Abstract

De novo expressed CD44 isoforms containing exon-v6 are frequently associated with gastric cancer (GC) aggressiveness, and may predict chemotherapy response in vitro. Whether exon-v6 itself is responsible for conferring these properties to CD44v6-containing isoforms remains to be elucidated. CRISPR/Cas9 and Phosphorodiamidate Morpholino oligomers (PMOs) were used to induce specific exon-v6 skipping, maintaining the CD44 reading frame, in two GC cell lines endogenously expressing CD44v6. Cisplatin and 5-fluorouracil treatment response, and self-renewal ability was compared between CRISPR/Cas9-edited, CD44v6 knockdown and mock cells. We obtained homozygous genome-edited cell lines with exon-v6 deletion. Edited cells transcribed CD44v isoforms presenting in frame v5–v7 splicing, mimicking exon-v6 skipping. Results showed that removing specifically exon-v6 sensitizes cells to cisplatin and impairs cells’ self-renewal ability, similarly to CD44v6 knockdown. In parallel, we also tested a clinically feasible approach for transient exon-v6 skipping with a PMO-based strategy. We demonstrate that exon-v6 specific removal from CD44v isoforms increases cell sensitivity to cisplatin and impairs GC cells self-renewal. We trust that a PMO approach designed towards CD44v6 overexpressing GC cells may be a suitable approach to sensitize tumor cells for conventional therapy.

Highlights

  • Gastric cancer (GC), the third leading cause of cancer-related death worldwide, is often diagnosed in advanced/unresectable stages, where patients are treated with conventional chemotherapy and have an expected survival of only 1 year [1]

  • We aimed at understanding if the presence of exon-v6 in CD44v isoforms may affect GC

  • We established a CRISPR/Cas9 strategy to target the adjacent areas of exon-v6 (Figure 1A), by designing single guide RNAs (g1–g6) in the exon-v6 vicinity (Figure 1B,C), to achieve exon-v6 skipping

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Summary

Introduction

Gastric cancer (GC), the third leading cause of cancer-related death worldwide, is often diagnosed in advanced/unresectable stages, where patients are treated with conventional chemotherapy and have an expected survival of only 1 year [1]. CD44 is a family of glycoproteins encoded by CD44 gene (locus 11p13) [2,3], that mediate cell-cell and cell-matrix contact essential for tissue integrity and maintenance. Human CD44 gene (NG_008937) is composed of two terminal constitutively expressed portions (exons 1–5/16–18/20), and in between, by different combinations of alternatively spliced exons (exons 7–15/v2–v10) [2,4,5]. CD44v6-containing isoforms encompass a group of isoforms, including variant exon-6 (v6) [3,6], a cancer stem cell (CSC) marker widely associated with poorer patient prognosis, increased invasion, metastization and drug resistance in several cancers, including GC [7,8,9,10,11,12]. Blockade of CD44v6 delays tumor growth and metastization in several in vivo models of pancreatic [13] and colorectal

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