In this study, we demonstrated that the expression level of
GRAF transcript was decreased in primary leukemic cells of all types of myeloid malignancies. Bojesen et al [
10] found that
GRAF promoter was hypermethylated in 38% cases with AML and MDS but not in healthy individuals, however, they did not detect the
GRAF transcript in primary leukemic cells of AML and MDS. GRAF contains a centrally located GTPase-activating protein (GAP) domain, followed by a serine/proline rich domain and a carboxy-terminal Srchomology 3 (SH3) domain. GRAF acts as a negative regulator of RhoA because the GRAF GAP domain enhances GTP hydrolysis of both Cdc42 and RhoA in vitro [
7]. Rho family GTPases play a role in the growth control besides regulating the organization of the actin cytoskeleton [
18,
19]. RhoA inhibits p21Cip1, p27Kip and p16Ink4 activities, permitting cell cycle progression [
20-
24]. Furthermore, RhoA has been shown involved in the regulation of apoptosis, migration, proliferation, differentiation [
18,
19]: for example, in vitro, constitutively active RhoA can stimulate transformation. In normal epithelia, RhoA contributes to the generation of epithelial polarity and junction assembly and function but also affects epithelial disruption during tumor progression [
25]. Recently, clinical studies have revealed the correlation of increased expression of RhoA and invasion, metastasis and progression of several solid tumors including liver, bladder, esophageal, head and neck, ovary, gastric, testicular, lung and breast carcinomas [
18]. As an upstream regulator, the loss of function of
GRAF might prevent the physiologic down-regulation of RhoA and lead to the repression of p21. Then, the
GRAF-defective cell will be driven into the S phase [
9]. Several mechanisms, including translocations, allelic loss, insertions and promoter methylation observed in AML and MDS, can lead to the inactivation of
GRAF [
9,
10].
The mechanisms responsible for the disease progression of CML remained poorly understood. Recent studies have suggested that several alterations promote this progress, including differentiation arrest caused by the suppression of translation of the transcription factor CEBPα induced by the BCR-ABL oncoprotein in CML cell, increasing genomic instability in CML cell resulting from the reduced capability of genome surveillance system, telomere shortening and loss of tumor suppressor gene (TSG) such as
TP53, retinoblastoma 1,
CDKN2A,
DAPK1 and others [
16,
26,
27]. Interestingly, we found that
GRAF transcript was further down-regulated during CML progression. p210 Bcr-Abl, containing a centrally located Rho-specific guanine nucleotide exchange factors (RhoGEF) domain, affects the actin cytoskeleton assembly and thereby the cellular adhesion and migration by RhoA signaling pathway [
28]. Further studies are required to elucidate the function of
GRAF and
RhoA in the pathogenesis and progression of CML.
Our preliminary results showed that MDS with 5q deletion might have lower expression of
GRAF than those without 5q deletion. Deleted 5q is a one of common chromosomal abnormalities in AML and MDS. Although
GRAF maps telomeric to the previously delineated commonly deleted 5(q31) region, Borkhardt et al found that one allele of
GRAF was consistently lost in all studied 10 patients with 5q deletion and with either MDS or AML [
9]. Besides
GRAF deletion, abnormal methylation of
GRAF promoter was also observed in AML and MDS [
10]. These results suggested that haploinsufficiency (i.e., decreased
GRAF mRNA expression) caused by deletion of
GRAF allele or promoter methylation might be instrumental in the development and progression of hematopoietic malignancies.
In conclusion, GRAF mRNA is decreased in myeloid malignancies. Whether the GRAF expression level could improve the stratification or prognostication of patients with myeloid diseases should be further addressed in future studies.