Disruption of the circadian clock drives Apc loss of heterozygosity to accelerate colorectal cancer

An alarming rise in young onset colorectal cancer (CRC) has been reported; however, the underlying molecular mechanism remains undefined. Suspected risk factors of young onset CRC include environmental aspects, such as lifestyle and dietary factors, which are known to affect the circadian clock. We find that both genetic disruption and environmental disruption of the circadian clock accelerate Apc-driven CRC pathogenesis in vivo. Using an intestinal organoid model, we demonstrate that clock disruption promotes transformation by driving Apc loss of heterozygosity, which hyperactivates Wnt signaling. This up-regulates c-Myc, a known Wnt target, which drives heightened glycolytic metabolism. Using patient-derived organoids, we show that circadian rhythms are lost in human tumors. Last, we identify that variance between core clock and Wnt pathway genes significantly predicts the survival of patients with CRC. Overall, our findings demonstrate a previously unidentified mechanistic link between clock disruption and CRC, which has important implications for young onset cancer prevention.

Automated summary

An alarming rise in young onset colorectal cancer (CRC) has been reported, but the underlying molecular mechanism is unknown. Lifestyle and dietary factors are suspected risk factors for young onset CRC. Clock disruption, both genetically and environmentally, accelerates Apc-driven CRC pathogenesis. Using an intestinal organoid model, researchers show that clock disruption promotes transformation by driving Apc loss of heterozygosity and hyperactivating Wnt signaling.