El Hajj, N. | bioRxiv Science

bioRxiv2026

Methylation-Guided Stratification of Colorectal Cancer Reveals Immune Subtypes with Distinct Clinical Outcomes

BackgroundAberrant DNA methylation is a hallmark of colorectal cancer (CRC). Yet, how DNA methylation is linked to transcriptional states, immune programs, and tissue resident microbiome within the same tumors has not been systematically analyzed. MethodsWe profiled genome-wide DNA methylation (Illumina MethylationEPIC) in 182 colon tumors and 76 adjacent normals from AC-ICAM, and integrated with matched transcriptomes, whole exome, microbiome, and clinical data. Tumor-specific methylation, promoter methylation-expression links, microbiome associations, and survival were analyzed and validated in TCGA-COAD. ResultsTumor and normal tissues exhibited distinct DNA methylation patterns, reflecting widespread epigenetic alterations in cancer. Pathway analysis identified two major tumor pathways regulated by DNA methylation. The first involved extracellular signaling and adhesion genes, with higher methylation linked to increased proliferation and lower immune infiltration. Similarly, higher tumor methylation in nitric oxide signaling was associated with reduced adaptive immune activity and interestingly, influenced immune-related survival. These findings were also validated in the TCGA-COAD cohort. An inverse methylation-expression pattern implicated modifications of TCR signaling in naive CD8, and interferon-/{beta} signaling which were hypermethylated and hypomethylated in tumors compared to normal, respectively. Combining methylation and microbiome revealed connections between Akkermansia muciniphila and TGF-{beta} and Prevotella nigrescens with MAPK signaling pathways. Finally, a methylation-based model using 43 promoters CpGs successfully identified patients with different survival outcomes, underscoring the clinical relevance of these epigenetic alterations in colon cancer. ConclusionDNA methylation shapes the molecular and immune landscape of colon cancer, altering signaling pathways and immune programs, interacting with the microbiome, and impacting patients survival.

cancer biology↗

bioRxiv2023

Epigenetic Age Acceleration in Surviving versus Deceased COVID-19 Patients with Acute Respiratory Distress Syndrome following Hospitalization

Aging has been reported as a major risk factor for severe symptoms and higher mortality rates in COVID-19 patients. Molecular hallmarks such as epigenetic alterations and telomere attenuation reflect the biological process of aging. Epigenetic clocks have been shown to be valuable tools for measuring biological age in a variety of tissues and samples. As such, these epigenetic clocks can determine accelerated biological aging and time-to-mortality across various tissues. Previous reports have shown accelerated biological aging and telomere attrition acceleration following SARS-CoV-2 infection. However, the effect of accelerated epigenetic aging on outcome (death/recovery) in COVID-19 patients with Acute Respiratory Distress Syndrome (ARDS) has not been well investigated. In this study, we measured DNA methylation age and telomere attrition in 87 severe COVID-19 cases with ARDS under mechanical ventilation. Furthermore, we compared dynamic changes in epigenetic aging across multiples time-points until recovery or death. Epigenetic age was measured using the Horvath, Hannum, DNAm skin and blood, GrimAge, and PhenoAge clocks, whereas telomere length was calculated using the surrogate marker DNAmTL. Our analysis revealed significant accelerated epigenetic aging but no telomere attrition acceleration in severe COVID-19 cases. In addition, we observed epigenetic age deceleration at inclusion vs end of follow-up in recovered but not in deceased COVID-19 cases using certain clocks. When comparing dynamic changes in epigenetic age acceleration (EAA), we detected higher EAA using both the Horvath and PhenoAge clocks in deceased vs recovered patients. The DNAmTL measurements revealed telomere attrition acceleration in deceased COVID19 patients between inclusion and end of follow-up as well as a significant change in dynamic telomere attrition acceleration when comparing patients who recovered vs those who died. In conclusion, EAA and telomere attrition acceleration was associated with treatment outcome in hospitalized COVID-19 Patients with ARDS. A better understanding of the long-term effects of EAA in COVID19 patients and how they might contribute to Long COVID symptoms in recovered individuals is urgently needed.

genetics↗