TY - JOUR AU - Ortiz, Michael V. AU - Ahmed, Saima AU - Burns, Melissa AU - Henssen, Anton G. AU - Hollmann, Travis J. AU - MacArthur, Ian AU - Gunasekera, Shehana AU - Gaewsky, Lyvia AU - Bradwin, Gary AU - Ryan, Jeremy AU - Letai, Anthony AU - He, Ying AU - Naranjo, Arlene AU - Chi, Yueh-Yun AU - LaQuaglia, Michael AU - Heaton, Todd AU - Cifani, Paolo AU - Dome, Jeffrey S. AU - Gadd, Samantha AU - Perlman, Elizabeth AU - Mullen, Elizabeth AU - Steen, Hanno AU - Kentsis, Alex T1 - Prohibitin is a prognostic marker and therapeutic target to block chemotherapy resistance in Wilms’ tumor PY - 2019/08/08/ AB - Wilms’ tumor is the most common type of childhood kidney cancer. To improve risk stratification and identify novel therapeutic targets for patients with Wilms’ tumor, we used high-resolution mass spectrometry proteomics to identify urine tumor markers associated with Wilms’ tumor relapse. We determined the urine proteomes at diagnosis of 49 patients with Wilms’ tumor, non–Wilms’ tumor renal tumors, and age-matched controls, leading to the quantitation of 6520 urine proteins. Supervised analysis revealed specific urine markers of renal rhabdoid tumors, kidney clear cell sarcomas, renal cell carcinomas as well as those detected in patients with cured and relapsed Wilms’ tumor. In particular, urine prohibitin was significantly elevated at diagnosis in patients with relapsed as compared with cured Wilms’ tumor. In a validation cohort of 139 patients, a specific urine prohibitin ELISA demonstrated that prohibitin concentrations greater than 998 ng/mL at diagnosis were significantly associated with ultimate Wilms’ tumor relapse. Immunohistochemical analysis revealed that prohibitin was highly expressed in primary Wilms’ tumor specimens and associated with disease stage. Using functional genetic experiments, we found that prohibitin was required for the growth and survival of Wilms’ tumor cells. Overexpression of prohibitin was sufficient to block intrinsic mitochondrial apoptosis and to cause resistance to diverse chemotherapy drugs, at least in part by dysregulating factors that control apoptotic cytochrome c release from mitochondrial cristae. Thus, urine prohibitin may improve therapy stratification, noninvasive monitoring of treatment response, and early disease detection. In addition, therapeutic targeting of chemotherapy resistance induced by prohibitin dysregulation may offer improved therapies for patients with Wilms’ and other relapsed or refractory tumors. JF - JCI Insight JA - JCI Insight SN - 2379-3708 DO - 10.1172/jci.insight.127098 VL - 4 IS - 15 UR - https://doi.org/10.1172/jci.insight.127098 PB - The American Society for Clinical Investigation ER -