Journal Article

Genomic Engineering of Oral Keratinocytes to Establish In Vitro Oral Potentially Malignant Disease Models as a Platform for Treatment Investigation

Brouns, Elisabeth R., Buijze, Marijke, Brakenhoff, Ruud H., Stigter-van Walsum, Marijke, van Kempen, Britt E., Peferoen, Laura, van der Meij, Erik H., Brink, Arjen, Wils, Leon J., Poell, Jos B., de Visscher, Jan G. A. M., Bloemena, Elisabeth

2024

Overview

Precancerous cells in the oral cavity may appear as oral potentially malignant disorders, but they may also present as dysplasia without visual manifestation in tumor-adjacent tissue. As it is currently not possible to prevent the malignant transformation of these oral precancers, new treatments are urgently awaited. Here, we generated precancer culture models using a previously established method for the generation of oral keratinocyte cultures and incorporated CRISPR/Cas9 editing. The generated cell lines were used to investigate the efficacy of a set of small molecule inhibitors. Tumor-adjacent mucosa and oral leukoplakia biopsies were cultured and genetically characterized. Mutations were introduced in CDKN2A and TP53 using CRISPR/Cas9 and combined with the ectopic activation of telomerase to generate cell lines with prolonged proliferation. The method was tested in normal oral keratinocytes and tumor-adjacent biopsies and subsequently applied to a large set of oral leukoplakia biopsies. Finally, a subset of the immortalized cell lines was used to assess the efficacy of a set of small molecule inhibitors. Culturing and genomic engineering was highly efficient for normal and tumor-adjacent oral keratinocytes, but success rates in oral leukoplakia were remarkably low. Knock-out of CDKN2A in combination with either the activation of telomerase or knock-out of TP53 seemed a prerequisite for immortalization. Prolonged culturing was accompanied by additional genetic aberrations in these cultures. The generated cell lines were more sensitive than normal keratinocytes to small molecule inhibitors of previously identified targets. In conclusion, while very effective for normal keratinocytes and tumor-adjacent biopsies, the success rate of oral leukoplakia cell culturing methods was very low. Genomic engineering enabled the prolonged culturing of OL-derived keratinocytes but was associated with acquired genetic changes. Further studies are required to assess to what extent the immortalized cultures faithfully represent characteristics of the cells in vivo.

• Publisher: MDPI AG
• Subject: Biopsy / Cancer therapies / Cell culture / cell culture models / Cell cycle / Cell division / Cell growth / CRISPR / CRISPR-Cas Systems - genetics / CRISPR/Cas9 / Cyclin-Dependent Kinase Inhibitor p16 - genetics / Cyclin-Dependent Kinase Inhibitor p16 - metabolism / Drugs / Genes / Genetic Engineering / Genetic transformation / Genomics / Humans / Immortalization / Keratinocytes / Keratinocytes - metabolism / Keratinocytes - pathology / Leukokeratosis / Leukoplakia, Oral - genetics / Leukoplakia, Oral - pathology / malignant transformation / Mouth Mucosa - pathology / Mouth Neoplasms - genetics / Mouth Neoplasms - pathology / Oral cancer / Oral cavity / oral diseases / oral leukoplakia / oral squamous cell carcinoma / p53 Protein / Patients / Precancerous Conditions - genetics / Precancerous Conditions - pathology / Senescence / Telomerase / Telomerase - genetics / Telomerase - metabolism / Tumor Suppressor Protein p53 - genetics / Tumor Suppressor Protein p53 - metabolism / Tumors