novel insights into the genetics and pathophysiology of adrenocortical tumors

International audienceAdrenocortical tumors (ACTs) are typically unilateral and can be classified as benign adrenocortical adenomas (ACAs) or malignant adrenocortical cancers (ACCs). In rare cases, tumors may occur in both adrenal glands as micronodular hyperplasia (primary pigmented nodular adrenal dysplasia) or as macronodular hyperplasia (primary bilateral macronodular adrenal hyperplasia, PBMAH). The study of certain tumor predisposition syndromes has improved our understanding of sporadic ACTs. Most ACAs are associated with abnormalities of the cAMP signaling pathway, whereas most ACCs are linked to alterations in IGF2, TP53, or the Wnt/βcatenin pathways. Over the past year, single-nucleotide polymorphism array technology and next-generation sequencing have identified novel genetic alterations in ACTs that shed new light on the molecular mechanisms of oncogenesis. Among these are somatic mutations of PKA catalytic subunit alpha gene (PRKACA) in ACA, germline, and somatic mutations of armadillo repeat containing 5 gene (ARMC5) in primary bilateral macronodular adrenal hyperplasia and somatic alterations of the E3 ubiquitin ligase gene ZNRF3 in ACC. This review focuses on the recent discoveries and their diagnostic, prognostic, and therapeutic implications

Silencing mutated β-catenin inhibits cell proliferation and stimulates apoptosis in the adrenocortical cancer cell line H295R

Adrenocortical carcinoma (ACC) is a rare and highly aggressive endocrine neoplasm, with limited therapeutic options. Activating β-catenin somatic mutations are found in ACC and have been associated with a poor clinical outcome. In fact, activation of the Wnt/β-catenin signaling pathway seems to play a major role in ACC aggressiveness, and might, thus, represent a promising therapeutic target. Similar to patient tumor specimen the H295 cell line derived from an ACC harbors a natural activating β-catenin mutation. We herein assess the in vitro and in vivo effect of β-catenin inactivation using a doxycyclin (dox) inducible shRNA plasmid in H295R adrenocortical cancer cells line (clone named shβ). Following dox treatment a profound reduction in β-catenin expression was detectable in shβ clones in comparison to control clones (Ctr). Accordingly, we observed a decrease in Wnt/βcatenin-dependent luciferase reporter activity as well as a decreased expression of AXIN2 representing an endogenous β-catenin target gene. Concomitantly, β-catenin silencing resulted in a decreased cell proliferation, cell cycle alterations with cell accumulation in the G1 phase and increased apoptosis in vitro. In vivo, on established tumor xenografts in athymic nude mice, 9 days of β-catenin silencing resulted in a significant reduction of CTNNB1 and AXIN2 expression. Moreover, continous β-catenin silencing, starting 3 days after tumor cell inoculation, was associated with a complete absence of tumor growth in the shβ group while tumors were present in all animals of the control group. In summary, these experiments provide evidences that Wnt/β-catenin pathway inhibition in ACC is a promising therapeutic target

Combined transcriptome studies identify AFF3 as a mediator of the oncogenic effects of β-catenin in adrenocortical carcinoma

International audienceAdrenocortical cancer (ACC) is a very aggressive tumor, and genomics studies demonstrate that the most frequent alterations of driver genes in these cancers activate the Wnt/β-catenin signaling pathway. However, the adrenal-specific targets of oncogenic β-catenin-mediating tumorigenesis have not being established. A combined transcriptomic analysis from two series of human tumors and the human ACC cell line H295R harboring a spontaneous β-catenin activating mutation was done to identify the Wnt/β-catenin targets. Seven genes were consistently identified in the three studies. Among these genes, we found that AFF3 mediates the oncogenic effects of β-catenin in ACC. The Wnt response element site located at nucleotide position − 1408 of the AFF3 transcriptional start sites (TSS) mediates the regulation by the Wnt/β-catenin signaling pathway. AFF3 silencing decreases cell proliferation and increases apoptosis in the ACC cell line H295R. AFF3 is located in nuclear speckles, which play an important role in RNA splicing. AFF3 overexpression in adrenocortical cells interferes with the organization and/or biogenesis of these nuclear speckles and alters the distribution of CDK9 and cyclin T1 such that they accumulate at the sites of AFF3/speckles. We demonstrate that AFF3 is a new target of Wnt/β-catenin pathway involved in ACC, acting on transcription and RNA splicing

Soluble markers of B cell activation suggest a role of B cells in the pathogenesis of systemic sclerosis-associated pulmonary arterial hypertension

IntroductionSoluble markers of B cell activation are interesting diagnostic and prognostic tools in autoimmune diseases. Data in systemic sclerosis (SSc) are scarce and few studies focused on their association with disease characteristics.Methods1. Serum levels of 14 B cell biomarkers (β2-microglobulin, rheumatoid factor (RF), immunoglobulins (Ig) G, IgA, IgM, BAFF, APRIL, soluble (s)TACI, sBCMA sCD21, sCD23, sCD25, sCD27, CXCL13) were measured in SSc patients and healthy controls (HC). 2. Associations between these biomarkers and SSc characteristics were assessed. 3. The pathophysiological relevance of identified associations was explored by studying protein production in B cell culture supernatant.ResultsIn a discovery panel of 80 SSc patients encompassing the broad spectrum of disease manifestations, we observed a higher frequency of RF positivity, and increased levels of β2-microglobulin, IgG and CXCL13 compared with HC. We found significant associations between several biomarkers and SSc characteristics related to disease phenotype, activity and severity. Especially, serum IgG levels were associated with pulmonary hypertension (PH); β2-microglobulin with Nt-pro-BNP and DLCO; and BAFF with peak tricuspid regurgitation velocity (TRV). In a validation cohort of limited cutaneous SSc patients without extensive ILD, we observed lower serum IgG levels, and higher β2-microglobulin, sBCMA, sCD23 and sCD27 levels in patients with pulmonary arterial hypertension (PAH). BAFF levels strongly correlated with Nt-pro-BNP levels, FVC/DLCO ratio and peak TRV in SSc-PAH patients. Cultured SSc B cells showed increased production of various angiogenic factors (angiogenin, angiopoietin-1, VEGFR-1, PDGF-AA, MMP-8, TIMP-1, L-selectin) and decreased production of angiopoietin-2 compared to HC.ConclusionSoluble markers of B cell activation could be relevant tools to assess organ involvements, activity and severity in SSc. Their associations with PAH could plead for a role of B cell activation in the pathogenesis of pulmonary microangiopathy. B cells may contribute to SSc vasculopathy through production of angiogenic mediators

Roles of the Wnt/β-catenin signaling pathway and a new target gene, AFF3, in adrenocortical carcinomas

Les carcinomes de la corticosurrénale (CC) sont des tumeurs malignes rares dont le pronostic est globalement sombre et les thérapeutiques encore limitées, la chirurgie étant le seul traitement efficace. Il est donc important de comprendre les mécanismes impliqués dans le développement et l'agressivité des CC. L’activation constitutive de la voie de signalisation Wnt/b-caténine est fréquente dans les CC (40%) et est associée à un caractère agressif. L’objectif de mon projet de thèse était d’étudier l’implication de la voie Wnt/β-caténine dans la tumorigenèse corticosurrénalienne. La lignée cellulaire humaine H295R, issue d’un CC présente une activation de la voie Wnt/β-caténine qui a pour origine une mutation activatrice de la β-caténine. Nous avons montré que l'invalidation de la β-caténine dans les cellules H295R inhibe l'activité transcriptionnelle de la voie Wnt/β-caténine, diminue la prolifération, augmente l'apoptose et bloque la progression du cycle cellulaire. De plus, nous avons montré que la voie Wnt/b-caténine est essentielle au développement tumoral de xénogreffes de ces cellules chez la souris. L’activation de la voie Wnt/b-caténine participe à la tumorigenèse de nombreux organes en régulant l’expression de gènes impliqués par exemple dans la prolifération, la survie cellulaire ou l'adhésion. Afin de mieux comprendre comment la voie Wnt/β-caténine participe à la tumorigenèse corticosurrénalienne, nous avons cherché à identifier les gènes cibles de cette voie dans les CC. L’analyse des transcriptomes de deux cohortes indépendantes de CC et des cellules H295R avec ou sans invalidation de la β-caténine a permis d’identifier des gènes dont l'expression est corrélée à l'activation de la voie Wnt/b-caténine. Nous avons montré que parmi ces gènes, AFF3 est essentiel pour transmettre les effets de l'activation de la voie Wnt/b-caténine dans les carcinomes de la corticosurrénale. En effet, AFF3 est un gène cible direct de la voie Wnt/b-caténine et son invalidation dans les cellules corticosurrénaliennes H295R diminue la prolifération cellulaire et déclenche l'apoptose à l'image de l'invalidation de la b-caténine. AFF3 est une protéine nucléaire, localisée au niveau des speckles qui sont impliqués dans l'épissage des ARNm. De plus, AFF3 interagit avec le P-TEFb (CDK9/CyclineT1/2) au sein du Super elongation complex (SEC) nécessaire à l’élongation de la transcription des ARNm par l'ARN polymérase II. Nous avons ainsi montré dans les cellules corticosurrénaliennes H295R, que la surexpression d'AFF3 altère l’organisation des speckles et la localisation de CDK9 et Cycline T1. En conclusion, ce travail a permis d'identifier une nouvelle cible transcriptionnelle de la voie de signalisation Wnt/b-caténine, AFF3, qui code pour un médiateur important des effets de l'activation de cette voie dans la tumorigenèse corticosurrénalienne. AFF3 agirait notamment en altérant la structure des speckles et en interagissant avec le P-TEFb qui sont importants respectivement pour l'épissage des ARNm et la transcription. Ces résultats conduisent à une meilleure compréhension de la tumorigenèse corticosurrénalienne et permettent d'envisager le P-TEFb et le SEC comme de nouvelles cibles thérapeutiques pour le traitement des CC.Adrenocortical carcinoma (ACC) is a rare and highly aggressive endocrine neoplasm, with limited therapeutic option. Currently, surgical resection is considered the only effective treatment. It is therefore essential to understand the molecular mechanisms involved in ACC development in order to improve their clinical management. Activation of the Wnt/b-catenin signaling pathway is frequent (40%) in ACC and is associated with poor prognosis. The aim of my thesis was to study the involvement of the Wnt/b-catenin signaling pathway in adrenocortical tumorigenesis. The human cell line H295R, derived from an ACC, carries the S45P β-catenin mutation which leads to constitutive β-catenin/TCF transcriptional activity. In the ACC cell line H295R we show that β-catenin silencing resulted in a decreased transcriptional activity of the Wnt/b-catenin signaling, cell cycle alterations, a decreased cell proliferation and an increased apoptosis. Moreover we show that β-catenin silencing abolish xenograft development of H295R adrenocortical cells. Aberrant activation of the Wnt/b-catenin signaling promotes tumorigenesis of several organs by enhancing expression of genes involved in proliferation, cell survival or cell adhesion. To better understand the role of the Wnt/b-catenin signaling in adrenocortical tumorigenesis, we wanted to identify target genes of this pathway in ACC. Combined transcriptomic analysis on two independent cohorts of ACC and on H295R adrenocortical cells with or without β-catenin silencing allow us to identify alterations of gene expression due to aberrant Wnt/βcatenin pathway activation. Among these genes, we show that AFF3 is essential to mediate the effect of the activation of the Wnt/β-catenin signaling pathway in adrenocortical cancer. Indeed, AFF3 is a direct target gene of the Wnt/b-catenin and its silencing in H295R adrenocortical cells induces a decreased cell proliferation and an increased apoptosis similar to that induced by b-catenin silencing. AFF3 is a nuclear protein located in nuclear speckles, which serve as a reservoir of factors participating in mRNA splicing. Moreover, AFF3 interacts with P-TEFb (CDK9/CyclinT1/2) in the Super elongation complex (SEC) required for transcriptional elongation of mRNA by RNA polymerase II. In H295R adrenocortical cells, we show that strong overproduction of AFF3 altered the structural organization of nuclear speckles and the localization of CDK9 and Cycline T1. In conclusion, this study has identified a new transcriptional target of the Wnt/β-catenin signaling pathway, AFF3, which encodes an important mediator of this pathway in adrenocortical tumorigenesis. AFF3 might especially act by affecting the structural organization of speckles and interacting with the P-TEFb, which are respectively involved in mRNA splicing and transcription. These results provide a better understanding of the biological process involved in ACC development and suggest that P-TEFb and SEC could be new therapeutic targets for the treatment of ACC

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<i>CTNNB1</i> silencing abolish xenograft development of ACC cell line.

<p><b>A</b>, Histograms represent <i>CTNNB1</i> (<i>β-catenin</i>) and <i>AXIN2</i> mRNA accumulation in xenograft for both Ctr (−dox n = 6; +dox, n = 5) and shβ (−dox, n = 5; +dox, n = 5) clones on established tumors and after 9 days of dox treatment. <b>B</b>, hematoxylin–eosin–saffron and β-catenin, staining (×20) on representative tumors of shβ clone without and with dox treatment (same experiment as B). <b>C</b>, Boxplots represent the tumor sizes for Ctr and shβ xenografts in mice continuously treated with vehicle or dox after 3 days of tumor induction. Boxplots in the left corner represent the weights of tumors excised. Ctr (−dox n = 7, + dox n = 8), shβ (−dox, n = 7; +dox, n = 8).</p

Identification of Positively and Negatively Selected Driver Gene Mutations Associated With Colorectal Cancer With Microsatellite Instability Positive Selection Pressure Mutational Background Negative Selection Pressure Mutational Frequency Microsatellite length (bp)

International audienceBackground & Aims: Recent studies have shown that cancers arise as a result of the positive selection of driver somatic events in tumor DNA, with negative selection playing only a minor role, if any. However, these investigations were concerned with alterations at nonrepetitive sequences and did not take into account mutations in repetitive sequences that have very high pathophysiological relevance in the tumors showing microsatellite instability (MSI) resulting from mismatch repair deficiency investigated in the present study.Methods: We performed whole-exome sequencing of 47 MSI colorectal cancers (CRCs) and confirmed results in an independent cohort of 53 MSI CRCs. We used a probabilistic model of mutational events within microsatellites, while adapting pre-existing models to analyze nonrepetitive DNA sequences. Negatively selected coding alterations in MSI CRCs were investigated for their functional and clinical impact in CRC cell lines and in a third cohort of 164 MSI CRC patients.Results: Both positive and negative selection of somatic mutations in DNA repeats was observed, leading us to identify the expected true driver genes associated with the MSI-driven tumorigenic process. Several coding negatively selected MSI-related mutational events (n = 5) were shown to have deleterious effects on tumor cells. In the tumors in which deleterious MSI mutations were observed despite the negative selection, they were associated with worse survival in MSI CRC patients (hazard ratio, 3; 95% CI, 1.1-7.9; P = .03), suggesting their anticancer impact should be offset by other as yet unknown oncogenic processes that contribute to a poor prognosis.Conclusions: The present results identify the positive and negative driver somatic mutations acting in MSI-driven tumorigenesis, suggesting that genomic instability in MSI CRC plays a dual role in achieving tumor cell transformation. Exome sequencing data have been deposited in the European genome-phenome archive (accession: EGAS00001002477)