TITLE: Interchromosomal Associations that Alter NF1 Gene Expression Can Modify Clinical Manifestations of Neurofibromatosis 1. Palo Alto, CA 94304

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AD AWARD NUMBER: W81XWH-06-1-0695 TITLE: Interchromosomal Associations that Alter NF1 Gene Expression Can Modify Clinical Manifestations of Neurofibromatosis 1 PRINCIPAL INVESTIGATOR: Andrew R. Hoffman, M.D. CONTRACTING ORGANIZATION: Palo Alto Institute for Research and Education Palo Alto, CA 94304 REPORT DATE: September 2009 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for Public Release; Distribution Unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation.

REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE 2. REPORT TYPE 3. DATES COVERED 1 September 2009 Annual 1 Sep 2008 31 Aug 2009 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Interchromosomal Associations that Alter NF1 Gene Expression Can Modify Clinical Manifestations of Neurofibromatosis 1 5b. GRANT NUMBER W81XWH-06-1-0695 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Andrew R. Hoffman, M.D. 5e. TASK NUMBER E-Mail: arhoffman@stanford.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT We have described a new form of epistasis in which direct, long range, physical interactions between genes, or gene-gene interactions mediated by specialized DNA binding proteins such as CTCF, lead to modification of phenotypic read-out. Using the associated chromatin trap (ACT) and chromosome conformation capture (3C) assays which are designed to assess physical propinquity, we investigated long range interactions of the human NF1 gene that are mediated by CTCF in normal cultured cells and in cells derived from patients with neurofibromatosis. Among the genes that were physically associated with NF1 (which is on chromosome 17) was ARF4 (ADP-ribosylation factor 4, a member of the RAS superfamily involved in membrane traffic, signal transduction and organelle integrity on chromosome 3p14.3. The relative expression of ARF4 was increased in cells and tissues from patients with neurofibromatosis compared to normal cells, suggesting that the interchromosomal interactions of NF1 regulate gene expression on chromosome 3p14.3. 4. Data obtained this year suggests that ARF4 might play a role in neurofibromatosis 1 tumorigenesis. The search for novel remote gene interactions with NF1 promises to open up totally new ranges of therapeutic targets. 15. SUBJECT TERMS neurofibromatosis; epigenetics; epistasis; long range interactions 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT a. REPORT U b. ABSTRACT U 18. NUMBER OF PAGES c. THIS PAGE U UU 7 19a. NAME OF RESPONSIBLE PERSON USAMRMC 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18

Table of Contents Page Introduction..... 3 Body.. 3 Key Research Accomplishments... 7 Reportable Outcomes 7 Conclusion 7 References. 7 Appendices None

INTRODUCTION One of the most remarkable aspects of neurofibromatosis 1 is the great variability in the expression of the disease, in which some affected patients may have few or mild manifestations, while others may have quite severe disease. Epistasis refers to a gene interaction in which gene A interferes with the phenotypic expression of gene B, in such a way that even if gene B is the disease gene (e.g., NF1), gene A may play an important or determining role in how the disease is manifest. We have described a new form of epistasis in which direct, long range, physical interactions between genes, or gene-gene interactions mediated by specialized DNA binding proteins such as CTCF, lead to modification of phenotypic read-out.(1) BODY Task 1/2: Characterize interactions between NF1 and IGF2 in normal and tumor cells. In our previous work, we had shown that the mouse Nf1 gene interacted with Igf2 (2). As we reported in the Annual Report for 2006-2007, we confirmed this association in humans, demonstrating by chromosome conformation capture (3C) and FISH that the imprinting control region between IGF2 and H19 on chromosome 11 interacted with NF1 on chromosome 17. Last year, we reported that NF1 s long range interactions were abrogated and new ones were formed in cells in which there is loss of IGF2 imprinting. Task 3: Search for new NF1-interacting partners Using the ACT assay, we began our exploration of which other genes interacted with NF1 in both normal cell lines and in cell lines derived from patients with neurofibromatosis. Using several CTCF-binding ECR regions, we have elucidated many of these interacting genes, which are located on the multiple different chromosomes. As we reported last year, we became particularly interested in the interaction of NF1 and ARF4 (ADP-ribosylation factor 4, a member of the RAS superfamily involved in membrane traffic, signal transduction and organelle integrity). We confirmed the ACT data which suggested a physical interaction by directly demonstrating the interaction of one NF1 allele with one ARF4 allele using FISH analysis. This year, we decided to examine the role of CTCF in NF1-related long range interactions in greater detail, since it appears that CTCF and its binding sites are absolutely crucial for the development and maintenance of inter- and intrachromosomal interactions. Changes in NF1 expression by changing DNA conformation at CTCF binding site ECR15 Locked Nucleic Acids (LNAs) are synthetic analogs of nucleic acids that contain a bridging methlyene carbon between the 2' and 4' positions of the ribose ring. We developed a sequence-specific anti-gene molecule, called Zorro- LNA, which binds to both strands of DNA simultaneously, and has the potential to inhibit gene transcription. Using a Zorro-LNA targeting the ECR15 CTCF binding site of the NF1 gene (Figure 1) in the GM01859 cell line led to greatly decreased expression from both NF1 alleles (Figure 2). Figure 1. Schematic of NF1 gene with various evolutionary conserved regions (ECR) noted 4

Figure 2. NF1 gene expression in control cells and in cells treated with Zorro-LNA. Figure 3. Conformation change in ECR15 region DNA In vitro binding of Zorro-LNA at the ECR15 region showed a smeared band pattern in agarose gel, suggesting that there was an ECR15 region DNA conformation change after Zorro-LNA binding (Figure 3). CTCF binding was also changed in this region, as shown by EMSA (Figure 3). Furthermore, long-range interactions between the ECR15 and the ECR4 region, which is located in promoter and exon1 region of NF1 gene, and ECR11 region, which is 30 kb upstream of ECR15 region, were changed in Zorro-LNAtreated GM01859 cells. A de novo interaction between ECR15 and ECR4 was detected in Zorro-LNA-treated GM01859 cells, while the previously seen interaction between ECR15 and ECR11 was lost in the Zorro-LNA- treated cells (Figure 4). These data show that Zorro-LNA targeting of the ECR15 CTCF binding site may alter DNA long-range interactions and result in lower gene expression of NF1. Figure 4. Chromosome conformation capture (3C) experiment demonstrating a physical interaction between regions ECR15 and ECR11 in normal cells. When the cells are exposed to the Zorro-LNA, this interaction disappears and a novel ECR15-ECR4 interaction appears. 5

When the Zorro-LNA targeted ECR15 region was amplified from Zorro-LNA-treated cells and cloned, sequencing revealed that the DNA sequence was unchanged in the target region (data not shown). Chromatin immunoprecipitation (ChIP) assays using CTCF and RNA Pol II antibodies showed altered protein binding of CTCF and Pol II at the ECR4 and ECR15 regions in treated cells (Figure 5), but no obvious protein binding changes in other ECR regions, such as ECR17, ECR18 and ECR20 (data not shown). Figure 5. Altered protein-dna interactions in Zorro-LNA treated cells These in vivo DNA-protein interaction data show that the changes in NF1 expression induced by Zorro-LNA are the result of changing DNA conformation and long-range DNA interactions without changes in DNA sequence. These data also show that the regulation of NF1expression is under the control of its nuclear architecture through long-range DNA interactions. This technique provides us a novel and efficient tool to manipulate gene expression and study gene function in disease development. 6

KEY RESEARCH ACCOMPLISHMENTS We have devised a simple method to alter long range interactions between chromatin regions. Changes in long range interactions are associated with changes in gene expression. CTCF is an important regulator of long range interactions. REPORTABLE OUTCOMES No new publications during this reporting period CONCLUSIONS 1. When mutations in NF1 occur, long range interactions may be altered, leading to changes in gene expression. 2. The relevance of these long range gene interactions in regard to the clinical manifestations of neurofibromatosis 1 needs to be investigated. 3. The search for novel remote gene interactions with NF1 promises to open up totally new ranges of therapeutic targets. REFERENCES 1. Ling JQ and Hoffman AR. Epigenetics of long-range chromatin interactions. Pediatr Res 61:11R-16R, 2007. 2. Ling JQ, Li T, Hu JF, Vu TH, Chen HL, Qiu XW, Cherry AM and Hoffman AR. CTCF mediates interchromosomal colocalization between Igf2/H19 and Wsb1/Nf1. Science 312:269-272, 2006. APPENDICES: none 7