Abstract

BackgroundMedulloblastoma (MB) is the most common malignant brain tumor in children. Current problems in the clinic include metastasis, recurrence, and treatment-related sequelae that highlight the need for targeted therapies. Epigenetic perturbations are an established hallmark of human MB and expression of Lysine Specific Demethylase 1 (LSD1) is elevated in MBs compared to normal tissue, suggesting that LSD1 inhibitors may have efficacy against human MB tumors.MethodsExpression of LSD1 was examined across a publicly-available database and correlated with patient outcomes. Sonic Hedgehog (SHH) MB samples were clustered based on expression of LSD1 and LSD1-associated RE-1 silencing transcription factor (REST) target genes as well as genes involved in metastasis. Resulting clusters were examined for patient outcomes associated with LSD1 and REST expression. Human SHH MB cell lines were transduced with a REST-transgene to create isogenic cell pairs. In vitro viability and cell migration assays were used to examine the effect of LSD1 knockdown or inhibition on these parameters.ResultsWe demonstrate that subsets of SHH MB tumors have elevated LSD1 expression coincident with increased expression of its deubiquitylase, USP7, and REST. Patients with co-elevation of USP7, REST, and LSD1 have poorer outcomes compared to those with lower expression of these genes. In SHH MB cell lines, REST elevation increased cell growth and LSD1 protein levels. Surprisingly, while genetic loss of LSD1 reduced cell viability, pharmacological targeting of its activity using LSD1 inhibitors did not affect cell viability. However, a reduction in REST-dependent cell migration was seen in wound healing, suggesting that REST-LSD1 interaction regulates cell migration. Ingenuity pathway analyses validated these findings and identified Hypoxia Inducible Factor 1 alpha (HIF1A) as a potential target. In line with this, ectopic expression of HIF1A rescued the loss of migration seen following LSD1 inhibition.ConclusionsA subset of SHH patients display increased levels of LSD1 and REST, which is associated with poor outcomes. REST elevation in MB in conjunction with elevated LSD1 promotes MB cell migration. LSD1 inhibition blocks REST-dependent cell migration of MB cells in a HIF1A-dependent manner.

Highlights

  • Medulloblastoma (MB) is the most common malignant brain tumor in children

  • Analysis of patient samples based on Lysine Specific Demethylase 1 (LSD1) expression and activity To investigate subgroup-specific differences in LSD1 gene expression, we examined a publicly available dataset (GSE85217) of 763 MB tumor samples

  • Previous studies have shown that histone H3K4 methylation is perturbed in Sonic hedgehog (SHH) MB, we did not see significant differences in survival based on LSD1 expression alone [28]

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Summary

Introduction

Medulloblastoma (MB) is the most common malignant brain tumor in children. Current problems in the clinic include metastasis, recurrence, and treatment-related sequelae that highlight the need for targeted therapies. MB is currently classified into 4 molecular subgroups: Wingless (WNT), Sonic hedgehog (SHH), Group 3, and Group 4 [1]. Approximately 20% and 30% of all patients with SHH and Group 3 tumors, respectively, present with metastasis [2, 5]. For these patients, the current standard of care is not curative and frequently results in unnecessary neurological toxicity. The current standard of care is not curative and frequently results in unnecessary neurological toxicity It is for these subsets of patients that the need for personalized and targeted therapy is dire

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