p53 and Pten control neural and glioma stem/progenitor cell renewal and differentiation

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Abstract
The Cancer Genome Atlas, a large-scale genomics project to catalogue cancer-linked mutations, is starting to produce results. Glioblastoma, the most common brain cancer, was the first target for the project and the initial results, published AOP on 4 September, are now in print. Genes newly implicated in glioblastoma include tumour suppressors (NF1, RB1, ATM and APC) and several tyrosine kinase genes. Glioblastoma is extremely resistant to therapy, hence the potential importance of the development of a possible model system. Zheng et al. report that mice lacking the tumour suppressors p53 and Pten develop tumours resembling human glioblastomas, associated with increased Myc protein levels. As well as offering a potential system for testing therapeutics, this points to c-Myc as a possible drug target. In a mouse model, it is found that the loss of the tumour suppressors p53 and Pten leads to the development of tumours resembling human primary glioblastomas, and both p53 and PTEN are frequently lost in the human cancer. Loss of these tumour suppressors impairs the differentiation of neural stem cells, due to upregulation of Myc by the concerted action of p53 and PTEN loss. Glioblastoma (GBM) is a highly lethal brain tumour presenting as one of two subtypes with distinct clinical histories and molecular profiles. The primary GBM subtype presents acutely as a high-grade disease that typically harbours mutations in EGFR, PTEN and INK4A/ARF (also known as CDKN2A), and the secondary GBM subtype evolves from the slow progression of a low-grade disease that classically possesses PDGF and TP53 events1,2,3. Here we show that concomitant central nervous system (CNS)-specific deletion of p53 and Pten in the mouse CNS generates a penetrant acute-onset high-grade malignant glioma phenotype with notable clinical, pathological and molecular resemblance to primary GBM in humans. This genetic observation prompted TP53 and PTEN mutational analysis in human primary GBM, demonstrating unexpectedly frequent inactivating mutations of TP53 as well as the expected PTEN mutations. Integrated transcriptomic profiling, in silico promoter analysis and functional studies of murine neural stem cells (NSCs) established that dual, but not singular, inactivation of p53 and Pten promotes an undifferentiated state with high renewal potential and drives increased Myc protein levels and its associated signature. Functional studies validated increased Myc activity as a potent contributor to the impaired differentiation and enhanced renewal of NSCs doubly null for p53 and Pten (p53-/- Pten-/-) as well as tumour neurospheres (TNSs) derived from this model. Myc also serves to maintain robust tumorigenic potential of p53-/- Pten-/- TNSs. These murine modelling studies, together with confirmatory transcriptomic/promoter studies in human primary GBM, validate a pathogenetic role of a common tumour suppressor mutation profile in human primary GBM and establish Myc as an important target for cooperative actions of p53 and Pten in the regulation of normal and malignant stem/progenitor cell differentiation, self-renewal and tumorigenic potential.