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Age-related remodelling of oesophageal epithelia by mutated cancer drivers
Abstract
Clonal expansion in aged normal tissues has been implicated in the development of cancer. However, the chronology and risk dependence of the expansion are poorly understood. Here we intensively sequence 682 micro-scale oesophageal samples and show, in physiologically normal oesophageal epithelia, the progressive age-related expansion of clones that carry mutations in driver genes (predominantly NOTCH1), which is substantially accelerated by alcohol consumption and by smoking. Driver-mutated clones emerge multifocally from early childhood and increase their number and size with ageing, and ultimately replace almost the entire oesophageal epithelium in the extremely elderly. Compared with mutations in oesophageal cancer, there is a marked overrepresentation of NOTCH1 and PPM1D mutations in physiologically normal oesophageal epithelia; these mutations can be acquired before late adolescence (as early as early infancy) and significantly increase in number with heavy smoking and drinking. The remodelling of the oesophageal epithelium by driver-mutated clones is an inevitable consequence of normal ageing, which-depending on lifestyle risks-may affect cancer development.
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“Instead, the discovery of widespread clonal expansions in ageing human tissues19,50–52 raises the possibility that some somatic mutations contribute to ageing by driving clonal expansions of functionally altered cells at a cost to the organism49,53,54.”
From Somatic mutation rates scale with lifespan across mammals (2022) · cites this paper as [52]
In the citing paper
“An equivalent state is also pervasive in the epithelium of skin 14 and esophagus 15,16, suggesting that somatic mutation-driven clonal expansions may be a characteristic of aging in several tissues.”
From Clonal hematopoiesis in human aging and disease (2019) · cites this paper as [16]
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BackgroundResultThe somatic mutation landscape of the human body
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BackgroundNotch1 mutations drive clonal expansion in normal esophageal epithelium but impair tumor growth
Abby, E., Dentro, S. C., Hall, M. W. J., Fowler, J. C., Ong, S. H., Sood, R., Herms, A., Piedrafita, G., Abnizova, I., Siebel, C. W., et al. (2023) · Nature Genetics · doi:10.1038/s41588-022-01280-z · Cited by 121
Dreßler, L., Bortolomeazzi, M., Keddar, M. R., Mišetić, H., Sartini, G., Acha‐Sagredo, A., Montorsi, L., Wijewardhane, N., Repana, D., Nulsen, J., et al. (2022) · Genome biology · doi:10.1186/s13059-022-02607-z · Cited by 119
Molecular mechanisms in colitis-associated colorectal cancer
Zhou, R. W., Harpaz, N., Itzkowitz, S. H., & Parsons, R. E. (2023) · Oncogenesis · doi:10.1038/s41389-023-00492-0 · Cited by 123
The translational challenges of precision oncology
Pich, O., Bailey, C., Watkins, T. B. K., Zaccaria, S., Jamal‐Hanjani, M., & Swanton, C. (2022) · Cancer Cell · doi:10.1016/j.ccell.2022.04.002 · Cited by 116
Outcompeting p53-Mutant Cells in the Normal Esophagus by Redox Manipulation
Fernández‐Antorán, D., Piedrafita, G., Murai, K., Ong, S. H., Herms, A., Frezza, C., & Jones, P. H. (2019) · Cell stem cell · doi:10.1016/j.stem.2019.06.011 · Cited by 111
“This process is exemplified by human esophageal epithelium (EE), in which mutations generated by cell-intrinsic processes colonize the majority of normal epithelium by middle age (Martincorena et al., 2018; Yokoyama et al., 2019).”
BackgroundClonal hematopoiesis, somatic mosaicism, and age-associated disease
Evans, M. A., & Walsh, K. X. (2022) · Physiological Reviews · doi:10.1152/physrev.00004.2022 · Cited by 112
Si, D., Ageeva, E. S., & Żukow, W. (2022) · Journal of Education Health and Sport · doi:10.12775/jehs.2022.12.08.074 · Cited by 105
Tumor-Naïve Multimodal Profiling of Circulating Tumor DNA in Head and Neck Squamous Cell Carcinoma
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Huang, K. K., Ma, H., Chong, R. H. H., Uchihara, T., Lian, B. S. X., Zhu, F., Sheng, T., Srivastava, S., Tay, S. T., Sundar, R., et al. (2023) · Cancer Cell · doi:10.1016/j.ccell.2023.10.004 · Cited by 110
Principles of the Molecular and Cellular Mechanisms of Aging
da Silva, P. F. L., & Schumacher, B. (2021) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2020.11.018 · Cited by 106
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“In total, 150 nonsynonymous variants were identified in 16 of the 17 new fitness-inferred CH drivers across these individuals (Supplementary Tables 7 and 9).”
Antagonistic Pleiotropy in Human Disease
Byars, S., & Voskarides, K. (2019) · Journal of Molecular Evolution · doi:10.1007/s00239-019-09923-2 · Cited by 96
Clonal hematopoiesis and associated diseases: A review of recent findings
Asada, S., & Kitamura, T. (2021) · Cancer Science · doi:10.1111/cas.15094 · Cited by 104
Organ System Crosstalk in Cardiometabolic Disease in the Age of Multimorbidity
Oishi, Y., & Manabe, I. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00064 · Cited by 98
“Similar age-related expansion of clones with driver mutations is observed in other normal tissues, including esophageal epithelium (109).”
BackgroundThe Origin and Immune Recognition of Tumor-Specific Antigens
Apavaloaei, A., Hardy, M., Thibault, P., & Perreault, C. (2020) · Cancers · doi:10.3390/cancers12092607 · Cited by 95
Age influences on the molecular presentation of tumours
Li, C. H., Haider, S. A., & Boutros, P. C. (2022) · Nature Communications · doi:10.1038/s41467-021-27889-y · Cited by 98
Mapping genomic and epigenomic evolution in cancer ecosystems
Ushijima, T., Clark, S. J., & Tan, P. B. O. (2021) · Science · doi:10.1126/science.abh1645 · Cited by 89
Dynamic Cancer Cell Heterogeneity: Diagnostic and Therapeutic Implications
Jacquemin, V., Antoine, M., Dom, G., Detours, V., Maenhaut, C., & Dumont, J. E. (2022) · Cancers · doi:10.3390/cancers14020280 · Cited by 92
“Genetic heterogeneity may also predate the tumor itself, as shown by the widespread prevalence—increasing with age—of oncogenic clones in non-tumoral esophagus [27,28].”
BackgroundTranslating insights into tumor evolution to clinical practice: promises and challenges
Fittall, M. W., & Loo, P. V. (2019) · Genome Medicine · doi:10.1186/s13073-019-0632-z · Cited by 91
Evolutionary histories of breast cancer and related clones
Nishimura, T., Kakiuchi, N., Yoshida, K., Sakurai, T., Kataoka, T. R., Kondoh, E., Chigusa, Y., Kawai, M., Sawada, M., Inoue, T., et al. (2023) · Nature · doi:10.1038/s41586-023-06333-9 · Cited by 85
Unveiling the link between chronic inflammation and cancer
Tripathi, S., Sharma, Y., & Kumar, D. (2025) · Metabolism Open · doi:10.1016/j.metop.2025.100347 · Cited by 103
“Surprisingly, comprehensive genomic research found that changes in cancer driver genes promote the age-related growth of cell clones in physiologically normal esophageal epithelia [27].”
Franco, I., Helgadottir, H. T., Moggio, A., Larsson, M., Vrtačnik, P., Johansson, A., Norgren, N., Lundin, P., Mas-Ponte, D., Nordström, J., et al. (2019) · Genome biology · doi:10.1186/s13059-019-1892-z · Cited by 83
“5b) and did not display the typical kidney cancer genetic lesions, nor mutations in TP53, a tumor suppressor often mutated in pre-cancer clones in human tissues [7, 8, 10] (Additional file 1: Table S5).”
BackgroundGenomic alterations driving precancerous to cancerous lesions in esophageal cancer development
Chang, J., Zhao, X., Wang, Y., Liu, T., Zhong, C., Lao, Y., Zhang, S., Liao, H., Bai, F., Lin, D., et al. (2023) · Cancer Cell · doi:10.1016/j.ccell.2023.11.003 · Cited by 85
The duality of human oncoproteins: drivers of cancer and congenital disorders
Castel, P., Rauen, K. A., & McCormick, F. P. (2020) · Nature reviews. Cancer · doi:10.1038/s41568-020-0256-z · Cited by 80
Clonal dynamics of haematopoiesis across the human lifespanPreprint
Mitchell, E., Chapman, M. S., Williams, N., Dawson, K. J., Mende, N., Calderbank, E. F., Jung, H., Mitchell, T. J., Coorens, T. H. H., Spencer, D. H., et al. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.08.16.456475 · Cited by 74
Epithelial defense against cancer (EDAC)
Tanimura, N., & Fujita, Y. (2019) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2019.05.011 · Cited by 71
Splicing Factor SRSF1 Promotes Pancreatitis and KRASG12D-Mediated Pancreatic Cancer
Wan, L., Lin, K., Rahman, M. A., Ishigami, Y., Wang, Z., Jensen, M. A., Wilkinson, J. E., Park, Y., Tuveson, D. A., & Krainer, A. R. (2023) · Cancer Discovery · doi:10.1158/2159-8290.cd-22-1013 · Cited by 72
Metadata
- Authors
- Yokoyama, A., Kakiuchi, N., Yoshizato, T., Nannya, Y., Suzuki, H., Takeuchi, Y., Shiozawa, Y., Sato, Y., Aoki, K., Kim, S. K., Fujii, Y., Yoshida, K., Kataoka, K., Nakagawa, M. M., Inoue, Y., Hirano, T., Shiraishi, Y., Chiba, K., Tanaka, H., Sanada, M., Nishikawa, Y., Amanuma, Y., Ohashi, S., Aoyama, I., Horimatsu, T., Miyamoto, S., Tsunoda, S., Sakai, Y., Narahara, M., Brown, J. B., Sato, Y., Sawada, G., Mimori, K., Minamiguchi, S., Haga, H., Seno, H., Miyano, S., Makishima, H., Muto, M., & Ogawa, S.
- Affiliations
- Kyoto University (JP)
- Institute of Medical Science, The University of Tokyo (JP)
- Nagoya Medical Center (JP)
- Kyoto University Hospital (JP)
- McGill University (CA)
- Kyushu University Beppu Hospital (JP)
- Corresponding author
- Ogawa, Seishi
- ORCID
- Yokoyama, Akira
- Kakiuchi, Nobuyuki
- Yoshizato, Tetsuichi
- Nannya, Yasuhito
- Suzuki, Hiromichi
- Takeuchi, Yasuhide
- Shiozawa, Yusuke
- Sato, Yusuke
- Aoki, Kosuke
- Kim, Soo Ki
- Fujii, Yoichi
- Yoshida, Kenichi
- Kataoka, Keisuke
- Nakagawa, Masahiro M.
- Inoue, Yoshikage
- Hirano, Tomonori
- Shiraishi, Yuichi
- Chiba, Kenichi
- Tanaka, Hiroko
- Sanada, Masashi
- Nishikawa, Yoshitaka
- Ohashi, Shinya
- Horimatsu, Takahiro
- Miyamoto, Shin’ichi
- Tsunoda, Shigeru
- Sakai, Yoshiharu
- Sato, Yoshitaka
- Mimori, Koshi
- Minamiguchi, Sachiko
- Haga, Hironori
- Seno, Hiroshi
- Miyano, Satoru
- Makishima, Hideki
- Muto, Manabu
- Ogawa, Seishi
- Venue
- Nature
- Published
- 2019-01-02
- Volume
- 565
- Issue
- 7739
- Pages
- 312-317
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W2905667684
- Cited by
- 628
- References
- 42
- Citations by year
- 2026: 43 · 2025: 54 · 2024: 64 · 2023: 97 · 2022: 109 · 2021: 95 · 2020: 106 · 2019: 58
- FWCI
- 19.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Kyoto University Research Information Repository (Kyoto University) (submittedVersion)
- Funders
- Ministry of Education, Science and Technology
- Japan Society for the Promotion of Science (18H02692, 15H05791, 15H05912, 17K19595, 15H05909)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Keywords
- esophageal epithelium, clonal expansion, driver mutations, Notch1, PPM1D, aging, esophageal squamous cell carcinoma, alcohol consumption, smoking, cancer risk, single-cell sequencing
- MeSH terms
- Mutation Accumulation, Protein Phosphatase 2C, Adolescent, Adult, Aged, Aged, 80 and over, Aging, Alcohol Drinking, Biopsy, Cell Count, Cell Transformation, Neoplastic, Child, Child, Preschool, Clone Cells, Epithelium, Esophageal Neoplasms, Female, Humans, Infant, Life Style, Male, Middle Aged, Mutation, Precancerous Conditions, Risk Factors, Smoking, Genome, Human, Sequence Analysis, DNA, Evolution, Molecular, Receptor, Notch1, Young Adult, DNA Copy Number Variations, Single-Cell Analysis, Gene-Environment Interaction
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