It has been proposed that evasion of the
p53 pathway through
MDM4 amplification is important for retinoblastoma in humans (
7). It is clear that strong overexpression of
MDM4 can promote retinoblastoma in mice (
26), but our study reveals that most cases of increased
MDM4 copy number in human retinoblastoma arise through low-level gain of the whole long arm of 1q (Supplemental Figure 2). A novel mouse model that exhibits low levels of
MDM4 overexpression (
27) will be an important tool to test the notion that low levels of increases in
MDM4 expression (i.e., via 1q gain) may be oncogenic in retinoblastoma. With a low frequency of focal, high-level
MDM4 amplifications in human retinoblastoma (2 out of 37 samples), we explored whether other components of the p53 pathway might be genetically altered in human retinoblastoma and mouse models. We report, for the first time to our knowledge,
p16INK4a/Arf deletions in both human and murine retinoblastoma. Our mouse genetic analyses showed particularly strong tumor suppressive ability for
Arf in a murine retinoblastoma model.
The strong effect of
Arf loss in promoting murine retinoblastoma (Figure B) suggests that
Arf is the major tumor suppressor in the large deleted region.
Arf only appeared to be inactivated through deletions, as we found no
Arf-specific mutations in retinoblastoma. Moreover, the
Arf promoter is not silenced via methylation in human retinoblastoma (
28). It is important to note that, in human and murine retinoblastomas with
Arf deletion, the region of loss invariably included
p16INK4a and
p15Ink4b as well.
p16INK4a loss alone led to a modest acceleration of
Rb/p107DKO retinoblastoma (Figure A), and we have not investigated the possibility that co-mutation of
Arf together with
p16INK4a and/or
p15Ink4b might exhibit cooperative effects in retinoblastoma suppression. Previous work indicated that upregulation of a number of CDK inhibitors (including p16Ink4a and p15Ink4b) occurs in response to
Rb/p107 deletion in the retina (
14). Also, deletion of another CDKI,
Cdkn1a, led to increased proliferation in the
Rb/p107DKO retina in vivo (
14). This result supports the notion that CDK inhibitors may act as tumor suppressors in the context of
RB deletion. It will be interesting for future work to assess the roles of CDK inhibitors as retinoblastoma suppressors in the context of
Arf mutation.
Arf has been shown to exhibit p53-independent activities in sperm development in mice (
29). It has been hypothesized that
p53-independent activities of
Arf could contribute to the tumor suppressor function of
Arf (reviewed in ref.
30). Indeed, mice lacking both
Arf and
p53 develop a wider spectrum of tumors than that found in
Arf-deficient or
p53-deficient mice (
19). We asked whether
p53 and
Arf loss would synergize to promote retinoblastoma. We found no additive effect of
Arf and
p53 codeletion on the incidence of murine retinoblastoma. Moreover, the absence of
p53 completely eliminated the selective pressure to inactivate the wild-type copy of
Arf. Our data support the idea that
Arf functions through the canonical
p53 pathway in retinoblastoma. We also report direct
p53 mutation and focal
MDM2 amplification in
Rb/p107DKO murine retinoblastoma. Importantly,
Arf deletion,
MDM2 amplification, and
p53 mutation were mutually exclusive in the murine tumors. Also,
MDM4 amplification and
CDKN2A deletion were not found in the same human retinoblastomas. Alterations in the same pathway at multiple levels across different tumors underscore the importance of this pathway in murine retinoblastoma models.
Human retinoblastoma has been proposed to arise from a benign lesion, termed retinoma (
4). It was shown that retinoma, adjacent to normal retina and contiguous with malignant retinoblastoma, exhibited homozygous
RB deletion but was nonproliferative (
4). A limitation of human retinoma studies is that the lesions are studied in the presence of late-stage retinoblastoma that resulted in removal of the eye. The possibility that retinoma could represent a regressed region of retinoblastoma cannot be ruled out. Using mouse models, we could identify lesions that resembled murine retinoblastoma based on marker analyses but were nonproliferative. We hypothesize that murine retinoma-like lesions would have progressed to retinoblastoma had secondary mutations impaired the ability of the
Rb/p107DKO cells to arrest/exit the cell cycle. Previous work has shown that many
Rb/p107DKO cells can exit the cell cycle after an extended period of inappropriate proliferation during retinal development (
5,
13) (also see Figure ). In this study, we found that p53 deletion strongly promotes retinoblastoma, but without suppression of apoptosis (Figure ). Instead, we found that p53 loss increased proliferation in the
Rb/p107DKO retina. Thus, the proliferation machinery may need to be altered through multiple mutations in a single tumor, beyond
Rb or
Rb/p107 mutation alone, for full disruption of the pathway. Recent studies investigating the
miR-17-92 microRNA cluster in retinoblastoma revealed that
miR-17-92 overexpression also promoted retinoblastoma via effects on proliferation control (
14). Interestingly, suppression of p21Cip1 was implicated as conferring some of the effects of
miR-17-92. As p21Cip1 is a known p53 target, it will be interesting for future work to assess whether p21Cip1 also plays a role in mediating the retinoblastoma-suppressing effects of p53. In human retinoblastoma, focal high-level amplification of
MDM4 or deletion of
CDKN2A was relatively infrequent. We hypothesize that the ultimate effect of these alterations is a bypass of a proliferative block to tumorigenesis. Higher resolution analyses of the retinoblastoma genome may reveal additional mutated genes that act in the same pathway.
We have shown that the CDKN2A locus is deleted in a subset of murine and human retinoblastomas. We demonstrated that Arf exhibits potent tumor suppressor activity in mouse models and that the tumor-suppressing effects of Arf require p53 to be intact. We found that p53 loss increases proliferation in the Rb/p107DKO retina without suppressing cell death. We believe that our study provides new insights into the p53 pathway in retinoblastoma in humans and mice and demonstrates the importance of cooperation between Rb and Arf in tumor suppression.