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From DEPARTMENT OF MEDICINE, SOLNA Karolinska Institutet, Stockholm, Sweden UNDERSTANDING THE ROLE OF NON-CODING RNAs IN SKIN HOMEOSTASIS AND CANCER KUNAL DAS MAHAPATRA Stockholm, 2020 All previously published papers were reproduced with permission from the publisher. Published by Karolinska Institutet. Printed by Eprint AB, 2020 © Kunal Das Mahapatra, 2020 ISBN 978-91-7831-900-8 Understanding the role of non-coding RNAs in skin homeostasis and cancer THESIS FOR DOCTORAL DEGREE (Ph.D.) The thesis will be defended on August 28, 2020 Location: Visiongatan 18, CMM Lecture Hall, Ground Floor, L8:00 Center for Molecular Medicine, Solna, Stockholm By KUNAL DAS MAHAPATRA Principal Supervisor: Opponent: Andor Pivarcsi, Associate Professor Wim Declercq, Professor Karolinska Institutet Ghent University Department of Medicine, Solna Department of Biomedical Molecular Biology Division of Dermatology and Venereology Examination Board: Co-supervisor(s): Gonçalo Castelo-Branco, Associate Professor Mona Ståhle, Professor Karolinska Institutet Karolinska Institutet Department of Medical Biochemistry and Biophysics Department of Medicine, Solna Division of Dermatology and Venereology Hans Törmä, Professor Uppsala University Leonard Girnita, Associate Professor Department of Dermatology and Venereology Karolinska Institutet Department of Oncology-Pathology Elisabet Nylander, Professor Umeå University Johan Hansson, Professor Department of Public Health and Clinical Medicine Karolinska Institutet Department of Oncology-Pathology ABSTRACT The epidermis is a stratified epithelium with continuous self-renewing capacity. As the outermost layer of our body, it provides a protective barrier against external trauma, produces pigmentation, and keeps the skin hydrated. Keratinocytes are the primary constituent cells type within the epidermis. A fine balance is maintained between keratinocyte cell proliferation and differentiation to sustain a functional epidermis. The interplay between multiple signaling pathways, transcription factors, epigenetic modulators, and non-coding RNAs is the key to maintaining this balance. Disrupted epidermal homeostasis can cause various diseases, including cancer. Cutaneous squamous cell carcinoma (cSCC) is one such keratinocyte-derived cancer that begins with the accumulation of somatic mutations and genetic abnormalities. The pigment-producing melanocytes within the epidermis can undergo oncogenic transformation due to numerous genetic and environmental factors, and give rise to malignant melanoma. In this thesis, we have explored the role of non-coding RNAs in epidermal homeostasis and the development of skin cancers. Paper I: In this study, we investigated the role of miR-203 in cSCC, and found that its expression was negatively correlated with the differentiation grade of the tumors. Functionally, miR-203 inhibited cell cycle progression, self-renewability, motility and proangiogenic-activity of cSCC cells in vitro, and reduced xenograft tumor growth and angiogenesis in vivo. We identified c-MYC as a potential upstream regulator of the transcriptomic changes caused by miR-203 overexpression, and subsequently demonstrated that c-MYC is a direct target of miR- 203 in cSCC. In line with these findings, overexpression of c-Myc rescued the growth- inhibitory effect of miR-203 in cSCC cell lines. Paper II: In this study, we analyzed the small RNA-seq data from the skin cutaneous melanoma (TCGA SKCM-cohort) and found that miR-203 is the most downregulated miRNA in metastatic melanoma. Moreover, high miR-203 abundance seems to confer longer overall survival to patients with metastatic melanoma. Methylome data from patient samples, together with results from in vitro experiments, suggested that promoter hypermethylation could suppress miR-203 expression in metastatic tumors. Functionally, miR-203 acted as a tumor suppressor by inhibiting cancer/metastatic hallmarks such as cell migration, invasion, self- renewal, and angiogenesis. SLUG, an essential regulator of epithelial-mesenchymal transition, was found to be a direct target of miR-203. In vivo, miR-203 effectively suppressed melanoma metastasis to the inguinal lymph nodes and the lungs. Paper III: In this study, we investigated the changes in the coding and non-coding landscape in cSCC using RNA-seq. We identified a large number of differentially expressed coding transcripts linear lncRNAs and circRNAs. Representative transcripts from each group were validated using an extended cohort. We found that several transcription factors regulating skin development and cSCC oncogenesis were altered at mRNA level. In addition to various lncRNAs with potential oncogenic function, we identified a set of skin-specific lncRNAs, which were mostly downregulated in cSCC. We observed a global downregulation of circRNA abundance in cSCC. Apart from previously annotated circRNAs, novel skin-enriched circRNAs were also identified and validated. Paper IV: In this study, we characterized a skin-specific lncRNA located at the Epidermal Differentiation Complex (EDC) on human chromosome 1. It is highly induced during the late stages of keratinocyte differentiation and localized to the granular layer of the human epidermis. We showed that transcription factor YY1 suppresses its expression in the progenitor keratinocytes. CRISPR-mediated activation of this lncRNA locus led to an increased expression of late differentiation marker genes. In contrast, loss-of-function experiment in a 3D organotypic skin model resulted in impaired terminal differentiation program and formation of thinner cornified envelope. Due to its functional requirement in late differentiation, we have renamed this lncRNA as ELDAR (Epidermal Late Differentiation Associated RNA). LIST OF SCIENTIFIC PAPERS I. MicroRNA-203 inversely correlates with differentiation grade, targets c-MYC, and functions as a tumor suppressor in cSCC Warangkana Lohcharoenkal, Masako Harada, Jakob Lovén, Florian Meisgen, Ning Xu Landén, Lingyun Zhang, Jan Lapins, Kunal Das Mahapatra, Hao Shi, Liisa Nissinen, Veli-Matti Kähäri, Mona Ståhle, Enikö Sonkoly, Dan Grander, Marie Arsenian- Henriksson and Andor Pivarcsi Journal of Investigative Dermatology. 2016 Dec 1;136(12):2485-94. II. Genome-wide screen for microRNAs reveals a role for miR-203 in melanoma metastasis Warangkana Lohcharoenkal, Kunal Das Mahapatra, Lorenzo Pasquali, Caitrin Crudden, Lara Kular, Yeliz Z. Akkaya Ulum, Lingyun Zhang, Ning Xu Landén, Leonard Girnita, Maja Jagodic, Mona Ståhle, Enikö Sonkoly and Andor Pivarcs Journal of Investigative Dermatology. 2018 Apr 1;138(4):882-92 III. A comprehensive analysis of coding and non-coding transcriptomic changes in cutaneous squamous cell carcinoma Kunal Das Mahapatra, Lorenzo Pasquali, Jonas Nørskov Søndergaard, Jan Lapins, István Balazs Nemeth, Eszter Baltás, Lajos Kemény, Bernhard Homey, Liviu-Ionut Moldovan, Jørgen Kjems, Claudia Kutter, Enikö Sonkoly, Lasse Sommer Kristensen and Andor Pivarcsi Scientific Reports. 2020 Feb 27;10(1):1-2. IV. LncRNA ELDAR acts as a key regulator of late epidermal differentiation program in the human epidermis Kunal Das Mahapatra, Lorenzo Pasquali, Christian Ziegler, Johannes Graf, Nicole Hemmer, Li Chen, Eniko Sonkoly, Markus Kretz, Andor Pivarcsi Manuscript PUBLICATIONS NOT INCLUDED IN THE THESIS Chromatin interactions in differentiating keratinocytes reveal novel Atopic Dermatitis and Psoriasis genes Pelin Sahlén, Rapolas Spalinskas, Samina Asad, Kunal Das Mahapatra, Pontus Höjer, Jesper Eisfeldt, Ankit Srivastava, Pernilla Nikamo, Anaya Mukherjee, Kyu- Han Kim, Otto Bergman, Mona Ståhle, Enikö Sonkoly, Andor Pivarcsi, Carl-Fredrik Wahlgren, Magnus Nordenskjöld, Fulya Taylan, Maria Bradley and Isabel Tapia- Páez Submitted The keratinocyte transcriptome in psoriasis: pathways related to immune responses, cell cycle and keratinization Lorenzo Pasquali, Ankit Srivastava, Florian Meisgen, Kunal Das Mahapatra, Ping Xia, Ning Xu Landén, Andor Pivarcsi, Enikö Sonkoly Acta Derm Venereol. 2019 Feb 1;99(2):196-205. MicroRNA-130a acts as a tumor suppressive miRNA in cutaneous squamous cell carcinoma and regulates the activity of the BMP/SMAD1 pathway by suppressing ACVR1 Warangkana Lohcharoenkal, Chen Li, Kunal Das Mahapatra, Jan Lapins, Bernhard Homey, Enikö Sonkoly and Andor Pivarcsi Submitted Contents LIST OF ABBREVIATIONS ...................................................................................................... 1 1 INTRODUCTION ................................................................................................................. 3 1.1 The Skin ......................................................................................................................... 3 1.1.1 The epidermis .............................................................................................................. 4 1.1.2 Epidermal differentiation and barrier formation ......................................................... 4 1.1.3 The Epidermal differentiation complex ....................................................................... 6 1.1.4 Regulation of epidermal differentiation ....................................................................... 8 1.1.4.1 Signaling pathways ............................................................................................... 8 1.1.4.2 Transcription factors .......................................................................................... 10 1.1.4.3 Non-coding RNAs in epidermal homeostasis .................................................... 11 1.2