SOX11 regulates SWI/SNF complex components as member of the adrenergic neuroblastoma core regulatory circuitry

The pediatric extra-cranial tumor neuroblastoma displays a low mutational burden while recurrent copy number alterations are present in most high-risk cases. Here, we identify SOX11 as a dependency transcription factor in adrenergic neuroblastoma based on recurrent chromosome 2p focal gains and amplifications, specific expression in the normal sympatho-adrenal lineage and adrenergic neuroblastoma, regulation by multiple adrenergic specific (super-)enhancers and strong dependency on high SOX11 expression in adrenergic neuroblastomas. SOX11 regulated direct targets include genes implicated in epigenetic control, cytoskeleton and neurodevelopment. Most notably, SOX11 controls chromatin regulatory complexes, including 10 SWI/SNF core components among which SMARCC1, SMARCA4/BRG1 and ARID1A. Additionally, the histone deacetylase HDAC2, PRC1 complex component CBX2, chromatin-modifying enzyme KDM1A/LSD1 and pioneer factor c-MYB are regulated by SOX11. Finally, SOX11 is identified as a core transcription factor of the core regulatory circuitry (CRC) in adrenergic high-risk neuroblastoma with a potential role as epigenetic master regulator upstream of the CRC.

Mesenchymal type neuroblastoma cells escape ALK inhibitors

Cancer therapy frequently fails due to the emergence of resistance. Many tumors include phenotypically immature tumor cells, which have been implicated in therapy resistance. Neuroblastoma cells can adopt a lineage committed adrenergic (ADRN) or an immature mesenchymal (MES) state. They differ in epigenetic landscape and transcription factors, and MES cells are more resistant to chemotherapy. Here we analyzed the response of MES cells to targeted drugs. Activating ALK mutations are frequently found in neuroblastoma and ALK inhibitors (ALKi) are in clinical trials. ALKi treatment of ADRN neuroblastoma cells with a tumor-driving ALK mutation induced cell death. Conversely, MES cells did not express either mutant or wild-type ALK and were resistant to ALKi, and MES cells formed tumors that progressed under ALKi therapy. In assessing the role of MES cells in relapse development, TRAIL was identified to specifically induce apoptosis in MES cells and suppress MES tumor growth. Addition of TRAIL to ALKi treatment of neuroblastoma xenografts delayed relapses in a subset of the animals, suggesting a role for MES cells in relapse formation. While ADRN cells resembled normal embryonal neuroblasts, MES cells resembled immature precursor cells which also lacked ALK expression. Resistance to targeted drugs can therefore be an intrinsic property of immature cancer cells based on their resemblance to developmental precursors.

Super enhancers define regulatory subtypes and cell identity in neuroblastoma

Half of the children diagnosed with neuroblastoma (NB) have high-risk disease, disproportionately contributing to overall childhood cancer-related deaths. In addition to recurrent gene mutations, there is increasing evidence supporting the role of epigenetic deregulation in disease pathogenesis. Yet, comprehensive cis-regulatory network descriptions from NB are lacking. Here, using genome-wide H3K27ac profiles across 60 NBs, covering the different clinical and molecular subtypes, we identified four major super-enhancer-driven epigenetic subtypes and their underlying master regulatory networks. Three of these subtypes recapitulated known clinical groups; namely, MYCN-amplified, MYCN non-amplified high-risk and MYCN non-amplified low-risk NBs. The fourth subtype, exhibiting mesenchymal characteristics, shared cellular identity with multipotent Schwann cell precursors, was induced by RAS activation and was enriched in relapsed disease. Notably, CCND1, an essential gene in NB, was regulated by both mesenchymal and adrenergic regulatory networks converging on distinct super-enhancer modules. Overall, this study reveals subtype-specific super-enhancer regulation in NBs.

Mesenchymal Neuroblastoma Cells Are Undetected by Current mRNA Marker Panels: The Development of a Specific Neuroblastoma Mesenchymal Minimal Residual Disease Panel

Patients with neuroblastoma in molecular remission remain at considerable risk for disease recurrence. Studies have found that neuroblastoma tissue contains adrenergic (ADRN) and mesenchymal (MES) cells; the latter express low levels of commonly used markers for minimal residual disease (MRD). We identified MES-specific MRD markers and studied the dynamics of these markers during treatment.

PATIENTS AND METHODS

Microarray data were used to identify genes differentially expressed between ADRN and MES cell lines. Candidate genes were then studied using real-time quantitative polymerase chain reaction in cell lines and control bone marrow and peripheral blood samples. After selecting a panel of markers, serial bone marrow, peripheral blood, and peripheral blood stem cell samples were obtained from patients with high-risk neuroblastoma and tested for marker expression; survival analyses were also performed.

RESULTS

PRRX1, POSTN, and FMO3 mRNAs were used as a panel for specifically detecting MES mRNA in patient samples. MES mRNA was detected only rarely in peripheral blood; moreover, the presence of MES mRNA in peripheral blood stem cell samples was associated with low event-free survival and overall survival. Of note, during treatment, serial bone marrow samples obtained from 29 patients revealed a difference in dynamics between MES mRNA markers and ADRN mRNA markers. Furthermore, MES mRNA was detected in a higher percentage of patients with recurrent disease than in those who remained disease free (53% v 32%, respectively; P = .03).

CONCLUSION

We propose that the markers POSTN and PRRX1, in combination with FMO3, be used for real-time quantitative polymerase chain reaction-based detection of MES neuroblastoma mRNA in patient samples because these markers have a unique pattern during treatment and are more prevalent in patients with poor outcome. Together with existing markers of MRD, these new markers should be investigated further in large prospective studies.

Abstract 3662: Plasticity of transcriptional and epigenetic cellular states in neuroblastoma is driven by core lineage transcription factors

Background: Cellular identity in development and disease is driven by Core Regulatory Circuitries (CRCs) of lineage transcription factors that associate with super-enhancers. We showed that neuroblastoma includes two types of tumor cells with divergent gene expression profiles. Undifferentiated mesenchymal (MES) cells and lineage-committed adrenergic (ADRN) tumor cells have divergent phenotypes, super-enhancer (SE) landscapes and Core Regulatory Circuitries (van Groningen et al., Nature Genetics, 2017).

Results: We study five pairs of MES- and ADRN-type cell lines, each of which are derived from the tumor of individual patients. These isogenic cell lines can show spontaneous bidirectional transdifferentiation. As the mechanisms of reprogramming in cancer are poorly understood, we studied the mechanism of MES and ADRN transdifferentiation. We identified a MES-specific Core Regulatory Circuitry consisting of 20 super enhancer-associated transcription factors. Amongst them were NOTCH and MAML transcription factors. Indeed MES cells were found to have an active NOTCH signaling. Inducible expression of NOTCH3-IC in ADRN cells induced a step-wise reprogramming of the ADRN transcriptome towards a dedifferentiated MES state. This transition induced genome-wide remodeling of the H3K27ac landscape and a switch from ADRN SEs to MES SEs. The NOTCH3-IC transgene activated a transcriptional feed-forward cascade including NOTCH ligands, -receptors and -cofactors to amplify the NOTCH signaling levels. Blocking of this endogenous feed-forward loop with a γ-secretase inhibitor showed that this cascade was essential to achieve MES reprogramming. The endogenous NOTCH feed-forward cascade maintained the induced MES state, also after abrogating expression of the NOTCH3-IC transgene. The induced MES cells and stable MES cell lines were resistant to chemotherapy, highlighting their clinical importance. Accordingly, we found that MES cells are strongly enriched in post-treatment samples, suggesting that MES cells play a role in resistance and relapse development. Since neuroblastoma is presumed to originate from the sympathetic nervous system, we analyzed normal sympathetic lineage development at single-cell resolution. We found that MES tumor cells resembled non-malignant precursor cells of the sympatho-adrenal (SA)-lineage, while ADRN cells expressed SA-lineage differentiation genes.

Conclusions: Our results demonstrate that the divergent transcriptional states of cancer cells resemble stages of normal lineage development. Lineage TFs induce transdifferentiation via remodeling of the epigenetic and transcriptional landscapes, mimicking spontaneous interconversion. Plasticity of CRCs and lineage identity may have profound implications for treatment strategies in neuroblastoma.

Citation Format: Johan van Nes, Tim van Groningen, Linda Valentijn, Danny Zwijnenburg, Ellen M. Westerhout, Mohamed Hamdi, Jan Koster, Rogier Versteeg. Plasticity of transcriptional and epigenetic cellular states in neuroblastoma is driven by core lineage transcription factors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3662.

Abstract SY24-02: Neuroblastoma: A developmental twist

Intra-tumor heterogeneity is considered as a source of drug-resistant cells that can escape therapy and form relapses. Several tumor types display a structured intra-tumor heterogeneity, consisting of immature tumor cells and lineage-committed tumor cells. The immature populations of some tumor types have been implicated in drug resistance. The pediatric tumor neuroblastoma includes besides lineage committed adrenergic (ADRN) cells a minority of undifferentiated mesenchymal (MES) tumor cells which diverge in gene expression and epigenetic modifications (van Groningen et al., Nature Genetics 2017). MES cells are relatively resistant to chemotherapy and are enriched in post-treatment samples, suggesting selection and a role in relapse development. However, the co-existence of two tumor cell populations, their differential drug sensitivity and their relation to normal development remain enigmatic. Here we show how MES-type neuroblastoma cells fundamentally differ from ADRN-type cells and resemble normal precursor cells of the adrenergic lineage, including expression of metabolic routes providing resistance to therapy. MES cells and ADRN cells share the same genetic defects, but strongly differ in super enhancers. Each cell type is marked by about 200 specific super enhancers that are absent in the other cell type. Analysis of the genes under their control identified about 20 MES-specific transcription factors and 20 ADRN-specific transcription factors. Chip-seq analysis showed that they conform to a model of MES-specific or ADRN-specific core regulatory circuitries (CRC). Such circuitries were proposed to form a feed-forward system that imposes lineage specification (Hnisz et al., Cell 2012). In agreement with a cell-type specifying role for the CRC, we found that induced expression of MES-specific CRC transcription factors could reprogram ADRN-type cells into MES-type cells. This included a shift towards MES-type super enhancers and expression of associated MES-type genes. Neuroblastoma are tumors of the peripheral adrenergic lineage, which is neural crest derived. MES-type cells lack expression of typical differentiation markers of this lineage, like enzymes for the adrenalin synthesis route TH and DBH. We therefore analyzed whether MES cells resemble precursor cell types of this lineage. Schwann Cell Precursors (SCP) were recently implicated as migratory precursor cells of the adrenergic lineage (Furlan et al., Science 2017). We found that MES cells are highly similar to SCP cells. We therefore analyzed whether the drug resistance of MES cells relate to their normal developmental counterparts. Indeed we observed that the similarity of SCP and MES cells extends to metabolic routes that affect resistance to drugs used in neuroblastoma therapy. Our analyses show that heterogeneity in neuroblastoma is structured and resembles cell types of the normal differentiation program of the adrenergic lineage. MES and ADRN cell types have conserved gene expression programs that determine their response to therapy. MES cells are thereby unresponsive to clinically used therapeutic drugs and may survive therapy. Targeting of lineage-differentiated as well as immature tumor cell types may therefore be a promising strategy to attenuate development of therapy-resistant tumor relapses.

Citation Format: Rogier Versteeg, Linda Valentijn, Jan Koster, Tim van Groningen, Mohamed Hamdi, Ellen Westerhout, Johan van Nes. Neuroblastoma: A developmental twist [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr SY24-02.

A NOTCH feed-forward loop drives reprogramming from adrenergic to mesenchymal state in neuroblastoma

Transition between differentiation states in development occurs swift but the mechanisms leading to epigenetic and transcriptional reprogramming are poorly understood. The pediatric cancer neuroblastoma includes adrenergic (ADRN) and mesenchymal (MES) tumor cell types, which differ in phenotype, super-enhancers (SEs) and core regulatory circuitries. These cell types can spontaneously interconvert, but the mechanism remains largely unknown. Here, we unravel how a NOTCH3 intracellular domain reprogrammed the ADRN transcriptional landscape towards a MES state. A transcriptional feed-forward circuitry of NOTCH-family transcription factors amplifies the NOTCH signaling levels, explaining the swift transition between two semi-stable cellular states. This transition induces genome-wide remodeling of the H3K27ac landscape and a switch from ADRN SEs to MES SEs. Once established, the NOTCH feed-forward loop maintains the induced MES state. In vivo reprogramming of ADRN cells shows that MES and ADRN cells are equally oncogenic. Our results elucidate a swift transdifferentiation between two semi-stable epigenetic cellular states.

Abstract IA10: Neuroblastoma is a biphasic tumor

Neuroblastoma is a pediatric tumor of the peripheral adrenergic lineage, which is neural crest derived. During embryogenesis cells delaminate from the neural crest, migrate ventrally, and differentiate to (nor)-adrenalin producing cells. Neuroblastoma typically expresses differentiation markers of the adrenergic lineage. High-stage neuroblastoma usually goes in complete remission upon therapy but often relapses as resistant disease. Several tumor types were recently found to include phenotypically divergent cell types, resembling lineage development stages. We have found that most neuroblastoma includes two types of tumor cells with shared genomic defects, but highly diverging gene expression profiles. Undifferentiated mesenchymal cells (MES-type) and more differentiated adrenergic cells (ADRN-type) can interconvert and may relate to normal lineage differentiation stages. ChIP-seq analysis of isogenic pairs of MES- and ADRN-type cells revealed distinct, highly consistent super-enhancer landscapes for each cell type. Lineage identity has been proposed to ensue super-enhancer (SE)-associated transcription factor (TF) networks. We identified two SE-associated TF networks that potentially master each cell type. Accordingly, the mesenchymal TF PRRX1 could reprogram the SE- and mRNA-profiles of ADRN-type cells towards an MES-state. Assessment of the clinical relevance of this biphasic system revealed that MES-type cells were more chemoresistant in vitro and were enriched in post-therapy and relapsed tumors. The super enhancer-associated TF networks, probably meant for lineage control in normal development, thus could impose two cellular states of neuroblastoma that shape intratumor heterogeneity.

Citation Format: Rogier Versteeg, Tim van Groningen, Jan Koster, Linda J. Valentijn, Johan van Nes. Neuroblastoma is a biphasic tumor [abstract]. In: Proceedings of the AACR Special Conference: Pediatric Cancer Research: From Basic Science to the Clinic; 2017 Dec 3-6; Atlanta, Georgia. Philadelphia (PA): AACR; Cancer Res 2018;78(19 Suppl):Abstract nr IA10.

Abstract 3876: Active enhancers delineate intra-tumor heterogeneity of developmental states in neuroblastoma

Background: Cellular heterogeneity within tumors is increasingly recognized as a source of therapeutic failure. However, the cis-regulatory landscapes driving transcriptional states of intra-tumor heterogeneity, drug-resistance and relapse remain elusive.

Results: Here, using H3K27Ac chromatin immunoprecipitation followed by sequencing (ChIP-seq) we characterized the active super-enhancer (SE) landscape in neuroblastoma, a pediatric cancer of the sympathetic nervous system. Analysis of differentially active SEs identified cis-regulatory modules associated with distinct transcriptional states in material derived from individual patients. These transcriptional states associated with two phenotypically divergent cellular subtypes.

One subtype is referred to as adrenergic (ADN) and expresses classic neuroblastoma markers from the peripheral sympathetic nervous system. In contrast, the other subtype referred to as mesenchymal (MES) has similarity to neural crest cells, expresses mesenchymal genes, is motile and lacks adrenergic markers. In contrast to ADN cells, MES-type cells are resistant to a wide variety of chemotherapeutics used in clinical management of neuroblastoma.

Computational reconstruction identified core transcription factor modules associated with ADN- and MES-type cells. DNA binding profiles of adrenergic TFs MAML3 and GATA3 suggest feed-forward activation of the adrenergic SE-associated TFs.

Interconversion of FACS-sorted MES- and ADN-type cells is observed in vitro. Induction experiments with the mesenchymal TF PRRX1 efficiently converted ADN-type cells to an induced-MES (iMES) state. These iMES cells acquired many features of MES-cells including motility, mesenchymal gene expression and -histone modifications as well as chemo-resistance.

Primary neuroblastoma biopsies included a small fraction of PRRX1-positive MES-type cells, as determined by immunohistochemistry. Importantly, the proportion of both cell types appears dynamic upon therapy and in relapse development, suggesting selective pressure of treatment.

Conclusions: Here we establish that intra-tumor heterogeneity in neuroblastoma follows a bi-phasic structure characterized by two different SE-associated TF programs that reflects stages of the normal developmental programs. The detailed understanding of core regulatory modules and pathways may redesign strategies for therapeutic intervention.

Citation Format: Johan van Nes, Tim van Groningen, Linda J. Valentijn, Danny Zwijnenburg, Jan J. Molenaar, Bart A. Westerman, Ellen M. Westerhout, Mohamed Hamdi, Godelieve A. Tytgat, Jan Koster, Rogier Versteeg. Active enhancers delineate intra-tumor heterogeneity of developmental states in neuroblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3876. doi:10.1158/1538-7445.AM2017-3876

Neuroblastoma is composed of two super-enhancer-associated differentiation states

Neuroblastoma and other pediatric tumors show a paucity of gene mutations, which has sparked an interest in their epigenetic regulation. Several tumor types include phenotypically divergent cells, resembling cells from different lineage development stages. It has been proposed that super-enhancer-associated transcription factor (TF) networks underlie lineage identity, but the role of these enhancers in intratumoral heterogeneity is unknown. Here we show that most neuroblastomas include two types of tumor cells with divergent gene expression profiles. Undifferentiated mesenchymal cells and committed adrenergic cells can interconvert and resemble cells from different lineage differentiation stages. ChIP-seq analysis of isogenic pairs of mesenchymal and adrenergic cells identified a distinct super-enhancer landscape and super-enhancer-associated TF network for each cell type. Expression of the mesenchymal TF PRRX1 could reprogram the super-enhancer and mRNA landscapes of adrenergic cells toward a mesenchymal state. Mesenchymal cells were more chemoresistant in vitro and were enriched in post-therapy and relapse tumors. Two super-enhancer-associated TF networks, which probably mediate lineage control in normal development, thus dominate epigenetic control of neuroblastoma and shape intratumoral heterogeneity.

Abstract PR08: Neuroblastoma is biphasic and includes classical neuroepithelial cells and chemoresistant mesenchymal cells

Introduction: Most high stage neuroblastoma initially respond to chemotherapy, but ultimately relapse as therapy-resistant tumor. The mechanisms driving relapse and resistance remain elusive. We investigated whether neuroblastoma tumors include phenotypically and functionally divergent subsets of tumor cells that may underlie its clinical plasticity.

Experimental Procedures: Fresh tumor cells were cultured in neural stem cell medium and analyzed by FACS, whole genome sequencing, mRNA profiling, motility assays and chemo-sensitivity assays. Lentivirally transduced inducible gene constructs were used to test state-transitions. Immunohistochemistry was used to define cellular subtypes in tumors.

Results: We observed that new neuroblastoma cell lines always include two phenotypically divergent cell types. Both types share the same genetic defects, but have highly divergent phenotypes. One cell type has a neuro-epithelial (NE) phenotype and expresses all classical and diagnostically used neuroblastoma markers. The other type has a mesenchymal (MES) character, lacks all neuroblastoma markers and is highly motile. At low frequency, both cell types can spontaneously transdifferentiate in vitro. Immunohistochemistry (IHC) of primary neuroblastoma detected a small fraction of MES cells in most tumors.

To analyze the clinical relevance of MES-type cells, we investigated their sensitivity to chemotherapeutics used in neuroblastoma treatment. In four isogenic pairs, MES cells were more resistant to the drugs than their NE-type counterparts. We investigated whether the chemo-resistance of MES cells may operate in vivo. We analyzed a series of primary neuroblastoma tumors surgically removed immediately after chemotherapy. The viable cells in the post-therapy samples were strongly enriched in MES-type cells as compared to the pre-treatment tumors of the same patients. We also compared primary, pre-treatment tumors with relapses emerging 4-5 years later in the same patients. Most strikingly, also the relapsed neuroblastoma tumors were highly enriched for MES-type cells.

As these data suggest a role for MES-type cells in development of therapy-resistant relapses, we analyzed their key regulatory pathways. mRNA profiling of isogenic MES-NE cell line pairs identified consistent mRNA expression differences between both phenotypes. Major signaling routes and transcription factors were highly differentially expressed. MES-type cells had high expression and activation of NOTCH pathway genes and expression of the homeobox gene PRRX1. Induced expression of NOTCH or PRRX1 transgenes in multiple NE-type cell lines converted them into MES-type cell lines, including chemo-resistance. Analysis of the changes in gene expression and activity downstream of NOTCH or PRRX1 allowed reconstruction of the molecular wiring of MES-type cells. This identified several drugable key-players, like MEK and PDGFRβ. Targeting of them with small-molecule inhibitors specifically killed MES cells in vitro.

Conclusions: Our data suggest that neuroblastoma is a bi-phasic tumor. MES and NE cells have very different characteristics, but can transdifferentiate into each other. It is tempting to speculate that the MES- and NE-phenotypes recapitulate two developmental stages of neuroblasts: MES cells may correspond to the migrating cell type that has delaminated from the neural crest, while NE cells could correspond to the more differentiated cell in the target organs expressing markers of the adrenalin synthesis route. MES cells strongly accumulate after chemo-therapy and in relapses. They may survive classical therapy and over time seed relapses, that ultimately become heterogeneous again. Targeted elimination of MES cells with small molecule inhibitors shows how cells with a potential key role in relapse development are amenable to therapy.

This abstract is also presented as Poster B30.

Citation Format: Rogier Versteeg, Tim van Groningen, Bart A. Westerman, Jan J. Molenaar, Ellen M. Westerhout, Mohamed Hamdi, Godelieve A. Tytgat, Jan Koster, Johan van Nes. Neuroblastoma is biphasic and includes classical neuroepithelial cells and chemoresistant mesenchymal cells. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Pediatric Cancer Research: From Mechanisms and Models to Treatment and Survivorship; 2015 Nov 9-12; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(5 Suppl):Abstract nr PR08.

A NOTCH3 transcriptional module induces cell motility in neuroblastoma

PURPOSE

Neuroblastoma is a childhood tumor of the peripheral sympathetic nervous system with an often lethal outcome due to metastatic disease. Migration and epithelial-mesenchymal transitions have been implicated in metastasis but they are hardly investigated in neuroblastoma.

EXPERIMENTAL DESIGN

Cell migration of 16 neuroblastoma cell lines was quantified in Transwell migration assays. Gene expression profiling was used to derive a migration signature, which was applied to classify samples in a neuroblastoma tumor series. Differential expression of transcription factors was analyzed in the subsets. NOTCH3 was prioritized, and inducible transgene expression studies in cell lines were used to establish whether it functions as a master switch for motility.

RESULTS

We identified a 36-gene expression signature that predicts cell migration. This signature was used to analyse expression profiles of 88 neuroblastoma tumors and identified a group with distant metastases and a poor prognosis. This group also expressed a known mesenchymal gene signature established in glioblastoma. Neuroblastomas recognized by the motility and mesenchymal signatures strongly expressed genes of the NOTCH pathway. Inducible expression of a NOTCH intracellular (NOTCH3-IC) transgene conferred a highly motile phenotype to neuroblastoma cells. NOTCH3-IC strongly induced expression of motility- and mesenchymal marker genes. Many of these genes were significantly coexpressed with NOTCH3 in neuroblastoma, as well as colon, kidney, ovary, and breast tumor series.

CONCLUSION

The NOTCH3 transcription factor is a master regulator of motility in neuroblastoma. A subset of neuroblastoma with high expression of NOTCH3 and its downstream-regulated genes has mesenchymal characteristics, increased incidence of metastases, and a poor prognosis.

LIN28B induces neuroblastoma and enhances MYCN levels via let-7 suppression

LIN28B regulates developmental processes by modulating microRNAs (miRNAs) of the let-7 family. A role for LIN28B in cancer has been proposed but has not been established in vivo. Here, we report that LIN28B showed genomic aberrations and extensive overexpression in high-risk neuroblastoma compared to several other tumor entities and normal tissues. High LIN28B expression was an independent risk factor for adverse outcome in neuroblastoma. LIN28B signaled through repression of the let-7 miRNAs and consequently resulted in elevated MYCN protein expression in neuroblastoma cells. LIN28B-let-7-MYCN signaling blocked differentiation of normal neuroblasts and neuroblastoma cells. These findings were fully recapitulated in a mouse model in which LIN28B expression in the sympathetic adrenergic lineage induced development of neuroblastomas marked by low let-7 miRNA levels and high MYCN protein expression. Interference with this pathway might offer therapeutic perspectives.

Sequencing of neuroblastoma identifies chromothripsis and defects in neuritogenesis genes

Neuroblastoma is a childhood tumour of the peripheral sympathetic nervous system. The pathogenesis has for a long time been quite enigmatic, as only very few gene defects were identified in this often lethal tumour. Frequently detected gene alterations are limited to MYCN amplification (20%) and ALK activations (7%). Here we present a whole-genome sequence analysis of 87 neuroblastoma of all stages. Few recurrent amino-acid-changing mutations were found. In contrast, analysis of structural defects identified a local shredding of chromosomes, known as chromothripsis, in 18% of high-stage neuroblastoma. These tumours are associated with a poor outcome. Structural alterations recurrently affected ODZ3, PTPRD and CSMD1, which are involved in neuronal growth cone stabilization. In addition, ATRX, TIAM1 and a series of regulators of the Rac/Rho pathway were mutated, further implicating defects in neuritogenesis in neuroblastoma. Most tumours with defects in these genes were aggressive high-stage neuroblastomas, but did not carry MYCN amplifications. The genomic landscape of neuroblastoma therefore reveals two novel molecular defects, chromothripsis and neuritogenesis gene alterations, which frequently occur in high-risk tumours.

The Cdx4 mutation affects axial development and reveals an essential role of Cdx genes in the ontogenesis of the placental labyrinth in mice

Caudal related homeobox (Cdx) genes have so far been shown to be important for embryonic axial elongation and patterning in several vertebrate species. We have generated a targeted mutation of mouse Cdx4, the third member of this family of transcription factor encoding genes and the last one to be inactivated genetically. Cdx4-null embryos were born healthy and appeared morphologically normal. A subtle contribution of Cdx4 to anteroposterior (AP) vertebral patterning was revealed in Cdx1/Cdx4 and Cdx2/Cdx4 compound mutants. Neither Cdx4-null nor Cdx1/Cdx4 double mutants are impaired in their axial elongation, but a redundant contribution of Cdx4 in this function was unveiled when combined with a Cdx2 mutant allele. In addition, inactivation of Cdx4 combined with heterozygous loss of Cdx2 results in embryonic death around E10.5 and reveals a novel function of Cdx genes in placental ontogenesis. In a subset of Cdx2/Cdx4 compound mutants, the fully grown allantois failed to fuse with the chorion. The remaining majority of these mutants undergo successful chorio-allantois fusion but fail to properly extend their allantoic vascular network into the chorionic ectoderm and do not develop a functional placental labyrinth. We present evidence that Cdx4 plays a crucial role in the ontogenesis of the allantoic component of the placental labyrinth when one Cdx2 allele is inactivated. The axial patterning role of Cdx transcription factors thus extends posteriorly to the epiblast-derived extra-embryonic mesoderm and, consequent upon the evolution of placental mammals, is centrally involved in placental morphogenesis. The relative contribution of Cdx family members in the stepwise ontogenesis of a functional placenta is discussed, with Cdx2 playing an obligatory part, assisted by Cdx4. The possible participation of Cdx1 was not documented but cannot be ruled out until allelic combinations further decreasing Cdx dose have been analyzed. Cdx genes thus operate in a redundant way during placentogenesis, as they do during embryonic axial elongation and patterning, and independently from the previously reported early Cdx2-specific role in the trophectoderm at implantation.

Developmental regulation of the Hox genes during axial morphogenesis in the mouse

The Hox genes confer positional information to the axial and paraxial tissues as they emerge gradually from the posterior aspect of the vertebrate embryo. Hox genes are sequentially activated in time and space, in a way that reflects their organisation into clusters in the genome. Although this co-linearity of expression of the Hox genes has been conserved during evolution, it is a phenomenon that is still not understood at the molecular level. This review aims to bring together recent findings that have advanced our understanding of the regulation of the Hox genes during mouse embryonic development. In particular, we highlight the integration of these transducers of anteroposterior positional information into the genetic network that drives tissue generation and patterning during axial elongation.