# Organoid modeling to determine and reverse age-related epigenetic changes contributing to risk of colorectal cancer

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $49,264

## Abstract

There is great need to develop systems in which the course for initiation and progression of cancer, and therapies
directed at these steps can be studied directly in mouse and human cells, and over time courses relevant to real
world tumorigenesis. While engineered mouse models are valuable, there is a need to develop complementary
systems where meaningful, relatively rapid in-vitro work can yield substantial pre-clinical insights leading to final
animal testing. In this regard, we have developed an organoid model which is yielding important data for studying
the age-related risks for developing colorectal cancer (CRC). The studies build on extensive data, now just in
press, derived from mouse organoids from normal proximal colon wherein we have modeled key steps in the
initiation and progression of CRC. The key findings are that despite the organoids being genetically stable over
time, they evolve an abnormal, gene promoter CpG island phenotype (CIMP) during long periods of growth. This
pattern is very similar to changes seen with aging in normal human colon and which parallels the increasing
CRC risk with age. CIMP involves repression of associated gene expression, and/or perhaps even more
importantly affects inducibility of genes which otherwise normally function in a feedback fashion to blunt abnormal
WNT and other stem pathway activation, prevent abnormal retention of cell renewal, and induce differentiation.
In this context, induction of Braf mutations in the older versus younger organoids result in a much more rapid
evolution of autonomous Wnt pathway activation, stem cell versus differentiation features and one-step
transformation by oncogenic Braf. The resulting cancers have typical histologic features and the epigenetic
abnormality of CIMP resembling oncogenic BRAF-driven human proximal colon CRCs. Critically, CRISPR-
mediated simultaneous inactivation of multiple CIMP target genes in young organoids rapidly converts these to
the old organoid phenotype, importantly resulting in rapid one-step transformation by oncogenic Braf. In the
current proposal, we will determine the role of genes affected by age-related CIMP in driving human CRC in the
context of KRAS, BRAF and APC mutations, thus addressing the epigenetic dependency of ~75% of CRC
evolution. This includes extrapolating our studies to human colon organoids. Importantly, our unique models
provide a novel setting to test whether epigenetic therapies can alter the above evolution of CIMP to suppress
age-related changes, which may otherwise enhance CRC risk. Results from these studies may allow insights for
strategies to prevent and/or intercept CRC evolution.
All of the work in our proposal has potential to define management strategies for CRC prevention and
interception, which could prove especially valuable for decreasing CRC risk in individuals harboring familial germ
line predisposition to colon polyps and for patients with inflammatory bowel diseases.

## Key facts

- **NIH application ID:** 10851844
- **Project number:** 5R01CA229240-06
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** STEPHEN B. BAYLIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $49,264
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10851844

## Citation

> US National Institutes of Health, RePORTER application 10851844, Organoid modeling to determine and reverse age-related epigenetic changes contributing to risk of colorectal cancer (5R01CA229240-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10851844. Licensed CC0.

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