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Abstract
The Wnt signalling pathway, one of the core de-regulated pathways in chronic lymphocytic leukaemia (CLL), is activated in only a subset of patients through somatic mutations. Here we describe alternative, microenvironment-dependent mechanisms of Wnt activation in malignant B cells. We show that tumour cells specifically induce Notch2 activity in mesenchymal stromal cells (MSCs) required for the transcription of the complement factor C1q. MSC-derived C1q in turn inhibits Gsk3-β mediated degradation of β-catenin in CLL cells. Additionally, stromal Notch2 activity regulates N-cadherin expression in CLL cells, which interacts with and further stabilises β-catenin. Together, these stroma Notch2-dependent mechanisms induce strong activation of canonical Wnt signalling in CLL cells. Pharmacological inhibition of the Wnt pathway impairs microenvironment-mediated survival of tumour cells. Similarly, inhibition of Notch signalling diminishes survival of stroma-protected CLL cells in vitro and disease engraftment in vivo. Notch2 activation in the microenvironment is a pre-requisite for the activation of canonical Wnt signalling in tumour cells.
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1 Wellcome Trust/ MRC Cambridge Stem Cell Institute & Department of Haematology, University of Cambridge, Cambridge, UK
2 Department of Hematology and Medical Oncology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
3 Department of Internal Medicine 5, Haematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
4 Institute of Cell Biology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
5 Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
6 Department of Hematology, University Hospital Essen,, University of Duisburg-Essen, Essen, Germany
7 Haematopathology and Oncology Diagnostic Service (HODS), Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
8 Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
9 Wellcome Trust/ MRC Cambridge Stem Cell Institute & Department of Haematology, University of Cambridge, Cambridge, UK; NHS Blood and Transplant, Cambridge, UK
10 Helmholz Zentrum, Research Unit Gene Vectors, Munich, Germany
11 Department of Hematology and Medical Oncology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; German Cancer Consortium, DKFZ, Heidelberg, Germany