Combined loss of CDH1 and downstream regulatory sequences drive early-onset diffuse gastric cancer and increase penetrance of hereditary diffuse gastric cancer

São José, Celina; Laurie, Steven, 1973-; Oliveira, Carla

Combined loss of CDH1 and downstream regulatory sequences drive early-onset diffuse gastric cancer and increase penetrance of hereditary diffuse gastric cancer

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dc.contributor.author São José, Celina
dc.contributor.author Laurie, Steven, 1973-
dc.contributor.author Oliveira, Carla
dc.date.accessioned 2023-07-18T06:18:48Z
dc.date.available 2023-07-18T06:18:48Z
dc.date.issued 2023
dc.description.abstract Background: Germline CDH1 pathogenic or likely pathogenic variants cause hereditary diffuse gastric cancer (HDGC). Once a genetic cause is identified, stomachs' and breasts' surveillance and/or prophylactic surgery is offered to asymptomatic CDH1 carriers, which is life-saving. Herein, we characterized an inherited mechanism responsible for extremely early-onset gastric cancer and atypical HDGC high penetrance. Methods: Whole-exome sequencing (WES) re-analysis was performed in an unsolved HDGC family. Accessible chromatin and CDH1 promoter interactors were evaluated in normal stomach by ATAC-seq and 4C-seq, and functional analysis was performed using CRISPR-Cas9, RNA-seq and pathway analysis. Results: We identified a germline heterozygous 23 Kb CDH1-TANGO6 deletion in a family with eight diffuse gastric cancers, six before age 30. Atypical HDGC high penetrance and young cancer-onset argued towards a role for the deleted region downstream of CDH1, which we proved to present accessible chromatin, and CDH1 promoter interactors in normal stomach. CRISPR-Cas9 edited cells mimicking the CDH1-TANGO6 deletion display the strongest CDH1 mRNA downregulation, more impacted adhesion-associated, type-I interferon immune-associated and oncogenic signalling pathways, compared to wild-type or CDH1-deleted cells. This finding solved an 18-year family odyssey and engaged carrier family members in a cancer prevention pathway of care. Conclusion: In this work, we demonstrated that regulatory elements lying down-stream of CDH1 are part of a chromatin network that control CDH1 expression and influence cell transcriptome and associated signalling pathways, likely explaining high disease penetrance and very young cancer-onset. This study highlights the importance of incorporating scientific-technological updates and clinical guidelines in routine diagnosis, given their impact in timely genetic diagnosis and disease prevention.
dc.description.sponsorship This work received funding from: (1) the European Union’s Horizon 2020 research and innovation programme under grant agreement No 779257 (Solve‐RD: H2020-SC1-2017-Single-Stage-RTD), which provided Ph.D. salaries to JG-P, AS, ItP; (2) The European Regional Development Fund (ERDF) through the COMPETE 2020-Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through Fundação para a Ciência e Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Inovação (LEGOH: PTDC/BTM-TEC/6706/2020); (3) FCT with salary support for Ph.D. studentships to CSJ (Ref. SFRH/BD/140796/2018), JG-P (Ref. 2022.11952.BD) and MF (Ref. 2020.05763.BD); (4) MT is supported by the NIHR Cambridge Biomedical Research Centre (BRC-1215-20014). Open access funding provided by FCT|FCCN (b-on).
dc.format.mimetype application/pdf
dc.identifier.citation São José C, Garcia-Pelaez J, Ferreira M, Arrieta O, André A, Martins N, et al. Combined loss of CDH1 and downstream regulatory sequences drive early-onset diffuse gastric cancer and increase penetrance of hereditary diffuse gastric cancer. Gastric Cancer. 2023 Sep;26(5):653-66. DOI: 10.1007/s10120-023-01395-0
dc.identifier.doi http://dx.doi.org/10.1007/s10120-023-01395-0
dc.identifier.issn 1436-3291
dc.identifier.uri http://hdl.handle.net/10230/57597
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof Gastric Cancer. 2023 Sep;26(5):653-66
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/779257
dc.rights © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.keyword CDH1
dc.subject.keyword Copy number variants
dc.subject.keyword Deletion
dc.subject.keyword Hereditary diffuse gastric cancer
dc.subject.keyword Regulatory elements
dc.subject.keyword Type-I interferon immune response
dc.title Combined loss of CDH1 and downstream regulatory sequences drive early-onset diffuse gastric cancer and increase penetrance of hereditary diffuse gastric cancer
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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