Comprehensive Analyses of the Effects of the Small-Molecule Inhibitor of the UHM Domain in the Splicing Factor U2AF1 in Leukemia Cells

<title>Abstract</title>         <p>Mutations in RNA splicing factor genes including SF3B1, U2AF1, SRSF2, and ZRSR2 have been reported to contribute to development of myeloid neoplasms including myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia (sAML). Chemical tools targeting cells carrying these mutant genes remain limited and underdeveloped. Among the four proteins, mutant U2AF1 (U2AF1<sup>mut</sup>) acquires an altered 3’ splice site selection preference and co-operates with the wild-type U2AF1 (U2AF1<sup>wt</sup>) to change various gene isoform patterns to support MDS cells survival and proliferation. U2AF1 mutations in MDS cells are always heterozygous and the cell viability is reduced when exposed to additional insult affecting U2AF1<sup>wt</sup> function. To investigate if the pharmacological inhibition of U2AF1wt function can provoke drug-induced vulnerability of cells harboring U2AF1mut, we conducted a fragment-based library screening campaign to discover compounds targeting the U2AF homology domain (UHM) in U2AF1 that is required for the formation of the U2AF1/U2AF2 complex to define the 3' splice site. The most promising hit (SF1-8) selectively inhibited growth of leukemia cell lines overexpressingU2AF1<sup>mut</sup> and human primary MDS cells carrying U2AF1<sup>mut</sup>. RNA-seq analysis of K562-U2AF1<sup>mut</sup> following treatment with SF1-8 further revealed alteration of isoform patterns for a set of proteins that impair or rescue pathways associated with endocytosis, intracellular vesicle transport, and secretion. Our data suggested that further optimization of SF1-8 is warranted to obtain chemical probes that can be used to evaluate the therapeutic concept of inducing lethality to U2AF1<sup>mut</sup> cells by inhibiting the U2AF1<sup>wt</sup> protein.</p>

section_content: The recent update of the hallmarks of cancer broadened the repertoire of cellular properties acquired by tumor cells along their transformation paths to cancer. 1 An overlooked characteristic of tumor cells is their manipulation of RNA processing to achieve the capability of the hallmark properties. In hematologic malignancies, frequent mutations of a set of genes that participate in RNA splicing have been discovered. 

In myelodysplastic syndrome (MDS) patients, gene sequencing studies of patients' samples [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] have revealed that genes encoding RNA splicing factors, SF3B1, U2AF1, SRSF2, ZRSR2, and LUC7L2, 2, [12] [13] [14] had a significantly higher mutational frequency and were associated with disease phenotypes (e. g., SF3B1, U2AF1). These genes are either a component of the spliceosome, such as SF3B1, or auxiliary splicing factors, including U2AF1, SRSF2, ZRSR2, that assist the execution of the splicing process where mutations in these genes was shown to have prognostic impact in myeloid malignancies. 15 In the 5 th edition of the WHO Classification of Hematolymphoid tumors, 16, 17 SF3B1 mutations have now replaced ring sideroblasts to become a subgroup in clinical diagnosis. Although SF3B1 mutations are associated with favorable outcome in MDS 6, 18, U2AF1 mutations 19 give significant adverse risk and poor prognosis. 6, 15 F2 mutations are less frequent but cooccur with additional gene mutations to cause shorter overall survival in MDS. 15 Despite the different prognosis in patient outcomes, targeting these mutant splicing factors offers a new therapeutic strategy to treat patients with hematological malignancies. 20, 21 1] [22] This implies that MDS cells may not tolerate acquisition of multiple mutant proteins involved in RNA splicing 5 and rely on a wild-type copy of the mutant splicing factor for survival. The synthetic lethality 23, 24 to induce toxicity to tumor cells carrying splicing factor mutations may be applicable by targeting the remaining wild-type copy of the splicing factor or a second splicing factor without mutations. Indeed, studies have shown that leukemia cells carrying SRSF2 25, 26 and U2AF1 27 mutations were sensitive to compounds impairing SF3B1 function. 

Genetic analysis of the disease progression of MDS patients further revealed that U2AF1 mutations occur in the early clonal evolution 5 and MDS patients carrying mutant U2AF1 (U2AF1 mut ) are at increased risk to progress to secondary acute myeloid leukemia (sAML). 3, 28, 29 Defective hematopoiesis associated with U2AF1 mut cannot be rescued by overexpression of wild-type U2AF1 (U2AF1 wt ) in mice 30, 31 suggesting that U2AF1 mut might gain a new function or be neomorphic. Functionally, U2AF1 heterodimerizes with U2AF2 to associate with SF1 to form a SF1/U2AF2/U2AF1 complex that binds to the branch point sequence (BPS, with SF1), polypyrimidine track (with U2AF2), and the 3' splice site (with U2AF1) on introns in the early step of pre-mRNA processing. 5, 32 Hotspot mutations (S34 and Q157) in the two zinc finger domains of U2AF1 (Fig. 1 ) directly impact the binding between U2AF1 and mRNA and have been shown to alter 3' splice site recognition preferences 2, 3, 33, 34, resulting in mRNA transcript pattern changes. Downstream effects associated with U2AF1 mutations have been demonstrated in several in vitro mechanistic studies in cells. For example, U2AF1 S34F in mouse pro-B cell line (Ba/F3) generated a long ATG7 transcript producing reduced levels of ATG7 and impaired autophagy to promote oncogenic transformation of MDS and AML. 35 AML samples carrying U2AF1 mutations (S34F, R156H, and Q157P/R) were found to produce the pro-inflammatory long IRAK4 isoforms instead of the short IRAK4 that would maximize the oncogenic NF-kB pro-survival signaling. 36 Induced pluripotent stem cells (iPSC) transfected with U2AF1 S34F were found to generate a long isoform of GNAS that activated ERK/MARK signaling potentially contributing to the neoplastic transformation of MDS. 37 Growing evidence indicating that specific U2AF1 mut -associated protein isoforms promote leukemia cell transformation strongly supports the notion that agents targeting U2AF1 will provide an important chemical tool to interrogate U2AF1 mut function and facilitate study of U2AF1 as a potential therapeutic target in U2AF1 mutant myeloid neoplasia. 

Previously, Chatrikhi et al. performed a compound library screen and identified a small molecule, NSC194308, that stabilized the SF1/U2AF2/U2AF1 complex and stalled pre-mRNA splicing at the early spliceosome assembly. 38 Moreover, NSC194309 induced toxicity to K562 wild-type (K562-U2AF1 wt ) and K562 expressing U2AF S34F (K562-U2AF S34F ) at a 2-3-fold lower IC50 value. Isoforms changes of select genes in the K562-U2AF1 wt and K562-U2AF1 S34F were also determined. Here, we report the results of our library screening campaign that identified SF1-8 inhibiting U2AF Homology Motifs (UHM) domain of U2AF1 (U2AF1-UHM) required for the binding between U2AF1 and U2AF2 and evaluated the effects of SF1-8 on the viability and molecular pathways in U2AF1 S34 mutant leukemia cells.
section_name: Introduction

section_name: Results

section_content: Analysis of the whole-exome sequences in 33 tumor types in the Cancer Genome Atlas (TCGA) showed somatic mutations involving at least ten amino acids in U2AF1 across six tumor types besides leukemia (Fig. 1A ). 39 More frequent mutations were found in U2AF1 S34. Analysis of the Catalogue of Somatic Mutations in Cancer (COSMIC) data showed that missense mutations of U2AF1 accounted for 80% of tumor samples. S34 and Q157 were two hotspot mutations in hematopoietic and lymphoid tumors (Fig. 1A ). Our collection of studies in the Cleveland Clinic cohort showed U2AF1 mutations at a frequency of 5-20% in MDS and sAML. Two hotspot mutations (S34; Q157) in U2AF1 were predominant (Fig. 1B ). 

U2AF1 mutations rarely co-occur with other common splicing factor mutations (SRSF2, SF3B1, ZSZR2). 40, 41 In a cohort of 202 MDS/AML patients at Cleveland Clinic, only eight patients acquired comutations of U2AF1 and other splicing factors with variable variant allele frequency (VAF) in both hits (Fig. 1B ). Using curated RNA-sequencing data from samples with myeloid neoplasia (PMID: 36926651), we compared RNA splicing profiles of clonal cells with S34 (n=19) and Q157 (n=26) (VAF >10%, for both). The splicing profiles of U2AF1 S34 and U2AF1 Q157 overlapped for a subset of genes distinctive from healthy controls suggesting convergence rather than divergence of splicing outcomes (Fig. 1C ).
section_name: Mutational landscape of U2AF1 in tumor samples

section_content: A previous small compound library screening study against the zinc finger (Zf) domains of U2AF1 did not identify hits. 38 To develop a different targeting strategy, we assessed potential tractable binding sites in U2AF1 using computational analysis and determined that the UHM domain of U2AF1 was for identifying hits (Fig. S1 ). 42 To discover hits, we screened the CCG fragment library from University of Michigan against the U2AF1-UHM domain using the Thermal Shift Assay (TSA). An initial single concentration screening at 200 μM led to identify 149 compounds that gave positive shifts of the melting temperature (DTm) in U2AF1-UHM. These compounds were subject to a secondary confirmatory screening in triplicate at 200 μM. Nine compounds showed DTm>1 ˚C in U2AF1-UHM (Fig. 2A ) in which CCG211578 and CCG210084 had a similar core structure with a difference of a methyl group (Fig. 2B ). 

CCG211578 gave the highest DTm at 2. 02 ˚C whereas 1. 50 ˚C of DTm was observed with CCG210084. 

Our screening data suggested CCG211578 and CCG210084 bound to stabilize U2AF1-UHM. 

TSA data provided no information of the binding site in U2AF1-UHM. To identify the binding sites of both hits to U2AF1-UHM, we synthesized CCG211578 (named Hit1/SF1-8) and CCG210084 (named Hit2/9 in Fig. 2C ) and asked if they inhibited the binding between U2AF1-UHM and U2AF2-ULM using our previously developed HTRF assay. 42 We found both SF1-8 and Hit2 inhibited the binding between U2AF1-UHM and U2AF2-ULM at the IC 50 values of 59. 33 ± 0. 02 and 343. 05 ± 62. 44 μM respectively. 

The IC 50 values of SF1-8 and Hit2 correlated with the DTm values observed in TSA. We have reported that the conserved Trp binding site in U2AF1-UHM dominated the binding affinity between U2AF2-ULM and U2AF1-UH. 42 Thus, data from TSA and HTRF assays suggested that both SF1-8 and Hit2 may target the Trp binding site in U2AF1-UHM. 

To determine the selectivity of SF1-8 against other homologous UHM domains, we measured the IC 50 values of SF1-8 to RBM39-UHM, SPF45-UHM and PUF60-UHM using the HTRF assay. 42 We found SF1-8 had a 4-12 fold selectivity against three other UHM domains (Fig. 2C ), whereas Hit2 was a much weaker and less selective inhibitor. In the chemical synthesis (Scheme S1), methylation on the pyrazole group in SF1-8 can occur at the N8 or N9 position (Fig. 2C ). Although the NMR spectra can be used to infer the methyl group position on the pyrazole, we determined the crystal structure of a SF1-8 precursor to clearly confirm the methyl group is at N9 in SF1-8 (Fig. 2C ). To further probe the interaction of SF1-8 with U2AF1-UHM, we synthesized SF1-8 analogs and developed the structure activity relationship (SAR) (Fig. 2C ). The SAR indicated that a methyl group at the N8 position (8a) decreased the activity against U2AF1-UHM. Although replacement of methyl with ethyl did not improve the activity to U2AF1-UHM, a propyl group at either the N8 (8c) or N9 (7c) position retained or had improved activity against U2AF1-UHM. When an isopropyl group was used, 8d had a modest decreased activity against U2AF1. A longer alkyl group was tolerated at the N8 position but not at the N9 position. We also replaced the methyl group on the piperidine ring with an ethyl group and found 8e had a comparable IC 50 value with SF1-8. 

Compounds (7c, 8c, 8d, 8e) that had comparable IC 50 values to SF1-8 were generally more selective against three other UHM domains except 7c that had a dual inhibitory activity against U2AF1 and SPF45 (Fig. 2C ). The crystal structure of a 7c precursor experimentally determined from SCXRD again confirmed the location of the propyl group (Fig. 2C ). The biophysical binding data indicated that SF1-8 and 8c preferentially inhibited U2AF1-UHM against other UHM domain proteins.
section_name: Identification of SF1-8 from fragment library screening against U2AF1-UHM domain

section_content: Because the biophysical assay suggested that SF1-8 was more effective and selective against U2AF1-UHM, we proceeded to evaluate SF1-8 in cell lines. Previous studies that introduced U2AF1 S34F in lung epithelial (HBEC3kt) 43, leukemia (K562) 38, 44, 45, and iPSC 37 cell lines have validated the function of U2AF1 S34F in these engineered cell lines while mutation of Q157 is less studied. We therefore focused our study on U2AF1 S34F and examined the effects of SF1-8 on a panel of leukemia cell lines including K562, U937, HL60 with isogenic overexpression of U2AF1 wt or U2AF1 S34F, K562 with isogenic overexpression of SRSF2 wt or SRSF2 P95H, and K562 with Crispr/Cas9 edited SF3B1 wt or SF3B1 E700K (denoted as K562-U2AF1 wt, K562-U2AF1 S34F, U937-U2AF1 wt, U937-U2AF1 S34F, HL60-U2AF1 wt, HL60-U2AF1 S34F, K562-SRSF2 wt, K562-SRSF2 P95H, K562-SF3B1 wt, K562-SF3B1 E700K ). We found that SF1-8 selectively decreased the viability of K562-U2AF1 S34F, K562-SF3B1 E700K but not their isogenic wild-type cells (Fig. 3A ). 

Although SF1-8 had no activity in K562-SRSF2 wt, K562-SRSF2 P95H, U937-U2AF1 wt, and U937-U2AF1 S34F, SF1-8 reduced cell viability in both HL60-U2AF1 wt and HL60-U2AF1 S34F similarly. The dosetitration experiment gave an IC 50 value of 1. 98 μM in K562-U2AF1 S34F but showed no activity in K562-U2AF1 wt (Fig. 3B ). In the native leukemia cell lines (MV-4-11 and HL-60) carrying U2AF1 wt, SF1-8 showed no activities up to 100 μM (Fig. 3B ). The data obtained from the engineered leukemia cell lines prompted us to query the activity of SF1-8 in primary MDS cells. We plated bone marrow cells from an MDS specimen that harbored U2AF1 S34F (VAF, 41%) and found SF1-8 dose-dependently reduced the viable cells to 20% at 10 μM (Fig. 3C ). In contrast, as much as 10 μM SF1-8 did not significantly decrease 20% of viable cells in healthy control cells. SF1-8 showed no significant toxicity to the bone marrow cells of healthy control from 1 to 20 μM in the colony formation assay (Fig. 3C ).
section_name: Activity of U2AF1-UHM inhibitors in model cell lines and primary cells from MDS patients

section_content: To understand the underlying mechanisms of the differential effects of SF1-8 on K562-U2AF1 S34F, we performed an RNA-seq experiment on K562-U2AF1 S34F cells treated with SF1-8 and control (Fig. 4 ). In the SF1-8 treated K562-U2AF1 S34F cells, we found 36 up-and 63 down-regulated genes in the top 99 differentially expressed genes (Figs. 4B, 4D ). Down-regulated genes included c-CBL (E3 ligase), CBLL1 (E3 ligase), CREB1 (transcription factor), AKT3 (kinase regulating signaling mediated by growth factor) and a set of collagens, including COL1A1, COL1A2, COL3A1, COL5A1, COL5A1, and COL6A1 (Fig. 4A ). 

Up-regulated genes included ATF-3 (stress response transcription factor), FRS2 (growth factor binding protein), DHFR2 (folate metabolism in mitochondria), and BCL-2 (anti-apoptotic). When the 99 genes were mapped to KEGG pathways 46, the top six enriched pathways were protein digestion and absorption, extracellular matrix-receptor interaction, focal adhesion, PI3K-Akt signaling pathway, human papillomavirus infection, and AGE-RAGE signaling pathway (Fig. S2 ). To determine if the protein levels of these genes were affected by their mRNA changes, we performed the western blots of select genes. An increase of ATF-3 was confirmed, but we found no change of c-CBL and decreased BCL2 (Fig. 4C ). 

Because of the role U2AF1 in RNA splicing, we asked if analysis of the isoform pattern changes may provide insight to explain the different observations between RNA-seq and western blot data. In the transcript analysis, we identified low FPKM numbers of three BCL2 transcripts (Fig. S3 ) that explained the relatively low BCL2 protein levels in K562. A significant increase of the BCL-2b transcript was also found. BCL-2b possessed an apoptotic function and was reported to have reduced mRNA and proteins stability than the canonical isoform 47 that partly explained the decreased BCL-2 protein level in western blot despite mRNA increased. Besides BCL2, BCLXL (encoded by BCL2L1) and MCL1 have isoforms (BCL-XS and MCL-1S) that had apoptotic functions. K562 cells expressed only the anti-apoptotic MCL1 transcript and the expression was not affected by SF1-8 (not shown). Similarly, SF1-8 did not significantly change the isoform pattern of BCL2L1 gene (Fig. S3 ). Another frequently studied gene involved in apoptosis regulation is survivin. 48, 49 Multiple transcripts of survivin have been discovered and possess either anti-apoptotic or apoptotic functions. 50 In the K562-U2AF1 S34F cells, we found SF1-8 markedly increased the transcript (Survivin-2a) that had the apoptotic function (Fig. S3 ).
section_name: Transcriptomic changes in K562-U2AF1 S34F cells treated with SF1-8

section_content: To identify additional players, we examined transcripts that were significantly changed by SF1-8 in K562-U2AF1 S34F cells. A total of 1034 transcripts significantly changed their mRNA expression levels after SF1-8 treatment in the K562-U2AF1 S34F cells. To filter potential false-positive hits, we included transcripts that had at least one sample containing FPKM >2. In this set of transcripts, we first identified for genes that changed expression patterns in ≥2 transcripts carrying different numbers of exons and identified 39 genes (Fig. 5 ). Additionally, eight genes (BCOR, CENPE, CENPK, ZBTB7B, HNRNPC, HNRNPH1, MRKN, and PARN) showed a same pattern of changes in two transcripts (either both up-or down-regulated) carrying different number of exons, and 32 genes exhibited variable changes of expression patterns in multiple transcripts containing the same number of exons (Fig. S4 ). 

Changes of isoform pattern in genes may alter their functions in cells; therefore, we focused on studying the 39 genes that changed isoform pattern. To understand if these genes interact with each other, we used the STRING database to map the interactome of the 39 genes (Fig. S5 ). A few network nodes of interaction were detected. They included the network interaction of a) FRS2, CBL, FN1, ASAP1, PACSIN2; b) VAMP7, PICALM, PLD3 and paired interaction nodes in NUP155/SP100, DNAJB11/HSF2, PSMA1/RPL15, NOL10/ELP3 and ELMO3/WDR35.
section_name: Isoform pattern changes in K562-U2AF1 S34F cells treated with SF1-8

section_content: We first analyzed the isoform pattern changes of the genes in the largest network node that included FRS2, CBL, FN1, ASAP1, and PACSIN2 (Fig. 6A ). SF1-8 treatment led to an expression change of CBL from the dominant transcript (encoding 906 aa) to an isoform, ENST00000637974, (encoding 869aa) that contained different amino acids in the C-terminal ubiquitin-associated (UBA) domain of CBL. 51 The alternative UBA domain in ENST00000637974 may adopt a disordered conformation according to AlphaFold 52 and impaired the homodimerization of CBL 51 that is required for its function in cells. 51, 53, 54 h isoforms of CBL may be indistinguishable in our western blot experiment because the C-terminal domain of c-CBL is not the epitope of our antibody (Fig. 6C ). For ASAP1, a dominant isoform (1129 aa) was switched to an isoform lacking part of the N-terminus preceding the BAR domain. 55 For FRS2, we found that the endogenous short isoform (encoding 183aa) was replaced by a dominant isoform (encoding 383 aa) that contained multiple regulatory tyrosine phosphorylation sites in the C-terminus. 56 A similar switch of PACSIN2 from an isoform that contained exon 9 skipped truncated EH domain binding region to the dominant isoform was found. 8] [59] Changes in the isoform patterns induced by SF1-8 may increase the regulation of FRS2, perturb the ASAP1 BAR domain mediated binding, and disable the UBA domain in c-CBL, collectively limiting or impairing the endocytosis of the growth factors such as EFGR and FGFR. On the other hand, exon 9 in PACSIN2 is mapped to a NPF(Asn-Pro-Phe)1 motif that interacts with the EH domain containing proteins. 60 PACSIN2 also contains an F-BAR domain 61, similar to the function of the BAR domain in ASAP1. The BAR domains are involved with creating membrane curvature and membrane dynamics. 60, 62, 63 Restoration of PACSIN2 to the dominant isoform by SF1-8 however may improve its function to participate in membrane dynamics and receptor-mediated endocytosis. 64 The changes in PACSIN2 may serve as a rescuing feedback loop. 

The second network node involved PICALM, VAMP7, and PLD3 (Fig. 6B ). PICALM has been reported to be an important gene contributing to leukemogenesis and expression pattern change was observed in MDS/AML patients harboring U2AF1 mutation. 65 Our analysis of the transcripts of PICALM and VAMP7

showed that isoforms switch in PICALM and VAMP7 led to deletion of NPF and DPF motifs in PICALM that interact with AP2 and a truncated PICALM binding domain in VAMP7. 66 Changes in the PICALM and VAMP7 isoforms may result in decreased interaction between PICALM, VAMP7 and AP2 that is important for clathrin-coated vesicle formation and clathrin-mediated endocytosis. 67, 68 0] [71] [72] Impairment of VAMP7 function may affect the vesicles sorting which involved PLD3. Although changes of three PLD3 transcripts were found, they encoded the same protein and total PLD3 mRNA was insignificantly downregulated by SF1-8. 

We also identified additional genes that participated in vesicle transport and protein excretion. 4] [75] For both genes, SF1-8 switched the isoforms to their dominant isoforms that may improve the protein transport between organelles (Fig. S6 ). Further, RUSC1 interacts with AP4 to regulate vesicle secretion. 76 Four transcripts of RUSC1 (Fig. S6 ) were detected and the most significantly upregulated was the transcript (ENST00000368349) encoding an isoform lacking the Nterminal 468 aa with an unknown function. Two transcripts of the same number of exons in AP4E1 also changed their expression pattern (Fig. S6 ). The dominant AP4E1 transcript switched to an isoform with a truncated N-terminal clathrin/cooctamer adapter domain that may impair the trans-Golgi network vesicle transport 77 and secretion function of AP4E1. 78 The isoform changes in RUSC1 and AP4E1 by SF1-8 treatment may impair normal vesicle secretion. A summary of the discussed genes involved with the endocytosis, vesicle transport, and protein secretion pathways was illustrated in Fig. 7.
section_name: Isoform pattern changes of multiple genes by SF1-8 affected endocytosis and vesicle transports in K562-U2AF1 S34F cells.

section_content: Another interaction node was between PSMA1 and RPL15. PSMA1 is a subunit of S20 proteosome and responsible for recruiting PSMC3 ATPase to facilitate the digestion of ubiquitinated proteins. F1-8 treatment led to reduce the endogenous PSMA1 isoform lacking the first 12 amino acid (ENST00000530457) to the dominant PSMA1 isoform encoding 263aa (ENST00000396394) and increased a longer isoform encoding 269aa (ENST00000418988). The effect may improve the proteosome activity. Although expressions of three RPL15 transcripts were detected, they all encoded the same protein. We also examined eight genes (BCOR, PICALM, RUSC1, XRCC4, ERGIC3, ICA1, MKRN1, and PFKM) affected by SF3B1, SRSF2, and U2AF1 mutations in MDS patients reported previously. 65 In our K562-U2AF1 S34F model cell line, SF1-8 markedly altered the isoform patterns of PICALM, ERGIC3, RUSC1 discussed previously (Fig. 5 ), BCOR, and MRKN1 (Fig. S4 ). For BCOR and MRKN1, our RNAseq analysis showed two isoforms of BCOR and MRKN1 were downregulated and upregulated respectively in K562-U2AF1 S34F treated with SF1-8.
section_name: Impact on isoform pattern changes of genes involved in proteosome, and in MDS patients harboring splicing factors mutation were found in K562-U2AF1 S34F cells treated with SF1-8

section_content: Next generation sequencing of patients' samples has led to discover a set of splicing factors that are frequently mutated in the development of MDS and AML. The clinical observation that heterozygous U2AF1 mutations are acquired in early clones suggests that mutant U2AF1 may play an important role in the initiation phase of disease development by cooperating with the wild-type allele. Pharmacological intervention to the evolution of U2AF1 mutant clone especially in MDS may offer an attractive therapeutic approach to mitigate the disease progression and improve patient treatment. Our strategy to abrogate the growth of the U2AF1 mutant cancer cells is to target U2AF1-UHM that binds with U2AF2 to form a dimer recognizing the 3' splice site in pre-mRNA splicing. Although inhibition of the U2AF1-UHM domain affects both the wild-type and mutant U2AF1, we hypothesized that the outcome may introduce a second alteration on the spliceosome assembly via U2AF1 to induce synthetic lethality to the U2AF1 mutant clones. 

To investigate the hypothesis, we performed a library screening against U2AF1-UHM and discovered SF1-8. Using the HTRF binding assay, we verified that SF1-8 inhibited the binding between U2AF1-UHM and U2AF2-ULM. We further characterized that SF1-8 was selective against three other UHMcontaining proteins (RBM39, SPF45, and PUF60). The SAR study of SF1-8 analogs led to identify several compounds giving similar or slightly improved activity than SF1-8, but SF1-8 remained more selective against RBM39, SPF45, and PUF60. Although the activity of SF1-8 to U2AF2-UHM was not determined, a relatively selective U2AF2-UHM inhibitor, UHMCP1, was recently reported 79 and characterized. 80 mprovement of the activities of UHMCP1 and our U2AF1-UHM inhibitors will provide selective chemical probes to interrogate the role of each UHM containing protein in RNA splicing. 

Our cellular activity study showed that SF1-8 selectively reduced viability of K562-U2AF1 S34F but not K562-U2AF1 wt cells. Similar selective growth inhibition was observed between K562-SF3B1 E700K and K562-SF3B1 wt cells but not between K562-SRSF2 P95H, U937-U2AF1 S34F, and HL60-U2AF1 S34F and their isogenic wild-type cells. Of note, a compound, NSC194308 that stabilized SF1/U2AF2/U2AF1 complex, was previously shown to exhibit 2-fold selectivity between K562-U2AF1 S34F and K562-U2AF1 wt. 38 hough K562 cell line has been used as a model system in previous studies, 27, 31, 36, 38, 43, [81] [82] [83] [84] the effects of U2AF1 S34F on the growth and survival in U937 and HL60 have not been characterized. To overcome the deficiency that no known MDS or AML cell lines acquired endogenous U2AF1 S34F mutation for inhibitor evaluation, we tested SF1-8 in primary MDS patient cells carrying U2AF1 S34F (VAF, 41%) and found SF1-8 also inhibited the proliferation of the primary cells. 

In the RNA-seq analysis of K562-U2AF1 S34F treated with SF1-8, we observed down-regulation of CBL and a subset of collagens genes. Analysis of mRNA transcripts led to identify pattern changes of 39 transcripts in genes expressing different number of exons. The gene network interaction analysis revealed sets of genes participating in endocytosis, clathrin-mediated coat formation, intra-cellular vesicle transports between organelles and vesicle secretion were affected by SF1-8. The isoform pattern changes of these genes likely resulted in impairment of endocytosis (EGFR), clathrin-mediated coat formation (PICALM), endolysosome transport (VAMP7), and vesicle secretion (RUSC1, AP4E1) (Fig. 7 ). 

Compensating effects on this pathway were observed in the restoration of the canonical transcripts in PACSIN2 (endocytosis). Two genes, ERGIC3 and COPB2, also switched to the dominant isoforms that may improve the COPI and COPII mediated vesicle exchange between ER and Golgi. 85 COPB2 is a subunit of COPI 75 that recycles proteins from Golgi to ER. Restoration of the canonical functions in ERGIC3 and COPB2 may be a feedback mechanism to manage impaired protein secretion associated with The figure was prepared using BioRender. com.
section_name: Discussion

section_name: Acknowledgements

section_content: This work was supported in part from the National Institute of Health 1R21CA270590-01 (C-Y. Y. ; V. V. ), the startup fund and the Drug Discovery Center pilot grant (C. -Y. Y. ) from University of Tennessee Health Science Center, the University of Michigan Rogel Cancer Center Core Grant from the National Cancer Institute, NIH P30 CA046592, and NIH 1S10OD030352 (M. A. S. ), and Department of Defense Bone Marrow Failure Idea W81XWH-15-1-0153 (S. J. C. ). We thanked Dejian Ma for technical assistance in collecting analytical data of the compounds.
section_name: Acknowledgements

section_name: Supplemental Material. Figures S1-S7, Table

section_content: Although we determined the impacts of SF1-8 on the growth inhibition and transcriptome of K562-U2AF1 S34F cells in this work, there are limitations to our findings. Despite the preferentially inhibition of SF1-8 to U2AF1-UHM, the activity and selectivity of SF1-8 need to be improved. Activity of SF1-8 against other potential targets in cells was not fully determined and may contribute to the activity observed in our study. Although RNA-seq data elucidated complex isoform transcript changes induced by SF1-8, follow-up experiments using PCR and western blot experiments (limited by suitable antibodies to detect specific protein isoforms) will be important to confirm the underlying mechanisms that reduced the viability of K562-U2AF1 S34F cells. Finally, murine models recapitulating heterozygous U2AF1 mutations under development 31 may be important tools to assess this therapeutic approach in future studies. Despite our demonstration of the feasibility to selectively target U2AF1-UHM with small-molecule inhibitors, the potential of advancing chemical tools targeting U2AF1 mutant cells to drug development in pre-clinical evaluation remains to be fully investigated. S1 -S2, methods, NMR, and mass spectra of the compounds are available free of charge. RNA-seq data were deposited at GEO under accession GSE267059. (The reviewer's token to access the data is "idancgmudlypzch". )

section_name: Declarations

section_content: Reprints and permissions information is available at www. nature. com/reprints. The authors declare no competing financial interests. Readers welcome to comment on the online version of the paper.
section_name: Author Information

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