1
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Geng H, Tsang M, Subbaraj L, Cleveland J, Chen L, Lu M, Sharma J, Vigneron DB, Kurhanewicz J, LaFontaine M, Luks T, Barshop BA, Gangoiti J, Villanueva-Meyer JE, Rubenstein JL. Tumor Metabolism and Neurocognition in CNS Lymphoma. Neuro Oncol 2021; 23:1668-1679. [PMID: 33625503 DOI: 10.1093/neuonc/noab045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The mechanistic basis for neurocognitive deficits in CNS lymphoma and other brain tumors is incompletely understood. We tested the hypothesis that tumor metabolism impairs neurotransmitter pathways and neurocognitive function. METHODS We performed serial cerebrospinal fluid (CSF) metabolomic analyses using liquid chromatography-electrospray tandem mass spectrometry to evaluate changes in the tumor microenvironment in 14 patients with recurrent CNS lymphoma, focusing on 18 metabolites involved in neurotransmission and bioenergetics. These were paired with serial mini-mental state examinations (MMSE) and MRI studies for tumor volumetric analyses. Patients were analyzed in the setting of the phase I trial of lenalidomide/rituximab. Associations were assessed by Pearson and Spearman correlation coefficient. Generalized estimating equation (gee) models were also established, adjusting for within-subject repeated measures. RESULTS Of 18 metabolites, elevated CSF lactate correlated most strongly with lower MMSE score (p<8E-8, rho=-0.67). High lactate was associated with lower GABA, higher glutamate/GABA ratio and dopamine. Conversely, high succinate correlated with higher MMSE score. Serial analysis demonstrated a reproducible, time-dependent, reciprocal correlation between changes in lactate and GABA concentrations. While high lactate and low GABA correlated with tumor contrast enhancing volume, they correlated more significantly with lower MMSE scores than tumor volumes. CONCLUSIONS We provide evidence that lactate production and Warburg metabolism may impact neurotransmitter dysregulation and neurocognition in CNS lymphomas. We identify novel metabolomic biomarkers that may be applied in future studies of neurocognition in CNS lymphomas. Elucidation of mechanistic interactions between lymphoma metabolism, neurotransmitter imbalance and neurocognition may promote interventions that preserve cognitive function.
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Affiliation(s)
- Huimin Geng
- Laboratory Medicine, University of California, San Francisco (UCSF).,Helen Diller Family Comprehensive Cancer Center, UCSF
| | - Mazie Tsang
- Hematology/Oncology, UCSF.,Department of Medicine, UCSF
| | | | | | - Lingjing Chen
- Hematology/Oncology, UCSF.,Department of Medicine, UCSF
| | - Ming Lu
- Hematology/Oncology, UCSF.,Department of Medicine, UCSF
| | | | - Daniel B Vigneron
- Helen Diller Family Comprehensive Cancer Center, UCSF.,Radiology and Biomedical Imaging
| | - John Kurhanewicz
- Helen Diller Family Comprehensive Cancer Center, UCSF.,Radiology and Biomedical Imaging
| | | | | | - Bruce A Barshop
- Genetics and Pediatrics, University of California, San Diego
| | - Jon Gangoiti
- Genetics and Pediatrics, University of California, San Diego
| | | | - James L Rubenstein
- Helen Diller Family Comprehensive Cancer Center, UCSF.,Hematology/Oncology, UCSF
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2
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Subbaraj L, Beleniski F, Courtier J, Vartanian S, Nijagal A. Congenital superior mesenteric artery aneurysm in a 6-week-old infant presenting with upper gastrointestinal bleeding. J Vasc Surg 2019; 71:1391-1394. [PMID: 31401110 DOI: 10.1016/j.jvs.2019.06.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
Visceral artery aneurysms are rare in infants and children. The majority of cases are caused by genetic syndromes, trauma, or infection. Although the majority of aneurysms are asymptomatic, visceral artery aneurysms can present with abdominal pain, nausea/vomiting, or rupture. Aneurysm rupture can manifest as hemodynamic instability and/or gastrointestinal bleeding. We present the case of a congenital idiopathic aneurysm of the superior mesenteric artery in a 6-week-old infant who presented with gastrointestinal bleeding. We report a stepwise surgical approach to achieving aneurysm exclusion and thrombosis, and highlight the robust mesenteric collateral circulation that can develop in pediatric patients.
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Affiliation(s)
- Lakshmipriya Subbaraj
- Division of Pediatric Surgery, University of California, San Francisco, San Francisco, Calif
| | - Florencia Beleniski
- Division of Pediatric Surgery, Kaiser Permanente Medical Group, Oakland, Calif
| | - Jesse Courtier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif
| | - Shant Vartanian
- Division of Vascular Surgery, University of California, San Francisco, San Francisco, Calif
| | - Amar Nijagal
- Division of Pediatric Surgery, University of California, San Francisco, San Francisco, Calif.
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3
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Adams CR, Htwe HH, Marsh T, Wang AL, Montoya ML, Subbaraj L, Tward AD, Bardeesy N, Perera RM. Transcriptional control of subtype switching ensures adaptation and growth of pancreatic cancer. eLife 2019; 8:45313. [PMID: 31134896 PMCID: PMC6538376 DOI: 10.7554/elife.45313] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDA) is a heterogeneous disease comprised of a basal-like subtype with mesenchymal gene signatures, undifferentiated histopathology and worse prognosis compared to the classical subtype. Despite their prognostic and therapeutic value, the key drivers that establish and control subtype identity remain unknown. Here, we demonstrate that PDA subtypes are not permanently encoded, and identify the GLI2 transcription factor as a master regulator of subtype inter-conversion. GLI2 is elevated in basal-like PDA lines and patient specimens, and forced GLI2 activation is sufficient to convert classical PDA cells to basal-like. Mechanistically, GLI2 upregulates expression of the pro-tumorigenic secreted protein, Osteopontin (OPN), which is especially critical for metastatic growth in vivo and adaptation to oncogenic KRAS ablation. Accordingly, elevated GLI2 and OPN levels predict shortened overall survival of PDA patients. Thus, the GLI2-OPN circuit is a driver of PDA cell plasticity that establishes and maintains an aggressive variant of this disease.
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Affiliation(s)
- Christina R Adams
- Department of Anatomy, University of California, San Francisco, San Francisco, United States
| | - Htet Htwe Htwe
- Department of Anatomy, University of California, San Francisco, San Francisco, United States
| | - Timothy Marsh
- Department of Pathology, University of California, San Francisco, San Francisco, United States
| | - Aprilgate L Wang
- Department of Anatomy, University of California, San Francisco, San Francisco, United States
| | - Megan L Montoya
- Department of Anatomy, University of California, San Francisco, San Francisco, United States
| | - Lakshmipriya Subbaraj
- Department of Otolaryngology, University of California, San Francisco, San Francisco, United States
| | - Aaron D Tward
- Department of Otolaryngology, University of California, San Francisco, San Francisco, United States.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, United States
| | - Nabeel Bardeesy
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, United States
| | - Rushika M Perera
- Department of Anatomy, University of California, San Francisco, San Francisco, United States.,Department of Pathology, University of California, San Francisco, San Francisco, United States.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, United States
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4
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Romero R, Sayin VI, Shawn DM, Bauer M, Singh SX, LeBoeuf S, Karakousi TR, Ellis DC, Bhutkar A, Sanchez-Rivera F, Subbaraj L, Martinez B, Bronson RT, Prigge JR, Schmidt EE, Thomas CJ, Davies A, Dolgalev I, Heguy A, Allaj V, Piorier JT, Moreira AL, Rudin CM, Pass HI, Heiden MGV, Jacks T, Papagiannakopoulos T. Abstract A43: Loss of Keap1 promotes KRAS-driven lung cancer and results in genotype-specific vulnerabilities. Cancer Res 2018. [DOI: 10.1158/1538-7445.mousemodels17-a43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Treating KRAS mutant lung adenocarcinoma (LUAD) remains a major challenge in cancer treatment given the difficulties associated with directly inhibiting the KRAS oncoprotein1. One approach to addressing this challenge is to define frequently co-occurring mutations with KRAS, which themselves may lead to therapeutic vulnerabilities in tumors. Approximately 20% of KRAS mutant LUAD tumors carry loss-of-function (LOF) mutations in Kelch-like ECH-associated protein 1 (KEAP1)2-4, a negative regulator of nuclear factor erythroid 2-like 2 (NFE2L2; hereafter NRF2), which is the master transcriptional regulator of the endogenous antioxidant response5-10. The high frequency of mutations in KEAP1, which would be predicted to result in activation of the NRF2 pathway, suggests an important role for the oxidative stress response in lung tumorigenesis. To test this directly, we used a CRISPR/Cas9-based approach in a mouse model of Kras-driven LUAD to examine the effects of loss of KEAP1 function in lung cancer progression. We show that loss of KEAP1 hyper-activates Nrf2 and promotes Kras-driven LUAD. Combining CRISPR/Cas9-based genetic screening and metabolomic analyses, we also show that KEAP1/NRF2 mutant cancers are dependent on increased glutaminolysis, and this property can be therapeutically exploited through the pharmacologic inhibition of glutaminase. Finally, we provide a rationale for sub-stratification of human lung cancer patients with KRAS-KEAP1 or -NRF2 mutant tumors as likely to respond to glutaminase inhibition.
Citation Format: Rodrigo Romero, Volkan I. Sayin, Davidson M. Shawn, Matthew Bauer, Simranjit X. Singh, Sarah LeBoeuf, Triantafyllia R. Karakousi, Donald C. Ellis, Arjun Bhutkar, Francisco Sanchez-Rivera, Lakshmipriya Subbaraj, Britney Martinez, Roderick T. Bronson, Justin R. Prigge, Edward E. Schmidt, Craig J. Thomas, Angela Davies, Igor Dolgalev, Adriana Heguy, Viola Allaj, John T. Piorier, Andre L. Moreira, Charles M. Rudin, Harvey I. Pass, Matthew G. Vander Heiden, Tyler Jacks, Thales Papagiannakopoulos. Loss of Keap1 promotes KRAS-driven lung cancer and results in genotype-specific vulnerabilities [abstract]. In: Proceedings of the AACR Special Conference: Advances in Modeling Cancer in Mice: Technology, Biology, and Beyond; 2017 Sep 24-27; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(10 Suppl):Abstract nr A43.
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Affiliation(s)
- Rodrigo Romero
- 1Koch Institute for Integrative Cancer Research, Cambridge, MA,
| | - Volkan I. Sayin
- 2Department of Pathology, New York University School of Medicine, New York, NY,
| | | | - Matthew Bauer
- 1Koch Institute for Integrative Cancer Research, Cambridge, MA,
| | - Simranjit X. Singh
- 2Department of Pathology, New York University School of Medicine, New York, NY,
| | - Sarah LeBoeuf
- 2Department of Pathology, New York University School of Medicine, New York, NY,
| | | | - Donald C. Ellis
- 1Koch Institute for Integrative Cancer Research, Cambridge, MA,
| | - Arjun Bhutkar
- 1Koch Institute for Integrative Cancer Research, Cambridge, MA,
| | | | | | - Britney Martinez
- 2Department of Pathology, New York University School of Medicine, New York, NY,
| | | | - Justin R. Prigge
- 4Department of Immunology and Infectious Diseases, Montana State University, Bozeman, MT,
| | - Edward E. Schmidt
- 4Department of Immunology and Infectious Diseases, Montana State University, Bozeman, MT,
| | | | | | - Igor Dolgalev
- 7Genome Technology Center, NYU School of Medicine, New York, NY,
| | - Adriana Heguy
- 7Genome Technology Center, NYU School of Medicine, New York, NY,
| | - Viola Allaj
- 8Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - John T. Piorier
- 8Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andre L. Moreira
- 2Department of Pathology, New York University School of Medicine, New York, NY,
| | - Charles M. Rudin
- 8Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Harvey I. Pass
- 8Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Tyler Jacks
- 1Koch Institute for Integrative Cancer Research, Cambridge, MA,
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5
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Papagiannakopoulos T, Bauer MR, Davidson SM, Heimann M, Subbaraj L, Bhutkar A, Bartlebaugh J, Vander Heiden MG, Jacks T. Circadian Rhythm Disruption Promotes Lung Tumorigenesis. Cell Metab 2016; 24:324-31. [PMID: 27476975 PMCID: PMC5367626 DOI: 10.1016/j.cmet.2016.07.001] [Citation(s) in RCA: 318] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 05/27/2016] [Accepted: 07/01/2016] [Indexed: 12/18/2022]
Abstract
Circadian rhythms are 24-hr oscillations that control a variety of biological processes in living systems, including two hallmarks of cancer, cell division and metabolism. Circadian rhythm disruption by shift work is associated with greater risk for cancer development and poor prognosis, suggesting a putative tumor-suppressive role for circadian rhythm homeostasis. Using a genetically engineered mouse model of lung adenocarcinoma, we have characterized the effects of circadian rhythm disruption on lung tumorigenesis. We demonstrate that both physiologic perturbation (jet lag) and genetic mutation of the central circadian clock components decreased survival and promoted lung tumor growth and progression. The core circadian genes Per2 and Bmal1 were shown to have cell-autonomous tumor-suppressive roles in transformation and lung tumor progression. Loss of the central clock components led to increased c-Myc expression, enhanced proliferation, and metabolic dysregulation. Our findings demonstrate that both systemic and somatic disruption of circadian rhythms contribute to cancer progression.
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Affiliation(s)
- Thales Papagiannakopoulos
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Matthew R Bauer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Shawn M Davidson
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Megan Heimann
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Lakshmipriya Subbaraj
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Arjun Bhutkar
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Jordan Bartlebaugh
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Matthew G Vander Heiden
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Tyler Jacks
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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6
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Sánchez-Rivera FJ, Papagiannakopoulos T, Romero R, Tammela T, Bauer MR, Bhutkar A, Joshi NS, Subbaraj L, Bronson RT, Xue W, Jacks T. Rapid modelling of cooperating genetic events in cancer through somatic genome editing. Nature 2014; 516:428-31. [PMID: 25337879 PMCID: PMC4292871 DOI: 10.1038/nature13906] [Citation(s) in RCA: 288] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/02/2014] [Indexed: 12/21/2022]
Abstract
Cancer is a multistep process that involves mutations and other alterations in oncogenes and tumour suppressor genes. Genome sequencing studies have identified a large collection of genetic alterations that occur in human cancers. However, the determination of which mutations are causally related to tumorigenesis remains a major challenge. Here we describe a novel CRISPR/Cas9-based approach for rapid functional investigation of candidate genes in well-established autochthonous mouse models of cancer. Using a Kras(G12D)-driven lung cancer model, we performed functional characterization of a panel of tumour suppressor genes with known loss-of-function alterations in human lung cancer. Cre-dependent somatic activation of oncogenic Kras(G12D) combined with CRISPR/Cas9-mediated genome editing of tumour suppressor genes resulted in lung adenocarcinomas with distinct histopathological and molecular features. This rapid somatic genome engineering approach enables functional characterization of putative cancer genes in the lung and other tissues using autochthonous mouse models. We anticipate that this approach can be used to systematically dissect the complex catalogue of mutations identified in cancer genome sequencing studies.
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Affiliation(s)
- Francisco J. Sánchez-Rivera
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Thales Papagiannakopoulos
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Rodrigo Romero
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Tuomas Tammela
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Matthew R. Bauer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Arjun Bhutkar
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Nikhil S. Joshi
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Lakshmipriya Subbaraj
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | | | - Wen Xue
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
| | - Tyler Jacks
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142
- Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA 02139
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