Epigenetic therapy induces transcription of inverted SINEs and ADAR1 dependency

Nature. 2020 Dec;588(7836):169-173. doi: 10.1038/s41586-020-2844-1. Epub 2020 Oct 21.

Abstract

Cancer therapies that target epigenetic repressors can mediate their effects by activating retroelements within the human genome. Retroelement transcripts can form double-stranded RNA (dsRNA) that activates the MDA5 pattern recognition receptor1-6. This state of viral mimicry leads to loss of cancer cell fitness and stimulates innate and adaptive immune responses7,8. However, the clinical efficacy of epigenetic therapies has been limited. To find targets that would synergize with the viral mimicry response, we sought to identify the immunogenic retroelements that are activated by epigenetic therapies. Here we show that intronic and intergenic SINE elements, specifically inverted-repeat Alus, are the major source of drug-induced immunogenic dsRNA. These inverted-repeat Alus are frequently located downstream of 'orphan' CpG islands9. In mammals, the ADAR1 enzyme targets and destabilizes inverted-repeat Alu dsRNA10, which prevents activation of the MDA5 receptor11. We found that ADAR1 establishes a negative-feedback loop, restricting the viral mimicry response to epigenetic therapy. Depletion of ADAR1 in patient-derived cancer cells potentiates the efficacy of epigenetic therapy, restraining tumour growth and reducing cancer initiation. Therefore, epigenetic therapies trigger viral mimicry by inducing a subset of inverted-repeats Alus, leading to an ADAR1 dependency. Our findings suggest that combining epigenetic therapies with ADAR1 inhibitors represents a promising strategy for cancer treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptive Immunity / drug effects
  • Adenosine Deaminase / deficiency
  • Adenosine Deaminase / metabolism*
  • Alu Elements / drug effects*
  • Alu Elements / genetics*
  • Alu Elements / immunology
  • Animals
  • Cell Line, Tumor
  • CpG Islands / drug effects
  • CpG Islands / genetics
  • DNA, Intergenic / drug effects
  • DNA, Intergenic / genetics
  • DNA, Intergenic / immunology
  • DNA-Cytosine Methylases / antagonists & inhibitors
  • Decitabine / pharmacology*
  • Decitabine / therapeutic use*
  • Epigenesis, Genetic / drug effects*
  • Feedback, Physiological
  • Humans
  • Immunity, Innate / drug effects
  • Interferon-Induced Helicase, IFIH1 / metabolism
  • Introns / drug effects
  • Introns / genetics
  • Introns / immunology
  • Inverted Repeat Sequences / drug effects
  • Inverted Repeat Sequences / genetics
  • Inverted Repeat Sequences / immunology
  • Male
  • Mice
  • Molecular Mimicry / drug effects
  • Molecular Mimicry / immunology
  • Neoplasms / drug therapy
  • Neoplasms / genetics
  • Neoplasms / immunology
  • Neoplasms / pathology
  • RNA, Double-Stranded / drug effects
  • RNA, Double-Stranded / genetics
  • RNA, Double-Stranded / immunology
  • RNA-Binding Proteins / antagonists & inhibitors
  • RNA-Binding Proteins / metabolism*
  • Transcription, Genetic / drug effects*
  • Viruses / drug effects
  • Viruses / immunology

Substances

  • DNA, Intergenic
  • RNA, Double-Stranded
  • RNA-Binding Proteins
  • Decitabine
  • DNA-Cytosine Methylases
  • ADAR protein, human
  • Adenosine Deaminase
  • IFIH1 protein, human
  • Interferon-Induced Helicase, IFIH1