Journal: Clinical cancer research : an official journal of the American Association for Cancer Research
Article Title: NRF2 activation promotes aggressive lung cancer and associates with poor clinical outcomes
doi: 10.1158/1078-0432.CCR-20-1985
Figure Lengend Snippet: (A) Representative high-magnification images of murine lungs at 7 weeks post adeno-Cre infection for each genotype. Blue Arrow: Atypical adenomatous hyperplasia; Blue Star: Solid adenoma; Red Arrow: Acinar carcinoma with mucous containing neoplastic cells; Yellow Star: Mucous present within gland lumen and airways; Green Cross: Papillary carcinoma. By 6–12 weeks, KrasLSL-G12D mice had only developed coalescing areas of AAH (blue arrow), while Keap1fl/flKrasLSL-G12D mice developed more extensive AAH, with a single Keap1fl/flKrasLSL-G12D mouse developing an adenoma (blue star) and 4/6 (66%) developing non-mucinous BEH. Stk11fl/flKrasLSL-G12D mice showed evidence of mucinous differentiation with large goblet cells (red arrow) and abundant wispy basophilic mucinous material in the alveolar spaces (yellow star). Unique among triple mutant lungs was the presence of intra-bronchiolar papillary carcinomas comprised of a fibrovascular core, long papillary fronds extending into the bronchiole lumen and loaded with abundant viscous mucus. (B) Representative images from 6–7-week old KrasLSL-G12 , Keapfl/flKrasLSL-G12D, Stk11fl/flKrasLSL-G12D and Keapfl/flStk11fl/flKrasLSL-G12D lungs stained with Alcian Blue/PAS to assess mucin production. The KrasLSL-G12D and Keapfl/flKrasLSL-G12D images display non-mucinous atypical epithelial hyperplasia, the Stk11fl/flKrasLSL-G12D image is of a carcinoma with mucinous differentiation and the Keapfl/flStk11fl/flKrasLSL-G12D image displays marked bronchiolar epithelial hyperplasia with mucinous differentiation. (C) Expression of Nkx2–1 and mucinous markers in murine lungs. High expression levels are shown in red; low levels in blue. The 16 murine lung samples are annotated by their Keap1 and Stk11 status. (D) The average expression of mucinous genes MUC5AC, MUC5B and AGR2 (mucinous signature score) in function of genotype in TCGA LUAD tumors. Tumors are grouped by STK11 and/or KEAP1/NRF2 alteration, independent of KRAS status. According to a multivariate linear model of mucinous marker expression as a function of STK11, KEAP1/NRF2, and KRAS status, both KEAP1/NRF2 and KRAS alterations are significantly associated with mucinous marker expression (p = 0.033 and 0.014, respectively), but the effect of STK11 loss is dominant (p = 5e-5). (E) NKX2–1 expression in function of genotype in TCGA LUAD tumors. Tumors are grouped by STK11 and/or KEAP1/NRF2 alteration, independent of KRAS status. (F) Flow cytometry-based assessment of ROS levels in dissociated mouse lung epithelium tumor cells (CD45−EpCAM+) using carboxy-H2DCFDA dye, graphed as percent of CD45−EpCAM+ (n=5). (G) Determination of oxidative stress levels in lungs from different genotypes. The TBARS (Thiobarbituric Acid Reactive Substances) assay was used to measure malondialdehyde levels, a marker of lipid peroxidation and resultant oxidative stress (n=7–8). (H) 4-hydroxynonenal (4HNE), a common byproduct of lipid peroxidation during oxidative stress, was measured in lung tissue homogenates by ELISA (n=7–8). (I) Estimation of total GSH levels in lungs from mice with different genotypes (n=6–8). Statistical analyses represent One-way ANOVA: *p<0.05, **p<0.01, ***p<0.001, ****p<0.0001.
Article Snippet: TCGA RNA-sequencing, Affymetrix SNP6 copy number, and whole exome-sequencing data for 439 lung adenocarcinoma (LUAD) ( 7 ) and 306 lung squamous cell carcinoma (LUSC) ( 24 ) tumors are from the National Cancer Institute Genomic Data Commons ( https://gdc.cancer.gov ).
Techniques: Infection, Mutagenesis, Staining, Expressing, Marker, Flow Cytometry, Enzyme-linked Immunosorbent Assay