A single-cell multi-omics atlas of IDH-mutant glioma identifies a tripartite distribution of cell types
We profiled 22 human IDH-mutant grade II/III gliomas via snATAC-seq: 10 ATRX-mutant IDH-A and 12 ATRX wildtype, 1p/19q co-deleted IDH-O tumors (Fig. 1A, Additional file 1: Fig. S1A-C; Additional file 2: Table S1; Methods). This generated open-chromatin profiles for 38,552 cells following quality control. We separated neoplastic from non-neoplastic cells and classified cell types using our previously described approaches [3, 10, 11]. This identified neoplastic cells harboring clonal mutations, unmutated glia, and monocytic-lineage cells (Fig. 1B).
Having isolated neoplastic cells, we used a SnapATAC-based [12] pipeline to bin reads and cluster cells (Methods). We identified three populations, which we visualized using a principal components analysis (PCA; Fig. 1C). The three clusters were stratified by the first two principal components, indicating that inter-cluster differences represent the primary source of variation in these data. Notably, the percentages of cells in each cluster were nearly equal between IDH-A and IDH-O specimens (Additional file 1: Fig. S1D).
To interpret these clusters, we used ChromVAR to scan sequenced reads from each cluster and identify sequences matching known transcription-factor motifs. We identified motifs that were significantly over- or under-represented compared to a data-driven background distribution. While both cluster one and cluster three were enriched for transcription factors associated with glioma-propagating cells (e.g., SOX2), markers of oligodendrocyte-progenitor cells (OPCs) were more enriched in cluster three (Fig. 1D, Additional file 1: Fig. S1E-F). Cluster one alone showed over-representation of motifs from proneural transcription factors that are expressed by NSCs in the ventricular and sub-ventricular zones of the developing human neocortex (e.g., ZIC1; Additional file 1: Fig. S1G). Cluster 2 was characterized by a depletion of makers of NSCs or OC lineage. Rather, the motifs of AC-lineage regulators (e.g., NFIA, ATF3) [13] were abundant in cluster two. These data confirm a tripartite distribution of cell types (AC, OC, and NSC-like) observed previously by ourselves and others [3, 14], while additionally resolving the transcription-factor programs that mediate differences between these phenotypes.
We profiled seven IDH-mutant grade II/III gliomas via scRNA-seq (Additional file 2: Table S1). We combined this with scRNA-seq data from 13 published IDH-mutant grade II/III gliomas. The combined cohort was comprised of both ATRX-mutant 1p/19q intact IDH-As and ATRX-wildtype 1p/19q-codeleted IDH-Os [14]. Quality control and separation of neoplastic cells from immune cells, nonmalignant glia, and endothelium were performed via our previously described approaches [10, 11, 15]. We further classified neoplastic cells into AC, OC, and NSC-like populations based on the signatures and procedure of Venticher et al. [14]. Cell-type-specific gene expression largely correlated with cluster-specific differences in motif frequency observed in the scATAC-seq data (Additional file 3: Table S2).
Proliferating IDH-A and IDH-O neoplastic cells utilize distinct glial-lineage programs
We compared gene expression in the NSC-like populations between IDH-A/O and to recent scRNA-seq-based lineage tracing studies performed in human and murine fetal brain tissues (Fig. 1E, Additional file 4: Table S3). This included studies mapping the transition from radial glia (a multipotent progenitor responsible for producing both cortical neuron and glial progenitors) to neuronal, astrocyte, and oligodendrocyte progenitors [16,17,18,19], as well as transitions along the oligodendrocyte [20] and astrocyte [21,22,23] lineages from glial progenitors to terminally differentiated glia. We found that NSC-like cells from both IDH-A/O gliomas express markers common to radial glia and glioblasts, while downregulating markers of mature AC and OC cells. However, proneural and pro-astrocytic transcription factors (e.g., NFIA) are upregulated in IDH-A NSC-like cells. Most of the markers that are significantly upregulated in IDH-O NSC-like cells were OC-lineage markers.
There are also significant differences in both the expression and motif enrichment for NFI, bHLH, and other transcription factors that we found when comparing IDH-A and IDH-O cells of the same cell type. We performed a differential test of transcription-factor motif frequencies between IDH-A and IDH-O cells (Fig. 2A, B, Additional file 1: Fig. S2A-B, Additional file 5: Table S4; Methods). We found significant increases of NFI transcription-factor expression and targeting in IDH-A cells, particularly in the cycling, NSC-like population (Figs. 1E and 2B). NFI gene expression regulates glia-genesis and NFIA in particular mediates AC-lineage commitment [22]. Additionally, we saw increases in Notch pathway (e.g., JAG1) and mitogen-associated pathway (MAP) kinase pathway genes in IDH-A cells. Conversely, IDH-O cells upregulate expression and motif frequency of genes governing OC lineage [20].
We called peaks in the scATAC-seq data and identified regions of differentially accessible chromatin between IDH-A and IDH-O specimens. Although we did identify differential peaks in both IDH-O and IDH-A datasets, IDH-A neoplastic cells were characterized by a marked increase in open chromatin compared to IDH-O cells (Fig. 2C). Motif analysis of differential peaks (Fig. 2D, Additional file 1: Fig. S2C) identified CCCTC-binding factor (CTCF), and paralog CTCF-like (CTCFL, aka BORIS), as the two most significantly over-represented in IDH-O cells. ATRX deficiency leads to changes in nucleosome density at CCCTC-motif sequences, reduced CTCF binding, changes in chromatin looping and gene expression in the neonatal brain [24]. ATRX-mutant colorectal cancer cells show reduced ability to form heterochromatic foci compared to wildtype controls [25]. This is consistent with the fact that all our IDH-A specimens (and over 86% of the IDH-A patient population) are ATRX mutant while the IDH-O samples (and most IDH-O gliomas) have ATRX intact. This led us to hypothesize that at some of the chromatin differences we observed between IDH-A and IDH-O tumors are due to ATRX loss of function.
IDH-As are more heavily infiltrated by monocytic-lineage cells derived from circulation, they upregulate myeloid-cell chemotaxis genes and upstream transcription factors, compared to IDH-Os
We found significantly higher percentages of monocytic-lineage cells in IDH-A tumors compared to IDH-O (Fig. 3A). The majority of monocytic-lineage cells from IDH-As were classified as macrophages derived from the peripheral blood, according to our previously described markers [6] and approach [11], while IDH-O monocytic-lineage cells were mostly microglia. Monocytic-lineage cells from IDH-A specimens over-expressed markers of a tumor-supportive phenotype (e.g., CD163; Fig. 3B), compared to IDH-O specimens. IDH-A monocytic-lineage cells also highly over-expressed lactate dehydrogenase relative to IDH-O samples (Fig. 3B), a hallmark of “M2” glycolytic metabolism that is implicated in enhancing macrophage extravasation of the blood-brain barrier [26] and in local immunosuppression [27]. Thus, IDH-A specimens are skewed toward greater infiltration of monocytic-lineage cells, expressing markers of bone marrow ontogeny and M2 polarization.
To elucidate differences in myeloid-neoplastic paracrine signaling between IDH-A and IDH-O, we identified ligands expressed by neoplastic cells whose cognate receptors were also expressed by monocytic lineage cells (Fig. 3C). Notably, myeloid chemotaxis factors (e.g., CSF1, FLT3LG) are over-expressed in IDH-A, as is the upstream transcription factor NFKB1. The latter correlates with significant increases in NFKB1 motif frequency (Additional file 1: Fig. S2A). Likewise, IDH-A specimens show correlated motif-usage and expression increases in ETS1 and increased FYN expression (Additional file 1: Fig. S2A, Additional file 3: Table S2), all regulators of inflammatory cytokines. We mapped differential scATAC-seq peaks called between IDH-A and IDH-O neoplastic cells to adjacent genes and correlated the results with snRNA-seq expression data (Additional file 1: Fig. S3A-B). We compared these correlated peaks to databases of transcription-factor binding sites (Additional file 1: Fig. S3C; Methods). We found an enrichment for the reported binding sites of ATRX co-factor DAXX within peaks correlating with lDH-A-specific ligand expression. This further supported our hypothesis that some of the observed differences between IDH-A and IDH-O microenvironments are mediated by ATRX loss of function.
An immunocompetent mouse model of ATRX-deficient glioma
To model ATRX deficiency in IDH-mutant glioma, we used the immunocompetent glioma model of SB28 cells injected intracranially in C57BL/6j mice as a starting point (Fig. 4A) [9, 28]. These cells produce a relatively modest immune response when injected into the mouse brain.
We transfected SB28 cells with plasmids expressing CRISPR double-nickase guide-RNAs targeting exon 9 of Atrx, as well as Cas9 nuclease (Methods). The CRISPR double-nickase platform uses two guide RNAs which target proximal sequences. The colocalization of both guide-RNAs is required to generate durable DNA alterations. This system, therefore, has much lower off-target rates than single-guide CRISPR systems. Following selection, we isolated single live cells via flow cytometry and expanded them as clones. We then screened clones for a homozygous ATRX knockout (KO) via a cleavage assay and validated the complete loss of ATRX protein via Western blot (Fig. 4B). We then transfected ATRX-KO and wildtype (WT) cells with plasmids expressing the most common IDH1 mutant, IDH1R132, or an IDH-wildtype control. Following selection, we confirmed over 3-fold increase in 2-hydroxyglutarate (the metabolic effector of mutant IDH) in transformed cells compared to controls (Fig. 4C) via an enzymatic assay [29].
ATRX-KO murine gliomas are more heavily infiltrated by immunosuppressive blood-derived monocytic lineage cells than controls, in an IDH-mutant background.
We performed intracerebral injections of ATRX-KO/IDH1R132H or ATRX-WT/IDH1R132H SB28 cells into the right cerebral hemispheres of mice, 50,000 cells per mouse, 6 mice per cohort. We monitored BLI intensity bi-weekly and found that both ATRX KOs and controls generated robust signals in all mice (Fig. 4D, E). Mice were sacrificed when they showed hunchback, seizures, hemiparesis, or weight loss of greater than 20%; two control mice and one ATRX-KO mouse were found dead and thus excluded.
Mice were perfused, and tumor tissue was harvested and snap-frozen. We then performed snRNA-seq and scATAC-seq on a cohort of tumors from five ATRX-KO and four wildtype mice, pooling tissue across ATRX-KO and control mice, respectively. We separated neoplastic cells and classified tumor-infiltrating cells based on our previously described approaches [6, 10]. We found significant increases in the percent of tumor-infiltrating macrophages derived from the peripheral blood compared to microglia (Fig. 4F). Tumor-infiltrating monocytic-lineage cells from ATRX KOs expressed less class II HLA and higher levels of Arg1, Vegfa, and other markers of the immunosuppressive M2 phenotype (Fig. 4F, G, Additional file 6: Table S5). Thus, the myeloid-rich, inflammatory microenvironment of the ATRX-KO/IDH1R132H SB28 model parallels that of ATRX-mutant IDH-A.
ATRX loss-of-function enhances glioma invasiveness, pro-AC, and pro-inflammatory regulatory programs
We found changes in gene expression and correlated changes in transcription-factor motif frequencies in neoplastic cells isolated from ATRX-KO murine tumors, compared to wildtype controls. Moreover, many of these differences agreed with the differences observed between IDH-A and IDH-O human tumors. These differences were organized around three pathways: genes regulating glial linage identity, genes regulating cytokine secretion, and genes enhancing invasiveness.
In particular, ATRX KO induces NFI transcription factors Nfia and Nfix in vivo (Fig. 4G, Additional file 6: Table S5), both regulators of the AC-lineage [13, 21, 22]. This correlates with an over-representation of NFI motifs in the scATAC-seq peaks specific to ATRX-KO specimens, but not observed in wildtype controls (Fig. 4H, I, Additional file 1: Fig. S4A, Additional file 7: Table S6). Thus, the correlation between increased NFI gene expression and motif usage that we had observed in human ATRX-mutant gliomas (Figs. 1 and 2) is conserved in ATRX-KO murine tumors. Likewise, we saw enrichment for OLIG2 and ASCL1 motifs in ATRX wildtype human and ATRX-WT specimens.
We found that in both ATRX KO and WT cells scATAC-seq open-chromatin signatures in neoplastic cells were divided into three clusters. The first was depleted of the stemness and proliferation TF motifs SOX2 and JUNB and dominated by TF motifs of core components of the expression and transduction of pro-inflammatory cytokines, e.g., NFKB and STAT3 signaling (Additional file 1: Fig. S4C-D). The second and third were more closely aligned with each other, enriched for SOX2 and JUNB but differed in the relative frequencies of glial-lineage TF motifs. We found a relatively homogeneous shift in all populations in the frequencies of glial lineage motifs from oligodendrocyte-lineage markers (e.g., OLIG2) to astrocytic (e.g., NFIA) across all three populations. The impact of ATRX deficiency on the global epigenome appears to be relatively homogeneous in our model.
The master-regulator of inflammation, Nfkb1, shows significantly upregulated gene expression in ATRX-KO and its recognition motif is enriched in ATRX-KO-specific peaks. This was similarly the case for human ATRX-mutant gliomas. Similarly, transcription-factor regulators (e.g., ZEB1) and enhancers (e.g., TNC) of invasion were significantly increased both in human ATRX-mutant and ATRX-KO murine glioma specimens. This again correlated with significant differences in motif frequency. We found that ATRX-KO glioma cells were more invasive in vitro than ATRX-wildtype controls, in an IDH1R132H background (Fig. 4J). This dovetails with previous findings that ATRX knockout enhances TNC expression and motility in murine neural stem cells [30]. We conclude that ATRX loss-of-function leads to significant changes in transcription factor expression and targeting. These changes regulate glial identity and cytokine expression programs that phenocopy human IDH-A.
ATRX loss induces a global decrease in CTCF binding, correlated gene dysregulation, and protection from therapy-induced senescence
Notably, CTCF recognition motifs were significantly over-represented in the scATAC-seq peaks that were specific to ATRX-wildtype SB28+IDH1R132H cells (q=0.0197), this was not the case for peaks specific to ATRX-KO cells (Fig. 4I, Additional file 7: Table S6). This is consistent with our human glioma scATAC-seq data, in which CTCF recognition motifs are the most over-represented in ATRX-wildtype specimens (c.f. Fig. 2D). It has been recently shown that ATRX-mutant colorectal cancer cells are resistant to therapy-induced senescence, due to an inability of ATRX-mutant cells to form the requisite heterochromatic foci [25]. Moreover, ATRX loss-of-function leads to a loss of CTCF binding and chromatin dysregulation in the developing brain [24]. To test if ATRX mediates CTCF binding in IDH-mutant glioma we performed anti-CTCF single-cell Cleavage Under Targets and Tagmentation (scCut&Tag) on ATRX wildtype (scrambled control) and KO SB28+IDH1R132H cells (Methods). We found reads aggregated around CTCF motifs defined via the JASPAR database in ATRX-wildtype cells, likewise in an ATRX-wildtype glioblastoma specimen used as a positive control, but this was not the case in ATRX-KO cells (Fig. 5A, Additional file 1: Fig. S1A-B). Sequenced reads from both ATRX-wildtype and ATRX-KO cells showed a significant over-representation of CTCF motifs compared to a data-driven background distribution, with significantly higher representation in ATRX-wildtype vs. ATRX-KO cells; similarly, a greater number of CTCF peaks were identified via MACS2 at an FDR of 0.05 in ATRX-wildtype vs. ATRX-KO cells (Fig. 5B; Methods). Lastly, as additional controls, we interrogated CTCF binding in imprinted regions that have been previously described [24, 31] as loci of ATRX-mediated CTCF binding and found significant differential CTCF enrichment in ATRX-wildtype over ATRX-KO conditions (Fig. 5C). We conclude that ATRX KO leads to a significant, global decrease in CTCF binding in IDH-mutant glioma. This explains the differences in CTCF motif frequency observed between ATRX-KO and ATRX-wildtype, as well as between IDH-A and IDH-O, IDH-mutant glioma specimens. When we compared KEGG pathway enrichment of genes within 25kbp of ATRX-WT/KO differential peaks to ATRX-KO/WT differentially expressed genes, we found co-enrichment of focal adhesion, Ras and MAPK signaling, proteoglycans, and other pathways (Additional file 1: Fig. S5C), supporting the conclusion that the observed changes in CTCF binding were related to the observed changes in gene expression between ATRX-KO and ATRX-WT neoplastic cells in vivo.
Recent studies support our conclusion that a global loss of CTCF binding explains the global increase in open chromatin observed in ATRX-deficient human and murine gliomas (Fig. 2C and 4H) and point to a mechanism by which these differences regulate gene expression. In particular, Pękowska et al. recently demonstrated that a gain of CTCF anchored chromatin loops was a hallmark of the transition from pluripotency to neuroglial lineage commitment [32]. They mapped CTCF and chromatin conformation genome-wide in murine neural stem cells (NSC) and embryonic stem cells and identified a genome-wide induction of CTCF-anchored loops that accompanied loss of pluripotency in NSCs. We compared their annotation of NSC chromatin loops and associated loop-boundary domains to our CTCF peaks in ATRX-KO and wildtype conditions (Fig. 5D). Consistent with the global depletion of CTCF observed upon ATRX KO, we found that approximately 47% of loops contained an ATRX-WT/KO differential peak in their loop-boundary domain, and another 47% of loops overlapped a CTCF-altered loop. To determine which loops demonstrated a coordinated change in gene expression upon ATRX KO, for each loop, we averaged the ATRX-KO/WT cell-averaged log fold-changes in gene expression from neoplastic cells based on in vivo snRNA-seq. To compare these loop-wide averages to a data-driven background estimate, for each loop, we computed a distribution of comparable averages by considering all stretches of consecutive genes of the same length, along the same chromosome (Methods). We then represented the average log fold-change for each loop as a percentile of its associated distribution. We found coordinated loop-wide changes in gene expression, correlating with differential ATRX-WT/KO CTCF peaks in associated loop-boundary domains, for loops containing Vegfa, Tnc, Nfkb1, and others (Fig. 5D–F, Additional file 1: Fig. S5D-E).
We reasoned that the loss of CTCF binding and global chromatin de-condensation that we observed upon ATRX KO may also explain the inability to form the heterochromatic foci necessary for therapy-induced senescence reported recently in ATRX-deficient cancers [25]. We found that ATRX-KO, IDH1R132H-overexpressing SB28 cells were resistant to therapy-induced senescence, as assayed via β-galactosidase activity (Methods), when treated with doxorubicin or a cyclin-dependent kinase inhibitor (CDKi). Likewise, ATRX-mutant patient-derived glioma cells were found to be more resistant than a wild-type control to senescence induced by Temodar, Imatanib, Doxorubicin, or CDKi treatment, in an IDH1-mutant background (Fig. 5G, Additional file 1: Fig. S5F). We conclude that ATRX loss-of-function leads to a decrease in CTCF binding and associated heterochromatin, enabling human and murine glioma cells to evade the desirable outcome of therapy-induced senescence.