initially conducted genome‐wide DNA methylation profiling in TLE patients, and then selected candidate CpGs in training cohort and validated in another independent cohort by employing machine learning algorithms. Furthermore, nomogram comprising DNA methylation and clinicopathological data was generated to predict the drug response in the entire patient cohort. Lastly, bioinformatics analysis for CpG‐associated genes was performed using Ingenuity Pathway Analysis.

          Results

          After screening and validation, eight CpGs were identified for diagnostic biomarker with an area under the curve (AUC) of 0.81 and six CpGs for drug‐resistant prediction biomarker with an AUC of 0.79. The nomogram for drug‐resistant prediction comprised methylation risk score, disease course, seizure frequency, and hippocampal sclerosis, with AUC as high as 0.96. Bioinformatics analysis indicated drug response–related CpGs corresponding genes closely related to DNA methylation.

          Conclusions

          This study demonstrates the ability to use peripheral DNA methylation signature as molecular biomarker for epilepsy diagnosis and drug‐resistant prediction.

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          Most cited references45

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          The DNA methyltransferases of mammals.

          T Bestor (2000)
          The biological significance of 5-methylcytosine was in doubt for many years, but is no longer. Through targeted mutagenesis in mice it has been learnt that every protein shown by biochemical tests to be involved in the establishment, maintenance or interpretation of genomic methylation patterns is encoded by an essential gene. A human genetic disorder (ICF syndrome) has recently been shown to be caused by mutations in the DNA methyltransferase 3B (DNMT3B) gene. A second human disorder (Rett syndrome) has been found to result from mutations in the MECP2 gene, which encodes a protein that binds to methylated DNA. Global genome demethylation caused by targeted mutations in the DNA methyltransferase-1 (Dnmt1) gene has shown that cytosine methylation plays essential roles in X-inactivation, genomic imprinting and genome stabilization. The majority of genomic 5-methylcytosine is now known to enforce the transcriptional silence of the enormous burden of transposons and retroviruses that have accumulated in the mammalian genome. It has also become clear that programmed changes in methylation patterns are less important in the regulation of mammalian development than was previously believed. Although a number of outstanding questions have yet to be answered (one of these questions involves the nature of the cues that designate sites for methylation at particular stages of gametogenesis and early development), studies of DNA methyltransferases are likely to provide further insights into the biological functions of genomic methylation patterns.
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            MGMT testing--the challenges for biomarker-based glioma treatment.

            Many patients with malignant gliomas do not respond to alkylating agent chemotherapy. Alkylator resistance of glioma cells is mainly mediated by the DNA repair enzyme O(6)-methylguanine-DNA methyltransferase (MGMT). Epigenetic silencing of the MGMT gene by promoter methylation in glioma cells compromises this DNA repair mechanism and increases chemosensitivity. MGMT promoter methylation is, therefore, a strong prognostic biomarker in paediatric and adult patients with glioblastoma treated with temozolomide. Notably, elderly patients (>65-70 years) with glioblastoma whose tumours lack MGMT promoter methylation derive minimal benefit from such chemotherapy. Thus, MGMT promoter methylation status has become a frequently requested laboratory test in neuro-oncology. This Review presents current data on the prognostic and predictive relevance of MGMT testing, discusses clinical trials that have used MGMT status to select participants, evaluates known issues concerning the molecular testing procedure, and addresses the necessity for molecular-context-dependent interpretation of MGMT test results. Whether MGMT promoter methylation testing should be offered to all individuals with glioblastoma, or only to elderly patients and those in clinical trials, is also discussed. Justifications for withholding alkylating agent chemotherapy in patients with MGMT-unmethylated glioblastomas outside clinical trials, and the potential role for MGMT testing in other gliomas, are also discussed.
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              Epigenetic mechanisms in neurological diseases: genes, syndromes, and therapies.

              Epigenetic mechanisms such as DNA methylation and modifications to histone proteins regulate high-order DNA structure and gene expression. Aberrant epigenetic mechanisms are involved in the development of many diseases, including cancer. The neurological disorder most intensely studied with regard to epigenetic changes is Rett syndrome; patients with Rett syndrome have neurodevelopmental defects associated with mutations in MeCP2, which encodes the methyl CpG binding protein 2, that binds to methylated DNA. Other mental retardation disorders are also linked to the disruption of genes involved in epigenetic mechanisms; such disorders include alpha thalassaemia/mental retardation X-linked syndrome, Rubinstein-Taybi syndrome, and Coffin-Lowry syndrome. Moreover, aberrant DNA methylation and histone modification profiles of discrete DNA sequences, and those at a genome-wide level, have just begun to be described for neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, and Huntington's disease, and in other neurological disorders such as multiple sclerosis, epilepsy, and amyotrophic lateral sclerosis. In this Review, we describe epigenetic changes present in neurological diseases and discuss the therapeutic potential of epigenetic drugs, such as histone deacetylase inhibitors.
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                Author and article information

                Contributors
                longhongyu@csu.edu.cn
                10353654@qq.com
                Journal
                CNS Neurosci Ther
                CNS Neurosci Ther
                10.1111/(ISSN)1755-5949
                CNS
                CNS Neuroscience & Therapeutics
                John Wiley and Sons Inc. (Hoboken )
                1755-5930
                1755-5949
                10 June 2020
                October 2020
                : 26
                : 10 ( doiID: 10.1111/cns.v26.10 )
                : 1021-1030
                Affiliations
                [ 1 ] Department of Neurology Xiangya Hospital Central South University Changsha China
                [ 2 ] Tsinghua‐Berkeley Shenzhen Institute Tsinghua University Shenzhen China
                [ 3 ] College of Bioinformatics Science and Technology Harbin Medical University Harbin China
                [ 4 ] Shanghai Biotechnology Corporation Shanghai China
                [ 5 ] Department of Geriatrics Second Xiangya Hospital Central South University Changsha China
                Author notes
                [*] [* ] Correspondence

                Hongyu Long and Lili Long, Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.

                Emails: longhongyu@ 123456csu.edu.cn (HL); 10353654@ 123456qq.com (LL)

                Author information
                https://orcid.org/0000-0002-8922-4654
                https://orcid.org/0000-0001-5204-1902
                https://orcid.org/0000-0001-5641-8850
                Article
                CNS13394
                10.1111/cns.13394
                7539843
                32519815
                ba71cc16-d97d-4eb3-a6e2-d465d3f50362
                © 2020 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 February 2020
                : 29 April 2020
                : 29 April 2020
                Page count
                Figures: 5, Tables: 1, Pages: 10, Words: 6152
                Funding
                Funded by: Fundamental Research Funds for the Central Universities of Central South University
                Award ID: 2018zzts248
                Funded by: Clinical Research Foundation of Xiangya Hospital
                Award ID: 2016L08
                Funded by: Hunan Provincial Science and Technology Department
                Award ID: 2019SK1012
                Funded by: National Natural Science Foundation of China
                Award ID: 81671299
                Award ID: 81671300
                Award ID: 81701182
                Award ID: 81974206
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                October 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.2 mode:remove_FC converted:07.10.2020

                Neurosciences
                biomarker,dna methylation,machine learning,nomogram,temporal lobe epilepsy
                Neurosciences
                biomarker, dna methylation, machine learning, nomogram, temporal lobe epilepsy

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