Metastatic melanoma is an aggressive, incurable cancer with historically few therapeutic options. The discovery that 60% of melanomas harbor the oncogenic BRAF_V600E mutation, which constitutively activates the MAPK pathway, has provided a promising new therapeutic axis. Although MAPK pathway inhibitor therapy has shown striking clinical results in BRAF_V600-mutant melanoma, this approach faces three limitations. First, 10-20% of BRAF_V600-mutant melanomas never achieve meaningful response to MAPK pathway inhibitor therapy (intrinsic resistance). Second, among BRAF_V600-mutant melanomas initially responding to MAPK pathway inhibitor therapy, relapse is universal (acquired resistance). Third, approximately 40% of melanomas lack BRAF_V600 mutations and so are not currently candidates for MAPK pathway inhibitor therapy. We sought to address each of these problems: by characterizing the phenomenon of intrinsic MAPK pathway inhibitor resistance, by finding ways to perturb mechanisms of acquired MAPK pathway inhibitor resistance, and by identifying novel dependencies in melanoma outside of the MAPK pathway. Intriguingly, the NF-kappa B pathway emerged as a common theme across these investigations. In particular, we establish that MAPK pathway inhibitor sensitive and resistant melanomas display distinct transcriptional signatures. Unlike most BRAF_V600-mutant melanomas, which highly express the melanocytic lineage transcription factor MITF, MAPK pathway inhibitor resistant lines display low MITF expression but high levels of NF-kappa B signaling. These divergent transcriptional states, which arise in melanocytes from aberrant MAPK pathway activation by BRAF_V600E, remain plastic and mutually antagonistic in established melanomas. Together, these results characterize a dichotomy between MITF and NF-kappa B cellular states as a determinant of intrinsic sensitivity versus resistance to MAPK pathway inhibitors in BRAF_V600-mutant melanoma. In separate investigations, we have shown that, NFKB1 p105, a member of the NF-kappa B family, intimately regulates levels of COT, a known effector of resistance to MAPK pathway inhibitors. Moreover, we have used shRNA screening to nominate particular nodes within the NF-kappa B pathway, including MYD88 and IRF3, as candidate melanoma lineage-specific dependencies. Cumulatively, although these studies use diverse approaches to investigate the limitations of MAPK pathway inhibitor therapy in melanoma, they converge in nominating the NF-kappa B pathway as a previously underappreciated feature of melanoma biology and suggest the relevance of this pathway for future investigation.

Mitf and Otx transcription factors have been identified as essential to the development of the retinal pigmented epithelium (RPE), but the relationship between these factors and their specific role in the RPE developmental pathway have not been clearly defined. The role of the two Mitf transcription factors (Mitfa and Mitfb) and two Otx transcription factors (Otx1a and Otx2) in zebrafish RPE development was explored in these experiments. The loss of Mitf activity in mitfa, mitfb, or double mitf null mutant fish lines had no effect on RPE pigmentation or development. The loss of Otx2 activity through morpholino knockdown produced a RPE deficient phenotype in a small percentage of embryos, while the additional knockdown of Otx1a caused widespread and severe RPE developmental abnormalities. Analysis of ocular sections revealed that the retinal layers remain unaffected in mitf mutants, as well as in most RPE-deficient otx morphants. Mitf and Otx combined loss of function experiments suggest that Mitfa and Mitfb may still play a role in zebrafish RPE development. Expression analysis through in situ hybridization has demonstrated that Otx transcription factors are necessary for the proper expression of mitfa and mitfb while Mitf transcriptions factors are not required for the expression of otx genes. The transcriptional regulation of Mitf by Otx transcription factors may explain why only Otx transcription factors are necessary for zebrafish RPE development despite the somewhat overlapping functions of Mitf and Otx transcription factors.

Le facteur de transcription Microphthalmia (Mitf) et la voie de signalisation des " Mitotic Activated Protein Kinase " (MAPK) sont des éléments déterminants pour la différentiation, la prolifération et la survie des melanocytes. L'altération des fonctions de l'un ou l'autre se manifeste par une perte totale ou partielle de ce type cellulaire. A l'inverse, le mélanome est associé très majoritairement à une activation constitutive des MAPK, et parfois, à un gain d'activité de MITF. Afin d'étudier les interaction entre les MAPK et l'activité de MITF, nous nous sommes intéressés aux modifications post transcriptionnelles qui permettent la génération d'isoformes multiples dotées d'activité différentes. MITF contient un site de phosphorylation, la serine 73 (S73), qui a été démontré par le passé comme jouant un rôle à la fois dans l'augmentation de l'activité et dans la réduction de la stabilité de MITF in vitro. Pour comprendre le rôle de cette serine in vivo, une tentative de mutation S73A de Mitf a été réalisée. Ce codon fait parti d'un " Exon splicing Enhencer " et sa mutation réduit l'affinité de fixation de la protéine SRp40 et l'exclusion de l'exon 2B dans lequel est situé ce site de phosphorylation. Pour dissocier l'exclusion de l'exon 2B et de sa phosphorylation, nous avons donc altéré la jonction de l'exon 2A-2B afin qu'elle ne soit plus reconnue par le spliceosome. En conséquence, l'exon 2B ne peut plus être exclu des transcrits Mitf quelque soit le statut du codon 73. La comparaison de 3 nouveaux allèles Mitf S-S73A S-S73D et S-S73S, où l'inclusion de l'exon 2B est forcée, nous a permis d'associer l'absence de phosphorylation à un gain d'activité de MITF.

Melanoma is the deadliest form of skin cancer and one of the most difficult cancers to treat. Gene alterations identified in melanoma pointed to distinct molecular subsets of tumors with direct implications in therapeutic strategies. Activating mutations in NRAS, found in 20-30% of melanomas have been associated with aggressive clinical behavior and a poor prognosis. Nevertheless, there is lack of effective targeted therapies for NRAS mutant melanoma.Out of the few MEK inhibitors, pimasertib, a potent inhibitor of both MEK1 and MEK2 has showed promising results in NRAS mutant advanced melanoma. However, as a single agent and similar to other MEK inhibitors, it showed a limited clinical benefit due to its rather cytostatic effect and high toxicity. Our and other preliminary studies clearly indicated a stimulation of MITF (Microphthalmia associated transcription factor), the master transcription factor regulating cell growth and differentiation in the melanocyte, under MEK inhibition challenge. Thus, in a context where the tumor suppressor p53 is largely inactivated in melanoma, the stimulation of MITF may be the cause of the restraint cytotoxic effects of MEK inhibitors. Therefore, we aimed to further investigate the downstream MITF targets that can explain the resistance to the drugs.First, we showed that, MEK inhibition (by Pimasertib) led to a significant inhibition of cell proliferation but with a very limited effect on apoptosis that may be explained by the systematic MITF upregulation in all lines tested. Indeed, Mimicking MITF activation of expression by stimulating cAMP conferred resistance to MEK inhibition and interestingly up-regulated Bcl-2 expression. Further evidence was provided by the fact that, acquired resistance to MEK inhibition is associated with substantial upregulation of the anti-apoptotic signaling MITF/Bcl-2. More importantly, selective Bcl-2 inhibition by ABT-199 or Bcl-2 knock out using CRISPER/Cas9 system restores the sensitivity of NRAS mutant melanoma cells to MEK inhibition and breaks the acquired resistance.Given the known p53 regulating effect on Bcl-2, we evaluated p53 reactivation by PRIMA-1Met (APR-246) under MEK inhibition on the promotion of apoptosis in a panel of Q61NRAS mutant melanoma cells. Strikingly and similarly, this combination not only resulted in a synergistic effect to induce massive apoptosis but also broke resistance to MEK inhibitors both in cells with wild type or mutant p53 alike.In conclusion, we showed that the activation of cAMP/MITF/Bcl-2 pathway is a main anti-apoptotic mechanism associated with resistance to MEK inhibition in NRAS mutant melanoma. We propose drug combinations cotargeting MEK and other proteins regulating apoptosis -p53/Bcl-2- as a promising and clinically relevant therapeutic strategy to not only act in synergy to cause massive apoptosis but also to overcome resistance to MEK inhibitors in NRAS mutant melanoma / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

Melanoma is one of the most aggressive and deadly forms of skin cancer. Arising from melanocytes, a pigment cell population derived from the neural crest, melanomas often adopt characteristics associated with the neural crest – the ability to rapidly proliferate, migrate and invade throughout the body. Historically, these characteristics along with a baseline resistance to chemotherapy have made melanoma extremely difficult to treat. Improvements in targeted and immunotherapeutic options have improved patient outcomes, but many patients still experience limited durable responses to therapy. In order to improve patient outcomes, new potential avenues of therapy must be identified based on the underlying pathogenesis of the disease. We previously identified and characterized the function of a novel melanoma oncogene, GDF6, uncovering a role in promoting melanoma cell survival and dedifferentiation by activating a neural crest identity. Here, we have a) identified a role for GDF6-activated BMP signaling during melanocyte development that forms a basis for its oncogenic role in melanoma, b) determined BMP signaling may play a role in promoting a neural crest-like state during melanoma initiation, and c) assayed novel monoclonal antibodies targeting GDF6 for use as blocking antibodies to treat advanced melanoma. Previous work identified GDF6 as a melanoma oncogene that promotes melanoma progression through suppression of apoptosis and differentiation in melanoma cells, by regulating neural crest factor expression and neural crest identity, suggesting a potential role for GDF6 in the embryonic neural crest. Additional studies had previously identified roles for GDF6 and its orthologous genes in specific biological contexts, including embryonic neuronal cell survival, bone and cartilage development, embryonic eye development, and bone and ligament repair in adult tissue. Furthermore, a study had indicated a role for a GDF6 ortholog, gdf6a, during zebrafish neural crest induction, but had not uncovered any specific role for gdf6a in further development of the neural crest or in any neural crest derivatives. We determined blocking gdf6a-activated BMP signaling acts to increase melanocyte development during embryogenesis by increasing the proportion of neural crest cells activating the pigment cell marker, mitfa. Furthermore, we showed the increase in melanocytes is at the expense of the iridophore population. These results indicate GDF6 function in melanoma is a reiteration of the normal physiological function of GDF6 during embryonic melanocyte development from the neural crest. Given these results and our previous findings of the role of GDF6-activated BMP signaling established melanomas, we hypothesized a potential role for GDF6-activated BMP signaling during melanoma initiation. Previous studies have determined neural crest identity and neural crest-like characteristics to be crucial during multiple phases of melanoma, including initiation, progression, and metastasis. We evaluated melanoma initiating lesions to determine the potential impact of BMP signaling on development and progression of these lesions. We found early lesions in our model to have active BMP signaling and that modulation of BMP signaling could alter the rate of development of these lesions in our animals. Furthermore, BMP modulation ultimately impacted the development of these lesions into melanomas. Together, these results indicate BMP signaling is a potential driving pathway during melanoma initiation and progression. Finally, we wanted to determine the therapeutic potential of targeting GDF6 in order to treat patients with advanced melanoma. Given our previous findings and mechanism of ligand-activated BMP signaling, we hypothesized a monoclonal antibody targeting GDF6 could block GDF6 activity at its receptor on melanoma cells, thus inhibiting GDF6-activated BMP signaling. Monoclonal antibodies have been widely used as therapy in cancer as well as many other rheumatologic and immunologic conditions. We established a panel of GDF6-targeting antibodies via a hybridoma approach. We then assessed the antibodies ability to identify mammalian GDF6 in vitro and performed functional assays to determine if anti-GDF6 antibody treatment yielded the expected results of inhibiting GDF6-activated BMP signaling. We observed decreased pathway activity, decreased cell viability, and increased cell death in melanoma cells treated with anti-GDF6 antibodies in vitro. We further investigated whether these antibodies could exert anti-melanoma effects in vivo. Together, these results indicate potential therapeutic value for our antibodies in treating GDF6-positive melanomas.

The cyclin-dependent kinase (Cdk) inhibitor p27Kip1 contributes to the timing of cell cycle withdrawal during development and, consequently, in organogenesis. Within the retina, this effector protein is up-regulated during the birth of neuronal and glial cells [Dev. Biol. (2000) 299]. However, its expression within the retinal pigment epithelium (RPE), a supporting cell layer that is essential for neural retina development and function, has not previously been reported. We show that p27Kip1 protein expression in the RPE occurs in two phases: an up-regulation during mid-to late embryonic stages and a down-regulation during the subsequent postnatal period. In the early phase of up-regulation, an inverse relationship is seen between expression of p27Kip1 and PCNA, an indicator of cycling cells. During both up-and down-regulation, the change in spatial pattern of expression proceeds in a central to peripheral manner, with p27Kip1 up-regulation paralleling retinal maturation. These data suggest that this cell cycle regulator may be an important factor controlling the timing of RPE cell cycle withdrawal.

No description available.

No description available.

Ce travail avait deux objectifs: 1) définir des groupes de patients (pts) susceptibles de bénéficier d’un conseil génétique par l’identification de facteurs prédictifs de l’existence d’une mutation du gène CDKN2A, un des gènes majeurs de prédisposition au mélanome, dans les familles ne comportant que deux cas (Fam_2 cas). 2) la caractérisation épidémiologique et clinique d’entités particulières du mélanome dans l’objectif secondaire de contribuer à l’identification de gènes de prédisposition à ces entités. Les 2 entités étudiées étaient le mélanome cutané (MC) associé au cancer du rein (CR) et les mélanomes muqueux de la sphère ano-génitale (MMAG).Les populations d’étude sont une collection de 293 pts atteints de MC recrutés de façon consécutive sans connaissance à priori de l'histoire familiale et la collection française MELARISK qui comprend ≥ 3000 sujets prélevés appartenant à des familles à cas multiples de mélanomes ou ayant un MC survenant dans un contexte particulier (association à un autre cancer, topographie rare, survenue avant l’âge de 20 ans, MC multiples sporadiques). Nous avons étudié l'effet de 3 facteurs prédictifs potentiels sur la présence d’une mutation de CDKN2A dans une famille en fonction du nombre de pts atteints dans une famille (2 pts versus ≥3 pts). L’étude a été menée dans 483 familles françaises comprenant 387 Fam_2 cas, et 96 familles avec ≥3 pts atteints de mélanome (Fam_3+ cas). Les facteurs étudiés dans la famille un à un puis conjointement étaient : l’âge médian <50 ans au diagnostic de MC, la survenue de ≥1 cas de MC primitifs multiples (MPM) et la survenue de ≥1 cas de cancer du pancréas (CPCP). La fréquence des mutations était plus élevée dans les Fam_3+ cas (32%) que dans les Fam_2 cas (13%). Alors qu’un âge jeune au diagnostic et la survenue de ≥ 1 MPM étaient associés à la présence de mutations de CDKN2A dans les Fam_2 cas, un âge jeune au diagnostic ainsi que la présence de ≥1 cas de CP était associé significativement aux mutations de CDKN2A dans les Fam_3+ cas. L’étude a montré que les caractéristiques cliniques associées aux mutations de CDKN2A varient, en France, pays de faible incidence de mélanome, en fonction du degré d’agrégation familiale. L’identification de facteurs prédictifs de mutations de CDKN2A dans les Fam_2 cas a contribué à définir des sous-groupes de familles (âge jeune au diagnostic, survenue de MPM) dans lesquels la fréquence des mutations de CDKN2A est supérieure à 20% et auxquels il est légitime de proposer un test génétique. L’analyse des deux séries de pts MM+CR et MMAG a permis d’identifier, en les comparant à la série de MC recrutés de manière consécutive, leurs caractéristiques cliniques et histologiques. Dans ces deux séries, nos résultats ont mis en évidence un contexte de prédisposition héréditaire en partie indépendant de CDKN2A. L’étude de l’association MC et CR chez un même patient a eu deux conséquences pratiques: pour les cliniciens ces résultats suggèrent l’intérêt d’un examen dermatologique en cas de CR et l’intérêt de l’échographie abdominale dans le bilan initial d’un MC pour le dépistage du CR; pour la recherche en génétique, cette série a contribué à l’identification d’une mutation germinale dans le gène MITF qui augmente le risque de développer un MC, un CR ou l’association des deux cancers et qui a des propriétés biologiques intéressantes. L’étude des MMAG a montré que ces mélanomes pouvaient être associés à des MC chez un même malade et/ou survenir dans un contexte familial de mélanome. Le corollaire clinique de ces résultats est que l’examen dermatologique de dépistage ou de surveillance doit être à la fois cutané et muqueux dans un contexte familial de mélanome et qu’en cas de MMAG un examen dermatologique des apparentés doit être proposé comme c’est la règle dans les MC. L’absence de mutation de CDKN2A dans ces localisations muqueuses incite à entreprendre des études génétiques pour identifier les gènes impliqués. / This thesis had two main objectives: 1) To define groups of patients which may benefit from genetic counseling by identifying predictors of mutations of the CDKN2A gene, a major gene predisposing to cutaneous melanoma (CM) in families with only two cases. 2) Epidemiological and clinical characterization of specific entities of melanoma with the secondary objective of contributing to the identification of susceptibility genes for these entities. Coexistence of CM with renal cell carcinoma and mucosal anogenital melanomas were studied.The study populations are a collection of 293 melanoma patients that were ascertained systematically and the French collection MELARISK which is a collection including over 3000 subjects drawn from families with multiple cases of melanoma or melanoma occurring in a particular context (association with another cancer, rare locations, occurrence before the age of 20, multiple sporadic melanomas).We investigated association of three clinical features with the presence of a CDKN2A mutation in a family by extent of CM family clustering (2 versus ≥3 CM patients among first-degree relatives in a family).The study was conducted in 483 French families including 387 families with two melanoma patients, and 96 families with three or more patients with melanoma. The factors examined individually and in a joint analysis in a family were: median age at diagnosis <50 years, ≥1 patient in a family with multiple primary melanomas (MPM) or with pancreatic cancer. The frequency of CDKN2A mutations was higher in F3+ families (32%) than in F2 families (13%). While early age at melanoma diagnosis and occurrence of MPM in ≥1 patient were significantly associated with the risk of a CDKN2A mutation in F2 families, early age at melanoma diagnosis and occurrence of pancreatic cancer in a family were significantly associated with CDKN2A mutations in F3+ families. Thus this study showed that clinical features associated with CDKN2A mutations vary, in France, a country of low incidence of melanoma, according to the degree of familial clustering. Identifying predictors of CDKN2A mutations in families with two melanoma cases has helped to define subgroups of families (early age at CM diagnosis, and/or ≥1 MPM patient) in which the frequency of CDKN2A mutations is above 20% such that these subgroups of F2 families should be offered genetic testing.The analysis of two series of patients, either patients with melanoma coexisting with renal cell carcinoma or patients with anogenital mucosal melanoma identified their clinical and histological features by comparing them to a series of melanomas that were ascertained systematically. In both series, our results suggested a genetic predisposition at least partly independent of CDKN2A. The study of the c renal cell carcinoma; coexistence of CM and renal cancer in the same patient had two practical consequences for clinicians: it suggests the interest of a dermatologic screening visit in patients with renal cell carcinoma and that abdominal ultrasonography or computed tomography scanning performed at the initial workup and during the follow-up of patients with CM may be of value for the early detection of renal cancer. Regarding genetic research, this series has contributed to the identification of a germline mutation in the MITF gene that increases the risk of developing melanoma, renal cancer or both cancers and has interesting biological properties. The study of anogenital melanoma has shown that these melanomas could be associated with cutaneous melanoma in the same patient and it has also shown a high frequency of family history of melanoma associating mucosal and CM suggesting a shared genetic predisposition. Consequently dermatological screening or monitoring must include examination of both skin and mucosa in families with multiple cases of CM; and in case of a mucosal melanoma, a dermatological examination should be offered to relatives. The genetic mechanism has to be identified

Domestic animals have become very different from their wild ancestors during domestication and animal breeding. This provides a good model to unravel the molecular mechanisms underlying phenotypic variation. In my thesis I have studied genes affecting two important traits, leanness in pigs and hair greying-associated melanoma in horses. In the first part of the thesis, I focused on an intronic mutation leading to more muscle growth and less fat deposition in domestic pigs to identify a transcription factor (TF) that binds to the regulatory element overlapping with the mutation. The aim has been to further study the function of the previously unknown TF in mouse myoblast cells and in insulin-producing cells (Paper I-III). We discovered a new TF ZBED6 binding to intron 3 of the IGF2 gene, in which a single nucleotide substitution in pigs abrogates the binding and causes increased leanness in domestic pigs. Silencing of ZBED6 expression in mouse myoblasts increased Igf2 expression, cell proliferation and migration, and myotube formation. This result is in line with the increased leanness phenotype in mutant pigs. Chromatin Immunoprecipitation-sequencing (ChIP-seq) using an anti-ZBED6 antibody identified 1200 ZBED6 target genes besides IGF2 and many are TFs controlling fundamental biological processes. In the first follow-up study we found ZBED6 mainly affected the expression of muscle protein genes by directly regulating Igf2 and Twist2 expression, in agreement with our previous observation of faster myotube formation in ZBED6-silenced cells. ChIP-seq with antibodies against six different histone modifications revealed that ZBED6 preferentially binds to active promoters and modulates transcriptional activity by a novel mechanism rather than by recruiting repressive histone modifications. The second follow-up study revealed that ZBED6 affects the morphology and insulin content and release in pancreatic ß cells. In the second part (Paper IV), we investigate the functional significance of an intronic duplication in the Syntaxin 17 (STX17) gene causing hair greying and melanoma in horses. We found two Microphtalmia-associated transcription factor (MITF) binding sites within the duplication and showed that the duplicated sequence up-regulates reporter gene expression in a melanocyte-specific manner both by reporter assays in mouse melanocytes and in transgenic zebrafish. These results established that the intronic duplication acts as a melanocyte-specific enhancer that becomes much stronger when it is duplicated.