Use of CRISPR-Modified Human Stem Cell Organoids to Study the Origin Of
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RESEARCH CANCER MLH1 in normal human colonic organoids, we used CRISPR-Cas9 technology to insert a puromycin- resistance cassette into the second exon of the MLH1 gene (Fig. 1A and fig. S1A). After puromycin Use of CRISPR-modified human stem selection, we clonally expanded single organoids and subsequently genotyped these to confirm cor- cell organoids to study the origin of rect biallelic targeting (figs. S1, A and B, and S2A). Gene inactivation was verified by quantitative mutational signatures in cancer reverse transcription polymerase chain reaction (qRT-PCR), revealing a substantial reduction in MLH1 mRNA expression in MLH1 knockout Jarno Drost,1,2*† Ruben van Boxtel,2,3*† Francis Blokzijl,2,3 Tomohiro Mizutani,1,2 (MLH1KO) organoids, most likely due to the deg- Nobuo Sasaki,1,2 Valentina Sasselli,1,2 Joep de Ligt,2,3 Sam Behjati,4,5 radation (through nonsense-mediated decay) of Judith E. Grolleman,6 Tom van Wezel,7 Serena Nik-Zainal,4,8 Roland P. Kuiper,6,9 nonsense mRNAs transcribed from the mutant Edwin Cuppen,2,3‡ Hans Clevers1,2,9‡ alleles (Fig. 1C). Western blot analysis confirmed the loss of MLH1 protein expression in the MLH1KO Mutational processes underlie cancer initiation and progression. Signatures of these processes organoids (Fig. 1E). in cancer genomes may explain cancer etiology and could hold diagnostic and prognostic Next, we passaged the MLH1KO and parental value. We developed a strategy that can be used to explore the origin of cancer-associated normal human colon organoids for 2 months to mutational signatures. We used CRISPR-Cas9 technology to delete key DNA repair genes allow cells to accumulate sufficient mutations re- in human colon organoids, followed by delayed subcloning and whole-genome sequencing. We quired for downstream analyses (fig. S1C). We Downloaded from MLH1 found that mutation accumulation in organoids deficient in the mismatch repair gene then used flow cytometry to establish subclonal is driven by replication errors and accurately models the mutation profiles observed in cultures of single cells (fig. S1C) and expanded mismatch repair–deficient colorectal cancers. Application of this strategy to the cancer these until sufficient DNA could be obtained (7). NTHL1 predisposition gene , which encodes a base excision repair protein, revealed a Both clonal and subclonal cultures were subjected mutational footprint (signature 30) previously observed in a breast cancer cohort. We to whole-genome sequencing (WGS) analyses to NTHL1 show that signature 30 can arise from germline mutations. identify the mutations that accumulated between the two clonal expansion steps and to correlate http://science.sciencemag.org/ ancer arises through the sequential accu- repair (NER) pathways (5). However, multiple their appearance with time (Fig. 2A). As expected, mulation of mutations in somatic cells. The processes are simultaneously active in tumors MLH1KO organoids showed an increased base overallmutationalburdenofsomaticcells with highly unstable genomes, which makes it substitution load (27.7 ± 4.9 mutations per genome C is determined by a balance between DNA difficult to causally link the presence of specific per day) compared with normal organoids (3.8 ± damage and repair activity. Mutational mutational signatures to DNA repair deficiency. 1.2 mutations per genome per day), as well as a processes leave specific signatures, as defined Organoid technology allows for the long-term change in type of base substitutions (increase in by systematic analysis of mutation characteristics in vitro expansion of epithelial tissues, starting C>T transitions). Similarly, the MLH1KO organoids across many independent cancer sequencing data from a single adult stem cell. Such organoids re- displayed an increased number of INDELs (Fig. sets (1). A recent study showed that a set of mu- main genetically stable over long periods of time 2A), which were predominantly single–base-pair tational signatures in genome-wide mutation col- (6). We have previously shown that clonal organ- deletions (Fig. 2B) at mononucleotide repeats lections of breast cancers predicts deficiency of oid cultures can be used for in-depth pattern anal- (Fig. 2C). This confirmed that deletion of MLH1 on January 29, 2018 BRCA1 and BRCA2, as well as sensitivity to PARP ysis of mutations that accumulate throughout is sufficient to generate the mutator phenotype [poly(adenosine diphosphate–ribose) polymerase] life in tissue-specific adult stem cells (7, 8). More- observed in MMR-deficient tumors. As expected, inhibition (2). To date, the main approach to link over, organoids can be readily modified using we did not observe an increase in structural specific mutational signatures to underlying molec- CRISPR-Cas9 genome editing (9). Mammalian variations. ular mechanisms has involved associating cancer species differ greatly in their DNA repair capacity Somatic mutations are unevenly distributed mutations with defined exposures to carcinogens, and will thus respond differently to mutagenic throughout the genomes of most cancers (15, 16) such as tobacco smoke (3) and ionizing radiation stress (10, 11), and mutation types and numbers and normal adult stem cells (7). In general, base (4), or with the absence of specific DNA repair will vary over a lifetime (7). We used CRISPR- substitutions are more frequent in heterochro- proteins, such as components of the DNA mis- Cas9 genome editing in human intestinal organoid matic and late-replicating regions of the genome. match repair (MMR) (1) and nucleotide excision cultures to systematically decipher the mutational It has been reported that specific DNA repair ac- consequences of DNA repair deficiency. tivity, including MMR (17)andNER(18), under- 1Hubrecht Institute, Royal Netherlands Academy of Arts and To establish a tool for dissecting mutational lies this variation in regional mutation rates, as Sciences (KNAW) and University Medical Center (UMC) signatures in human organoid cultures, we in- tumors lacking essential components of either 2 Utrecht, 3584CT Utrecht, Netherlands. Cancer Genomics troduced loss-of-function mutations in the MMR of these DNA repair pathways show a less biased Netherlands, UMC Utrecht, 3584CX Utrecht, Netherlands. 3Center for Molecular Medicine, Department of Genetics, gene MutL homolog 1 (MLH1). Inactivating mu- genomic distribution. To directly test this, we per- UMC Utrecht, 3584CX Utrecht, Netherlands. 4Cancer tations in MMR genes, including MLH1,pre- formed a genome-wide analysis of replication Genome Project, Wellcome Trust Sanger Institute, Wellcome dispose people to colorectal cancer (12, 13). These timing (Repli-seq) (19) on human intestinal organ- Trust Genome Campus, Hinxton, Cambridgeshire CB10 1SA, tumors are characterized by an immense muta- oids. We defined early, intermediate, and late UK. 5Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, UK. 6Department of Human Genetics, tional load, such as base substitutions and small replicating genomic regions and determined the Radboud Institute for Molecular Life Sciences, Radboud insertions and deletions (INDELs) at short repeat relationship between somatic mutational load University Medical Center, Nijmegen, Netherlands. sequences in the genome, referred to as micro- and replication timing. As observed in most can- 7 Departments of Pathology, Leiden University Medical satellite instability (MSI) (13). We used organoids cers (16), in vitro–accumulated mutations in Center, Leiden, Netherlands. 8East Anglian Medical Genetics Service, Cambridge University Hospitals National Health derived from human normal colon epithelium, normal organoids were more frequent in late- Service Foundation Trust, Cambridge, UK. 9Princess Máxima because this allowed us to study the effect of dis- replicating DNA (Fig. 3A). This bias was no longer Center for Pediatric Oncology, 3584CT Utrecht, Netherlands. ruption of single DNA repair genes in an otherwise present in MLH1KO cells, in line with the notion † *These authors contributed equally to this work. Present address: normal genetic background. Moreover, human thatMMRmightbemoreactiveineuchromatic Princess Máxima Center for Pediatric Oncology, 3584CT Utrecht, Netherlands. ‡Corresponding author. Email: ecuppen@ colonic organoids are as close as possible to the early-replicating regions of the genome, thereby umcutrecht.nl (E.C.); [email protected] (H.C.) cell-of-origin of colorectal cancer (14). To inactivate creating variation in regional mutation rates (17). Drost et al., Science 358, 234–238 (2017) 13 October 2017 1of5 RESEARCH | REPORT MLH1 locus exon 2 NTHL1 locus exon 2 sgRNA Targeting sgRNA strategy 5’ homology arm 3’ homology arm 5’ homology arm 3’ homology arm puromycin puromycin Homologous recombination puromycin puromycin MLH1 WT KO1 KO2 Downloaded from 1 1 MLH1 (~ 85kD) 70 * 55 tubulin (~55 kD) mRNA expression mRNA mRNA expression mRNA 0.5 0.5 NTHL1 http://science.sciencemag.org/ NTHL1 MLH1 WT KO4 KO5 KO6 35 NTHL1 (~34 kD) Relative Relative 0 0 wild-type MLH1 MLH1 wild-type NTHL1 NTHL1 NTHL1 knock-out 1 knock-out 2 knock-out 4 knock-out 5 knock-out 6 35 GAPDH (~37 kD) Fig. 1. Generation of DNA repair gene knock-outs in human intestinal independent experiments are indicated. (D)Sameasin(C),butforNTHL1. stem cell cultures. Targeting strategy for the generation of MLH1 (A)and (E) Western blot analysis of MLH1 expression in normal and MLH1KO organoids NTHL1 n (B) knockout organoids using CRISPR-Cas9 genome editing. sgRNA, (representative from = 3). Tubulin was