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      Tissue Microbiome Profiling Identifies an Enrichment of Specific Enteric Bacteria in Opisthorchis viverrini Associated Cholangiocarcinoma

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          Abstract

          Cholangiocarcinoma (CCA) is the primary cancer of the bile duct system. The role of bile duct tissue microbiomes in CCA tumorigenesis is unestablished. To address this, sixty primary CCA tumors and matched normals, from both liver fluke ( Opisthorchis viverrini) associated (OVa, n = 28) and non- O. viverrini associated (non-OVa, n = 32) cancers, were profiled using high-throughput 16S rRNA sequencing. A distinct, tissue-specific microbiome dominated by the bacterial families Dietziaceae, Pseudomonadaceae and Oxalobacteraceae was observed in bile duct tissues. Systemic perturbation of the microbiome was noted in tumor and paired normal samples (vs non-cancer normals) for several bacterial families with a significant increase in Stenotrophomonas species distinguishing tumors vs paired normals. Comparison of parasite associated (OVa) vs non-associated (non-OVa) groups identified enrichment for specific enteric bacteria ( Bifidobacteriaceae, Enterobacteriaceae and Enterococcaceae). One of the enriched families, Bifidobacteriaceae, was found to be dominant in the O. viverrini microbiome, providing a mechanistic link to the parasite. Functional analysis and comparison of CCA microbiomes revealed higher potential for producing bile acids and ammonia in OVa tissues, linking the altered microbiota to carcinogenesis. These results define how the unique microbial communities resident in the bile duct, parasitic infections and the tissue microenvironment can influence each other, and contribute to cancer.

          Highlights

          • Stenotrophomonas, implicated in bile duct infections, is enriched in tumor tissues of non-fluke related cholangiocarcinoma.

          • O. viverrini infection may alter composition of bile duct tissue microbiomes.

          • Enteric bacteria with metabolic outputs linked to carcinogenesis are enriched in O. viverrini associated tissue microbiomes.

          The link between microbiota and cancer of the gastrointestinal (GI) tract has been extensively studied. However, the role of tissue microbiome in cholangiocarcinoma (CCA), cancer of the bile duct (an organ connected to the GI tract), is largely unknown. In this study, we detected intriguing compositional differences in the tissue microbiomes of liver fluke related and non-related CCA. Taken together, our data suggests a connection between parasitic infections, tissue microbiome alterations, tissue micro-environment changes and CCA development.

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          Most cited references35

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          The placenta harbors a unique microbiome.

          Humans and their microbiomes have coevolved as a physiologic community composed of distinct body site niches with metabolic and antigenic diversity. The placental microbiome has not been robustly interrogated, despite recent demonstrations of intracellular bacteria with diverse metabolic and immune regulatory functions. A population-based cohort of placental specimens collected under sterile conditions from 320 subjects with extensive clinical data was established for comparative 16S ribosomal DNA-based and whole-genome shotgun (WGS) metagenomic studies. Identified taxa and their gene carriage patterns were compared to other human body site niches, including the oral, skin, airway (nasal), vaginal, and gut microbiomes from nonpregnant controls. We characterized a unique placental microbiome niche, composed of nonpathogenic commensal microbiota from the Firmicutes, Tenericutes, Proteobacteria, Bacteroidetes, and Fusobacteria phyla. In aggregate, the placental microbiome profiles were most akin (Bray-Curtis dissimilarity <0.3) to the human oral microbiome. 16S-based operational taxonomic unit analyses revealed associations of the placental microbiome with a remote history of antenatal infection (permutational multivariate analysis of variance, P = 0.006), such as urinary tract infection in the first trimester, as well as with preterm birth <37 weeks (P = 0.001). Copyright © 2014, American Association for the Advancement of Science.
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            Tumor microenvironment complexity: emerging roles in cancer therapy.

            The tumor microenvironment (TME) consists of cells, soluble factors, signaling molecules, extracellular matrix, and mechanical cues that can promote neoplastic transformation, support tumor growth and invasion, protect the tumor from host immunity, foster therapeutic resistance, and provide niches for dormant metastases to thrive. An American Association for Cancer Research (AACR) special conference held on November 3-6, 2011, addressed five emerging concepts in our understanding of the TME: its dynamic evolution, how it is educated by tumor cells, pathways of communication between stromal and tumor cells, immunomodulatory roles of the lymphatic system, and contribution of the intestinal microbiota. These discussions raised critical questions on how to include the analysis of the TME in personalized cancer diagnosis and treatment. ©2012 AACR.
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              Integrative molecular analysis of intrahepatic cholangiocarcinoma reveals 2 classes that have different outcomes.

              Cholangiocarcinoma, the second most common liver cancer, can be classified as intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma. We performed an integrative genomic analysis of ICC samples from a large series of patients. We performed a gene expression profile, high-density single-nucleotide polymorphism array, and mutation analyses using formalin-fixed ICC samples from 149 patients. Associations with clinicopathologic traits and patient outcomes were examined for 119 cases. Class discovery was based on a non-negative matrix factorization algorithm and significant copy number variations were identified by Genomic Identification of Significant Targets in Cancer (GISTIC) analysis. Gene set enrichment analysis was used to identify signaling pathways activated in specific molecular classes of tumors, and to analyze their genomic overlap with hepatocellular carcinoma (HCC). We identified 2 main biological classes of ICC. The inflammation class (38% of ICCs) is characterized by activation of inflammatory signaling pathways, overexpression of cytokines, and STAT3 activation. The proliferation class (62%) is characterized by activation of oncogenic signaling pathways (including RAS, mitogen-activated protein kinase, and MET), DNA amplifications at 11q13.2, deletions at 14q22.1, mutations in KRAS and BRAF, and gene expression signatures previously associated with poor outcomes for patients with HCC. Copy number variation-based clustering was able to refine these molecular groups further. We identified high-level amplifications in 5 regions, including 1p13 (9%) and 11q13.2 (4%), and several focal deletions, such as 9p21.3 (18%) and 14q22.1 (12% in coding regions for the SAV1 tumor suppressor). In a complementary approach, we identified a gene expression signature that was associated with reduced survival times of patients with ICC; this signature was enriched in the proliferation class (P < .001). We used an integrative genomic analysis to identify 2 classes of ICC. The proliferation class has specific copy number alterations, activation of oncogenic pathways, and is associated with worse outcome. Different classes of ICC, based on molecular features, therefore might require different treatment approaches. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                EBioMedicine
                EBioMedicine
                EBioMedicine
                Elsevier
                2352-3964
                06 May 2016
                June 2016
                06 May 2016
                : 8
                : 195-202
                Affiliations
                [a ]Genome Institute of Singapore, 138672, Singapore
                [b ]Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore
                [c ]Laboratory of Cancer Epigenome, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore
                [d ]Department of Gastroenterology and Hepatology, Singapore General Hospital, Outram Road, 169608, Singapore
                [e ]Department of Pathology, Singapore General Hospital, Outram Road, 169608, Singapore
                [f ]Cancer Science and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore
                [g ]Edwin L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
                [h ]Center of Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania
                [i ]Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
                [j ]Dept. of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
                [k ]Dept. of Gastroenterology and Hepatology, National University Health System, Singapore
                [l ]Oncology Academic Clinical Program, Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore
                Author notes
                [* ]Correspondence to: C. Pairojkul, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.Department of PathologyFaculty of MedicineKhon Kaen UniversityKhon Kaen40002Thailand chawalit-pjk2011@ 123456hotmail.com
                [** ]Correspondence to: J. Ngeow, Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, 169610, Singapore.Cancer Genetics ServiceDivision of Medical OncologyNational Cancer Centre169610Singapore Joanne.Ngeow.Yuen.Yie@ 123456nccs.com.sg
                [*** ]Correspondence to: N. Nagarajan, Genome Institute of Singapore, 60 Biopolis Street, #02-01 Genome, 138672, Singapore.Genome Institute of Singapore60 Biopolis Street, #02-01 Genome138672Singapore nagarajann@ 123456gis.a-star.edu.sg
                Article
                S2352-3964(16)30177-3
                10.1016/j.ebiom.2016.04.034
                4919562
                27428430
                18c2a52c-86d2-49f6-b6b3-3ecf0697eaf4
                © 2016 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 February 2016
                : 13 April 2016
                : 25 April 2016
                Categories
                Research Paper

                microbiome,cancer,cholangiocarcinoma,liver fluke
                microbiome, cancer, cholangiocarcinoma, liver fluke

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