Abstract
Nontuberculous mycobacterial lung disease (NTM), including Mycobacterium avium complex (MAC), is a growing health problem in North America and worldwide. Little is known about the molecular alterations occurring in the tissue microenvironment during NTM pathogenesis. Utilizing next generation sequencing, we sequenced sputum and matched lymphocyte DNA in 15 MAC patients for a panel of 19 genes known to harbor cancer susceptibility associated mutations. Thirteen of 15 NTM subjects had a diagnosis of breast cancer (BCa) before or after NTM infection. Thirty three percent (4/12) of these NTM-BCa cases exhibited at least 3 somatic mutations in sputa compared to matched lymphocytes. Twenty four somatic mutations were detected with at least one mutation in ATM, ERBB2, BARD1, BRCA1, BRCA2, AR, TP53, PALB2, CASP8, BRIP1, NBN and TGFB1 genes. All four NTM-BCa patients harboring somatic mutations also exhibited 15 germ line BRCA1 and BRCA2 mutations. The two NTM subjects without BCa exhibited twenty somatic mutations spanning BRCA1, BRCA1, BARD1, BRIP1, CHEK2, ERBB2, TP53, ATM, PALB2, TGFB1 and 3 germ line mutations in BRCA1 and BRCA2 genes. A single copy loss of STK11 and AR gene was noted in NTM-BCa subjects. Periodic screening of sputa may aid to develop risk assessment biomarkers for neoplastic diseases in NTM patients.
Highlights
Generation sequencing is a powerful tool for detecting molecular abnormalities in tissues and body fluids and guiding biomarker and therapeutic development in various diseases including cancer
Thirty three percent (4/12) of these Nontuberculous mycobacterial lung disease (NTM)-breast cancer (BCa) cases has been detected with 24 somatic mutations with at least one mutation in ATM, ERBB2, BARD1, BRCA1, BRCA2, Androgen Receptor gene (AR), TP53, PALB2, CASP8, BRIP1, NBN and TGFB1 genes
Four out of these thirteen subjects were detected with NTM disease first and BCa within a period of 4–6 years (Table 1)
Summary
Generation sequencing is a powerful tool for detecting molecular abnormalities in tissues and body fluids and guiding biomarker and therapeutic development in various diseases including cancer. Thirty three percent (4/12) of these NTM-BCa cases has been detected with 24 somatic mutations with at least one mutation in ATM, ERBB2, BARD1, BRCA1, BRCA2, AR, TP53, PALB2, CASP8, BRIP1, NBN and TGFB1 genes. Numerous (N = 15) germ line BRCA1 and BRCA2 mutations were detected in these four subjects. The two NTM subjects with no history of BCa exhibited 20 somatic mutations spanning BRCA1, BRCA1, BARD1, BRIP1, CHEK2, ERBB2, TP53, ATM, PALB2, and TGFB1 and 3 germ line mutations in BRCA1 and BRCA2 genes. In addition to genomic mutations, copy number loss in STK11, AR gene was evident in one NTM subject with BCa
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