Cell
Volume 177, Issue 3, 18 April 2019, Pages 608-621.e12
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Article
Somatic Mutations Increase Hepatic Clonal Fitness and Regeneration in Chronic Liver Disease

https://doi.org/10.1016/j.cell.2019.03.026Get rights and content
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Highlights

  • Deep seq reveals an accumulation of mutations in chronic liver disease tissues

  • PKD1, PPARGC1B, KMT2D, and ARID1A are recurrently mutated

  • In vivo CRISPR screens validate functional relevance of Pkd1, Kmt2d, and Arid1a

  • Mutations seen in liver tissues but not in cancer promote hepatocyte fitness

Summary

Normal tissues accumulate genetic changes with age, but it is unknown if somatic mutations promote clonal expansion of non-malignant cells in the setting of chronic degenerative diseases. Exome sequencing of diseased liver samples from 82 patients revealed a complex mutational landscape in cirrhosis. Additional ultra-deep sequencing identified recurrent mutations in PKD1, PPARGC1B, KMT2D, and ARID1A. The number and size of mutant clones increased as a function of fibrosis stage and tissue damage. To interrogate the functional impact of mutated genes, a pooled in vivo CRISPR screening approach was established. In agreement with sequencing results, examination of 147 genes again revealed that loss of Pkd1, Kmt2d, and Arid1a promoted clonal expansion. Conditional heterozygous deletion of these genes in mice was also hepatoprotective in injury assays. Pre-malignant somatic alterations are often viewed through the lens of cancer, but we show that mutations can promote regeneration, likely independent of carcinogenesis.

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