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The Role of SOX9 in Medulloblastoma
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. (Swartling)
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Medulloblastoma (MB) is the most common malignant pediatric brain tumor. Overall survival is about 70% and in cases where current treatment fails, the disease recurs and most often is fatal. At the molecular level, MB can be divided into four defined subgroups: WNT, SHH, Group 3 and Group 4. Amplification of MYC family genes is common in MB and correlates with poor prognosis and tumor relapse.

In this thesis we showed how MYCN initiates brain tumors when transduced in neural stem cells (NSCs). Prior to transduction, NSCs were isolated from different brain regions and at various time points. While overexpression of wild-type MYCN did not generate any tumors, orthotopic transplantation of MYCNT58A-expressing forebrain, brain stem and cerebellar NSCs induced diffuse malignant glioma, PNET-like tumors and MB, respectively. Interestingly, MYCNT58A-expressing cerebellar NSCs induced SHH-dependent MB from embryonic cells but SHH-independent MB from postnatal cells. We further showed that cerebellar NSCs transduced with both MYCNT58A and transcription factor SOX9 developed tumors faster and promoted distant migration into the forebrain.

The function and regulation of SOX9 in MB cells is poorly understood. We identified SOX9 protein as target of FBW7 ubiquitin ligase and demonstrated the effects of SOX9 on MB cells migration, metastasis and drug resistance. We further blocked PI3K pathway to destabilize SOX9 which sensitized cells to cytostatic treatment.

We used a (TetOFF) transgenic mouse model of MYCN-induced MB (GTML) and crossed it with a (TetON) transgene which allowed us to specifically target rare SOX9-positive cells in the tumor. In this system, MB develops spontaneously and SOX9-negative tumor cells can be killed off by doxycycline. The few remaining SOX9-positive cancer cells were able to promote distant MB recurrences. Such a pattern of relapse was recently shown for Group 3 and 4 human MB where about 90% of the recurrences were distant.

In summary, this thesis demonstrates that MYCN can generate various types of brain tumors depending on the timing and location of its expression. It further defines the existence of a rare population of SOX9-expressing MB cells that are involved in causing distant MB recurrences. Finally, it describes how SOX9 is stabilized in MB cells and increases MB migration and therapy resistance.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. , 39 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1175
Keyword [en]
Medulloblastoma, SOX9, MYCN, cancer development, recurrence, regulation, tumor metastasis, migration
National Category
Cell and Molecular Biology Cancer and Oncology Pediatrics
Research subject
Medical Science
URN: urn:nbn:se:uu:diva-274630ISBN: 978-91-554-9461-2 (print)OAI: diva2:897227
Public defence
2016-03-11, Rudbecksalen, Dag Hammarskjоlds vаg 20, Uppsala, 09:15 (English)
Available from: 2016-02-18 Created: 2016-01-24 Last updated: 2016-03-09
List of papers
1. Distinct Neural Stem Cell Populations Give Rise to Disparate Brain Tumors in Response to N-MYC
Open this publication in new window or tab >>Distinct Neural Stem Cell Populations Give Rise to Disparate Brain Tumors in Response to N-MYC
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2012 (English)In: Cancer Cell, ISSN 1535-6108, E-ISSN 1878-3686, Vol. 21, no 5, 601-613 p.Article in journal (Refereed) Published
Abstract [en]

The proto-oncogene MYCN is mis-expressed in various types of human brain tumors. To clarify how developmental and regional differences influence transformation, we transduced wild-type or mutationally stabilized murine N-myc(T58A) into neural stem cells (NSCs) from perinatal murine cerebellum, brain stem, and forebrain. Transplantation of N-myc(WT) NSCs was insufficient for tumor formation. N-myc(T58A) cerebellar and brain stem NSCs generated medulloblastoma/primitive neuroectodermal tumors, whereas forebrain NSCs developed diffuse glioma. Expression analyses distinguished tumors generated from these different regions, with tumors from embryonic versus postnatal cerebellar NSCs demonstrating Sonic Hedgehog (SHH) dependence and SHH independence, respectively. These differences were regulated in part by the transcription factor SOX9, activated in the SHH subclass of human medulloblastoma. Our results demonstrate context-dependent transformation of NSCs in response to a common oncogenic signal.

National Category
Medical and Health Sciences
urn:nbn:se:uu:diva-176237 (URN)10.1016/j.ccr.2012.04.012 (DOI)000304214100005 ()
Available from: 2012-06-19 Created: 2012-06-18 Last updated: 2017-12-07Bibliographically approved
2. FBW7 suppression leads to SOX9 stabilization and increased malignancy in medulloblastoma
Open this publication in new window or tab >>FBW7 suppression leads to SOX9 stabilization and increased malignancy in medulloblastoma
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2016 (English)In: EMBO Journal, ISSN 0261-4189, E-ISSN 1460-2075, Vol. 35, no 20, 2192-2212 p.Article in journal (Refereed) Published
Abstract [en]

SOX9 is a master transcription factor that regulates development and stem cell programs. However, its potential oncogenic activity and regulatory mechanisms that control SOX9 protein stability are poorly understood. Here, we show that SOX9 is a substrate of FBW7, a tumor suppressor, and a SCF (SKP1/CUL1/F-box)-type ubiquitin ligase. FBW7 recognizes a conserved degron surrounding threonine 236 (T236) in SOX9 that is phosphorylated by GSK3 kinase and consequently degraded by SCFFBW7 alpha. Failure to degrade SOX9 promotes migration, metastasis, and treatment resistance in medulloblastoma, one of the most common childhood brain tumors. FBW7 is either mutated or downregulated in medulloblastoma, and in cases where FBW7 mRNA levels are low, SOX9 protein is significantly elevated and this phenotype is associated with metastasis at diagnosis and poor patient outcome. Transcriptional profiling of medulloblastoma cells expressing a degradation-resistant SOX9 mutant reveals activation of pro-metastatic genes and genes linked to cisplatin resistance. Finally, we show that pharmacological inhibition of PI3K/AKT/mTOR pathway activity destabilizes SOX9 in a GSK3/FBW7-dependent manner, rendering medulloblastoma cells sensitive to cytostatic treatment.

FBW7, SOX9, Medulloblastoma, FBXW7, ubiquitin, migration, metastasis, drug resistance
National Category
Cell and Molecular Biology
urn:nbn:se:uu:diva-274626 (URN)10.15252/embj.201693889 (DOI)000385708000004 ()
Swedish Childhood Cancer FoundationSwedish Cancer SocietySwedish Research CouncilEU, European Research Council, 640275Ragnar Söderbergs stiftelseSwedish Society of MedicineÅke Wiberg FoundationScience for Life Laboratory - a national resource center for high-throughput molecular bioscienceThe Karolinska Institutet's Research Foundation

Aldwin Suryo Rahmanto and Vasil Savov contributed equally to this work as first authors

Andrä Brunner, Sara Bolin and Holger Weishaupt contributed equally to this work as second authors

Fredrik J Swartling and Olle Sangfelt contributed equally to this work as corresponding authors

Available from: 2016-01-24 Created: 2016-01-24 Last updated: 2017-11-30Bibliographically approved
3. Metastasis and tumor recurrence from rare SOX9-positive cells in MYCN-driven medulloblastoma
Open this publication in new window or tab >>Metastasis and tumor recurrence from rare SOX9-positive cells in MYCN-driven medulloblastoma
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(English)Manuscript (preprint) (Other academic)
SOX9, medulloblastoma, relapse, recurrence, MYCN, mouse model, pediatric cancer
National Category
Cell and Molecular Biology Cancer and Oncology Pediatrics
urn:nbn:se:uu:diva-274629 (URN)
Available from: 2016-01-24 Created: 2016-01-24 Last updated: 2016-09-18

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