Oesophageal adenocarcinoma (OAC) is one of the most common causes of cancer deaths and yet compared to other common cancers, we know relatively little about the underlying molecular mechanisms. Barrett's oesophagus (BO) is the only known precancerous precursor to OAC, but our understanding about the specific events leading to OAC development is limited. Here, we have integrated gene expression and chromatin accessibility profiles of human biopsies of BO and OAC and identified a strong cell cycle gene expression signature in OAC compared to BO. Through analysing associated chromatin accessibility changes, we have implicated the transcription factor KLF5 in the transition from BO to OAC. Importantly, we show that KLF5 expression is unchanged during this transition, but instead, KLF5 is redistributed across chromatin in OAC cells to directly regulate cell cycle genes specifically in OAC. Our findings have potential prognostic significance as the survival of patients with high expression of KLF5 target genes is significantly lower. We have provided new insights into the gene expression networks in OAC and the mechanisms behind progression to OAC, chiefly the repurposing of KLF5 for novel regulatory activity in OAC. similar GO terms to those enriched in genes upregulated in OAC compared to BO ( Fig. 3F).GSEA also identified the same gene set terms: "G2M checkpoint" and "E2F1 targets" (Fig. 3G).Next we asked whether these genes are directly regulated by KLF5, and carried out ChIPseq for KLF5 in OE19 cells. Anti-KLF5 antibodies precipitated KLF5 ( Supplementary Fig. 3I) and biological replicates were highly reproducible ( Supplementary Fig. 3J). Therefore, we took the overlap of peaks between biological replicates forward for downstream analyses, resulting in 13,542 peaks ( Supplementary Fig. 3K; Supplementary Table S5). These peaks are highly enriched in the KLF5 motif, demonstrating the validity of the dataset, and also in AP1(FRA1) and GATA (GATA6) motifs, which we have previously revealed in genome wide studies as implicated in OAC (Britton et al., 2017; Rogerson et al., 2019) ( Supplementary Fig. 3L). Focussing on the 97 genes that are upregulated in OAC and also downregulated after KLF5 depletion, 97% have a KLF5 ChIP-seq peak within 0.5 Mb of the TSS and the median distance between a KLF5 ChIP-seq peak and the TSS was 15,604 bp ( Supplementary Fig. 3M). This is indicative of direct regulation by KLF5. An example gene is CDC25B which harbours multiple KLF5 ChIP-seq peaks surrounding its locus (Fig. 3H).Collectively, these results suggest a direct activator role of KLF5 in controlling cell cycle genes in OAC.
The KLF5 cistrome is reconfigured during the progression from BO to OAC.Having determined a role for KLF5 in controlling cell cycle associated gene expression in OAC cells, we sought to determine the mechanism through which KLF5 acquires these functions. We first asked whether KLF5 expression changes in the transition from BO to OAC, however no increase in expression was found (Fig. 4A). An alternative me...