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Integrative genetic, epigenetic and pathological analysis of paraganglioma reveals complex dysregulation of NOTCH signaling |
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| Authors: | Alessandro Cama Fabio Verginelli Lavinia Vittoria Lotti Francesco Napolitano Annalisa Morgano Andria D’Orazio Michele Vacca Silvia Perconti Felice Pepe Federico Romani Francesca Vitullo Filippo di Lella Rosa Visone Massimo Mannelli Hartmut P. H. Neumann Giancarlo Raiconi Carlo Paties Antonio Moschetta Roberto Tagliaferri Angelo Veronese Mario Sanna Renato Mariani-Costantini |
| Affiliation: | 1. Unit of General Pathology, Aging Research Center (Ce.S.I.), G. d’Annunzio University Foundation, Via Colle dell’Ara, 66100, Chieti, Italy 2. Department of Pharmacy, G. d’Annunzio University, Via dei Vestini 1, 66100, Chieti, Italy 3. Department of Experimental Medicine, University La Sapienza, Viale Regina Elena 324, 00161, Rome, Italy 4. NeuRoNe Lab, Department of Informatics, University of Salerno, Via Ponte Don Melillo, 84084, Fisciano, Salerno, Italy 5. Laboratory of Lipid Metabolism and Cancer, Department of Translational Pharmacology, Consorzio Mario Negri Sud, Via Nazionale 8/A, 66030, Santa Maria Imbaro, Chieti, Italy 6. IRCCS National Cancer Research Center Giovanni Paolo II, Viale Orazio Flacco 65, 70124, Bari, Italy 7. Gruppo Otologico, Via Emmanueli 42, 29100, Piacenza, Italy 8. Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University, Via dei Vestini 1, 66100, Chieti, Italy 9. Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy 10. Section of Preventive Medicine, Department of Nephrology, Albert-Ludwigs-University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany 11. Unit of Anatomic Pathology, Department of Clinical Pathology, Hospital G. da Saliceto, Via Giuseppe Taverna 49, 29100, Piacenza, Italy |
| Abstract: | Head and neck paragangliomas, rare neoplasms of the paraganglia composed of nests of neurosecretory and glial cells embedded in vascular stroma, provide a remarkable example of organoid tumor architecture. To identify genes and pathways commonly deregulated in head and neck paraganglioma, we integrated high-density genome-wide copy number variation (CNV) analysis with microRNA and immunomorphological studies. Gene-centric CNV analysis of 24 cases identified a list of 104 genes most significantly targeted by tumor-associated alterations. The “NOTCH signaling pathway” was the most significantly enriched term in the list (P = 0.002 after Bonferroni or Benjamini correction). Expression of the relevant NOTCH pathway proteins in sustentacular (glial), chief (neuroendocrine) and endothelial cells was confirmed by immunohistochemistry in 47 head and neck paraganglioma cases. There were no relationships between level and pattern of NOTCH1/JAG2 protein expression and germline mutation status in the SDH genes, implicated in paraganglioma predisposition, or the presence/absence of immunostaining for SDHB, a surrogate marker of SDH mutations. Interestingly, NOTCH upregulation was observed also in cases with no evidence of CNVs at NOTCH signaling genes, suggesting altered epigenetic modulation of this pathway. To address this issue we performed microarray-based microRNA expression analyses. Notably 5 microRNAs (miR-200a,b,c and miR-34b,c), including those most downregulated in the tumors, correlated to NOTCH signaling and directly targeted NOTCH1 in in vitro experiments using SH-SY5Y neuroblastoma cells. Furthermore, lentiviral transduction of miR-200s and miR-34s in patient-derived primary tympano-jugular paraganglioma cell cultures was associated with NOTCH1 downregulation and increased levels of markers of cell toxicity and cell death. Taken together, our results provide an integrated view of common molecular alterations associated with head and neck paraganglioma and reveal an essential role of NOTCH pathway deregulation in this tumor type. |
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