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Germline genetic predisposition to glioma
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Gliomas are the most common primary malignant tumors of the central nervous system, encompassing a heterogeneous group of subtypes with varying clinical outcomes. Despite advances inthe molecular understanding of glioma biology, therapeutic options—especially for higher-grade gliomas—remain limited, and survival outcomes have not been significantly improved. While environmental factors play a minor role in glioma development, germline genetics have emerged as an important contributor toward glioma susceptibility. Nevertheless, the biological mechanisms and complete spectrum ofgenetic risk factors require further investigation.

Aim: The aim of this thesis was to further contribute to the knowledge of genetic susceptibility to glioma through three studies: a functional study to understand the biological mechanism behind an established risk variant in the LRIG1 gene (Paper I), a genome-wide association study (GWAS) of common genetic variation investigating risk for pediatric glioma (Paper II), and a study investigating rare germline variants in adult glioma patients from a regional cohort (Paper III).

Methods: In Paper I, CRISPR-Cas9 was used to generate isogenic HEK293 with and without a known risk allele (rs11706832, A/C). Transcriptome profiling and metabolomics were performed to investigate the functional impact of the allele in the cell lines. In PaperII, a meta-GWAS was performed, including over 4,069 pediatric gliomas and 8,778 controls from Sweden, Denmark, and the United States. Germline genotyping was performed using single nucleotidepolymorphism (SNP) arrays on blood-derived DNA. Transcriptome-wide association studies (TWAS) and a colocalization analysis were performedusing publicly available expression quantitative trait locus data. In PaperIII, whole-genome sequencing was performed on blood samples from 113 adult glioma patients from a regional cohort from northern Sweden. 

Results: In Paper I, no direct effect from the risk allele on LRIG1 expression or splicing was found. However, altered expression of mitochondrial genes was observed, possibly due to dysregulation of SLC25A26. A global pattern of dysregulated innate immunity was observed and validated using bulk gene-expression data from the Cancer Genome Atlas low-grade gliomas. In Paper II, a genome-wide significant risk locus for childhood pediatric gliomas was identified at 9p21.3 (CDKN2B-AS1 locus, lead SNP rs573687, odds ratio = 1.27, p = 6.97e10). TWAS and colocalization results linked this risk to a reduced expression of tumor suppressor CDKN2B. In Paper III, 17.6% of the adult glioma patients had pathogenic or likely pathogenic variants in viestablished predisposition genes, primarily in DNA repair genes. Additionally, gene-wise burden tests suggested enrichment for rare germline variants in TP53 and in two genes not previously linked toglioma predisposition, CREBBP and DNMT3A.

Conclusion: Collectively, the results from this thesis demonstrate that genetic predisposition to glioma involves multiple genetic factors and must be studied using a wide range of methodologies, including methods to capture rare germline mutations and common genetic variation. These results highlight the importance of both rare and common germline variants in glioma predisposition, underscoring the potential of integrating germline genetics into future risk stratification and research efforts. 

Place, publisher, year, edition, pages
Umeå: Umeå University, 2025. , p. 62
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2387
Keywords [en]
Brain Tumors, Glioma, Cancer, Cancer Predisposition, Cancer Epidemiology, Cancer Genetics
National Category
Cancer and Oncology
Research subject
Cancer Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-246174ISBN: 978-91-8070-809-8 (print)ISBN: 978-91-8070-810-4 (electronic)OAI: oai:DiVA.org:umu-246174DiVA, id: diva2:2011715
Public defence
2025-12-05, Stora Hörsalen 5B, Norrlands Universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2025-11-14 Created: 2025-11-05 Last updated: 2025-11-27Bibliographically approved
List of papers
1. Low-grade glioma risk SNP rs11706832 is associated with type I interferon response pathway genes in cell lines
Open this publication in new window or tab >>Low-grade glioma risk SNP rs11706832 is associated with type I interferon response pathway genes in cell lines
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, article id 6777Article in journal (Refereed) Published
Abstract [en]

Genome-wide association studies (GWAS) have contributed to our understanding of glioma susceptibility. To date, 25 risk loci for development of any of the glioma subtypes are known. However, GWAS studies reveal little about the molecular processes that lead to increased risk, especially for non-coding single nucleotide polymorphisms (SNP). A particular SNP in intron 2 of LRIG1, rs11706832, has been shown to increase the susceptibility for IDH1 mutated low-grade gliomas (LGG). Leucine-rich repeats and immunoglobulin-like domains protein 1 (LRIG1) is important in cancer development as it negatively regulates the epidermal growth factor receptor (EGFR); however, the mechanism responsible for this particular risk SNP and its potential effect on LRIG1 are not known. Using CRISPR-CAS9, we edited rs11706832 in HEK293T cells. Four HEK293T clones with the risk allele were compared to four clones with the non-risk allele for LRIG1 and SLC25A26 gene expression using RT-qPCR, for global gene expression using RNA-seq, and for metabolites using gas chromatography-mass spectrometry (GC–MS). The experiment did not reveal any significant effect of the SNP on the expression levels or splicing patterns of LRIG1 or SLC25A26. The global gene expression analysis revealed that the risk allele C was associated with upregulation of several mitochondrial genes. Gene enrichment analysis of 74 differentially expressed genes in the genome revealed a significant enrichment of type I interferon response genes, where many genes were downregulated for the risk allele C. Gene expression data of IDH1 mutated LGGs from the cancer genome atlas (TCGA) revealed a similar under expression of type I interferon genes associated with the risk allele. This study found the expression levels and splicing patterns of LRIG1 and SLC25A26 were not affected by the SNP in HEK293T cells. However, the risk allele was associated with a downregulation of genes involved in the innate immune response both in the HEK293T cells and in the LGG data from TCGA.

Place, publisher, year, edition, pages
Springer Nature, 2023
National Category
Cancer and Oncology Medical Genetics and Genomics
Identifiers
urn:nbn:se:umu:diva-208211 (URN)10.1038/s41598-023-33923-4 (DOI)000984494600021 ()37185361 (PubMedID)2-s2.0-85154566176 (Scopus ID)
Available from: 2023-05-16 Created: 2023-05-16 Last updated: 2025-11-05Bibliographically approved
2. Multi-ancestry genome-wide association study of 4069 children with glioma identifies 9p21.3 risk locus
Open this publication in new window or tab >>Multi-ancestry genome-wide association study of 4069 children with glioma identifies 9p21.3 risk locus
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2023 (English)In: Neuro-Oncology, ISSN 1522-8517, E-ISSN 1523-5866, Vol. 25, no 9, p. 1709-1720Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Although recent sequencing studies have revealed that 10% of childhood gliomas are caused by rare germline mutations, the role of common variants is undetermined and no genome-wide significant risk loci for pediatric central nervous system tumors have been identified to date.

METHODS: Meta-analysis of 3 population-based genome-wide association studies comprising 4069 children with glioma and 8778 controls of multiple genetic ancestries. Replication was performed in a separate case-control cohort. Quantitative trait loci analyses and a transcriptome-wide association study were conducted to assess possible links with brain tissue expression across 18 628 genes.

RESULTS: Common variants in CDKN2B-AS1 at 9p21.3 were significantly associated with astrocytoma, the most common subtype of glioma in children (rs573687, P-value of 6.974e-10, OR 1.273, 95% CI 1.179-1.374). The association was driven by low-grade astrocytoma (P-value of 3.815e-9) and exhibited unidirectional effects across all 6 genetic ancestries. For glioma overall, the association approached genome-wide significance (rs3731239, P-value of 5.411e-8), while no significant association was observed for high-grade tumors. Predicted decreased brain tissue expression of CDKN2B was significantly associated with astrocytoma (P-value of 8.090e-8).

CONCLUSIONS: In this population-based genome-wide association study meta-analysis, we identify and replicate 9p21.3 (CDKN2B-AS1) as a risk locus for childhood astrocytoma, thereby establishing the first genome-wide significant evidence of common variant predisposition in pediatric neuro-oncology. We furthermore provide a functional basis for the association by showing a possible link to decreased brain tissue CDKN2B expression and substantiate that genetic susceptibility differs between low- and high-grade astrocytoma.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
Childhood brain tumors, genetic susceptibility, glioma, GWAS, pediatric neuro-oncology
National Category
Cancer and Oncology Medical Genetics and Genomics
Identifiers
urn:nbn:se:umu:diva-214245 (URN)10.1093/neuonc/noad042 (DOI)000959346400001 ()36810956 (PubMedID)2-s2.0-85151731119 (Scopus ID)
Funder
Swedish Childhood Cancer FoundationCancerforskningsfonden i NorrlandSwedish Research CouncilSwedish Cancer Society
Available from: 2023-09-18 Created: 2023-09-18 Last updated: 2025-11-05Bibliographically approved
3. Rare germline variants contribute to glioma predisposition: Whole-genome analysis of a regional cohort of glioma patients
Open this publication in new window or tab >>Rare germline variants contribute to glioma predisposition: Whole-genome analysis of a regional cohort of glioma patients
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(English)Manuscript (preprint) (Other academic)
Keywords
Adult glioma, Whole-Genome Sequencing, Rare variants, germline genetics, glioma predisposition
National Category
Cancer and Oncology
Research subject
Cancer Epidemiology
Identifiers
urn:nbn:se:umu:diva-246169 (URN)
Funder
Swedish Research Council, 2019-01566Umeå University, 7003839Swedish Cancer Society, CAN2018/390Cancerforskningsfonden i Norrland, AMP 23-1141, AMP 24-1190, AMP 25-1221
Available from: 2025-11-05 Created: 2025-11-05 Last updated: 2025-11-06Bibliographically approved

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