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ELF3 suppresses gallbladder cancer development through downregulation of the EREG/EGFR/mTOR complex 1 signalling pathway

Nakamura, Takeharu Nishikawa, Yoshihiro Shiokawa, Masahiro Takeda, Haruhiko Yokode, Masataka Matsumoto, Shimpei Muramoto, Yuya Ota, Sakiko Yoshida, Hiroyuki Okada, Hirokazu Kuwada, Takeshi Marui, Saiko Matsumori, Tomoaki Maruno, Takahisa Uza, Norimitsu Kodama, Yuzo Hatano, Etsuro Seno, Hiroshi 京都大学 DOI:10.1002/path.6144

2023.09

概要

The prognosis of gallbladder cancer (GBC) remains poor, and a better understanding of GBC molecular mechanisms is important. Genome sequencing of human GBC has demonstrated that loss-of-function mutations of E74-like ETS transcription factor 3 (ELF3) are frequently observed, with ELF3 considered to be a tumour suppressor in GBC. To clarify the underlying molecular mechanisms by which ELF3 suppresses GBC development, we performed in vivo analysis using a combination of autochthonous and allograft mouse models. We first evaluated the clinical significance of ELF3 expression in human GBC tissues and found that low ELF3 expression was associated with advanced clinical stage and deep tumour invasion. For in vivo analysis, we generated Pdx1-Cre; KrasG12D; Trp53R172H; Elf3f/f (KPCE) mice and Pdx1-Cre; KrasG12D; Trp53R172H; Elf3wt/wt (KPC) mice as a control and analysed their gallbladders histologically. KPCE mice developed larger papillary lesions in the gallbladder than those developed by KPC mice. Organoids established from the gallbladders of KPCE and KPC mice were analysed in vitro. RNA sequencing showed upregulated expression of epiregulin (Ereg) in KPCE organoids, and western blotting revealed that EGFR/mechanical targets of rapamycin complex 1 (mTORC1) were upregulated in KPCE organoids. In addition, ChIP assays on Elf3-overexpressing KPCE organoids showed that ELF3 directly regulated Ereg. Ereg deletion in KPCE organoids (using CRISPR/Cas9) induced EGFR/mTORC1 downregulation, indicating that ELF3 controlled EGFR/mTORC1 activity through regulation of Ereg expression. We also generated allograft mouse models using KPCE and KPC organoids and found that KPCE organoid allograft tumours exhibited poorly differentiated structures with mTORC1 upregulation and mesenchymal phenotype, which were suppressed by Ereg deletion. Furthermore, EGFR/mTORC1 inhibition suppressed cell proliferation and epithelial–mesenchymal transition in KPCE organoids. Our results suggest that ELF3 suppresses GBC development via downregulation of EREG/EGFR/mTORC1 signalling. EGFR/mTORC1 inhibition is a potential therapeutic option for GBC with ELF3 mutation. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

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J Pathol 2023; 261: 28–42

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SUPPLEMENTARY MATERIAL ONLINE

Supplementary materials and methods

Figure S1. Gene recombination in extrahepatic biliary epithelial cells confirmed using X-gal staining in biliary tract of Pdx1-Cre; Rosa26LSL-LacZ mice

Figure S2. ELF3 is not essential for development and maintenance of extrahepatic biliary tract in mice

Figure S3. Elf3 deletion does not cause tumour formation in gallbladder in context of Trp53 mutation in mice

Figure S4. Genotyping and RT-qPCR analysis for verification of origin of organoids

Figure S5. EGFR signalling regulates mTORC1 activity through PI3K/AKT and AMPK

Figure S6. Dedifferentiation and epithelial–mesenchymal transition (EMT) are induced in KPCE allograft tumour cells in vitro

Figure S7. EGFR/mTORC1 inhibition suppresses cell proliferation and EMT in KPCE organoids

Figure S8. Gene sets related to EGFR, mTOR, and EMT are significantly enriched in human GBC tissues with ELF3 mutations

Table S1. Clinical information of 85 patients with GBC

Table S2. Antibodies for IHC, western blotting, and ChIP assay used in this study

Table S3. Primer sets for RT-qPCR, ChIP, and genotyping analyses used in this study

© 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd

on behalf of The Pathological Society of Great Britain and Ireland. www.pathsoc.org

J Pathol 2023; 261: 28–42

www.thejournalofpathology.com

10969896, 2023, 1, Downloaded from https://pathsocjournals.onlinelibrary.wiley.com/doi/10.1002/path.6144 by Cochrane Japan, Wiley Online Library on [19/09/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

T Nakamura et al

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