Name: defining gene functions in tumorigenesis by ex vivo ablation of floxed alleles in malignant peripheral nerve sheath tumor cells
Uploaded: 2021-08-25T14:00:00
Description: Watch this Scientific Journal Video about Defining Gene Functions in Tumorigenesis by Ex vivo Ablation of Floxed Alleles in Malignant Peripheral Nerve Sheath Tumor Cells at JoVE.com

This work was supported by grants from the National Institute of Neurological Diseases and Stroke (R01 NS048353, R01 NS109655), the National Cancer Institute (R01 CA122804), the Department of Defense (X81XWH-09-1-0086, W81XWH-11-1-0498, W81XWH-12-1-0164, W81XWH-14-1-0073, and W81XWH-15-1-0193), and The Children&#39;s Tumor Foundation (2014-04-001 and 2015-05-007).

Prior to performing any procedures with mice, all procedures must be reviewed and approved by the Institutional Animal Care and Use Committee. The protocol described in this manuscript was approved by the Institutional Animal Care and Use Committee of the Medical University of South Carolina. This protocol was performed by properly trained personnel following MUSC&#39;s institutional animal care guidelines.
1. Generation of mice that develop MPNSTs homozygous for Erbb4 flox</su...

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	<li>Ricciuti, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antibody-drug+conjugates+for+lung+cancer+in+the+era+of+personalized+oncology.">Antibody-drug conjugates for lung cancer in the era of personalized oncology.</a> Seminars in Cancer Biology. 69, 268-278 (2019).</li><li>Litak, J., Mazurek, M., Grochowski, C., Kamieniak, P., Rolinski, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=PD-L1/PD-1+axis+in+glioblastoma+multiforme.">PD-L1/PD-1 axis in glioblastoma multiforme.</a> International Journal of Molecular Sciences. 20 (21), 5347 (2019).</li><li>Roskoski, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Properties+of+FDA-approved+small+molecule+protein+kinase+inhibitors.">Properties of FDA-approved small molecule protein kinase inhibitors.</a> Pharmacological Research. 144, 19-50 (2019).</li><li>Heffner, C. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Supporting+conditional+mouse+mutagenesis+with+a+comprehensive+cre+characterization+resource.">Supporting conditional mouse mutagenesis with a comprehensive cre characterization resource.</a> Nature Communications. 3, 1218 (2012).</li><li>Longo, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ErbB4+promotes+malignant+peripheral+nerve+sheath+tumor+pathogenesis+via+Ras-independent+mechanisms.">ErbB4 promotes malignant peripheral nerve sheath tumor pathogenesis via Ras-independent mechanisms.</a> Cell Communication and Signaling. 17 (1), 74 (2019).</li><li>Kazmi, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transgenic+mice+overexpressing+neuregulin-1+model+neurofibroma-malignant+peripheral+nerve+sheath+tumor+progression+and+implicate+specific+chromosomal+copy+number+variations+in+tumorigenesis.">Transgenic mice overexpressing neuregulin-1 model neurofibroma-malignant peripheral nerve sheath tumor progression and implicate specific chromosomal copy number variations in tumorigenesis.</a> American Journal of Pathology. 182 (3), 646-667 (2013).</li><li>Brosius, S. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuregulin-1+overexpression+and+Trp53+haploinsufficiency+cooperatively+promote+de+novo+malignant+peripheral+nerve+sheath+tumor+pathogenesis.">Neuregulin-1 overexpression and Trp53 haploinsufficiency cooperatively promote de novo malignant peripheral nerve sheath tumor pathogenesis.</a> Acta Neuropatholica. 127 (4), 573-591 (2014).</li><li>Ducatman, B. S., Scheithauer, B. W., Piepgras, D. G., Reiman, H. M., Ilstrup, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Malignant+peripheral+nerve+sheath+tumors.+A+clinicopathologic+study+of+120+cases.">Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases.</a> Cancer. 57 (10), 2006-2021 (1986).</li><li>Gassmann, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aberrant+neural+and+cardiac+development+in+mice+lacking+the+ErbB4+neuregulin+receptor.">Aberrant neural and cardiac development in mice lacking the ErbB4 neuregulin receptor.</a> Nature. 378 (6555), 390-394 (1995).</li><li>Tidcombe, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neural+and+mammary+gland+defects+in+ErbB4+knockout+mice+genetically+rescued+from+embryonic+lethality.">Neural and mammary gland defects in ErbB4 knockout mice genetically rescued from embryonic lethality.</a> Proceedings of the Nationall Academy of Sciences of the United States of America. 100 (14), 8281-8286 (2003).</li><li>Golub, M. S., Germann, S. L., Lloyd, K. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Behavioral+characteristics+of+a+nervous+system-specific+erbB4+knock-out+mouse.">Behavioral characteristics of a nervous system-specific erbB4 knock-out mouse.</a> Behavioral Brain Research. 153 (1), 159-170 (2004).</li><li>Huijbregts, R. P., Roth, K. A., Schmidt, R. E., Carroll, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypertrophic+neuropathies+and+malignant+peripheral+nerve+sheath+tumors+in+transgenic+mice+overexpressing+glial+growth+factor+beta3+in+myelinating+Schwann+cells.">Hypertrophic neuropathies and malignant peripheral nerve sheath tumors in transgenic mice overexpressing glial growth factor beta3 in myelinating Schwann cells.</a> Journal of Neuroscience. 23 (19), 7269-7280 (2003).</li><li>Jackson-Fisher, A. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Formation+of+Neu/ErbB2-induced+mammary+tumors+is+unaffected+by+loss+of+ErbB4.">Formation of Neu/ErbB2-induced mammary tumors is unaffected by loss of ErbB4.</a> Oncogene. 25 (41), 5664-5672 (2006).</li><li>Byer, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tamoxifen+inhibits+malignant+peripheral+nerve+sheath+tumor+growth+in+an+estrogen+receptor-independent+manner.">Tamoxifen inhibits malignant peripheral nerve sheath tumor growth in an estrogen receptor-independent manner.</a> Neuro-oncology. 13 (1), 28-41 (2011).</li><li>Kang, Y., Pekmezci, M., Folpe, A. L., Ersen, A., Horvai, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnostic+utility+of+SOX10+to+distinguish+malignant+peripheral+nerve+sheath+tumor+from+synovial+sarcoma,+including+intraneural+synovial+sarcoma.">Diagnostic utility of SOX10 to distinguish malignant peripheral nerve sheath tumor from synovial sarcoma, including intraneural synovial sarcoma.</a> Modern Pathology. 27 (1), 55-61 (2014).</li><li>Longo, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+and+genomic+characterization+of+a+sporadic+malignant+peripheral+nerve+sheath+tumor+cell+line.">Establishment and genomic characterization of a sporadic malignant peripheral nerve sheath tumor cell line.</a> Scientific Reports. 11 (1), 5690 (2021).</li><li>Chomczynski, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+reagent+for+the+single-step+simultaneous+isolation+of+RNA,+DNA+and+proteins+from+cell+and+tissue+samples.">A reagent for the single-step simultaneous isolation of RNA, DNA and proteins from cell and tissue samples.</a> Biotechniques. 15 (3), 532-537 (1993).</li><li>Bolger, A. M., Lohse, M., Usadel, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Trimmomatic:+a+flexible+trimmer+for+Illumina+sequence+data.">Trimmomatic: a flexible trimmer for Illumina sequence data.</a> Bioinformatics. 30 (15), 2114-2120 (2014).</li><li>Grozdanov, P. N., Li, J., Yu, P., Yan, W., MacDonald, C. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cstf2t+regulates+expression+of+histones+and+histone-like+proteins+in+male+germ+cells.">Cstf2t regulates expression of histones and histone-like proteins in male germ cells.</a> Andrology. 6 (4), 605-615 (2018).</li><li>Kaur, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CD63,+MHC+class+1,+and+CD47+identify+subsets+of+extracellular+vesicles+containing+distinct+populations+of+noncoding+RNAs.">CD63, MHC class 1, and CD47 identify subsets of extracellular vesicles containing distinct populations of noncoding RNAs.</a> Scientific Reports. 8 (1), 2577 (2018).</li><li>Avraham, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Satellite+glial+cells+promote+regenerative+growth+in+sensory+neurons.">Satellite glial cells promote regenerative growth in sensory neurons.</a> Nature Communications. 11 (1), 4891 (2020).</li><li>Love, M. I., Huber, W., Anders, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Moderated+estimation+of+fold+change+and+dispersion+for+RNA-seq+data+with+DESeq2.">Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2.</a> Genome Biology. 15 (12), 550 (2014).</li><li>Lin, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+normalization+and+differential+expression+analyses+using+RNA-Seq+data+from+726+individual+Drosophila+melanogaster.">Comparison of normalization and differential expression analyses using RNA-Seq data from 726 individual Drosophila melanogaster.</a> BMC Genomics. 17, 28 (2016).</li><li>Eden, E., Navon, R., Steinfeld, I., Lipson, D., Yakhini, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=GOrilla:+a+tool+for+discovery+and+visualization+of+enriched+GO+terms+in+ranked+gene+lists.">GOrilla: a tool for discovery and visualization of enriched GO terms in ranked gene lists.</a> BMC Bioinformatics. 10, 48 (2009).</li><li>Huang, D. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+DAVID+Gene+Functional+Classification+Tool:+a+novel+biological+module-centric+algorithm+to+functionally+analyze+large+gene+lists.">The DAVID Gene Functional Classification Tool: a novel biological module-centric algorithm to functionally analyze large gene lists.</a> Genome Biology. 8 (9), 183 (2007).</li><li>Mi, H., Muruganujan, A., Casagrande, J. T., Thomas, P. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Large-scale+gene+function+analysis+with+the+PANTHER+classification+system.">Large-scale gene function analysis with the PANTHER classification system.</a> Nature Protocols. 8 (8), 1551-1566 (2013).</li><li>Subramanian, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gene+set+enrichment+analysis:+a+knowledge-based+approach+for+interpreting+genome-wide+expression+profiles.">Gene set enrichment analysis: a knowledge-based approach for interpreting genome-wide expression profiles.</a> Proceedings of the Nationall Academy of the Sciences of the United States of America. 102 (43), 15545-15550 (2005).</li><li>Merico, D., Isserlin, R., Stueker, O., Emili, A., Bader, G. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Enrichment+map:+a+network-based+method+for+gene-set+enrichment+visualization+and+interpretation.">Enrichment map: a network-based method for gene-set enrichment visualization and interpretation.</a> PLoS One. 5 (11), 13984 (2010).</li><li>Yoon, S., Kim, S. Y., Nam, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+gene-set+enrichment+analysis+of+RNA-Seq+data+with+small+replicates.">Improving gene-set enrichment analysis of RNA-Seq data with small replicates.</a> PLoS One. 11 (11), 0165919 (2016).</li><li>Koch, C. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+beginner's+guide+to+analysis+of+RNA+sequencing+data.">A beginner's guide to analysis of RNA sequencing data.</a> American Journal of Respiratory Cell and Molecular Biology. 59 (2), 145-157 (2018).</li><li>Turk, A. N., Byer, S. J., Zinn, K. R., Carroll, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Orthotopic+xenografting+of+human+luciferase-tagged+malignant+peripheral+nerve+sheath+tumor+cells+for+in+vivo+testing+of+candidate+therapeutic+agents.">Orthotopic xenografting of human luciferase-tagged malignant peripheral nerve sheath tumor cells for in vivo testing of candidate therapeutic agents.</a> Journal of Visualized Experiments: JoVE. (49), e2558 (2011).</li><li>Faul, F. E., Lang, A. G., Buchner, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=G*Power+3:+a+flexible+statistical+power+analysis+program+for+the+social,+behavioral,+and+biomedical+sciences.">G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.</a> Behavior Research Methods. 39 (2), 175 (2007).</li><li>Chen, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cells+of+origin+in+the+embryonic+nerve+roots+for+NF1-associated+plexiform+neurofibroma.">Cells of origin in the embryonic nerve roots for NF1-associated plexiform neurofibroma.</a> Cancer Cell. 26 (5), 695-706 (2014).</li><li>Mo, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Humanized+neurofibroma+model+from+induced+pluripotent+stem+cells+delineates+tumor+pathogenesis+and+developmental+origins.">Humanized neurofibroma model from induced pluripotent stem cells delineates tumor pathogenesis and developmental origins.</a> Journal of Clinical Investigation. 131 (1), 139807 (2021).</li><li>Chau, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preclinical+therapeutic+efficacy+of+a+novel+pharmacologic+inducer+of+apoptosis+in+malignant+peripheral+nerve+sheath+tumors.">Preclinical therapeutic efficacy of a novel pharmacologic inducer of apoptosis in malignant peripheral nerve sheath tumors.</a> Cancer Research. 74 (2), 586-597 (2014).</li><li>Dodd, R. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=NF1(+/-)+Hematopoietic+cells+accelerate+malignant+peripheral+nerve+sheath+tumor+development+without+altering+chemotherapy+response.">NF1(+/-) Hematopoietic cells accelerate malignant peripheral nerve sheath tumor development without altering chemotherapy response.</a> Cancer Research. 77 (16), 4486-4497 (2017).</li><li>Eckert, J. M., Byer, S. J., Clodfelder-Miller, B. J., Carroll, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuregulin-1+beta+and+neuregulin-1+alpha+differentially+affect+the+migration+and+invasion+of+malignant+peripheral+nerve+sheath+tumor+cells.">Neuregulin-1 beta and neuregulin-1 alpha differentially affect the migration and invasion of malignant peripheral nerve sheath tumor cells.</a> Glia. 57 (14), 1501-1520 (2009).</li></ol>

The detailed methods presented here were developed using a GEM model of MPNSTs. However, if the tumor tissue of interest can be dispersed into individual cells, these methodologies are easily adaptable for various tumor types arising in GEMs. It is important to ensure that the floxed allele does not result in i) decreased survival that can make it difficult to obtain sufficient mice to screen for tumors, or ii) increased tumor latency that can make it difficult to obtain enough tumor-bearing mice. If the floxed allele do...

Before the last two decades, the treatment of human cancers relied heavily on radiotherapy and chemotherapeutic agents that broadly targeted rapidly proliferating cellular populations by damaging DNA or inhibiting DNA synthesis. Although these approaches did inhibit cancer cell growth, they also had deleterious side effects on normal rapidly proliferating cell types such as intestinal epithelial cells and hair follicle cells. More recently, cancer therapy has begun to utilize chemotherapeutic agents that precisely target proteins within signaling pathways that are critically important for the growth of an individual patient&#39;s neoplasm. This approach, commonly referred to as &#34;Precision Medicine,&#34; has led to the development of an ever-expanding repertoire of monoclonal antibodies and small molecular inhibitors. These agents effectively inhibit tumor cell proliferation and survival while avoiding the deleterious side effects on normal cell types seen with conventional chemotherapeutic agents and radiotherapy. Monoclonal antibodies used for the treatment of human cancers most commonly target cell surface molecules such as growth factor receptors1 (e.g., the large family of membrane-spanning receptor tyrosine kinases) and immune response modulators2 (e.g., programmed cell death protein 1, programmed death-ligand 1). Small molecular inhibitors can inhibit either cell surface proteins or signaling proteins that are located intracellularly3. However, to effectively employ these new therapeutic agents, it must be established that a particular cancer is dependent upon the molecule that is being targeted by a candidate therapeutic agent.
Although these new therapeutic agents have more focused effects, many of them still inhibit the action of more than one protein. In addition, multiple agents with varying effectiveness and specificity are often available to target a specific protein. Consequently, during preclinical investigations, it is wise to use additional approaches such as genetic ablation to validate a candidate protein as a therapeutic target. One especially useful approach to validating a protein as a therapeutic target is to ablate the gene encoding the candidate protein in a genetically engineered animal model that develops the specific cancer type of interest. This approach can be relatively straightforward if mice with a null mutation (either a natural mutation, a genetically engineered null mutation [a &#34;knockout&#34;], or a null mutation introduced by a gene trap)&#160;are available, and the mice are viable into adulthood. Unfortunately, mice with a null mutation that meet these criteria are often not available, typically because the null mutation results in death embryonically or in the first days of postnatal life. In this circumstance, mice prone to develop the tumor type of interest may instead be crossed to mice in which key segments of the gene of interest are flanked by loxP sites (&#34;floxed&#34;), which allows the gene to be ablated by introducing a transgene expressing Cre recombinase into the tumor cells (a conditional knockout). This approach provides several advantages. First, if a Cre driver is available that is expressed in the tumor but not in the cell type that led to death in conventional knockouts, this approach can potentially validate the candidate therapeutic target. Second, ablating the gene encoding the candidate protein in tumor cells but not in other intratumoral elements such as tumor-associated fibroblasts or immune cells allows the investigator to distinguish between cell-autonomous and non-cell-autonomous effects of the therapeutic target. Finally, a tamoxifen-inducible Cre driver (CreERT2) allows the investigator to delete the gene of interest at different stages in tumor development and define the window in which the candidate therapeutic agent is most likely to be effective.
Unfortunately, there are also technical issues that can limit the use of conditional knockouts in tumors arising in GEM models. For instance, a Cre driver that is expressed in tumor cells and avoids gene deletion in normal cells essential for life may not be available. Another issue, which may be underestimated, is that Cre and CreERT2 drivers often variably ablate floxed alleles in mice, resulting in mosaicism for the null mutation in a GEM cancer. When this occurs, tumor cells in which the targeted gene has not been ablated will continue to proliferate rapidly, overgrowing the tumor cells with ablated alleles. Mosaicism in Cre driver lines can occur due to non-ubiquitous Cre expression in the lineage targeted and by failed recombination in individual cells independent of Cre expression4. This is a known phenomenon of Cre drivers that is cell-type dependent and should be considered during experimental design and data interpretation. Mosaicism can mask the effect of the knockout and lead an investigator to erroneously conclude that the gene of interest is not essential for tumor cell proliferation and/or survival and thus is not a valid therapeutic target.
Several of these problems were encountered in a previous study that attempted to determine whether the receptor tyrosine kinase erbB4 was a potential therapeutic target in MPNST cells5. In these studies, mice were used that express a transgene encoding the neuregulin-1 (NRG1) isoform glial growth factor-&#946;3 (GGF&#946;3) under the control of the Schwann cell-specific myelin protein zero promoter (P0-GGF&#946;3 mice). P0-GGF&#946;3 mice develop multiple plexiform neurofibromas that progress to become MPNSTs via a process that recapitulates the processes of neurofibroma pathogenesis and plexiform neurofibroma-MPNST progression seen in patients with the autosomal dominant tumor susceptibility syndrome neurofibromatosis type 1 (NF1)6. When crossed to mice with a Trp53 null mutation, the resulting P0-GGF&#946;3;Trp53+/- mice develop MPNSTs de novo as is seen in cis-Nf1+/-;Trp53+/- mice.
These MPNSTs recapitulate the progression from World Health Organization (WHO) grade II to WHO grade IV lesions seen in humans7. In P0-GGF&#946;3 mice, MPNSTs arise within pre-existing plexiform neurofibromas in the trigeminal nerve (58%) and spinal dorsal nerve roots (68%)7; the MPNSTs arising in P0-GGF&#946;3;Trp53+/- mice have a highly similar distribution. In humans, MPNSTs most commonly arise in the sciatic nerve followed by the brachial plexus, spinal nerve roots, vagus, femoral, median, sacral plexus, popliteal obturator, and posterior tibial and ulnar nerves8. This tumor distribution in these GEM models is somewhat different from what is seen in humans. However, the MPNSTs that arise in P0-GGF&#946;3 and P0-GGF&#946;3;Trp53+/- mice are histologically identical to human MPNSTs, carry many of the same mutations seen in human MPNSTs, and recapitulate the process of neurofibroma-MPNST progression seen in NF1 patients. The generation of P0-GGF&#946;3 or P0-GGF&#946;3;Trp53+/- mice that were Erbb4-/- was not feasible as mice with two Erbb4 null alleles die in utero at embryonic day 10.5 secondary to cardiac defects9. Because rescuing Erbb4 expression in the heart by introducing a cardiac-specific Erbb4 transgene (&#945;-myosin heavy chain (MHC)-Erbb4) results in viable Erbb4-/- mice10, the generation of mice with a complicated P0-GGF&#946;3;Trp53+/-;&#945;-MHC-Erbb4;Erbb4-/- genotype was attempted.
However, the matings did not produce mice in the expected Mendelian ratios, indicating that the desired genotype was deleterious. Therefore, the generation of P0-GGF&#946;3;Trp53+/- mice with floxed Erbb4 alleles11 and a CreERT2 driver was attempted to allow the deletion of Erbb4 in the MPNSTs arising in these mice. In these animals, numerous tumor cells with intact Erbb4 alleles were still present (mosaicism). The mosaicism observed could result from inefficient tamoxifen delivery, which resulted in differences in recombination efficiency within the tissue. The possibility of spontaneous compensatory mechanisms could further contribute to mosaicism in tamoxifen-mediated recombination by bypassing the requirement for Erbb4 expression. It is feasible that the loss of Trp53 makes tumor cells susceptible to additional spontaneous &#34;permissive&#34; mutations that could confuse the interpretation of the data. As it seemed likely that the Erbb4-intact MPNST cells would mask the consequences of ablating Erbb4 in other tumor cells, this approach was abandoned.
These obstacles led to the development of a methodology for ablating Erbb4 in very early passage MPNST cells using an adenovirus expressing Cre recombinase and eGFP. These cells can be separated from non-infected cells using FACS, which markedly reduces mosaicism for the ablated Erbb4 gene. Below, the methods used to achieve this, together with the methods used to assess the effects of gene ablation in vitro and in vivo, are described. The following protocol is an example of how to produce tumor-bearing mice that yield tumors carrying floxed alleles of embryonic lethal genes of interest for ex vivo excision prior to in vivo allograft tumor growth assessment. This includes a description of the approaches used to analyze the effect that Erbb4 ablation exerts on tumor cell proliferation, survival, and gene expression in vitro and proliferation, survival, and angiogenesis in orthotopic allografts.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Ad5CMV-eGFP</td>
			<td>Gene Transfer Vector Core, Univ of Iowa</td>
			<td>VVC-U of Iowa-4</td>
			<td></td>
		</tr>
		<tr>
			<td>Ad5CMVCre-eGFP</td>
			<td>Gene Transfer Vector Core, Univ of Iowa</td>
			<td>VVC-U of Iowa-1174</td>
			<td></td>
		</tr>
		<tr>
			<td>alexa 568 secondary antibody</td>
			<td>Thermo/Fisher</td>
			<td>GaR A11036</td>
			<td></td>
		</tr>
		<tr>
			<td>Bioconductor Open Source Software for Bioninformatics</td>
			<td>Bioconductor</td>
			<td>http://www.bioconductor.org</td>
			<td>alternative statistical analysis tool used for step 4.4</td>
		</tr>
		<tr>
			<td>CD31</td>
			<td>Abcam</td>
			<td>ab28364</td>
			<td></td>
		</tr>
		<tr>
			<td>Celigo Image Cytometer</td>
			<td>Nexcelom Bioscience</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>Cell Stripper</td>
			<td>Corning</td>
			<td>25-056-Cl</td>
			<td>mixture of chelators</td>
		</tr>
		<tr>
			<td>DAB staining kit</td>
			<td>Vector Labs</td>
			<td>MP-7800</td>
			<td></td>
		</tr>
		<tr>
			<td>DAVID (Database for Annotation, Visualization, and Integrated Discovery)</td>
			<td>DAVID</td>
			<td>https://david.ncifcrf.gov</td>
			<td>functional enrichment analysis software used for step 4.5</td>
		</tr>
		<tr>
			<td>DMEM</td>
			<td>Corning</td>
			<td>15-013-Cl</td>
			<td></td>
		</tr>
		<tr>
			<td>DreamTaq and Buffer (Genotyping PCR)</td>
			<td>Thermo/Fisher</td>
			<td>EP0701 and K1072</td>
			<td></td>
		</tr>
		<tr>
			<td>erbB4 antibodies</td>
			<td>Santa Cruz</td>
			<td>sc-284</td>
			<td></td>
		</tr>
		<tr>
			<td>erbB4 antibodies</td>
			<td>Abcam</td>
			<td>ab35374</td>
			<td></td>
		</tr>
		<tr>
			<td>erbB4 antibodies</td>
			<td>Millipore</td>
			<td>HFR1: 05-1133</td>
			<td></td>
		</tr>
		<tr>
			<td>FACS Sorter</td>
			<td>BD Biosciences</td>
			<td>Aria II</td>
			<td></td>
		</tr>
		<tr>
			<td>Forskolin</td>
			<td>Sigma</td>
			<td>F6886</td>
			<td></td>
		</tr>
		<tr>
			<td>GenomeSpace Tools and Data Sources</td>
			<td>GenomeSpace</td>
			<td>https://genomespace.org/support/tools/</td>
			<td>general resource for several types of open source bioinformatic tools for step 4.5</td>
		</tr>
		<tr>
			<td>Glutamine</td>
			<td>Corning</td>
			<td>25-005-Cl</td>
			<td></td>
		</tr>
		<tr>
			<td>Gorilla Gene Ontology enRIchment anaLysis and visuaLizAtion tool</td>
			<td>Gorilla</td>
			<td>N/A, http://cbl-gorilla.cs.technion.ac.il</td>
			<td>functional enrichment analysis software used for step 4.5</td>
		</tr>
		<tr>
			<td>GSEA Gene Set Enrichment Analysis</td>
			<td>Broad Institute</td>
			<td>N/A, https://www.gsea-msigdb.org/gsea/index.jsp</td>
			<td>functional enrichment analysis software used for step 4.5</td>
		</tr>
		<tr>
			<td>HSD: Athymic Nude-FOxn1nu mice</td>
			<td>Envigo (Previously Harlan Labs)</td>
			<td>69</td>
			<td></td>
		</tr>
		<tr>
			<td>Illumina HiSeq2500 (next generation DNA sequencer)</td>
			<td>Illumina</td>
			<td>Hi Seq 2500</td>
			<td>DNA sequencer used for step 4.2</td>
		</tr>
		<tr>
			<td>Lasergene: ArrayStar Gene expression and variant analysis</td>
			<td>DNAStar LaserGene software</td>
			<td>N/A</td>
			<td>software statistical and normalization analysis used for step 4.4</td>
		</tr>
		<tr>
			<td>Lasergene: SeqMan NGen sequence alignment assembly</td>
			<td>software alignment used for step 4.3</td>
			<td>N/A</td>
			<td>software alignment used for step 4.3</td>
		</tr>
		<tr>
			<td>Matrigel, low growth factor basement membrane matrix</td>
			<td>Corning</td>
			<td>354230</td>
			<td></td>
		</tr>
		<tr>
			<td>NRG1-beta</td>
			<td>In house</td>
			<td>Generated by SLC, also commercially available from R &#38; D Systems(396-HB-050/CF).</td>
			<td></td>
		</tr>
		<tr>
			<td>Nuclear Stain Hoeschst 33342</td>
			<td>Thermo</td>
			<td>62249</td>
			<td></td>
		</tr>
		<tr>
			<td>Panther Gene Ontology Classification System</td>
			<td>Panther</td>
			<td>http://pantherdb.org</td>
			<td>functional enrichment analysis software used for step 4.5</td>
		</tr>
		<tr>
			<td>Partek (BWA aligner and analyzer)</td>
			<td>Partek, Ver 7</td>
			<td>N/A</td>
			<td>software alignment and statistical/normalization used for step 4.3</td>
		</tr>
		<tr>
			<td>Pen/Strep</td>
			<td>Corning</td>
			<td>30-002-Cl</td>
			<td></td>
		</tr>
		<tr>
			<td>Primer 1: 5&#8242;-CAAATGCTCTCTCTGTTCTTTGT 
			GTCTG- 3&#8242;</td>
			<td>Eurofins Genomics</td>
			<td>Primer 1 + 2: 250&#8201;bp ErbB4 null product and a 350&#8201;bp Floxed ErbB4 product;</td>
			<td></td>
		</tr>
		<tr>
			<td>Primer 2: 5&#8242;-TTTTGCCAAGTTCTAATTCCATC 
			AGAAGC-3&#8242;</td>
			<td>Eurofins Genomics</td>
			<td>Primer 1 + 2: 250&#8201;bp ErbB4 null product and a 350&#8201;bp Floxed ErbB4 product;</td>
			<td></td>
		</tr>
		<tr>
			<td>
			Primer 3: 5&#8242;-TATTGTGTTCATCTATCATTGCA 
			ACCCAG-3&#8242;
			</td>
			<td>Eurofins Genomics</td>
			<td>Primer 1 + 3: 350&#8201;bp wild-type ErbB4 product.</td>
			<td></td>
		</tr>
		<tr>
			<td>Propidium Iodine</td>
			<td>Fisher</td>
			<td>51-351-0</td>
			<td></td>
		</tr>
		<tr>
			<td>Proteom Profiler Phospho-Kinase Arrays</td>
			<td>R&#38;D Systems</td>
			<td>ARY003B</td>
			<td></td>
		</tr>
		<tr>
			<td>Real time glo</td>
			<td>Promega</td>
			<td>G9712</td>
			<td>bioluminescent cell viability assay</td>
		</tr>
		<tr>
			<td>ToppGene Suite</td>
			<td>ToppGene</td>
			<td>https://toppgene.cchmc.org</td>
			<td>functional enrichment analysis software used for step 4.5</td>
		</tr>
		<tr>
			<td>Trizol (acid-quanidinium-phenol and choloroform based reagent)</td>
			<td>Invitrogen</td>
			<td>15596026</td>
			<td></td>
		</tr>
		<tr>
			<td>Tyramide Signal Amplification Kit</td>
			<td>Perkin Elmer</td>
			<td>NEL721001EA</td>
			<td></td>
		</tr>
	</tbody>
</table>

defining gene functions in tumorigenesis by ex vivo ablation of floxed alleles in malignant peripheral nerve sheath tumor cells

The development of new drugs that precisely target key proteins in human cancers is fundamentally altering cancer therapeutics. However, before these drugs can be used, their target proteins must be validated as therapeutic targets in specific cancer types. This validation is often performed by knocking out the gene encoding the candidate therapeutic target in a genetically engineered mouse (GEM) model of cancer and determining what effect this has on tumor growth. Unfortunately, technical issues such as embryonic lethality in conventional knockouts and mosaicism in conditional knockouts often limit this approach. To overcome these limitations, an approach to ablating a floxed embryonic lethal gene of interest in short-term cultures of malignant peripheral nerve sheath tumors (MPNSTs) generated in a GEM model was developed.
This paper describes how to establish a mouse model with the appropriate genotype, derive short-term tumor cultures from these animals, and then ablate the floxed embryonic lethal gene using an adenoviral vector that expresses Cre recombinase and enhanced green fluorescent protein (eGFP). Purification of cells transduced with adenovirus using fluorescence-activated cell sorting (FACS) and the quantification of the effects that gene ablation exerts on cellular proliferation, viability, the transcriptome, and orthotopic allograft growth is then detailed. These methodologies provide an effective and generalizable approach to identifying and validating therapeutic targets in vitro and in vivo. These approaches also provide a renewable source of low-passage tumor-derived cells with reduced in vitro growth artifacts. This allows the biological role of the targeted gene to be studied in diverse biologic processes such as migration, invasion, metastasis, and intercellular communication mediated by the secretome.

Figure 4&#160;illustrates a typical result obtained when transducing P0-GGF&#946;3;Trp53-/+;Erbb4fl/fl MPNST cells with either the Ad5CMV-eGFP adenovirus or Ad5CMV-Cre/eGFP adenovirus (Figure 4A). Cultures are viewed with fluorescence microscopy to identify eGFP-expressing cells and by phase-contrast microscopy to determine the total number of cells present in the same field at 10x (top) and 40x (bottom). The pe...

Watch this Scientific Journal Video about Defining Gene Functions in Tumorigenesis by Ex vivo Ablation of Floxed Alleles in Malignant Peripheral Nerve Sheath Tumor Cells at JoVE.com

Defining Gene Functions in Tumorigenesis by Ex vivo Ablation of Floxed Alleles in Malignant Peripheral Nerve Sheath Tumor Cells

Here, we present a protocol for performing gene knockouts that are embryonic lethal in vivo in genetically engineered mouse model-derived tumors and then assessing the effect that the knockout has on tumor growth, proliferation, survival, migration, invasion, and the transcriptome in vitro and in vivo.

Defining Gene Functions in Tumorigenesis by Ex vivo Ablation of Floxed Alleles in Malignant Peripheral Nerve Sheath Tumor Cells

The development of new drugs that precisely target key proteins in human cancers is fundamentally altering cancer therapeutics. However, before these ...

This protocol provides an alternative in vivo method to study the tumor growth role of an embryonic lethal gene knockout. The advantage of this method is that gene knockouts that are normally embryonic lethal can be performed in tumors derived from a genetically engineered mouse model to study their loss of function effects in vivo. This technique can be applied to diseases that require studying the in vivo role of embryonic essential genes unattainable from traditional gene knockout mouse models.Generating the animal model takes time and empirical testing is required to determine the optimal MOI for adenoviral infection to ensure that appropriate recombination is achieved. To begin with, identify the mouse with the desired genotype. When a tumor-bearing mouse reaches its humane endpoint, euthanize the mouse and use a sterile scalpel knife to remove the tumor.Dissect the tumor into three sections in bread loaf-style cuts using a scalpel knife to generate the tissue segments for formalin fixation paraffin embedding early passage culture generation and flash freezing for analytical analyses. Stain a five-micrometer thick formalin-fixed, paraffin-embedded tissue section with hematoxylin and eosin. Once a pathologist confirms the tumor, perform the immunohistochemical staining to confirm the tumor diagnosis.Place the freshly-collected malignant peripheral nerve sheath tumor tissue in 10 milliliters of ice-cold sterile PBS on ice, and then transfer it to a sterile work area to establish early passage cultures. Mince the tumor tissue into two to four-millimeter pieces and triturate eight to 10 times in a 10-square centimeter treated tissue culture dish containing 10 milliliters of growth medium. Culture these tissues in high glucose DMEM-10 growth medium supplemented with 10 nanomolar neuregulin-1 beta and two micromolar forskolin.Seed the early passaged tumor cells at a density of 1.5 times 10 to the sixth cells per one 10-square centimeter treated tissue culture dish containing DMEM-10 growth medium. After 12 to 16 hours, wash the adherent cultures with two to four milliliters of DPBS, and infect the cells with adenovirus at approximately 400 plaque-forming units per cell in 10 milliliters of serum-free DMEM. After 48 hours of the infection, briefly check the cells for EGFP signal on a fluorescence microscope to ensure efficient infection with approximately 50 to 100%positive cells, and then FACS sort the EGFP-positive infected cells.After FACS sorting, let the cells recover in a tissue culture incubator for at least 24 to 48 hours, and then prepare the cells for in vitro cell-based analyses or in vivo grafting. Confirm Erbb4 deletion by performing PCR using genomic DNA isolated from a portion of the sorted EGFP-positive cells. Perform the proliferation assays over the next seven days on sorted tumor cells plated in a 96-well plate using an image-based automated cytometer.Stain the cells with hooks and propidium iodide dyes and capture the images of the cells using an automated plate reader to count the number of live and dead cells in each well. Isolate total RNA from sorted tumor cells using standard acid guanidinium phenol and chloroform-based method. Open the software to perform the RNA sequence alignment following the program-specific steps using the default settings.Select the analysis method, RNA seek, and then select the mouse reference genome. Upload the BED file if provided one by the sequencing core. Upload the FASTQ sequencing files and assign unique replicate names to the files.Group replicate the FASTQ files, and designate the files to a replicate set. For the statistical and normalization analysis to identify the differential gene expression signals with robust statistical power, open the analysis software and select the GFP FASTQ files as the control data set. Next, select DESeq2 as the statistical and normalization method and start the assembly and analysis.Use the gene ontology data sets integrated into the open access functional enrichment analysis tools to perform the functional enrichment analysis on the identified statistically significant Erbb4-mediated DEG to determine the biological and pathway significance of Erbb4 gene loss. Inject the tumor cells into the sciatic nerve of the anesthetized mouse to assess the in vivo allograft growth potential in post-infected cells. Once the tumor reaches the required size, dissect the tumor from a euthanized mouse in two-three sections as demonstrated previously.Fix one tissue section in 4%Paraformaldehyde overnight, and then embed the fixed section in the paraffin. After making five-micrometer thick sections from the FFPE tissue, mount the section on the slides and confirm the presence of tumor cells in the grafted tissue using H&E and immunostaining as demonstrated previously. To confirm in vivo Erbb4 expression differences between the two experimental conditions, stain the formalin-fixed, paraffin-embedded tissue with Erbb4-specific antibodies.The transduction of the malignant peripheral nerve sheath tumor tissue cells with adenovirus was analyzed. The EGFP expressing cells were detected using fluorescence microscopy, and the total number of cells was determined using phase-contrast microscopy. After the Cre-mediated gene ablation, depending on the transfection efficiency, the PCR genotyping showed a complete gene knockout and a heterogeneous population of induced and uninduced cells compared to the control transduction.The characteristic histopathology found in the orthotopic allografts of malignant peripheral nerve sheath tumor tissues compared to the tumors derived from the original genetically-engineered animal models demonstrated a difference in the cell morphology. The Erbb4 ablation decreased cellular density and cellular proliferation in adeno5-CMV-Cre-ablated cells control adeno5-CMV-GFP-transduced cells. The expression of Erbb4 in the tumor cells transduced with adeno5-CMV-Cre, or EGFP virus, was decreased in the result in adeno5-CMV-Cre transduced allografts compared to the control adeno5-CMV-EGFP-treated allograft tumors.The vascular density was assessed via immunoreactivity detection for CD31, and the representative results showed markedly reduced vascular density in allografts of adeno5-CMV-Cre-transduced cells compared to the control adeno5-CMV-EGFP-transduced cells. After gene ablation, the cells can be used for many different types of cell-based assays such as proliferation, migration, 3D growth, or microenvironment alterations, as well as for in vivo orthotopic injections.

Research

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