Review Article

Epigenetic versus Genetic Deregulation of the KEAP1/NRF2 Axis in Solid Tumors: Focus on Methylation and Noncoding RNAs

Table 1

Functionally investigated KEAP1 gene mutations in tumor tissues and cell lines.

Cancer tissue or cell line typesNucleotide changeAmino acid changeMutation type/clinical predictionProtein domainFunctional effects of KEAP1 mutant

Breast cell line and ductal carcinomac.68G>Ap.C23YMissense/pathogenicNTRRepression of NRF2-dependent transcription activity and ubiquitination defects
Lung AC, lung SCCc.212G>Tp.R71LMissense/pathogenicBTBWild-type behavior
Stomach ACc.246G>Tp.Q82HMissense/pathogenicBTBImpaired effect on NRF2 pathway activation
EOCc.319T>Cp.F107LMissense/pathogenicBTBEnhance the NRF2 nuclear localization and its transcription activity
BUC, EOCc.347G>Cp.R116PMissense/pathogenicBTBEnhance the NRF2 nuclear localization and its transcription activity
Lung AC, lung SCCc.463G>Tp.V155FMissense/pathogenicBTBEnhance the binding of KEAP1 to NRF2 and facilitate NRF2 ubiquitination
EOCc.475G>Ap.A159TMissense/pathogenicBTBEnhance the NRF2 nuclear localization and its transcription activity
Lung AC, lung SCCc.499G>Tp.V167FMissense/pathogenicBTBWeakly affect the bind of KEAP1 to NRF2 without suppressing the NRF2 activity
BTCc.543_544insCp.S181fs11Frameshift/NSIVRInduce the loss of KEAP1 repression activity on NRF2
HCCc.548A>Gp.N183SMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
Lung ACc.556G>Cp.G186RMissense/pathogenicIVRInduce an enhanced binding of KEAP1 to NRF2 and facilitate its ubiquitination without suppressing NRF2-mediated transcription
EOCc.563C>Tp.A188VMissense/pathogenicIVREnhance activation of NRF2 pathway and an increase of its transcriptional activity and nuclear localization
Lung ACc.599A>Cp.H200PMissense/pathogenicIVRWild-type behavior
Lung SCCc.671C>Ap.S224YMissense/pathogenicIVRWild-type behavior
Lung SCCc.691C>Gp.L231VMissense/pathogenicIVRWild-type behavior
Stomach ACc.698G>Ap.S233NMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
CESC, colorectal ACc.700C>Tp.R234WMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
Lung ACc.706G>Cp.D236HMissense/pathogenicIVRReduce KEAP1-mediated repression of NRF2
Lung SCC, liverc.706G>Tp.D236YMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
Lung ACc.711delGp.L237fs1Frameshift (stop codon)/NSIVRReduce KEAP1-mediated repression of NRF2
Lung ACc.724G>Ap.E242KMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
Lung SCCc.728C>Gp.S243CMissense/pathogenicIVRInduce an enhanced binding of KEAP1 to NRF2 and facilitate its ubiquitination without suppressing NRF2-mediated transcription
BUC, lung ACc.730G>Ap.E244KMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
BTC, stomachc.746G>Ap.C249YMissense/pathogenicIVRMutant KEAP1 fails to repress NRF2-dependent transactivation
Breast ACc.767A>Gp.D256GMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
PFc.790G>Ap.V264IMissense/pathogenicIVRReduce KEAP1-mediated repression of NRF2
Lung ACc.814C>Tp.R272CMissense/pathogenicIVRReduce KEAP1-mediated repression of NRF2 (impaired Nrf2 degradation)
Stomach ACc.838T>Cp.F280LMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
Stomach ACc.842T>Cp.L281PMissense/pathogenicIVRInduce an impaired binding of KEAP1 to the CUL3 ubiquitin ligase
Lung AC, lung LCCc.851A>Tp.Q284LMissense/pathogenicIVRReduce KEAP1-mediated repression of NRF2
Stomach ACc.863G>Ap.C288YMissense/pathogenicIVRInduce and impair binding of KEAP1 to NRF2 and facilitate NRF2 ubiquitination and its degradation
Lung AC, liverc.880G>Tp.D294YMissense/pathogenicIVRLead to deleterious effect on protein stability
Lung SCCc.953C>Tp.P318LMissense/pathogenicKELCH1Wild-type behavior
Lung SCCc.?p.P318_fsFrameshift/NSKELCH1Impact on the KEAP1-NRF2 association and NRF2 degradation
EOCc.1234C>Tp.P319SMissense/NSKELCH1Enhance activation of NRF2 pathway and an increase of its transcriptional activity and nuclear localization
Lung SCCc.959G>Ap.R320QMissense/pathogenicKELCH1Induce an enhanced binding of KEAP1 to NRF2 and facilitate its ubiquitination without suppressing NRF2-mediated transcription
Lung AC, lung SCCc.965C>Tp.P322LMissense/pathogenicKELCH1Lead to deleterious effects on KEAP1 protein stability
Colorectal ACc.989C>Tp.T330IMissense/pathogenicKELCH1Impair the KEAP1 binding to NRF2 through the KEAP1 DC pocket (lower affinity)
Lung ACc.994G>Tp.G332CMissense/pathogenicKELCH1Induce an enhancement of the NRF2 activity
Gallbladderc.996_996delCp.G332fs67Frameshift/NSKELCH1Lead a loss of NRF2 repression by KEAP1
Lung ACc.997G>Tp.G333CMissense/pathogenicKELCH1Induce misfolding effects and decrease the KEAP1 stability and capability to bind NRF2
Lungc.1001>Tp.Y334FMissense/NSKELCH1Disrupt the integrity of the Kelch domain of KEAP1
HCCc.1007G>Ap.R336QMissense/pathogenicKELCH1Impair the KEAP1 binding to NRF2 through the KEAP1 DC pocket (lower affinity)
Gallbladder AC, breast ACc.1013C>Tp.S338LMissense/pathogenicKELCH1Mutant KEAP1 fails to repress NRF2-dependent transactivation
HCCc.1024C>Ap.L342MMissense/pathogenicKELCH1Impair the KEAP1 binding to NRF2 through the KEAP1 DC pocket (lower affinity)
Lung ACc.1036InsTp.S346_fsFrameshift (stop codon)/pathogenicKELCH1Lead to a premature termination and truncated KEAP1 protein
PFc.1043insGp.348_fsFrameshift (stop codon)/NSKELCH1Result in a frameshift and produce a truncated KEAP1 protein, with a lower KEAP1-mediated repression of NRF2
Lung AC, stomach cell linesc.1048G>Ap.G350SMissense/NSKELCH1Reduce KEAP1-mediated repression of NRF2
Prostatec.1069G>Ap.D357NMissense/pathogenicKELCH1Impair the KEAP1 binding to NRF2 through the KEAP1 DC pocket (lower affinity)
Colorectal ACc.1075C>Tp.Q359XNonsense/pathogenicKELCH1Impair the KEAP1 binding to NRF2 through the KEAP1 DC pocket (lower affinity)
Lung AC samples and cell linesc.1090G>Tp.G364CMissense/pathogenicKELCH2Abolish the KEAP1-NRF2 interaction
Lung ACc.GCC1098TTAp.L367_fsFrameshift/pathogenicKELCH2Produce a truncated KEAP1 protein
Lung ACc.1106T>Cp.V369AMissense/pathogenicKELCH2Lead to deleterious effects on KEAP1 protein stability
Gallbladder AC, HCCc.1136G>Ap.G379DMissense/pathogenicKELCH2Mutant KEAP1 fails to repress NRF2-dependent transactivation. Induce a misfolding effects on the KEAP1 protein and decrease its ability to bind NRF2
Lung ACc.1238G>Tp.L413RMissense/pathogenicKELCH3Mutant KEAP1 fails to repress NRF2-dependent transactivation. Induce misfolding effects on the KEAP1 protein and decrease its ability to bind NRF2
Lung ACc.DelGG?p.L413_fsFrameshift (stop codon)/NSKELCH3Reduce KEAP1-mediated repression of NRF2
Lung ACc.1243C>Gp.R415GMissense/pathogenicKELCH3Affect the ability of KEAP1 to repress NRF2 and lost the ability to bind and sequester NRF2 in the cytoplasm
Lung SCC, ESCCc.1264G>Ap.D422NMissense/pathogenicKELCH3Enhance the binding of KEAP1 to NRF2 and facilitate NRF2 ubiquitination
Lung AC, lung SCCc.1268G>Tp.G423VMissense/pathogenicKELCH3Enhance the binding of KEAP1 to NRF2 and facilitate NRF2 ubiquitination
Lung ACc.1280C>Tp.A427VMissense/pathogenicKELCH3Reduce KEAP1-mediated NRF2 repression ability but Kelch domain should still be able to interact effectively with the ETGE and the DLG sites of NRF2
Lung ACc.1288G>Tp.G430CMissense/pathogenicKELCH3Induce a misfolding effect on the KEAP1 protein and decrease its ability to bind NRF2 and sequester NRF2 in the cytoplasm.
Lung AC cell linec.1329T>Gp.Y443_fsFrameshift (stop codon)/NSKELCH3Reduce KEAP1-mediated repression of NRF2
Lung ACc.1370delGp.L457fs1Frameshift (stop codon)/NSKELCH3Result in a frameshift and produce a truncated KEAP1 protein, with a lower KEAP1-mediated repression of NRF2
Lung ACc.1396G>Cp.A466PMissense/pathogenicKELCH4Lead to deleterious effects on KEAP1 protein stability
Lung SCCc.?p.N469fsFrameshift/NSKELCH4Impact on the KEAP1-NRF2 association and the KEAP1 ability to suppress NRF2
Lung AC, lung SCC, ESCC, UADTc.1408C>Tp.R470CMissense/pathogenicKELCH4Exhibit enhanced binding to NRF2 and facilitate NRF2 ubiquitination
Lung LCCc.1426G>Ap.G476RMissense/NSKELCH4Induce a misfolding effect on the KEAP1 protein and decrease its ability to bind NRF2 and sequester NRF2 in the cytoplasm.
Lung SCCc.1438G>Tp.G480WMissense/pathogenicKELCH4Reduce the KEAP1-NRF2 binding
Lung ACc.1448G>Ap.R483HMissense/pathogenicKELCH4Reduce the KEAP1-NRF2 binding
Lung ACc.1477G>Cp.E493QMissense/pathogenicKELCH4Induce an upregulation of the NRF2 activity
Lung SCCc.1632G>Tp.W544CMissense/pathogenicKELCH5Reduce the KEAP1-NRF2 binding
Liver, lung ACc.1661G>Ap.R554QMissense/pathogenicKELCH6Reduce the KEAP1-NRF2 binding
Liverc.1662G>Ap.W554XMissense/pathogenicKELCH6Decrease the NRF2 repression activity
PFc.1663_1680del18p.S555_T560delIn frame/NSKELCH6Reduce KEAP1-mediated repression of NRF2
Lung ACc.1709G>Tp.G570VMissense/pathogenicKELCH6Reduce the KEAP1-NRF2 binding
Lung ACc.1772G>Tp.W591LMissense/pathogenicKELCH6Impair the KEAP1 binding to NRF2 through the KEAP1 DC pocket (lower affinity)
Colorectal ACc.1816G>Ap.V606MMissense/pathogenicCTRInduce an upregulation of the NRF2 activity
EOCc.1831G>Ap.E611KMissense/pathogenicCTREnhance activation of NRF2 pathway and an increase of its transcriptional activity and nuclear localization

Cosmic (Catalogue of Somatic Mutations in Cancer) database IP (http://cancer.sanger.ac.uk/cosmic/gene/analysis?ln=KEAP1#variants). AC: adenocarcinoma; BUC: bladder urothelial carcinoma; CESC: cervical squamous cell carcinoma; DC: C-terminal β-propeller domain; EOC: epithelial ovarian cancer; ESCC: esophageal squamous cell carcinoma; HCC: hepatocellular carcinoma; LCC: large cell carcinoma; PF: pleural fluid; SCC: squamous cell carcinoma; UADT: upper aerodigestive tract; NS: not specified.