Abstract

Primary cilia are sensory organelles involved in regulation of cellular signaling. Cilia loss is frequently observed in tumors; yet, the responsible mechanisms and consequences for tumorigenesis remain unclear. We demonstrate that cilia structure and function is disrupted in human pheochromocytomas – endocrine tumors of the adrenal medulla. This is concomitant with transcriptional changes within cilia-mediated signaling pathways that are associated with tumorigenesis generally and pheochromocytomas specifically. Importantly, cilia loss was most dramatic in patients with germline mutations in the pseudohypoxia-linked genes SDHx and VHL. Using a pheochromocytoma cell line derived from rat, we show that hypoxia and oncometabolite-induced pseudohypoxia are key drivers of cilia loss and identify that this is dependent on activation of an Aurora-A/HDAC6 cilia resorption pathway. We also show cilia loss drives dramatic transcriptional changes associated with proliferation and tumorigenesis. Our data provide evidence for primary cilia dysfunction contributing to pathogenesis of pheochromocytoma by a hypoxic/pseudohypoxic mechanism and implicates oncometabolites as ciliary regulators. This is important as pheochromocytomas can cause mortality by mechanisms including catecholamine production and malignant transformation, while hypoxia is a general feature of solid tumors. Moreover, pseudohypoxia-induced cilia resorption can be pharmacologically inhibited, suggesting potential for therapeutic intervention.

Highlights

  • Pheochromocytomas (PCCs) are neuroendocrine tumors that originate from chromaffin cells of the adrenal medulla or autonomic nervous system, where they are termed paragangliomas (PGLs)

  • We demonstrate that primary cilia loss is a feature of PCC/PGL and in particular those that are driven by germline mutations in pseudohypoxia-linked genes

  • We show that knockdown of pseudohypoxiacausing PCC/PGL genes and treatment with inhibitors that trigger accumulation of oncometabolites result in primary cilia loss

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Summary

Introduction

Pheochromocytomas (PCCs) are neuroendocrine tumors that originate from chromaffin cells of the adrenal medulla or autonomic nervous system, where they are termed paragangliomas (PGLs). Recent analyses of germline and somatic mutations have classified PCC/PGL into four molecularly defined groups, including a pseudohypoxia-linked subtype (Fishbein et al 2017) These pseudohypoxic tumors occur due to mutations that impact regulation of the hypoxia transcription factors HIF1α and HIF2α. Increased HIF activity results from germline mutation in genes that encode the succinate dehydrogenase (SDH) complex subunits (SDHA, SDHB, SDHC, SDHD), succinate dehydrogenase complex assembly factor 2 (SDHAF2), fumarate hydratase (FH) and malate dehydrogenase (MDH2) (Fishbein & Nathanson 2012) This is because loss of their function leads to accumulation of oncometabolites that inhibit pVHL-mediated degradation of HIFα (Selak et al 2005)

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