Abstract
Abstract Diffuse intrinsic pontine glioma (DIPG) is one of the most devastating childhood cancers that limited response to radiation therapy, resulting in median overall survival of approximately 10 months. There is a critical need for new therapeutics that enhance the radiation effect while enabling the use of lower doses of radiation to limit long-term side effects in young patients. We, therefore, tested the hypothesis that targeting RAD52 activity sensitizes the radiation response of DIPG. Genome-wide CRISPR/Cas9 screening identified RAD52 as potential therapeutic target in DIPG cells. RAD52 inhibition, using shRNA mediated RAD52 depletion and treatment with RAD52 inhibitor, D-I03, suppressed DIPG cell proliferation. Importantly, RAD52 inhibition in combination with radiation therapy further increased radiosensitivity of DIPG cells. Immunocytochemistry of DNA double-strand breaks (DSB) marker γH2AX and repair marker 53BP1 showed that RAD52 inhibition sustained DNA damage with high levels of γH2AX at 24 hours following radiation while the level of 53BPI was decreased, thereby inhibiting DNA DSB repair. Western blotting also revealed that RAD52 inhibition causes a sustained level of phosphorylated Rad50 and γH2AX in irradiated DIPG cells. DNA repair assay showed that RAD52 inhibition suppressed DNA DSB repair through a homologous recombination pathway. RNA sequencing showed that RAD52 inhibition downregulated genes associated with the DNA repair pathway. Finally, the combination therapy of D-I03 RAD52 inhibitor and radiation inhibited tumor growth and significantly increased survival of mice bearing DIPG patient-derived xenografts, outperforming either monotherapy. Together, these results highlight RAD52 inhibitor as a potential radiosensitizer and provide a rationale for developing combination therapy with radiation in the treatment of DIPG.
Accepted Version
Published Version
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