Purpose
To identify the genes and pathways responsible for treatment resistance (TR) in retinoblastoma (RB) by analyzing serum small extracellular vesicles (sEVs) of patients with TR active RB (TR-RB) and completely regressed RB (CR-RB).
Methods
Serum-derived sEVs were characterized by transmission electron microscopy and nanoparticle tracking analysis. sEV transcriptome profiles of two TR-RB and one CR-RB with good response (>20 years tumor free) were compared to their age-matched controls (
n
= 3). Gene expression data were analyzed by the R Bioconductor package. The CD9 protein and mRNA expression of CD9, CD63, and CD81 were studied in five RB tumors and two control retinae by immunohistochemistry and quantitative reverse transcription–polymerase chain reaction.
Results
The isolated serum sEVs were round shaped and within the expected size (30–150 nm), and they had zeta potentials ranging from −10.8 to 15.9 mV. The mean ± SD concentrations of sEVs for two adults and four children were 1.1 × 10
12
± 0.1 and 5.8 × 10
11
± 1.7 particles/mL. Based on log2 fold change of ±2 and
P
< 0.05 criteria, there were 492 dysregulated genes in TR-RB and 184 in CR-RB.
KAT2B
,
VWA1
,
CX3CL1
,
MLYCD
,
NR2F2
,
USP46-AS1
,
miR6724-4
, and
LINC01257
genes were specifically dysregulated in TR-RB. Negative regulation of apoptotic signaling, cell growth, and proton transport genes were greater than fivefold expressed only in TR-RB. CD9, CD63, and CD81 mRNA levels were high in RB tumors versus control retina, with increased and variable CD9 immunoreactivity in the invasive areas of the tumor.
Conclusions
Serum sEVs could serve as a potential liquid biopsy source for understanding TR mechanisms in RB.