Barts Cancer Institute Queen Mary University of London

There is great interest in the molecular characterisation of intestinal metaplasia, such as Barrett’s esophagus (BE), to understand the basic biology of metaplastic development from a tissue of origin. BE is asymptomatic, so it is not generally known how long a patient has lived with this precursor of esophageal adenocarcinoma (EAC) when initially diagnosed in the clinic. We previously constructed a BE clock model using patient-specific methylation data to estimate BE onset times using Bayesian inference techniques, and thus obtain the biological age of BE tissue (Curtius et al. 2016). We find such epigenetic drift to be widely evident in BE tissue (Luebeck et al. 2017) and the corresponding tissue ages show large inter-individual heterogeneity in two patient populations.               

From a basic biological mechanism standpoint, it is not fully understood how the Barrett’s tissue first forms in the human esophagus because this process is never observed in vivo, yet such information is critical to inform biomarkers of risk based on temporal features (e.g., growth rates, tissue age) reflecting the evolution toward cancer. We analysed multi-region samples from 17 BE patients to

1) measure the spatial heterogeneity in biological tissue ages, and 2) use these ages to calibrate mathematical models (agent-based and continuum) of the mechanisms for formation of the segment itself. Most importantly, we found that tissue must be regenerated nearer to the stomach, perhaps driven by wound healing caused by exposure to reflux, implying a gastric tissue of origin for the lesions observed in BE. Combining bioinformatics and mechanistic modelling allowed us to infer evolutionary processes that cannot be clinically observed and we believe there is great translational promise to develop such hybrid methods to better understand multiscale cancer data.

References:

Curtius K, Wong C, Hazelton WD, Kaz AM, Chak A, et al. (2016) A Molecular Clock Infers Heterogeneous Tissue Age Among Patients with Barrett's Esophagus. PLoS Comput Biol 12(5): e1004919

Luebeck EG, Curtius K, Hazelton WD, Made S, Yu M, et al. (2017) Identification of a key role of epigenetic drift in Barrett’s esophagus and esophageal adenocarcinoma. J Clin Epigenet 9:113