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Dryad

A novel CRISPR screen identifies mediators of cfDNA release

Abstract

The detection of circulating tumor DNA (ctDNA) via liquid biopsy has become routine practice in clinical oncology. Despite its widespread use, the majority of clinically approved tests have limited sensitivity due to the relative paucity of ctDNA. We reasoned that understanding the biogenesis of cell-free DNA (cfDNA) might identify opportunities to increase DNA production from cancer cells and thereby increase the sensitivity of clinical ctDNA testing. Here, we used a novel CRISPR screen to identify the most relevant molecular mediators of cfDNA release and validated these effectors using multiple human cancer and non-cancer cell lines. Previously, apoptosis, necrosis, and extracellular vesicle release have been posited to correlate with DNA release from cancer cells. We find that different cell lines naturally release cfDNA in diverse amounts and fragmentation patterns. Our results also demonstrate that the apoptotic pathway is the major regulator of cfDNA release. Further, cfDNA fragments released through apoptosis have traditionally been thought to be small ~167bp fragments, the size of those identified in human blood. We instead find apoptosis can lead to cfDNA release as large >1000bp fragments, suggesting that the cfDNA found in blood may require additional processing towards this size. We additionally establish that TRAIL can increase cfDNA release across the majority of cancer cell lines, consistent with this ligand’s known proapoptotic role. These results show that the apoptotic pathway is a major mechanism of cfDNA release, and provide opportunities for optimizing liquid biopsies for cancer diagnostics.