INTRODUCTION: Despite best current therapy, acute lymphoblastic leukemia (ALL) still remains the most common cause of cancer-related death in children and young adults. Relapse is the main reason for treatment failure in ALL patients and occurs in 15-20% of these patients. Current risk stratification criteria have not been sufficient to predict relapse in ALL patients. The Philadelphia (Ph) chromosome is a chromosomal abnormality found in a subset of high risk ALL patients and is associated with a poor prognosis. Recent genome-wide studies have identified focal deletions of the Ikaros gene (IKZF1) in 70-80% of B-cell ALL patients that have the Philadelphia (Ph) chromosome. Subsequent studies have also found a strong correlation between IKZF1 deletions and ALL patients (Ph+ and Ph-) that relapse. IKZF1 is required for normal lymphoid development and loss of IKZF1 results in haploidinsufficiency or the overexpression of dominant negative IKZF1 isoforms, in particular Ik6 in high risk ALL patients. Most studies used DNA microarrays to detect IKZF1 deletions. Multiplex ligation probe dependent amplification (MLPA) is a low cost, rapid technique that can detect small DNA copy number changes of up to 50 targets in a single reaction and is not as technically challenging to analyse as arrays. MLPA has also been suggested to be used as an alternative to array based techniques in developing countries. METHODS: There were 31 ALL (paediatric and adult) patients that were tested using MLPA and 24 ALL patients tested using reverse transcriptase PCR (RT-PCR) to detect IKZF1 copy number changes and IKZF1 isoform expression pattern respectively. RT-PCR was validated with DNA sequencing and MLPA was validated with Fluorescent in situ hybridization (FISH). MLPA was also compared to cytogenetics in certain cases. RESULTS: MLPA detected 156 copy number changes (7.1 aberrations per sample) in 22 leukemic patients. IKZF1 deletions accounted for the majority of the aberrations (41%) and were detected in 53% of Ph+ ALL patients (n=15) by MLPA. IKZF1 deletions were detected at presentation and relapse in Ph+ and Ph- ALL patients. IKZF1 isoform Ik6 was detected in 70% of Ph+ and relapsed ALL patients after performing RT-PCR. IKZF1 deletions of exons 4-7 resulted in exclusive expression of Ik6. MLPA results were also correlated with certain aneuploidies detected with cytogenetics. CONCLUSION: This study showed that IKZF1 deletions could have assisted with prognosis in certain ALL cases and thus, newly diagnosed ALL patients should be screened for IKZF1 deletions. MLPA proved to be a reliable, rapid and cost effective technique to detect small copy number changes in multiple genes and should be implemented as a diagnostic test to detect IKZF1 deletions.

Le but de mon travail était d’étudier les modifications post-traductionnelles et plus précisément la sumoylation d’Ikaros. Mes études ont montré que le facteur de transcription Ikaros est modifié non seulement par SUMO-1 mais aussi par SUMO-2/3 sur plusieurs sites consensus. Cette modification est conditionnelle et dépendante du stade de développement des cellules T. J’ai trouvé un site consensus en plus des sites déjà décrits dans l’étude de Gómez-del Arco et al., 2005. En accord avec les résultats publiés, dans mon système expérimental, l’absence de sumoylation augmente les propriétés anti-prolifératives d’Ikaros, car ses mutants qui ne peuvent pas être sumoylés inhibent mieux la prolifération des cellules leucémiques. Un effet surprenant est l’absence d’un effet cumulatif de l’absence de sumoylation sur la prolifération des cellules. Par exemple, des mutants ponctuels qui ne perdent pas complètement leur sumoylation sont les meilleurs répresseurs de la prolifération, comparés avec le mutant où tous les sites modifiés sont mutés. Ce résultat est en contradiction avec les données publiées, parce qu’il suggère un rôle différent de la sumoylation, et non seulement comme un interrupteur physique des complexes Ikaros – NURD. J’ai fait des expériences utilisant l’expression d’un gène rapporteur comme un moyen de révéler des différences subtiles entre les propriétés répressives d’Ikaros et ses mutants sumo-déficients. Pour ces essais j’ai utilisé des cellules HeLa, un type cellulaire qui n’exprime pas Ikaros endogène et qu’il est donc théoriquement convenable pour étudier son effet sur l’expression d’un gène rapporteur. Mes résultats ont démontré que dans des cellules HeLa, il n’y pas de différence significative entre les propriétés répressives d’Ikaros et ses mutants sumo-déficients. Ces différences par rapport aux résultats obtenues avec la lignée de cellule T suggèrent une grande importance de contexte du système utilisé et que certains effets peuvent être observés uniquement dans des cellules T. Pour mieux comprendre le rôle de la sumoylation dans le fonctionnement d’Ikaros, j’ai analysé les transcriptomes des lignées cellulaires T qui surexpriment IK1-ER ou ses mutants. L’analyse des puces d’ADN a démontré un phénotype de dérégulation d’expression des gènes cibles d’Ikaros, différent entre la protéine WT et les mutants, ainsi qu’entre les mutants mêmes. Ce résultat suggère un rôle de la sumoylation d’Ikaros beaucoup plus complexe que l’interruption mécanique de son interaction avec le complexe NURD. Mes résultats ont aussi démontré que les autres membres de la famille d’Ikaros (Helios, Aiolos et Eos) sont également sumoylés, un événement qui pourrait être important pour la régulation de leurs fonctions. / The main topic of my PhD studies was to investigate the role of sumoylation in the function of Ikaros transcription factor, that regulates the lymphocyte differentiation and function. Sumoylation is a posttranslational modification that can change the properties and regulate the function of a given protein. Up to now, one study addressed the question of how sumoylationmodulates Ikaros function. It shows that Ikaros is sumoylated in total primary thymocytes, and that this dynamic event modulates Ikaros' repressive function. It also describes two consensus sumoylation sites on Ikaros (K58 and K240), the sumoylation of which leads to loss of Ikaros repressive function in ectopic reporter gene assays. The final conclusion of the study is that sumoylation does not alter the nuclear localization of Ikaros but acts as a mechanism disrupting its participation in both histone deacetylase (HDAC) dependent and independent repression. My work shows the presence of additional sumoylation site on Ikaros and demonstrates that sumoylation does not significantly alter its interaction with the nucleosome remodelling and histone deacetylase (NURD) complex in T-cell lines. The functional analysis of sumo-deficientmutants indicates a complex role of this modification in regulating Ikaros' transcriptional properties. The identification of this new sumoylation site contributes to a better understanding of Ikaros' dual repressive - activating function and suggests the existence of conditional Ikaros' interacting partners. Moreover, the different Ikaros splicing isoforms would have differentsumoylation profiles, which would complete the knowledge of their functional diversity.

The main topic of my PhD studies was to investigate the role of sumoylation in the function of Ikaros transcription factor, that regulates the lymphocyte differentiation and function. Sumoylation is a posttranslational modification that can change the properties and regulate the function of a given protein. Up to now, one study addressed the question of how sumoylationmodulates Ikaros function. It shows that Ikaros is sumoylated in total primary thymocytes, and that this dynamic event modulates Ikaros' repressive function. It also describes two consensus sumoylation sites on Ikaros (K58 and K240), the sumoylation of which leads to loss of Ikaros repressive function in ectopic reporter gene assays. The final conclusion of the study is that sumoylation does not alter the nuclear localization of Ikaros but acts as a mechanism disrupting its participation in both histone deacetylase (HDAC) dependent and independent repression. My work shows the presence of additional sumoylation site on Ikaros and demonstrates that sumoylation does not significantly alter its interaction with the nucleosome remodelling and histone deacetylase (NURD) complex in T-cell lines. The functional analysis of sumo-deficientmutants indicates a complex role of this modification in regulating Ikaros' transcriptional properties. The identification of this new sumoylation site contributes to a better understanding of Ikaros' dual repressive - activating function and suggests the existence of conditional Ikaros' interacting partners. Moreover, the different Ikaros splicing isoforms would have differentsumoylation profiles, which would complete the knowledge of their functional diversity.