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BCL6

BCL6, also known as B-cell lymphoma 6, is a zinc-finger transcription factor encoded by the BCL6 gene located on chromosome 3q27 in humans, functioning primarily as a transcriptional repressor that plays a central role in regulating B-cell development, germinal center formation, and humoral immunity.^[1] First identified through chromosomal translocations in non-Hodgkin lymphomas, BCL6 is essential for the differentiation of germinal center B cells and T follicular helper cells, enabling processes like somatic hypermutation and class-switch recombination to produce high-affinity antibodies.^[2] Dysregulation of BCL6, often via translocations or mutations, transforms it into an oncogene driving the pathogenesis of aggressive B-cell malignancies, while also influencing inflammation and other immune responses.^[3] Structurally, BCL6 is a 95 kDa multi-domain protein featuring an N-terminal BTB/POZ domain for corepressor recruitment, a central RD2/PEST region involved in protein stability, and a C-terminal array of six C2H2 zinc-finger motifs that facilitate sequence-specific DNA binding to BCL6 response elements.^[1] This architecture allows BCL6 to interact with corepressors such as SMRT, NCOR1, and BCOR, thereby silencing target genes critical for cell cycle progression (e.g., CDKN1A), DNA damage response (TP53, ATR), and differentiation (PRDM1/BLIMP1).^[4] The protein's repressive activity is further modulated by post-translational modifications and partnerships, such as with Maf family members in T cells, enabling context-specific regulation across immune lineages.^[4] In the immune system, BCL6 is indispensable for adaptive humoral responses, particularly within germinal centers of secondary lymphoid organs, where it promotes B-cell proliferation and survival while inhibiting terminal differentiation and apoptosis.^[3] In B cells, BCL6 represses genes that would otherwise trigger exit from the germinal center, such as BLIMP1 and IRF4, ensuring sustained antibody affinity maturation; genetic ablation of Bcl6 in mice results in the complete absence of germinal centers and impaired immunoglobulin class switching.^[5] Beyond B cells, BCL6 drives the differentiation of T follicular helper (Tfh) cells by suppressing alternative T helper pathways (Th1, Th2, Th17) through repression of transcription factors like T-bet, GATA3, and RORγt, and it also regulates follicular regulatory T (Tfr) cells to balance immune tolerance.^[1] Additionally, BCL6 modulates innate immunity by controlling macrophage polarization toward an anti-inflammatory M2-like state and limiting Th17-mediated inflammation in peripheral tissues.^[4] As an oncogenic driver, BCL6 is deregulated in approximately 40-45% of diffuse large B-cell lymphomas (DLBCL), the most common lymphoid malignancy, where translocations juxtapose the BCL6 locus with heterologous promoters (e.g., IGH), leading to its aberrant overexpression and blockade of B-cell differentiation.^[3] This overexpression enables lymphoma cells to mimic the germinal center state, evading DNA damage checkpoints and apoptosis while cooperating with oncogenes like MYC and BCL2.^[1] BCL6 alterations are also implicated in follicular lymphoma, Burkitt lymphoma, and non-B-cell cancers such as acute myeloid leukemia, breast cancer, and glioblastoma, often correlating with poor prognosis and therapy resistance.^[6] Therapeutically, BCL6 inhibitors like RI-BPI peptides and small molecules (e.g., FX1, 79-6) have shown preclinical efficacy in disrupting corepressor interactions and inducing lymphoma cell death, with ongoing clinical trials exploring their potential in relapsed/refractory B-cell neoplasms.^[3]

Molecular Biology

Gene Characteristics

The BCL6 gene was discovered in 1993 as a proto-oncogene frequently translocated in non-Hodgkin lymphomas, particularly diffuse large B-cell lymphoma, where chromosomal rearrangements disrupt its regulatory regions.^[7] This identification highlighted its role in B-cell malignancies, with the gene encoding a zinc-finger transcription factor involved in lymphoid development.^[8] The BCL6 gene is located on chromosome 3q27.3 in humans, spanning approximately 24 kb of genomic DNA and consisting of 10 exons.^[9] The translation initiation site resides in exon 3, and the gene structure includes regulatory elements prone to translocation within a major translocation cluster in the first intron.^[9] Alternative splicing of BCL6 pre-mRNA generates multiple isoforms, with the full-length variant serving as the dominant form that produces a 706-amino-acid protein.^[10] A notable short isoform, BCL6S, arises from exclusion of exon 7, resulting in a 650-amino-acid protein with altered repressor function, though the full-length isoform predominates in normal and neoplastic B cells.^[11] BCL6 expression is tissue-specific, primarily occurring in B cells within germinal centers of lymphoid tissues, where it peaks during the germinal center reaction.^[12] Low-level expression is also detected in other immune cells, such as CD4+ T cells in germinal centers and subsets of macrophages, but it is minimal or absent in non-lymphoid tissues under normal conditions.^[13]^[14] The BCL6 gene exhibits strong evolutionary conservation across vertebrate species, reflecting its essential function as a zinc-finger transcription factor in immune regulation and stress responses.^[15] Orthologs are present in mammals, birds, reptiles, amphibians, and fish, with particularly high sequence identity in the zinc-finger DNA-binding domains, underscoring its ancient origin in vertebrate adaptive immunity.^[16]

Protein Structure

BCL6 is a nuclear transcription factor composed of 706 amino acids, with a calculated molecular weight of approximately 79 kDa.^[17] The protein features a modular architecture, including an N-terminal BTB/POZ domain spanning residues 5-127, which mediates homodimerization and recruitment of corepressor complexes, and a C-terminal DNA-binding domain containing six C2H2-type zinc finger motifs (residues 378-678) that recognize specific DNA sequences.^[17] Between these domains lies a central region of about 400 residues that includes a proline-, glutamic acid-, serine-, and threonine-rich (PEST) sequence involved in protein turnover.^[18] Additionally, BCL6 harbors a nuclear localization signal within its structure, facilitating its predominant localization to the nucleus where it exerts transcriptional control.^[17] Structural studies have elucidated key aspects of BCL6's architecture, particularly the BTB/POZ domain. The crystal structure of this domain, determined at 2.3 Å resolution (PDB: 1R28), reveals a homodimeric assembly with a 2:2 interface involving lateral β-strands and α-helices, essential for stable dimer formation and interaction surfaces for corepressors like BCOR and NCOR.^[19] While the zinc finger domain lacks a high-resolution crystal structure, modeling and biochemical data confirm its classical C2H2 configuration, enabling sequence-specific DNA binding.^[17] BCL6 undergoes post-translational modifications that influence its stability and activity. Notably, phosphorylation occurs at multiple serine residues in the PEST region, including Ser333 and Ser343, mediated by mitogen-activated protein kinase (MAPK) in response to signaling cues; this modification triggers ubiquitination and proteasomal degradation, thereby limiting protein half-life.^[20] Alternative splicing of the BCL6 transcript generates isoforms with altered functionality. A prominent short isoform, BCL6S, results from exon 7 skipping, producing a truncated protein that lacks the first two zinc fingers (residues 378-455) but retains the remaining four, potentially impairing DNA-binding specificity while preserving dimerization capability.^[11]

Physiological Functions

Transcriptional Regulation

BCL6 primarily functions as a transcriptional repressor, utilizing its N-terminal BTB/POZ domain to recruit corepressor complexes such as NCOR1 and SMRT (also known as NCOR2). These corepressors, in association with histone deacetylases (HDACs), facilitate histone deacetylation and subsequent chromatin condensation at target gene promoters, thereby silencing transcription.^[21] This repression mechanism is essential for modulating gene expression in immune cells, where BCL6's activity prevents untimely activation of differentiation or stress response pathways.^[22] The C-terminal zinc finger domains of BCL6 confer sequence-specific DNA binding, recognizing palindromic motifs such as 5'-TTCCTAGAA-3'. These domains enable BCL6 to dock at regulatory elements within target genes, initiating the recruitment of repressive machinery.^[23] Among its key targets are genes involved in the DNA damage response, including TP53, ATR, and CHEK1, whose repression attenuates checkpoint activation and allows cellular proliferation under genotoxic stress.^[24] In B cells, BCL6 represses hundreds of genes, underscoring its role as a master regulator of transcriptional programs.^[22] BCL6 protein stability is tightly controlled, with its short half-life modulated by ubiquitination-mediated proteasomal degradation via the SCF^FBXO11 E3 ligase complex. This post-translational regulation ensures transient repression activity, preventing indefinite gene silencing.^[25] Additionally, BCL6 participates in negative feedback loops, binding to autoregulatory elements in its own promoter to self-repress transcription and maintain balanced expression levels.^[26]

Role in Germinal Center Formation

BCL6 plays a pivotal role in the formation and maintenance of germinal centers (GCs), specialized microenvironments in secondary lymphoid organs where B cells undergo proliferation, somatic hypermutation (SHM), and affinity maturation during T cell-dependent immune responses. As a transcriptional repressor, BCL6 establishes the GC B cell (GCB) identity by directly binding to regulatory elements of genes that promote alternative differentiation pathways, thereby preventing premature exit from the GC niche. This repression is essential for sustaining the proliferative and mutagenic state required for generating high-affinity antibodies.^[13] A key mechanism involves BCL6-mediated suppression of PRDM1 (encoding Blimp-1), a master regulator of plasma cell differentiation. By directly repressing PRDM1 transcription through binding to its promoter, BCL6 inhibits the expression of genes associated with post-GCB fates, such as those driving immunoglobulin secretion and terminal differentiation, allowing GCBs to prioritize proliferation and mutation over antibody production. This antagonism ensures that GCBs remain poised for iterative selection cycles within the GC. Additionally, BCL6 promotes SHM and class-switch recombination (CSR) by repressing DNA damage response genes, including CHEK1, ATR, and TP53, which would otherwise trigger apoptosis in response to the DNA lesions introduced by activation-induced cytidine deaminase (AID). This protective repression enables error-prone repair pathways to facilitate antibody diversification without excessive cell death.^[27] Spatially, BCL6 expression is elevated in the dark zone (DZ) of GCs, where centroblasts undergo rapid division and SHM, compared to lower levels in the light zone (LZ), where centrocytes interact with follicular dendritic cells and T follicular helper cells for selection. This zonal gradient supports the DZ-specific gene program, including repression of differentiation cues like IRF4 and CD38, reinforcing the proliferative architecture of GCs. Studies in Bcl6 knockout (Bcl6^{-/-}) mice demonstrate the indispensability of BCL6, as these animals fail to form GCs entirely, exhibit impaired T cell-dependent responses, and produce only low-affinity IgM antibodies without class switching or affinity maturation.^[28]^[29]^[30] Temporally, BCL6 expression peaks during the initiation of T-dependent immune responses, coinciding with B cell activation and GC seeding, and gradually declines as GCs resolve and selected B cells differentiate into memory or plasma cells. This dynamic regulation, driven by signals from CD40 and cytokines like IL-21, ensures transient GC maintenance, typically lasting 2-3 weeks in mice, after which BCL6 downregulation permits post-GC fates.^[13]^[31]

Immune Cell Differentiation

T Follicular Helper Cell Development

BCL6 plays a central role in the differentiation of T follicular helper (Tfh) cells by being upregulated in activated CD4+ T cells, which drives commitment to the Tfh lineage. Upon antigen stimulation, BCL6 expression is induced in CD4+ T cells through signals such as IL-6 and IL-21, promoting the expression of Tfh-specific genes while suppressing alternative effector programs.^[32]^[33] This upregulation enables BCL6 to repress key transcription factors associated with other CD4+ T cell subsets, such as T-bet and GATA3, thereby favoring the Tfh phenotype characterized by markers like CXCR5 and PD-1. By binding to the promoters of these effector genes, BCL6 prevents the development of Th1 or Th2 cells, ensuring that activated CD4+ T cells adopt the Tfh identity necessary for humoral immunity.^[34]^[35] BCL6 is essential for the migration of Tfh cells into B cell follicles and their subsequent interactions with B cells within germinal centers. It achieves this by repressing genes encoding retention signals in the T cell zone, including CCR7, PSGL-1, and EBI2, which allows Tfh cells to relocate to the B-T border and enter follicles to provide help for B cell activation and affinity maturation.^[36]^[37] Experimental studies have demonstrated the potency of BCL6 in inducing Tfh characteristics; for instance, ectopic expression of BCL6 in CD4+ T cells leads to Tfh-like transdifferentiation in vitro, marked by upregulation of CXCR5 and ICOS, and enhanced helper function against B cells. This 2024 research highlights BCL6's sufficiency in reprogramming non-Tfh CD4+ T cells toward the Tfh fate, independent of other lineage-specifying factors.^[38] In vivo, BCL6 dosage critically influences Tfh cell numbers, as evidenced by mouse models where Bcl6 haploinsufficiency results in a 20-30% reduction in Tfh cell generation compared to wild-type controls, underscoring its dose-dependent role in lineage commitment and germinal center support.^[32] BCL6 also directs the differentiation of follicular regulatory T (Tfr) cells, a suppressive subset that arises from the same Foxp3+ T regulatory precursors as Tfh cells. By repressing alternative lineage genes similar to its action in Tfh cells, BCL6 enables Tfr cells to co-enter germinal centers, where they modulate Tfh-B cell interactions to prevent autoimmunity and excessive responses while preserving tolerance.^[1]

B Cell Maturation and Antibody Response

BCL6 plays a pivotal role in germinal center B cells (GCBs) by repressing genes that drive premature differentiation, thereby enabling the processes of affinity maturation and isotype switching essential for high-affinity antibody production. Specifically, BCL6 inhibits transcription factors such as PRDM1 (encoding Blimp-1) and IRF4, which promote plasma cell differentiation, allowing GCBs to maintain a proliferative and mutable state within the germinal center. This repression is mediated through BCL6's recruitment of corepressor complexes, including BCOR and NCOR, to target gene promoters, ensuring that B cells prioritize somatic hypermutation and class-switch recombination over terminal differentiation.^[4] BCL6 coordinates with activation-induced cytidine deaminase (AID) by repressing negative regulators, including microRNAs such as miR-155 and miR-361, which otherwise suppress AID expression and impair somatic hypermutation and class-switch recombination. By downregulating these miRNAs, BCL6 enhances AID levels in GCBs, facilitating the introduction of mutations in immunoglobulin genes for affinity maturation and enabling efficient isotype switching to generate diverse antibody subclasses like IgG and IgA. This regulatory mechanism ensures robust humoral immunity against pathogens by optimizing antibody quality and versatility.^[39] In memory B-cell formation, BCL6 expression is dynamically regulated: high levels sustain the GCB phenotype during the germinal center reaction, but its downregulation post-germinal center exit permits differentiation into long-lived memory B cells capable of rapid recall responses. Sustained low BCL6 levels in these post-GC cells prevent re-entry into proliferation while preserving antigen specificity, contributing to durable humoral protection. This transition is critical for establishing immunological memory that underpins vaccine efficacy and secondary immune responses.^[40] Integration with signals from T follicular helper (Tfh) cells further amplifies BCL6's role, as IL-21 produced by Tfh cells directly induces BCL6 expression in B cells, promoting their survival and persistence within the germinal center to support ongoing maturation. In human studies, reduced BCL6 expression in germinal centers has been linked to compromised antibody responses, such as lower IgG titers following vaccination, highlighting its conservation across species for effective humoral immunity.^[41]^[42]

Pathological Roles

Deregulation in Lymphomas

Deregulation of BCL6 expression is a hallmark of several lymphoid malignancies, particularly those originating from germinal center B cells, where it shifts from transient physiological activation to pathological persistence. Chromosomal translocations represent one of the most common genetic alterations, with the t(3;14)(q27;q32) translocation juxtaposing the BCL6 gene on chromosome 3q27 to the immunoglobulin heavy chain (IGH) locus enhancers, thereby placing BCL6 under the control of constitutively active immunoglobulin promoters. This event occurs in approximately 20-40% of diffuse large B-cell lymphomas (DLBCL), leading to ectopic and sustained BCL6 expression independent of normal germinal center signals.^[43]^[44] In addition to translocations, point mutations in the 5' non-coding regions of BCL6, particularly within the first intron and promoter, disrupt autoregulatory mechanisms and stabilize mRNA, contributing to overexpression. These mutations, often resulting from aberrant somatic hypermutation, are observed in about 70% of follicular lymphomas (FL) and a significant proportion of DLBCL cases, with higher prevalence in the germinal center B-cell-like (GCB) subtype compared to the activated B-cell-like (ABC) subtype.^[44]^[45] Epigenetic modifications further promote BCL6 deregulation by altering chromatin accessibility at its regulatory elements. For instance, hypermethylation of CpG islands in BCL6 intron 1 inhibits binding of the insulator protein CTCF, thereby preventing transcriptional silencing and maintaining aberrant expression in lymphomas. Alterations in histone modifications, such as reduced acetylation due to mutations in CREBBP or EP300 coactivators, or increased repressive H3K27 trimethylation from EZH2 gain-of-function mutations, also enhance BCL6 activity in DLBCL and FL. These epigenetic changes are frequent, with CREBBP mutations in up to 65% of FL and 16% of DLBCL cases.^[46]^[45] Overexpression of BCL6 is particularly prominent in the GCB subtype of DLBCL, where it distinguishes this aggressive form from the ABC subtype, correlating with translocations in 10-40% of GCB cases and mutations disrupting negative feedback loops.^[44]^[45]

Contribution to Oncogenesis

Deregulated BCL6 expression plays a central role in the oncogenesis of B-cell lymphomas by hijacking its normal transcriptional repressor functions to promote tumor cell survival, proliferation, and genomic instability. In particular, sustained BCL6 activity in malignant germinal center B cells (GCBs) prevents terminal differentiation, disables DNA damage checkpoints, and enhances proliferative signaling, thereby enabling the accumulation of genetic alterations that drive lymphomagenesis.^[47] One key mechanism involves BCL6-mediated blockade of B-cell differentiation through direct repression of the transcription factor BLIMP1 (encoded by PRDM1), which is essential for plasma cell maturation. By binding to the PRDM1 promoter and recruiting corepressors, BCL6 maintains lymphoma cells in a proliferative GCB-like state, preventing their exit from the cell cycle and post-GC differentiation. This repression is critical for sustaining the oncogenic phenotype, as restoration of BLIMP1 expression in BCL6-dependent lymphomas induces differentiation and apoptosis.^[48] BCL6 also contributes to oncogenesis by evading apoptosis and promoting genomic instability through repression of TP53 and ATR, key regulators of the DNA damage response. In lymphoma cells, BCL6 directly suppresses TP53 transcription, inhibiting p53-mediated cell cycle arrest and apoptosis in response to DNA breaks, while ATR repression allows tolerance of replication stress and hypermutation without triggering checkpoint activation. This dual repression enables the survival of genomically unstable cells harboring translocations and mutations characteristic of diffuse large B-cell lymphoma (DLBCL).^[49]^[50] Furthermore, BCL6 drives proliferation by collaborating with MYC and activating cell cycle genes, such as CCND1, which encodes cyclin D1. In normal GCBs, BCL6 represses MYC to limit proliferation, but in lymphomas, pathologic co-expression allows BCL6 and MYC to physically interact and synergistically upregulate genes promoting G1/S transition and biomass accumulation. This cooperation amplifies oncogenic signaling, contributing to the high proliferative rates observed in BCL6-driven tumors.^[51] BCL6's oncogenic dependency exhibits subtype specificity, being essential in approximately 70% of germinal center B-cell-like DLBCL (GCB-DLBCL) cases, where it sustains the malignant GCB phenotype, but showing reduced reliance in activated B-cell-like DLBCL (ABC-DLBCL). Recent studies have revealed that BCL6 inhibition induces synthetic lethality with BCL2 inhibitors in lymphoma models, as BCL6 normally represses BCL2; combined targeting exploits this vulnerability to trigger apoptosis in BCL6-addicted cells.^[52]^[53]

Clinical Applications

Diagnostic Utility

BCL6 serves as a key biomarker in the immunohistochemical (IHC) classification of diffuse large B-cell lymphoma (DLBCL), particularly through its role in the Hans algorithm, which stratifies cases into germinal center B-cell-like (GCB) and non-GCB subtypes based on expression patterns of CD10, BCL6, and MUM1. In this algorithm, nuclear BCL6 staining in more than 30% of tumor cells, combined with the absence of strong MUM1 expression, supports assignment to the GCB subtype, which is associated with distinct clinical outcomes.^[54] This threshold-based assessment is routinely performed on formalin-fixed paraffin-embedded tissues and provides a cost-effective, accessible method for subtype determination at diagnosis.^[55] Fluorescence in situ hybridization (FISH) is widely employed to detect BCL6 rearrangements, which occur in approximately 20-40% of DLBCL cases and 5–15% of follicular lymphomas (FL), aiding in the confirmation of specific translocation events such as t(3;14)(q27;q32). Break-apart FISH probes targeting the BCL6 locus on chromosome 3q27 enable visualization of these genetic alterations, distinguishing neoplastic from reactive lymphoid proliferations and identifying high-grade B-cell lymphomas with BCL6 involvement.^[56]^[57] This technique is particularly valuable in cases where IHC alone is inconclusive, offering high specificity for translocation detection in routine diagnostic workflows.^[58] High BCL6 expression, often indicative of GCB-DLBCL, correlates with improved responses to rituximab-containing regimens such as R-CHOP, with studies showing enhanced progression-free and overall survival in BCL6-positive patients compared to those with low or absent expression. This prognostic benefit is attributed to the sensitivity of GCB subtypes to rituximab-mediated cytotoxicity, where BCL6 positivity serves as an independent favorable marker beyond the International Prognostic Index.^[59] In contrast, BCL6-negative cases, typically non-GCB, exhibit poorer outcomes and rituximab resistance.^[59] In differential diagnosis, BCL6 rearrangements detected by FISH help differentiate FL from reactive lymphoid hyperplasia, as the latter lacks such genetic abnormalities while FL frequently harbors BCL6 translocations alongside or independent of BCL2 rearrangements. IHC for BCL6, showing strong nuclear positivity in germinal center cells of FL but polyclonal patterns in hyperplasia, further supports this distinction, preventing misclassification of benign reactive processes as malignancy.^[60] This combined approach ensures accurate grading and management of low-grade B-cell neoplasms. Recent advances as of 2025 incorporate next-generation sequencing (NGS) panels for comprehensive genomic assessment, enabling sensitive monitoring of minimal residual disease (MRD) in lymphomas through detection of mutations, rearrangements, or other alterations in circulating tumor DNA. These tumor-informed NGS assays, which often integrate immunoglobulin gene tracking, predict relapse risk post-therapy with high precision, surpassing traditional methods in sensitivity for early intervention in DLBCL and FL.^[61] Such integration facilitates personalized surveillance and risk stratification in clinical practice.^[62]

Targeted Therapies

Targeted therapies for BCL6 primarily focus on inhibiting or degrading the protein to disrupt its oncogenic role in B-cell lymphomas, particularly diffuse large B-cell lymphoma (DLBCL), where BCL6 deregulation drives tumor survival and proliferation. Small-molecule inhibitors targeting the BTB domain of BCL6, which mediates corepressor recruitment, represent a key strategy. For instance, the compound 79-6 binds the BTB domain with an IC50 of approximately 200 μM and specifically disrupts BCL6-corepressor interactions, leading to derepression of target genes and suppression of DLBCL cell growth in preclinical models both in vitro and in vivo. Recent preclinical studies in 2024 have further validated BTB domain blockers like 79-6 for their ability to inhibit lymphoma progression by reactivating BCL6-repressed genes essential for apoptosis. These inhibitors demonstrate selective cytotoxicity against BCL6-dependent malignancies without broadly affecting normal B cells. Natural compounds have also emerged as BCL6 inhibitors with therapeutic promise. Resveratrol, a polyphenol, acts as a direct BCL6 binder that inhibits its transcriptional repression activity, resulting in reduced proliferation of germinal center-derived non-Hodgkin lymphoma (NHL) cells in preclinical models. A 2025 study showed that resveratrol markedly suppressed tumor growth in animal models of GC-derived NHL by targeting BCL6, highlighting its potential as a natural agent for BCL6-dependent cancers. To enhance efficacy beyond reversible inhibition, proteolysis-targeting chimeras (PROTACs) have been developed to induce BCL6 ubiquitination and proteasomal degradation. BCL6 PROTACs, such as those with DC50 values around 600 nM, achieve rapid and sustained protein loss, outperforming reversible inhibitors by fully eliminating BCL6 function and leading to more profound derepression of target genes in lymphoma cells. Preclinical data from 2024-2025 demonstrate that orally bioavailable BCL6 PROTACs exhibit strong anti-tumor activity in DLBCL models, with complete degradation observed within hours and improved selectivity over non-degradative approaches. Several BCL6 inhibitors have advanced to clinical evaluation in relapsed DLBCL. For example, the BCL6 PROTAC BMS-986458 is under investigation in a phase I/II trial (NCT06090539, initiated 2023) assessing its safety, pharmacokinetics, and preliminary efficacy alone or with rituximab in patients with relapsed/refractory B-cell malignancies, including DLBCL. Early data from 2024-2025 trials indicate tolerable dosing and biological activity, such as BCL6 degradation in patient samples, supporting further development in BCL6-driven lymphomas. Combination therapies address resistance mechanisms arising from BCL6 inhibition, which can induce oncogene addiction switching and reactivation of anti-apoptotic pathways. Pairing BCL6 inhibitors with BCL2 antagonists, like venetoclax, overcomes this by simultaneously blocking derepressed BCL2 survival signals, enhancing apoptosis in resistant DLBCL cells. Preclinical studies show that this combinatorial approach yields synergistic tumor regression, providing a rationale for ongoing trials in relapsed settings.

Protein Interactions

Corepressor Partners

BCL6 primarily exerts its transcriptional repressor function through recruitment of corepressor complexes via its N-terminal BTB/POZ domain. This domain facilitates direct interactions with nuclear receptor corepressors NCOR1 and NCOR2 (also known as SMRT), forming a multiprotein repressive complex that includes histone deacetylases HDAC1 and HDAC2. These associations enable BCL6 to deacetylate histones at target gene promoters, promoting a closed chromatin conformation and gene silencing essential for germinal center B-cell biology.^[63]^[64] A key partner in this repression is BCOR (BCL6 corepressor), which binds competitively to the same BTB domain groove as NCOR1/2 and SMRT, but can also form ternary complexes with them to enhance silencing. BCOR integration into the BCL6 complex recruits Polycomb group proteins, such as CBX8, leading to H2AK119 ubiquitination and chromatin compaction at specific target loci, thereby stabilizing long-term gene repression in B cells.^[65] Biophysical studies have quantified these interactions, revealing high-affinity binding between the BCL6 BTB domain and corepressor peptides; for instance, the dissociation constant (Kd) for the SMRT-BCL6 interaction is approximately 16 nM, with similar nanomolar affinities for NCOR1, while BCOR shows micromolar affinity (Kd ≈ 1.3 μM).^[63]^[18] Disruption of these corepressor partnerships, such as through BCL6 knockout, results in specific derepression of target genes, including reactivation of the tumor suppressor TP53, which elevates p53 protein levels and triggers DNA damage responses in B cells.^[66] Proteomic analyses using tandem mass spectrometry on B-cell lymphoma extracts have identified over 20 BCL6-interacting proteins, including the corepressors BCOR, NCOR1, and SMRT, confirming the composition of these repressive complexes in vivo.^[67]

Regulatory Interactions

BCL6 expression and activity are modulated by a network of regulatory proteins that control its transcription, stability, and post-transcriptional processing, ensuring balanced function in immune responses. Positive regulation of BCL6 occurs through transcription factor binding to its promoter, particularly in T follicular helper (Tfh) cells, where STAT5 and STAT6 contribute to induction under specific cytokine signals like IL-2 and IL-4, respectively, promoting Tfh differentiation.^[68]^[69] Negative regulation is mediated by SIAH1, an E3 ubiquitin ligase that binds BCL6 and promotes its ubiquitination, leading to rapid proteasomal degradation and a short protein half-life of approximately 2 hours, which limits BCL6 accumulation in non-germinal center contexts.^[70]^[71] BCL6 and IRF4 exhibit mutual antagonism in germinal center B cells, where BCL6 represses IRF4 to maintain proliferation and somatic hypermutation in the dark zone, while elevated IRF4 levels suppress BCL6 to drive differentiation toward plasma cells in the light zone, thus balancing B cell fate decisions.^[72]^[73] Post-transcriptional suppression of BCL6 is achieved via microRNA-34a (miR-34a), which directly binds the 3' untranslated region (3'UTR) of BCL6 mRNA, inhibiting its translation and reducing protein levels, particularly in contexts where BCL6 overexpression promotes lymphomagenesis.^[74]^[75] Recent studies have developed bivalent molecules that tether CDK9 to BCL6, relocalizing CDK9 to BCL6 target loci to promote phosphorylation of RNA polymerase II, thereby reactivating repressed genes and inducing apoptosis in B-cell lymphoma cells.^[76]

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These results are consistent with the notion that BCL-6 may repress its own transcription in a feedback loop. Fig 2. Open in Viewer BCL-6 exon 1 contains two ...
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Dynamics of B cells in germinal centres - PMC - NIH
B cell lymphoma 6 (BCL-6) is required for the establishment of the specialized dark zone-associated gene expression programme that allows for somatic ...
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Germinal center B cell development has distinctly regulated stages ...
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BCL6 is critical for the development of a diverse primary B cell ...
May 24, 2010 · BCL6 protects germinal center (GC) B cells against DNA damage–induced apoptosis during somatic hypermutation and class-switch recombination.RESULTS · DISCUSSION · MATERIALS AND METHODS · Acknowledgments
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Article Bcl6 Protein Expression Shapes Pre-Germinal Center B Cell ...
Jun 24, 2011 · The transcription factor Bcl6 is essential for the development of germinal center (GC) B cells and follicular helper T (Tfh) cells.
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Sep 18, 2009 · Bcl-6 positively directs Tfh cell differentiation, through combined repression of miRNAs and transcription factors.
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Bcl6 expression specifies the T follicular helper cell program in vivo
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Memory T Follicular Helper CD4 T Cells - Frontiers
Bcl6 expression promotes Tfh differentiation, at least in part by suppressing transcription of the transcriptional regulators Tbet, RORγt, GATA3, and Blimp-1 (8 ...
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Transcription tipping points for T follicular helper cell and T ... - Nature
Sep 30, 2020 · For example, in human Tfh cells, BCL6 binds to the promoter regions of genes important for alternate Th fates, including GATA3, RORA, and IFNGR1 ...
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Transcriptional regulation of Tfh dynamics and the formation of ...
Jun 3, 2024 · Bcl6 simultaneously represses the expression of CCR7, PSGL-1, and EBI2, leading Tfh cells to migrate from the T-cell zone to the B:T border and ...
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Bcl6-Mediated Transcriptional Regulation of Follicular Helper T cells ...
This review focuses on advances in our understanding of Bcl6-mediated gene regulation of T FH functions, and the modulation of T FH by other TFs.
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BCL6 positively regulates AID and germinal center gene expression ...
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IL-21 regulates germinal center B cell differentiation and ...
Feb 8, 2010 · We show that the absence of IL-21 signaling profoundly affects the B cell response to protein antigen, reducing splenic and bone marrow plasma ...
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The metabolic hormone leptin promotes the function of T FH cells ...
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Genetic alterations in mature B- and T-cell lymphomas – a practical guide to WHO-HAEM5
### Summary of Genetic Alterations in BCL6 for Mature B-Cell Lymphomas (2023-2024)
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Genetic lesions in diffuse large B-cell lymphomas - PubMed Central
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Epigenetic Programing of B-Cell Lymphoma by BCL6 and Its ...
Nov 7, 2019 · Here we review the direct and indirect mechanisms BCL6 dysregulation in B cell lymphoma, including transcriptional and post-translational regulation of BCL6 ...
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Breaking bad in the germinal center: how deregulation of BCL6 ...
To sustain proliferation and survival during affinity maturation, BCL6 represses key genes involved in sensing DNA damage, error prone division, and cell cycle ...
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Epstein–Barr virus miRNA connection in Burkitt's lymphoma
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The expanding role of the BCL6 oncoprotein as a cancer therapeutic ...
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a mechanism for the regulation of Blimp-1 expression and B ...
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BCL6 represses CHEK1 and suppresses DNA damage pathways in ...
BCL6 represses CHEK1, suppressing genes involved in sensing, transducing, and responding to DNA damage, including ATR, TP53, and CDKN1A.
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B-cell Lymphoma 6 (BCL6): From Master Regulator of Humoral ...
BCL6 is known to drive the self-renewal capacity of leukemia-initiating cells (LIC), with high BCL6 expression in acute lymphoblastic leukemia (ALL), acute ...
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Jun 2, 2014 · Transient Bcl6 expression induces mature B-cell lymphoma. Sca1-Bcl6floxed mice are viable and develop normally, with a typical haematopoietic ...
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https://doi.org/10.1016/j.bcp.2024.116466
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Cell-of-origin for diffuse large B-cell lymphoma survival
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Confirmation of the molecular classification of diffuse large B-cell ...
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Performance of MYC, BCL2, and BCL6 break-apart FISH in small ...
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t(14;18)-negative Follicular Lymphomas Are Associated with a ... - NIH
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Prognostic significance of Bcl-6 protein expression in DLBCL treated ...
Bcl-6 protein expression, a marker of germinal center origin, has been associated with a favorable prognosis in diffuse large B-cell lymphoma (DLBCL).
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The Expression of Bcl-6 In Diffuse Large B Cell Lymphoma (DLBCL ...
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CD10 and BCL-6 expression in paraffin sections of normal lymphoid ...
CD10 and BCL-6 immunostaining have an important role in differential diagnosis of FL from RLH and other low-grade B-cell lymphomas.
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14 mar 2025 · NGS enhances the diagnostic accuracy of mature B-cell lymphomas by complementing traditional methods, refining WHO-classified subtypes, and improving detection.
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Characteristics and Clinical Value of MYC, BCL2, and BCL6...
These results indicated that targeted NGS is a powerful clinical diagnostics tool for comprehensive MYC, BCL2, and BCL6 rearrangement detection.
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Mechanism of SMRT Corepressor Recruitment by the BCL6 BTB ...
Thus, in BCL6, the BTB domain mediates interactions with the SMRT, N-CoR, BcoR, and mSin3A corepressors, as well as with histone deacetylase 1 (HDAC-1), and ...Missing: NCOR1 | Show results with:NCOR1
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Histone deacetylase 3 controls a transcriptional network required for ...
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BCoR, a novel corepressor involved in BCL-6 repression
BCoR is a novel corepressor that interacts with BCL-6, and can function as a corepressor when tethered to DNA, potentiating BCL-6 repression.Missing: NCOR1 | Show results with:NCOR1
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BCL6-mediated repression of p53 is critical for leukemia stem cell ...
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Multi-Source Pathways of T Follicular Helper Cell Differentiation - PMC
Feb 25, 2021 · STAT5 Regulates the Development of Tfh Cells and Subsets One study demonstrated that STAT5 binding to the Bcl6 promoter increases in high IL-2 ...
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Transcriptional regulation of follicular T-helper (Tfh) cells - PMC - NIH
A constitutive active form of STAT5 efficiently inhibits Tfh differentiation by suppressing the expression of Tfh-associated genes such as CXCR5, c-Maf, Bcl6, ...
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Small molecule-induced polymerization triggers degradation of BCL6
It has been previously shown that inhibition of BCL6 or degradation by PROTACs results in insufficient inhibition of downstream targets and consequently only ...
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Proximity-Based Modalities for Biology and Medicine
Jul 14, 2023 · ... ubiquitin E3 ligase to trigger targeted protein ubiquitination and subsequent degradation. ... Degradation of BCL6. Nature 2020, 588 (7836) ...<|separator|>
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CFP1 promotes germinal center affinity maturation and restrains ...
Aug 27, 2025 · In addition, mutual antagonism between BCL6 and PC-specific transcription factors IRF4 and BLIMP1 dynamically determines the fate choice ...
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Transcriptional regulation of germinal center B and plasma cell fates ...
IRF4 regulates Bcl6 and Pou2af1 during a GC B cell response. To determine if IRF4 regulates Bcl6 and Obf1 expression within antigen responding B cells in ...
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Uncovering MicroRNA Regulatory Hubs that Modulate Plasma Cell ...
Dec 11, 2015 · BCL6 and BACH2 were suppressed by overexpression of miR-34a-5p, -148a-3p, or -183-5p, but their expression was elevated by their ...
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Vinculin, Sema4b, Pofut1, and Bcl6 are targets of miR-34a,-b, and-c....
MicroRNA-34 family members (miR-34a, -34b, and -34c) are up-regulated in the heart in response to stress. In this study, we assessed whether inhibition of the ...
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Correction: Emerging opportunities in the rewiring of biology through ...
Oct 7, 2025 · ... CDK9 can help relocate it to the vicinity of the BCL6 and then release it to carry out the required phosphorylation.” The Royal Society of ...
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Relocalizing transcriptional kinases to activate apoptosis - PMC - NIH
These molecules relocalized CDK9 to BCL6-bound DNA and directed phosphorylation of RNA polymerase II. The resulting expression of pro-apoptotic, ...