Rôle du stress oxydant et des cassures de l’ADN dans l’émergence néoplasique post-sénescence

Senescence is a permanent cell-cycle arrest activated in response to DNA damage. If a cell escapes from this state, it should inherit mutations and could potentially initiate a tumor. NHDFs (Normal Human Dermal Fibroblasts) display a classical irreversible and stable senescence plateau. In contrast, senescent NHEKs (Normal Human Epidermal Keratinocytes) experience two different outcomes. Most of them undergo autophagic cell death and about one on 10000 spontaneously resumes mitosis and generates clones of transformed, mutated and tumorigenic cells.I contributed in a first time to studying the role of macroautophagy in the cell death / post-senescence neoplastic emergence balance of senescent NHEKs. We have shown that macroautophagy plays antagonistic roles during senescence, inducing cell death or promoting neoplastic transformation, depending on its level of activation. Indeed, the progenitors of post-senescent emergent cells display oxidative stress and autophagic activity levels slightly lower than the average, what allows them to avoid autophagic cell death and to ensure the quality control indispensable for mitosis re-entry.Since oxidative stress is the motor of the post-senescence neoplastic emergence in NHEKs, I wondered next whether oxidative stress could operate through the generation of some mutagenic DNA damage. I took advantage of the comparison of senescent NHEKs to NHDFs. I have shown that unlike NHDFs, NHEKs do not suffer from significantly shortened telomeres, nor accumulate DSBs, do not activate a DDR (DNA Damage Response) pathway and in consequence do not significantly activate the p53/p21 pathway. Instead, they suffer from a decrease in PARP1 expression, which compromises the repair of SSBs generated by oxidative stress. In consequence, SSBR foci, precisely XRCC1 foci, become persistent. These persistent foci initiate a signalization, through p38MAPK, which leads to up-regulation of p16INK4A and to cell cycle arrest. Notably, the accumulation of unrepaired SSBs is sufficient for the post-senescence neoplastic emergence phenomenon, in addition, paradoxically to its involvement in the onset of senescence.In conclusion, senescence results from the persistence of a DNA damage signalization, but the exact nature of the damages could vary in different cell types depending on their repair capacities and could dictate completely different outcomes. Namely, persistent DSBs, including telomeric ones, dictate a permanent tumor-suppressor cell cycle arrest, whereas persistent SSBs are permissive to mutation and senescence evasion.La sénescence est un état d’arrêt prolifératif mis en place par les cellules en réponse à des dommages à l’ADN. Elle est considérée comme un mécanisme de protection qui s’oppose à l’initiation et au développement d’un cancer. Or, les mécanismes de sénescence et la capacité des cellules à s’échapper de cet état et à générer des cellules transformées semblent varier selon les types cellulaires. Chez les kératinocytes humains normaux de peau (NHEKs), la sénescence est transitoire et débouche pour la plupart des cellules sur une mort par autophagie et, pour environ une sur dix mille, sur une émergence néoplasique post-sénescence. Les cellules émergentes présentent des caractères de transformation et accumulent des mutations et des délétions. Cet échappement néoplasique de la sénescence n’est jamais observé dans les fibroblastes normaux de peau (NHDFs) qui, au contraire, une fois en sénescence sont bloqués irréversiblement dans le cycle cellulaire.J’ai participé dans un premier temps à l’étude du rôle de l’autophagie dans la balance échappement néoplasique et mort des NHEKs sénescents. Nous avons pu démontrer que les progéniteurs de cellules néoplasiques ont une activité autophagique modérée plus faible que ceux qui subissent la mort. Ainsi, ils échappent à la mort par autophagie tout en gardant un niveau d’activité autophagique de ménage suffisant pour éliminer leurs composés altérés par le stress oxydant et être capable de ré-entrer en mitose.J’ai ensuite cherché à caractériser les dommages oxydants mutagènes impliqués dans l’échappement néoplasique. Ma stratégie a été d’analyser de façon comparative les NHEKs par rapport aux NHDFs, puisque les uns mais non les autres développent une émergence néoplasique. J’ai ainsi pu constater que le taux de cassures augmente à la sénescence dans les deux types cellulaires, mais que ces cassures sont de nature différente, uniquement des SSBs (Single Strand Breaks) pour les NHEKs et principalement des DSBs (Double Strand Breaks) pour les NHDFs. L’accumulation de DSBs à la sénescence des NHDFs s’accompagne d’une induction robuste de la voie DDR (DNA Damage Response), d’une activation la voie p53-p21 et d’un arrêt stable dans le cycle cellulaire. Dans le cas des NHEKs, l’augmentation du taux de SSBs est la conséquence de l’augmentation du niveau de stress oxydant et de la perte de l’expression et de l’activité de la PARP1. Ceci contribue à une agglomération aberrante de XRCC1 au niveau des cassures engendrant une induction de la voie p38MAPK - p16INK4a et un arrêt dans le cycle cellulaire caractéristique de la sénescence. D’une manière paradoxale, l’échappement néoplasique de la sénescence dépend également de cette accumulation de SSBs non réparés. Ainsi, la nature des dommages à l’ADN influence le devenir des cellules sénescentes. Les DSBs renforcent la stabilité de l’arrêt du cycle cellulaire alors que les SSBs promeuvent l’acquisition de mutations et l’échappement néoplasique

HIC1 (hypermethylated in cancer 1) SUMOylation is dispensable for DNA repair but is essential for the apoptotic DNA damage response (DDR) to irreparable DNA double-strand breaks (DSBs).

The tumor suppressor gene HIC1 (Hypermethylated In Cancer 1) encodes a transcriptional repressor mediating the p53-dependent apoptotic response to irreparable DNA double-strand breaks (DSBs) through direct transcriptional repression of SIRT1. HIC1 is also essential for DSB repair as silencing of endogenous HIC1 in BJ-hTERT fibroblasts significantly delays DNA repair in functional Comet assays. HIC1 SUMOylation favours its interaction with MTA1, a component of NuRD complexes. In contrast with irreparable DSBs induced by 16-hours of etoposide treatment, we show that repairable DSBs induced by 1 h etoposide treatment do not increase HIC1 SUMOylation or its interaction with MTA1. Furthermore, HIC1 SUMOylation is dispensable for DNA repair since the non-SUMOylatable E316A mutant is as efficient as wt HIC1 in Comet assays. Upon induction of irreparable DSBs, the ATM-mediated increase of HIC1 SUMOylation is independent of its effector kinase Chk2. Moreover, irreparable DSBs strongly increase both the interaction of HIC1 with MTA1 and MTA3 and their binding to the SIRT1 promoter. To characterize the molecular mechanisms sustained by this increased repression potential, we established global expression profiles of BJ-hTERT fibroblasts transfected with HIC1-siRNA or control siRNA and treated or not with etoposide. We identified 475 genes potentially repressed by HIC1 with cell death and cell cycle as the main cellular functions identified by pathway analysis. Among them, CXCL12, EPHA4, TGFβR3 and TRIB2, also known as MTA1 target-genes, were validated by qRT-PCR analyses. Thus, our data demonstrate that HIC1 SUMOylation is important for the transcriptional response to non-repairable DSBs but dispensable for DNA repair

Role of oxidative DNA damage in post-senescence neoplastic emergence

La sénescence est un état d’arrêt prolifératif mis en place par les cellules en réponse à des dommages à l’ADN. Elle est considérée comme un mécanisme de protection qui s’oppose à l’initiation et au développement d’un cancer. Or, les mécanismes de sénescence et la capacité des cellules à s’échapper de cet état et à générer des cellules transformées semblent varier selon les types cellulaires. Chez les kératinocytes humains normaux de peau (NHEKs), la sénescence est transitoire et débouche pour la plupart des cellules sur une mort par autophagie et, pour environ une sur dix mille, sur une émergence néoplasique post-sénescence. Les cellules émergentes présentent des caractères de transformation et accumulent des mutations et des délétions. Cet échappement néoplasique de la sénescence n’est jamais observé dans les fibroblastes normaux de peau (NHDFs) qui, au contraire, une fois en sénescence sont bloqués irréversiblement dans le cycle cellulaire.J’ai participé dans un premier temps à l’étude du rôle de l’autophagie dans la balance échappement néoplasique et mort des NHEKs sénescents. Nous avons pu démontrer que les progéniteurs de cellules néoplasiques ont une activité autophagique modérée plus faible que ceux qui subissent la mort. Ainsi, ils échappent à la mort par autophagie tout en gardant un niveau d’activité autophagique de ménage suffisant pour éliminer leurs composés altérés par le stress oxydant et être capable de ré-entrer en mitose.J’ai ensuite cherché à caractériser les dommages oxydants mutagènes impliqués dans l’échappement néoplasique. Ma stratégie a été d’analyser de façon comparative les NHEKs par rapport aux NHDFs, puisque les uns mais non les autres développent une émergence néoplasique. J’ai ainsi pu constater que le taux de cassures augmente à la sénescence dans les deux types cellulaires, mais que ces cassures sont de nature différente, uniquement des SSBs (Single Strand Breaks) pour les NHEKs et principalement des DSBs (Double Strand Breaks) pour les NHDFs. L’accumulation de DSBs à la sénescence des NHDFs s’accompagne d’une induction robuste de la voie DDR (DNA Damage Response), d’une activation la voie p53-p21 et d’un arrêt stable dans le cycle cellulaire. Dans le cas des NHEKs, l’augmentation du taux de SSBs est la conséquence de l’augmentation du niveau de stress oxydant et de la perte de l’expression et de l’activité de la PARP1. Ceci contribue à une agglomération aberrante de XRCC1 au niveau des cassures engendrant une induction de la voie p38MAPK - p16INK4a et un arrêt dans le cycle cellulaire caractéristique de la sénescence. D’une manière paradoxale, l’échappement néoplasique de la sénescence dépend également de cette accumulation de SSBs non réparés. Ainsi, la nature des dommages à l’ADN influence le devenir des cellules sénescentes. Les DSBs renforcent la stabilité de l’arrêt du cycle cellulaire alors que les SSBs promeuvent l’acquisition de mutations et l’échappement néoplasique.Senescence is a permanent cell-cycle arrest activated in response to DNA damage. If a cell escapes from this state, it should inherit mutations and could potentially initiate a tumor. NHDFs (Normal Human Dermal Fibroblasts) display a classical irreversible and stable senescence plateau. In contrast, senescent NHEKs (Normal Human Epidermal Keratinocytes) experience two different outcomes. Most of them undergo autophagic cell death and about one on 10000 spontaneously resumes mitosis and generates clones of transformed, mutated and tumorigenic cells.I contributed in a first time to studying the role of macroautophagy in the cell death / post-senescence neoplastic emergence balance of senescent NHEKs. We have shown that macroautophagy plays antagonistic roles during senescence, inducing cell death or promoting neoplastic transformation, depending on its level of activation. Indeed, the progenitors of post-senescent emergent cells display oxidative stress and autophagic activity levels slightly lower than the average, what allows them to avoid autophagic cell death and to ensure the quality control indispensable for mitosis re-entry.Since oxidative stress is the motor of the post-senescence neoplastic emergence in NHEKs, I wondered next whether oxidative stress could operate through the generation of some mutagenic DNA damage. I took advantage of the comparison of senescent NHEKs to NHDFs. I have shown that unlike NHDFs, NHEKs do not suffer from significantly shortened telomeres, nor accumulate DSBs, do not activate a DDR (DNA Damage Response) pathway and in consequence do not significantly activate the p53/p21 pathway. Instead, they suffer from a decrease in PARP1 expression, which compromises the repair of SSBs generated by oxidative stress. In consequence, SSBR foci, precisely XRCC1 foci, become persistent. These persistent foci initiate a signalization, through p38MAPK, which leads to up-regulation of p16INK4A and to cell cycle arrest. Notably, the accumulation of unrepaired SSBs is sufficient for the post-senescence neoplastic emergence phenomenon, in addition, paradoxically to its involvement in the onset of senescence.In conclusion, senescence results from the persistence of a DNA damage signalization, but the exact nature of the damages could vary in different cell types depending on their repair capacities and could dictate completely different outcomes. Namely, persistent DSBs, including telomeric ones, dictate a permanent tumor-suppressor cell cycle arrest, whereas persistent SSBs are permissive to mutation and senescence evasion

Role of oxidative DNA damage in post-senescence neoplastic emergence

La sénescence est un état d’arrêt prolifératif mis en place par les cellules en réponse à des dommages à l’ADN. Elle est considérée comme un mécanisme de protection qui s’oppose à l’initiation et au développement d’un cancer. Or, les mécanismes de sénescence et la capacité des cellules à s’échapper de cet état et à générer des cellules transformées semblent varier selon les types cellulaires. Chez les kératinocytes humains normaux de peau (NHEKs), la sénescence est transitoire et débouche pour la plupart des cellules sur une mort par autophagie et, pour environ une sur dix mille, sur une émergence néoplasique post-sénescence. Les cellules émergentes présentent des caractères de transformation et accumulent des mutations et des délétions. Cet échappement néoplasique de la sénescence n’est jamais observé dans les fibroblastes normaux de peau (NHDFs) qui, au contraire, une fois en sénescence sont bloqués irréversiblement dans le cycle cellulaire.J’ai participé dans un premier temps à l’étude du rôle de l’autophagie dans la balance échappement néoplasique et mort des NHEKs sénescents. Nous avons pu démontrer que les progéniteurs de cellules néoplasiques ont une activité autophagique modérée plus faible que ceux qui subissent la mort. Ainsi, ils échappent à la mort par autophagie tout en gardant un niveau d’activité autophagique de ménage suffisant pour éliminer leurs composés altérés par le stress oxydant et être capable de ré-entrer en mitose.J’ai ensuite cherché à caractériser les dommages oxydants mutagènes impliqués dans l’échappement néoplasique. Ma stratégie a été d’analyser de façon comparative les NHEKs par rapport aux NHDFs, puisque les uns mais non les autres développent une émergence néoplasique. J’ai ainsi pu constater que le taux de cassures augmente à la sénescence dans les deux types cellulaires, mais que ces cassures sont de nature différente, uniquement des SSBs (Single Strand Breaks) pour les NHEKs et principalement des DSBs (Double Strand Breaks) pour les NHDFs. L’accumulation de DSBs à la sénescence des NHDFs s’accompagne d’une induction robuste de la voie DDR (DNA Damage Response), d’une activation la voie p53-p21 et d’un arrêt stable dans le cycle cellulaire. Dans le cas des NHEKs, l’augmentation du taux de SSBs est la conséquence de l’augmentation du niveau de stress oxydant et de la perte de l’expression et de l’activité de la PARP1. Ceci contribue à une agglomération aberrante de XRCC1 au niveau des cassures engendrant une induction de la voie p38MAPK - p16INK4a et un arrêt dans le cycle cellulaire caractéristique de la sénescence. D’une manière paradoxale, l’échappement néoplasique de la sénescence dépend également de cette accumulation de SSBs non réparés. Ainsi, la nature des dommages à l’ADN influence le devenir des cellules sénescentes. Les DSBs renforcent la stabilité de l’arrêt du cycle cellulaire alors que les SSBs promeuvent l’acquisition de mutations et l’échappement néoplasique.Senescence is a permanent cell-cycle arrest activated in response to DNA damage. If a cell escapes from this state, it should inherit mutations and could potentially initiate a tumor. NHDFs (Normal Human Dermal Fibroblasts) display a classical irreversible and stable senescence plateau. In contrast, senescent NHEKs (Normal Human Epidermal Keratinocytes) experience two different outcomes. Most of them undergo autophagic cell death and about one on 10000 spontaneously resumes mitosis and generates clones of transformed, mutated and tumorigenic cells.I contributed in a first time to studying the role of macroautophagy in the cell death / post-senescence neoplastic emergence balance of senescent NHEKs. We have shown that macroautophagy plays antagonistic roles during senescence, inducing cell death or promoting neoplastic transformation, depending on its level of activation. Indeed, the progenitors of post-senescent emergent cells display oxidative stress and autophagic activity levels slightly lower than the average, what allows them to avoid autophagic cell death and to ensure the quality control indispensable for mitosis re-entry.Since oxidative stress is the motor of the post-senescence neoplastic emergence in NHEKs, I wondered next whether oxidative stress could operate through the generation of some mutagenic DNA damage. I took advantage of the comparison of senescent NHEKs to NHDFs. I have shown that unlike NHDFs, NHEKs do not suffer from significantly shortened telomeres, nor accumulate DSBs, do not activate a DDR (DNA Damage Response) pathway and in consequence do not significantly activate the p53/p21 pathway. Instead, they suffer from a decrease in PARP1 expression, which compromises the repair of SSBs generated by oxidative stress. In consequence, SSBR foci, precisely XRCC1 foci, become persistent. These persistent foci initiate a signalization, through p38MAPK, which leads to up-regulation of p16INK4A and to cell cycle arrest. Notably, the accumulation of unrepaired SSBs is sufficient for the post-senescence neoplastic emergence phenomenon, in addition, paradoxically to its involvement in the onset of senescence.In conclusion, senescence results from the persistence of a DNA damage signalization, but the exact nature of the damages could vary in different cell types depending on their repair capacities and could dictate completely different outcomes. Namely, persistent DSBs, including telomeric ones, dictate a permanent tumor-suppressor cell cycle arrest, whereas persistent SSBs are permissive to mutation and senescence evasion

Relative Risk of Bladder and Kidney Cancer in Lynch Syndrome: Systematic Review and Meta-Analysis

Background: The association between Lynch syndrome (LS) and a higher risk of upper tract urothelial carcinoma is well established, but its effect on the risk of bladder and kidney cancers remains controversial. This review aimed to compare the relative risk (RR) of bladder and kidney cancer in confirmed LS germline mutation carriers compared to the general population. Methods: Medline, Embase, Cochrane Central, and Google Scholar were searched on 14 July 2022 for studies published in English that reported on the rates of urological cancer in adults with confirmed LS germline mutation. The quality of included studies was assessed using Cochrane’s tool to evaluate risk of bias in cohort studies. Random effects meta-analysis estimated the pooled relative risk of bladder and kidney cancer in LS carriers compared to the general population. The quality of the overall evidence was evaluated using GRADE. Results: Of the 1839 records identified, 5 studies involving 7120 participants from 3 continents were included. Overall, LS carriers had a statistically significantly higher RR of developing bladder cancer (RR: 7.48, 95% CI: 3.70, 15.13) and kidney cancer (RR: 3.97, 95% CI: 1.23, 12.81) compared to unaffected participants (p < 0.01). The quality of the evidence was assessed as “low” due to the inclusion of cohort studies, the substantial heterogeneity, and moderate-to-high risk of bias. Conclusion: Lynch syndrome is associated with a significant increase in the relative risk of kidney and bladder cancer. Clinicians should adopt a lower threshold for germline mutation genetic testing in individuals who present with bladder cancer. Further studies evaluating the role and cost-effectiveness of novel urine-based laboratory tests are needed. High-quality studies in histologically proven renal cell carcinoma and their underlying germline mutations are necessary to strengthen the association with LS

Expanding the role of PSMA PET in active surveillance

Abstract Introduction Accurate grading at the time of diagnosis is fundamental to risk stratification and treatment decision making, particularly for men being considered for Active Surveillance (AS). With the introduction of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) there has been considerable improvement in sensitivity and specificity for the detection and staging of clinically significant prostate cancer. Our study aims to determine the role of PSMA PET/CT in men with newly diagnosed low or favourable intermediate risk prostate cancer to better select men for AS. Method This is a retrospective single centre study performed from January 2019 and October 2022. This study includes men identified from electronic medical record system who had undergone a PSMA PET/CT following newly diagnosed low or favourable-intermediate risk prostate cancer. Primary outcome was to assess the change in management for men being considered for AS following PSMA PET/CT results on the basis of PSMA PET characteristics. Results In total, there were 11 of 30 men (36.67%) who were assigned management by AS and 19 of 30 men (63.33%) who had definitive treatment. 15 of the 19 men that needed treatment had concerning features on PSMA PET/CT results. Of the 15 men with concerning features on PSMA PET, 9 (60%) men were found to have adverse pathological features on final prostatectomy features. Conclusion This retrospective study suggests that PSMA PET/CT has potential to influence the management of men with newly diagnosed prostate cancer that would otherwise be appropriate for active surveillance

Prostate Artery Embolisation of Megaprostate Causing External Iliac Vein Compression

None

TZAP overexpression induces telomere dysfunction and ALT-like activity in ATRX/DAXX-deficient cells

Summary: The appropriate regulation of telomere length homeostasis is crucial for the maintenance of genome integrity. The telomere-binding protein TZAP has been suggested to regulate telomere length by promoting t-circle and c-circle excisions through telomere trimming, yet the molecular mechanisms by which TZAP functions at telomeres are not understood. Using a system based on TZAP overexpression, we show that efficient TZAP recruitment to telomeres occurs in the context of open telomeric chromatin caused by loss of ATRX/DAXX independently of H3.3 deposition. Moreover, our data indicate that TZAP binding to telomeres induces telomere dysfunction and ALT-like activity, resulting in the generation of t-circles and c-circles in a Bloom-Topoisomerase IIIα-RMI1-RMI2 (BTR)-dependent manner

Multiparametric Magnetic Resonance Imaging of the Prostate and Prostate-specific Membrane Positron Emission Tomography Prior to Prostate Biopsy (MP4 Study)

Background: Prostate-specific membrane antigen (PSMA) positron emission tomography/computerised tomography (PET/CT) is increasingly being utilised in the diagnostic pathway for prostate cancer (PCa). Recent publications have suggested that this might help identify those who can avoid biopsy. Objective: The primary objective of this study was to determine whether PET magnetic resonance imaging (MRI) fusion could negate the need to biopsy prior to prostatectomy in a selected population of men. Design, setting, and participant: Multiparametric MRI (mpMRI) for PCa is our standard of care prior to prostate biopsy. Biopsy-naïve men with one or more Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesions ≥10 mm on mpMRI were invited to undergo PSMA PET/CT prior to biopsy. Following ethics approval, 60 men were recruited between September 2020 and March 2021. The key exclusion criteria included a previous history of PCa and previous prostate surgery or biopsy. Outcome measurements and statistical analysis: A positive PET MRI fusion scan was defined as “consistent with” as per the Memorial Sloan Kettering Cancer Center lexicon of certainty, and concordance with biopsy results was analysed. Clinically significant PCa (csPCa) was defined as grade group (GG) ≥2 on pathology. A chi-square analysis was performed with statistical significance defined at p < 0.05. Results and limitations: A total of 71 mpMRI lesions were positive on 61 (86%) PET MRI fusion scans. Fifty-nine of 61 lesions biopsied confirmed csPCa in 54 (92%). Of five of 59 lesions for which either biopsy was negative or low-grade cancer was found, three had rebiopsy of which two were confirmed to have csPCa corroborating with PET MRI fusion and one was reconfirmed to have GG1 only. For the remaining two, both had another lesion elsewhere in the gland confirming csPCa, and hence rebiopsy was not performed. Ultimately, 56 of 59 (95%) lesions with a positive PET MRI fusion scan were confirmed to have csPCa. All GG ≥3 cancers had a positive PET MRI fusion scan. Conclusions: This prospective study of PET MRI fusion assessment of men with PI-RADS 4 or 5 lesion ≥10 mm on mpMRI confirms that the majority of men (95%) with a positive PET MRI fusion scan will have csPCa. This supports recently published retrospective data suggesting that selected men might avoid prostate biopsy prior to radical prostatectomy. Patient summary: In this research, we have confirmed that prostate-specific membrane antigen positron emission tomography/computerised tomography in combination with magnetic resonance imaging could have an important role in enabling a diagnosis of prostate cancer. Using the combination of these scans, we could confidently predict the presence of aggressive prostate cancer in some men for which treatment is warranted. This means that there are some men who could possibility proceed directly to having prostate cancer surgery without the need for a confirmatory prostate biopsy