The m6A epitranscriptomic landscape in T-ALL and therapeutic implications of targeting HNRNPC and FTO. m6A is regulated by “writers” (METTL3/14, WTAP, VIRMA, RBM15, HAKAI) and “erasers” (FTO, ALKBH5). In T-ALL, global m6A is reduced, but MYC and cholesterol-related transcripts are hypermethylated and recognized by HNRNPC, enhancing their translation and promoting leukemia. METTL3 inhibition paradoxically increases m6A and expression of MYC and cholesterol metabolism despite reduced global m6A. In contrast, FTO inhibition lowers MYC and metabolic gene expression. FTO inhibition or HNRNPC loss impairs cholesterol metabolism, reduces MYC, and decreases leukemic proliferation and survival, ultimately lowering T-ALL burden.

The m6A epitranscriptomic landscape in T-ALL and therapeutic implications of targeting HNRNPC and FTO. m6A is regulated by “writers” (METTL3/14, WTAP, VIRMA, RBM15, HAKAI) and “erasers” (FTO, ALKBH5). In T-ALL, global m6A is reduced, but MYC and cholesterol-related transcripts are hypermethylated and recognized by HNRNPC, enhancing their translation and promoting leukemia. METTL3 inhibition paradoxically increases m6A and expression of MYC and cholesterol metabolism despite reduced global m6A. In contrast, FTO inhibition lowers MYC and metabolic gene expression. FTO inhibition or HNRNPC loss impairs cholesterol metabolism, reduces MYC, and decreases leukemic proliferation and survival, ultimately lowering T-ALL burden.

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