Uveal melanoma, as opposed to cutaneous melanoma, is a tumor which is predominantly located in the center of the eye. Given its potential aggressive nature with fatal consequences, it is important... Show moreUveal melanoma, as opposed to cutaneous melanoma, is a tumor which is predominantly located in the center of the eye. Given its potential aggressive nature with fatal consequences, it is important to start treatment in a timely manner. Currently, treatment consists of decreasing the size of the tumor by means of radiation therapy or surgery, but by mapping the genetic makeup of uveal melanoma, personalized treatment potentially becomes possible. In this thesis we tried to solve a piece of this genetic puzzle by focusing on genetic and cellular differences within and between different uveal melanoma. By means of an innovative new technique, digital PCR, we aimed to visualize this so-called heterogeneity. We demonstrate that we can accurately assess which genetic aberrations are present in uveal melanoma. Moreover, we show in what percentage of cells these aberrations are present. Additionally, we illustrate which cell types play an important role in uveal melanoma development. This way, we characterized a substantial amount of different uveal melanoma based on their heterogeneity profile. Lastly, we display whether and how uveal melanomas with a specific heterogeneity profile are susceptible to treatment. Show less
Zoutman, W.H.; Nell, R.J.; Versluis, M.; Pico, I.; Vu, T.H.K.; Verdijk, R.M.; ... ; Velden, P.A. van der 2022
B cells fulfill an important role in the adaptive immunity. Upon activation and immunoglobulin (IG) class switching, these cells function in the humoral immunity compartment as plasma cells. For... Show moreB cells fulfill an important role in the adaptive immunity. Upon activation and immunoglobulin (IG) class switching, these cells function in the humoral immunity compartment as plasma cells. For clinical applications, it can be important to quantify (switched) B cells accurately in a variety of body fluids and tissues of benign, inflammatory and malignant origin. For decades, flow cytometry and immunohistochemistry (IHC) have been the preferred methods for quantification. Although these methods are widely used, both depend on the accessibility of B cell epitopes and therefore require intact (fixed) cells. Whenever samples are low in quantity and/or quality, accurate quantification can be difficult. By shifting the focus from epitopes to DNA markers, quantification of B cells remains achievable. During differentiation and maturation, B cells are subjected to programmed genetic recombination processes like VDJ rearrangements and class switch recombination (CSR), which result in deletion of specific sequences of the IGH locus. These cell type-specific DNA "scars" (loss of sequences) in IG genes can be exploited as B cell markers in digital PCR (dPCR) based quantification methods. Here, we describe a novel, specific and sensitive digital PCR-based method to quantify mature and switched B cells in DNA specimens of benign and (copy number unstable) malignant origin. We compared this novel way of B cell quantitation with flow cytometric and immunohistochemical methods. Through cross-validation with flow cytometric sorted B cell subpopulations, we gained quantitative insights into allelic involvement in different recombination processes in the IGH locus. Our newly developed method is accurate and independent of the cellular context, offering new possibilities for quantification, even for (limited) small samples like liquid biopsies. Show less
Nell, R.J.; Menger, N.V.; Versluis, M.; Luyten, G.P.M.; Verdijk, R.M.; Madigan, M.C.; ... ; Velden, P.A. van der 2021
BackgroundActivating G alpha (q) signalling mutations are considered an early event in the development of uveal melanoma. Whereas most tumours harbour a mutation in GNAQ or GNA11, CYSLTR2 (encoding... Show moreBackgroundActivating G alpha (q) signalling mutations are considered an early event in the development of uveal melanoma. Whereas most tumours harbour a mutation in GNAQ or GNA11, CYSLTR2 (encoding G-protein coupled receptor CysLT(2)R) forms a rare alternative. The role of wild-type CysLT(2)R in uveal melanoma remains unknown.MethodsWe performed a digital PCR-based molecular analysis of benign choroidal nevi and primary uveal melanomas. Publicly available bulk and single cell sequencing data were mined to further study mutant and wild-type CYSLTR2 in primary and metastatic uveal melanoma.Results1/16 nevi and 2/120 melanomas carried the CYSLTR2 mutation. The mutation was found in a subpopulation of the nevus, while being clonal in both melanomas. In the melanomas, secondary, subclonal CYSLTR2 alterations shifted the allelic balance towards the mutant. The resulting genetic heterogeneity was confirmed in distinct areas of both tumours. At the RNA level, further silencing of wild-type and preferential expression of mutant CYSLTR2 was identified, which was also observed in two CYSLTR2 mutant primary melanomas and one metastatic lesion from other cohorts. In CYSLTR2 wild-type melanomas, high expression of CYSLTR2 correlated to tumour inflammation, but expression originated from melanoma cells specifically.ConclusionsOur findings suggest that CYSLTR2 is involved in both early and late development of uveal melanoma. Whereas the CYSLTR2 p.L129Q mutation is likely to be the initiating oncogenic event, various mechanisms further increase the mutant allele abundance during tumour progression. This makes mutant CysLT(2)R an attractive therapeutic target in uveal melanoma. Show less
The studies in this thesis explored several aspects of genetic dependencies in the development of familial and sporadic melanoma. CDKN2A is the most common high-penetrance susceptibility gene... Show moreThe studies in this thesis explored several aspects of genetic dependencies in the development of familial and sporadic melanoma. CDKN2A is the most common high-penetrance susceptibility gene responsible for up to 40% of melanoma families worldwide. Interestingly, more than half of germline variation in familial predisposition to melanoma remains to be determined. To identify novel high-penetrance melanoma susceptibility genes we applied Whole Exome Sequencing (WES) and co-segregation analysis in a Dutch melanoma family. We identified NEK11 as a candidate high-penetrance melanoma susceptibility gene and performed functional characterization in cancer cell lines to show loss-of-function (chapter 2). Our additional focus of investigation was a specific cohort of familial melanoma patients carrying a CDKN2A founder mutation, a 19-bp deletion known as the p16-Leiden mutation. Due to the variability in occurrence of pancreatic cancer (PC) and melanoma within familial melanoma families, we sought to examine genetic modifiers predicting the risk of PC and melanoma (chapter 3). In this specific cohort of familial melanoma patients, the timing of CDKN2A wild-type allele loss in melanoma development is unknown. We have applied a customized SNP-based digital PCR (dPCR) methodology to precisely quantify CDKN2A allelic imbalance depicting loss-of-heterozygosity (LOH) and attempted to deduce the order of genetic events based on absolute quantification of mutations and losses (CDKN2A LOH, BRAFV600E, TERT promoter, chromosome 9q LOH) (chapter 4). Finally, in addition to high-penetrance genes in familial melanoma, there are genes that are important fitness factors for cancer cell growth and may provide insight into the biology and progression of sporadic melanoma. The application of screening technologies has been successful in identifying genetic dependencies that could possibly be implemented as therapeutic targets in cancer. We have therefore analyzed Clustered Regular Interspaced Short Palindromic Repeats (CRISPR-Cas9) screening data to identify fitness genes in melanoma and used in-vitro systems to validate our findings (chapter 5). Combined, we hope to have uncovered novel genetic dependencies that could be used in the targeted treatment of sporadic as well as familial melanoma. Show less
