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Kolterud Å, Välimäki N, Kuisma H, Patomo J, Ilves ST, Mäkinen N, Kaukomaa J, Palin K, Kaasinen E, Karhu A, Pasanen A, Bützow R, Heikinheimo O, Kopp Kallner H, Aaltonen LA. Molecular subclass of uterine fibroids predicts tumor shrinkage in response to ulipristal acetate. Hum Mol Genet 2023; 32:1063-1071. [PMID: 36048862 PMCID: PMC10026225 DOI: 10.1093/hmg/ddac217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/05/2022] [Accepted: 08/28/2022] [Indexed: 11/12/2022] Open
Abstract
Precision medicine carries great potential for management of all tumor types. The aim of this retrospective study was to investigate if the two most common genetically distinct uterine fibroid subclasses, driven by aberrations in MED12 and HMGA2 genes, respectively, influence response to treatment with the progesterone receptor modulator ulipristal acetate. Changes in diameter and mutation status were derived for 101 uterine fibroids surgically removed after ulipristal acetate treatment. A significant difference in treatment response between the two major subclasses was detected. MED12 mutant fibroids had 4.4 times higher odds of shrinking in response to ulipristal acetate treatment as compared to HMGA2 driven fibroids (95% confidence interval 1.37-13.9; P = 0.013), and in a multivariate analysis molecular subclassification was an independent predictive factor. Compatible with this finding, gene expression and DNA methylation analyses revealed subclass specific differences in progesterone receptor signaling. The work provides a proof-of-principle that uterine fibroid treatment response is influenced by molecular subclass and that the genetic subclasses should be taken into account when evaluating current and future uterine fibroid therapies.
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Affiliation(s)
- Åsa Kolterud
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden
| | - Niko Välimäki
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Heli Kuisma
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Joonatan Patomo
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Sini T Ilves
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Netta Mäkinen
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Jaana Kaukomaa
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Kimmo Palin
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
- iCAN Digital Precision Cancer Medicine Flagship, University of Helsinki, 00290 Helsinki, Finland
| | - Eevi Kaasinen
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Auli Karhu
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
| | - Annukka Pasanen
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, 00290 Helsinki, Finland
| | - Ralf Bützow
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, 00290 Helsinki, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, 00029 HUS Helsinki, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, 00029 HUS Helsinki, Finland
| | - Helena Kopp Kallner
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Obstetrics and Gynecology, Danderyd Hospital, 182 88 Stockholm, Sweden
| | - Lauri A Aaltonen
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden
- Department of Medical and Clinical Genetics, University of Helsinki; Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland
- iCAN Digital Precision Cancer Medicine Flagship, University of Helsinki, 00290 Helsinki, Finland
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Walton KD, Whidden M, Kolterud Å, Shoffner SK, Czerwinski MJ, Kushwaha J, Parmar N, Chandhrasekhar D, Freddo AM, Schnell S, Gumucio DL. Villification in the mouse: Bmp signals control intestinal villus patterning. Development 2016; 143:427-36. [PMID: 26721501 PMCID: PMC4760312 DOI: 10.1242/dev.130112] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/18/2015] [Indexed: 01/18/2023]
Abstract
In the intestine, finger-like villi provide abundant surface area for nutrient absorption. During murine villus development, epithelial Hedgehog (Hh) signals promote aggregation of subepithelial mesenchymal clusters that drive villus emergence. Clusters arise first dorsally and proximally and spread over the entire intestine within 24 h, but the mechanism driving this pattern in the murine intestine is unknown. In chick, the driver of cluster pattern is tensile force from developing smooth muscle, which generates deep longitudinal epithelial folds that locally concentrate the Hh signal, promoting localized expression of cluster genes. By contrast, we show that in mouse, muscle-induced epithelial folding does not occur and artificial deformation of the epithelium does not determine the pattern of clusters or villi. In intestinal explants, modulation of Bmp signaling alters the spatial distribution of clusters and changes the pattern of emerging villi. Increasing Bmp signaling abolishes cluster formation, whereas inhibiting Bmp signaling leads to merged clusters. These dynamic changes in cluster pattern are faithfully simulated by a mathematical model of a Turing field in which an inhibitor of Bmp signaling acts as the Turing activator. In vivo, genetic interruption of Bmp signal reception in either epithelium or mesenchyme reveals that Bmp signaling in Hh-responsive mesenchymal cells controls cluster pattern. Thus, unlike in chick, the murine villus patterning system is independent of muscle-induced epithelial deformation. Rather, a complex cocktail of Bmps and Bmp signal modulators secreted from mesenchymal clusters determines the pattern of villi in a manner that mimics the spread of a self-organizing Turing field.
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Affiliation(s)
- Katherine D Walton
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Mark Whidden
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48105, USA
| | - Åsa Kolterud
- Department of Biosciences and Nutrition, Karolinska Instituet, Novum, Huddinge SE-141 83, Sweden
| | - Suzanne K Shoffner
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48105, USA
| | - Michael J Czerwinski
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Juhi Kushwaha
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Nishita Parmar
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Deepa Chandhrasekhar
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Andrew M Freddo
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Santiago Schnell
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48105, USA Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI 48105, USA
| | - Deborah L Gumucio
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
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Gumucio DL, Walton KD, Kolterud Å, Czerwinski MJ, Kushwaha JS, Prakash A, Bell MJ, Schnell S. Hedgehog responsive mesenchymal clusters direct emergence of intestinal villi. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.339.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Åsa Kolterud
- Environmental ToxicologyKarolinska InstitutetHuddingeSweden
| | | | - Juhi S. Kushwaha
- Cell & Developmental BiologyThe University of MichiganAnn ArborMI
| | - Ajay Prakash
- Cell & Developmental BiologyThe University of MichiganAnn ArborMI
| | | | - Santiago Schnell
- Molecular and Integrative PhysiologyThe University of MichiganAnn ArborMI
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VanDussen KL, Carulli AJ, Keeley TM, Patel SR, Puthoff BJ, Magness ST, Tran IT, Maillard I, Siebel C, Kolterud Å, Grosse AS, Gumucio DL, Ernst SA, Tsai YH, Dempsey PJ, Samuelson LC. Notch signaling modulates proliferation and differentiation of intestinal crypt base columnar stem cells. Development 2011; 139:488-97. [PMID: 22190634 DOI: 10.1242/dev.070763] [Citation(s) in RCA: 396] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Notch signaling is known to regulate the proliferation and differentiation of intestinal stem and progenitor cells; however, direct cellular targets and specific functions of Notch signals had not been identified. We show here in mice that Notch directly targets the crypt base columnar (CBC) cell to maintain stem cell activity. Notch inhibition induced rapid CBC cell loss, with reduced proliferation, apoptotic cell death and reduced efficiency of organoid initiation. Furthermore, expression of the CBC stem cell-specific marker Olfm4 was directly dependent on Notch signaling, with transcription activated through RBP-Jκ binding sites in the promoter. Notch inhibition also led to precocious differentiation of epithelial progenitors into secretory cell types, including large numbers of cells that expressed both Paneth and goblet cell markers. Analysis of Notch function in Atoh1-deficient intestine demonstrated that the cellular changes were dependent on Atoh1, whereas Notch regulation of Olfm4 gene expression was Atoh1 independent. Our findings suggest that Notch targets distinct progenitor cell populations to maintain adult intestinal stem cells and to regulate cell fate choice to control epithelial cell homeostasis.
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Affiliation(s)
- Kelli L VanDussen
- Department of Molecular & Integrative Physiology, The University of Michigan, Ann Arbor, MI 48109, USA
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Kolterud Å, Grosse AS, Zacharias WJ, Walton KD, Kretovich KE, Madison B, Waghray M, Ferris JE, Hu C, Merchant JL, Dlugosz A, Kottmann AH, Gumucio DL. Paracrine Hedgehog signaling in stomach and intestine: new roles for hedgehog in gastrointestinal patterning. Gastroenterology 2009; 137:618-28. [PMID: 19445942 PMCID: PMC2717174 DOI: 10.1053/j.gastro.2009.05.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 04/29/2009] [Accepted: 05/06/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Hedgehog signaling is critical in gastrointestinal patterning. Mice deficient in Hedgehog signaling exhibit abnormalities that mirror deformities seen in the human VACTERL (vertebral, anal, cardiac, tracheal, esophageal, renal, limb) association. However, the direction of Hedgehog signal flow is controversial and the cellular targets of Hedgehog signaling change with time during development. We profiled cellular Hedgehog response patterns from embryonic day 10.5 (E10.5) to adult in murine antrum, pyloric region, small intestine, and colon. METHODS Hedgehog signaling was profiled using Hedgehog pathway reporter mice and in situ hybridization. Cellular targets were identified by immunostaining. Ihh-overexpressing transgenic animals were generated and analyzed. RESULTS Hedgehog signaling is strictly paracrine from antrum to colon throughout embryonic and adult life. Novel findings include the following: mesothelial cells of the serosa transduce Hedgehog signals in fetal life; the hindgut epithelium expresses Ptch but not Gli1 at E10.5; the 2 layers of the muscularis externa respond differently to Hedgehog signals; organogenesis of the pyloric sphincter is associated with robust Hedgehog signaling; dramatically different Hedgehog responses characterize stomach and intestine at E16; and after birth, the muscularis mucosa and villus smooth muscle consist primarily of Hedgehog-responsive cells and Hh levels actively modulate villus core smooth muscle. CONCLUSIONS These studies reveal a previously unrecognized association of paracrine Hedgehog signaling with several gastrointestinal patterning events involving the serosa, pylorus, and villus smooth muscle. The results may have implications for several human anomalies and could potentially expand the spectrum of the human VACTERL association.
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Affiliation(s)
- Åsa Kolterud
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Ann S. Grosse
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - William J. Zacharias
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Katherine D. Walton
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Katherine E. Kretovich
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Blair Madison
- Department of Genetics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104
| | - Meghna Waghray
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Jennifer E. Ferris
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Chunbo Hu
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Juanita L. Merchant
- Department of Physiology and Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Andrzej Dlugosz
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
| | - Andreas H. Kottmann
- Department of Psychiatry, Genome Center and Center for Motor Neuron Biology and Disease, Columbia University, New York, NY 10032
| | - Deborah L. Gumucio
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109-2200
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