Inherited determinants of early recurrent somatic mutations in prostate cancer

Prostate cancer is a highly heritable molecularly and clinically heterogeneous disease. To discover germline events involved in prostate cancer predisposition, we develop a computational approach to nominate heritable facilitators of somatic genomic events in the context of the androgen receptor signaling. Here, we use a ranking score and benign prostate transcriptomes to identify a non-coding polymorphic regulatory element at 7p14.3 that associates with DNA repair and hormone-regulated transcript levels and with an early recurrent prostate cancer-specific somatic mutation in the Speckle-Type POZ protein (SPOP) gene. The locus shows allele-specific activity that is concomitantly modulated by androgen receptor and by CCAAT/enhancer-binding protein (C/EBP) beta (CEBPB). Deletion of this locus via CRISPR-Cas9 leads to deregulation of the genes predicted to interact with the 7p14.3 locus by Hi-C chromosome conformation capture data. This study suggests that a polymorphism at 7p14.3 may predispose to SPOP mutant prostate cancer subclass through a hormone-dependent DNA damage response. Prostate cancer is a heterogeneous disease, and many cases show somatic mutations of SPOP. Here, the authors show that a non-coding polymorphic regulatory element at 7p14.3 may predispose to SPOP mutant prostate cancer subclass through a hormone dependent DNA damage response.

P rostate cancer (PCa) is the second most frequent cancer in men causing each year more than 250,000 deaths worldwide. From a genomic perspective PCa is a collection of molecular subclasses 1 . Approximately 58% of risk for prostate cancer has been estimated to be due to inherited genetic factors 2 . Genome-wide association studies have identified more than 100 common single-nucleotide polymorphisms (SNPs) associated with the risk of developing PCa 3 . Most of these variants reside in non-coding regulatory regions and may affect the transcription factors (TFs)-binding affinity 4 . Androgen receptor (AR) regulates genes expression in multiple tissues and diseases, by targeting binding elements in promoters and distant enhancers. A recent PCa whole-genome sequencing study revealed a significant correspondence between DNA breakpoints and AR-binding sites implicating an inter-play between hormone regulation and genomic events 5 . These studies highlight an important role of androgens in the initiation and development of PCa. Indeed, at the earliest time point of clinical presentation, PCa already harbors a range of genomic lesions 1 possibly due to DNA repair defects. We reasoned that, over a man's lifetime, heritable variants could potentially predispose to genomic instability in the context of variable AR signaling leading to early PCa-specific somatic genomic events. To test this hypothesis, we interrogated the constellation of transcriptomic changes in benign prostate cells for clues as to how genetic variants could impact prostate cancer development through alterations in the expression of DNA repair genes and hormone-regulated genes. Here we report a link between an inherited non-coding variant and prostate cancer somatic mutations through the interrogation of large cohorts of human data and experimental support of the functional activity of the variant locus.

Results
In silico selection of germline triggers of somatic mutations. To quantitatively assess the predisposition to genomic changes in the context of AR signaling, we developed an approach to nominate potential heritable facilitators (referred hereafter as triggers) of somatic genomic events. We considered human variants within functionally active regions of the genome defined by the Encyclopedia of DNA Elements (ENCODE) histone mark ChIP-seq data 6 , and established a ranking score, the trigger score, which quantifies the fraction of the transcriptome putatively modulated by each human variant leveraging individuals' genotypes and transcript levels (Fig. 1a). The trigger score-unlike eQTL-based approach-only queries a predefined set of transcripts and ranks the variants for their likelihood to play a role in predisposition to cancer hallmarks 7 . When applied to a RNA-seq data set comprising more than 200 samples including benign human prostate tissue from The Cancer Genome Atlas (TCGA) and samples from the 1000 Genomes Project with known genotype at variants in transcriptionally active regulatory elements 4,6,8 , the trigger score nominated 300 polymorphisms linked to DNA repair and hormone-regulated genes (Fig. 1b,  Supplementary Data 1-3). Sixty-nine of those sites had a minimal trigger score in non-prostate samples (Supplementary Data 3).
Several recent genomic studies now establish PCa as best being regarded as a collection of molecularly defined cancers -similar to breast and lung cancer-with major subclasses defined by either ETS gene fusions (most commonly TMPRSS2-ERG rearrangements), SPOP or FOXA1 single-nucleotide mutations 1,9,10 . These genomic events are recognized as early clonal events that are recurrent in primary untreated prostate cancers 9,11 , and are mainly prostate specific. To explore genotype/phenotype relationship for these common prostate cancer mutations, we assembled a data set comprising 539 prostate tumors from three recent studies 1,9,11 , and observed 47.2, 12.1, and 5.4% incidence, respectively, (Supplementary Data 4). To test the relationship between the trigger candidates and the three somatic phenotypes, we used a computational insilico cross-validation strategy that limits false positives results and implements multiple discovery and validation partitions from the entire cohort preserving somatic event incidence. No signal was detected for the FOXA1 phenotype and, surprisingly, no signal was observed for the largest genomic subclass defined by the ETS rearrangement phenotype (i.e., TMPRSS2-ERG). In contrast, a polymorphic site on 7p14.3 (rs1376350) was significantly associated with SPOP somatic mutations in 97.4% of the partitions with any positive signal (Fig. 1b Fig. 1c and Table 1), the association with the phenotype was highly significant (P = 6.7e-06, OR = 4.83 logistic regression analysis). Further analyses including SPOP wild-type samples of the prostate cancer Tyrol PSA screening cohort 12 and of the 1000 Genomes Project confirmed the association (P = 1.22e-08, OR = 5.54 logistic regression analysis). Moreover, the genotype/ phenotype relationship with SPOP mutation was confirmed in an independent non-Caucasian prostate cancer cohort of Korean men (P = 4e-02, OR = 5.84 logistic regression analysis) 13 , indicating that this phenomenon is not limited to Caucasian male populations but rather may extend across multi-ethnic populations (Table 1 and Fig. 1d). No association was detected between the genotype and the total number of somatic single-nucleotide variants (SNVs) in the tumor, but we observed increased somatic genomic burden in men with the minor allele associated with SPOP mutant prostate cancer ( Supplementary Fig. 1). Linkage disequilibrium analysis on the 1000 Genomes Project data did not reveal variants in functional or coding regions linked to rs1376350 across populations (Supplementary Data 6).
Regulatory impact of 7p14.3 variant. Fourteen DNA repair genes and 15 hormone-regulated genes contributed to the high trigger score for the 7p14.3 variant (Supplementary Data 7), of which DAZAP2, DDX18, SET, and XRCC5 were also significantly deregulated in SPOP mutant as compared to SPOP wild-type human prostate carcinoma cases ( Supplementary Fig. 2). Interestingly, 93% of DNA repair and hormone-regulated transcripts are downregulated by the 7p14.3 variant minor allele; this proportion is significantly higher than the fraction of transcripts downregulated by the 7p14.3 minor allele in the whole transcriptome (48%, P = 3.2e-06 proportion test). Protein-protein-interaction (PPI) network data projected on the fraction of the whole transcriptome modulated by the variant (Supplementary Fig. 3) revealed a connected subnetwork of significant relative size when compared to the same analysis for each polymorphic transcriptionally active regulatory element considered in the study (P = 1e-02 resampling, Supplementary  Fig. 4). Genes in the subnetwork are significantly enriched for gene expression and translation pathways terms (FDR = 5.1e-17 and FDR = 1.6e-07, respectively) and, as expected, for hormoneregulated and DNA repair genes (P = 0.048, P = 6e-04 permutation test). In addition, of all the 57 oncogenes 14 including 39 TFs we queried for targets enrichment 15 , c-MYC resulted as the only significant one (FDR = 0.005; P < 1e-05 permutation test) with a majority of downregulated targets (P = 0.018 proportion test). Overall, this suggests a broad transcriptional regulatory impact of the variant 7p14.3 4 .
In vitro validation. We then verified the activity of the polymorphic regulatory region containing the 7p14.3 variant with an in vitro luciferase assay in two model systems, AR-negative (PC-3) and AR-positive (LNCaP) prostate cancer cells (Fig. 2a). In PC-3 cells, significantly increased activity was observed in the presence of the minor allele (adenine) associated with SPOP mutation compared to the ancestral one (guanine). In contrast, inhibitory activity was observed in LNCaP cells, suggesting differential effects of the variant with respect to AR status. TF DNA-binding site (TFBS) motifs analysis demonstrated an AR consensus motif at the variant locus with the minor but not with the ancestral allele ( Supplementary Fig. 5a, Supplementary Data 8). In addition, we identified a consensus motif for the CEBP family ( Supplementary Fig. 5b), which includes known AR corepressors 16 . RNA-seq data show high levels of CEBPB transcripts in multiple prostate tissue cell lines and a marked anticorrelation with AR levels in human prostate cancers (N = 319, P = 8e-18 Pearson correlation, Supplementary Fig. 6a, b). A less stringent TFBS search in a wider genomic region revealed additional CEBPB-specific consensus motifs in proximity of the variant locus. In addition, we found overlapping CEBPB and AR motifs~70 bp downstream the variant and a CEBPB putativebinding site~180 bp upstream the variant, along with motifs for MAFB and c-MYC TFs, known to co-localize with CEBPB 17 (Supplementary Data 8). We, therefore, investigated the effect of AR over-expression on TFs binding at the 7p14.3 locus.
ChIP-qPCR experiments showed AR and CEBPB recruitment at the site of interest upon AR over-expression (KLK3 and IL-6 were used as positive controls, respectively) (Fig. 2b). Based on the wider TFBS search results, we also verified the recruitment of c-MYC at the 7p14.3 region upon AR over-expression and dihydrotestosterone (DHT) treatment ( Supplementary Fig. 7). To address the potential functional consequences of AR and CEBPB binding to the polymorphic site, we examined the effects of modulating androgenic signaling. We observed decreased responsiveness of the reporter constructs in PC-3 cells upon AR overexpression and DHT treatment ( Supplementary Fig. 8), whereas loss of repressive activity upon AR knock-down in LNCaP cells was seen ( Supplementary Fig. 9a, b). PC-3 cells also showed a decreased enhancer activity upon CEBPB over-expression, which was even stronger upon AR over-expression (Fig. 2c), and an increase in enhancer transactivation upon CEBPB knock-down (Fig. 2d). The construct harboring the minor allele (A) showed the same behavior, while eliciting higher enhancer activity at all conditions ( Supplementary  Fig. 10). These data suggest that CEBPB may act as an AR co-repressor at the variant locus, potentially through its recruitment by AR and that the 7p14.3 locus may undergo allele-dependent TF binding altering the expression of DNA repair and hormone-dependent genes.
Structural associations with 7p14.3 locus. To further demonstrate that the 7p14.3 region is functionally active, we deleted 731 bp of genomic sequence around the site via CRISPR-Cas9 (Supplementary Data 9) in PC-3 cells and sequenced their transcriptomes. Differential transcript expression analysis of edited vs. non-edited cells (control cells) showed enriched deregulation when compared to the same analysis in edited vs. edited and control vs. control (P = 1e-04 and P = 3e-05 Mann-Whitney test, respectively, Supplementary Fig. 11) as validated by real-time PCR in selected genes ( Supplementary  Fig. 12). The fraction of deregulated genes that showed upregulation resulted on average in 70%, 65%, and 62%,   respectively. Along chromosome 7 the analysis between edited vs. control cells, but not edited vs. edited or control vs. control, showed significant concordance with genes predicted to physically interact with the 7p14.3 locus by previously generated Hi-C chromosome conformation capture data from benign prostate cells 18 ( Fig. 3a, b, P = 1e-05 and P = 5e-09 Mann-Whitney test, respectively). Validation of ETV1, NT5C3A and IGFBP3 deregulation upon deletion of 7p14.3 locus is shown (Fig. 3b, c) further supporting medium-range interaction.

Discussion
Over the past 15 years, numerous non-coding SNPs have been linked to the susceptibility to developing prostate cancer 3 , the second most frequent cancer in men causing each year more than 250,000 deaths worldwide, with modest albeit highly significant effects. Evidence of predisposition to TMPRSS2-ERG prostate cancer subtype was previously tested in small familial or sporadic small cohorts [19][20][21] . Recently, two out of 27 common prostate cancer risk variants were found associated with modest signal to the ETS subclass 22 . Here we tested a specific hypothesis on large collections of human prostate tissues and identified a strong association with an emerging class involving mutation in the SPOP gene. Its phenotype is related to DNA repair and AR dysfunction 11,23 and defines a distinct molecular class as confirmed by the TCGA prostate adenocarcinoma publication 1 .
Our findings suggest that the genetic component of this common disease is linked, at least partially, to specific molecularly defined sub-classes through the modulation of AR targets and DNA repair genes. SPOP mutations that predominately involve hotspots located in the MATH substrate binding domain of the protein are prostate cancer specific 24 . Using in vitro models, we recently linked the SPOP mutant prostate cancer to genomic instability due to defects in homologous repair 23 . While the mechanism linking the 7p14.3 variant and SPOP mutation remains elusive and future studies should investigate the role of the allele in the emergence of SPOP somatic mutations, we propose a relevant role in cancer predisposition of non-coding variants that lead to allele-specific transactivation of central TF programs with age dependent and tissue-specific effect 8,21,25 manifesting in early somatic genomic events. This study has potential important implications for the aging male whose testosterone levels change with advancing age, where a subtle differential effect might become significant to the cell (Fig. 4, Supplementary Fig. 13) and facilitate or accelerate the initiation of tumorigenesis in hormone sensitive tissues.
Findings from this study may be generalizable to other cancer subtypes. The predisposition to neoplastic development manifests in a combination of genomic and epigenetic events over time. Unlike many of the model systems that require results to occur in short periods of time, neoplastic development is a fitness selection process. As suggested with the 7p14.3 allele in this study, association with disease-specific pathways potentially enables a cascade of events over time to provide an advantage for cells that are hormonally regulated, for example, to undergo more frequent DNA damaging events that are not repaired. As in the current study, this genetic predisposition may positively select for SPOP mutations as they accelerate the DNA damage phenotype with a complex interplay of multiple TFs at the site of interest involving AR, CEBPB, and possibly c-MYC. Future large scale studies should explore the role of germline trigger events to announce driver somatic mutations.

Methods
Selection of human genome variants in functional regions. ChIP-Seq ENCODE data were queried for 16 cell-lines selected based on availability of H3K4m1, H3K4m3, and H3K27ac regions of signal enrichment data (broadPeak format). The cell line set includes GM12878, H1-hESC, Hela-S3, HepG2, HMEC, HSMM, HSMMtube, HUVEC, K562, Monocytes-CD14 + , NHA, NHDF-Ad, NHEK, NHLF, Osteobl, Dnd41. Consensus regions were determined for all three marker signals. Specifically, for each marker the consensus was generated as the overlap of all regions with enrichment signal above five detected in at least two cell lines as follow: (i) retain a region if it overlaps at least another cell line region for at least 50% of its length; (ii) concatenate the coordinates of regions from step i; (iii) sort and merge retained regions. BEDTools 26 and ENCODE data as of January 2014 were used. Next we considered known SNVs that were commonly genotyped in prostate tumors and matched healthy DNA that demonstrated high quality hybridization signal 9, 12 and the interim TCGA prostate cancer cohort 1 . Variants within functional regions supported by presence of H3K4me1 and H3K27ac consensus signals and absence of H3K4me3 consensus signal were selected retaining only one among multiple completely dependent variants (linkage disequilibrium data provided by the International HapMap Project (http://hapmap. ncbi.nlm.nih.gov/) for all populations was used; we define two variants to be completely dependent when both D' and R 2 measures are equal to 1). A total of 21,364 variants in functional regions were finally considered (hereafter referred to as ''functional variants'').
Selection of DNA repair genes and hormone-regulated genes. DNA repair genes list was obtained from the Human DNA Repair Genes database (http:// sciencepark.mdanderson.org/labs/wood/dna_repair_genes.html) and an additional curated list (Supplementary Data 1) (N = 180). The list of hormone-regulated genes was obtained from 27 (N = 330). Specifically, data for three biological replicates of LNCaP cells treated with small interfering RNA (siRNA) targeting AR and corresponding controls were considered (GSM288299, GSM288300, GSM288301, GSM288293, GSM288294, GSM288295) and for each replicate differentially expressed genes were selected as follows: (i) selection and quintile normalization of genes with reported detection P-values < 5% both in AR treated  Somatic phenotype data sets. Whole-exome or whole-genome sequencing data from prostate cancer tissue samples was queried for early somatic lesions 1,9,11 . Patients with relevant clinical annotations (age, PSA), functional variant genotypes and lesion status for SPOP (N = 539, 12.1% mutated), TMPRSS2-ERG (N = 451, 47.2% rearranged) and FOXA1 (N = 520, 5.4% mutated) were included in the study (N total = 539, Supplementary Data 4). Variants genotypes were determined using standard APT tools 1.16.1 pipeline from Affymetrix SNP 6.0. As all data sets used clinically localized prostate cancer cases, none of these data sets have meaningful clinical follow up data, which would require ten or more years.
Ethnicity analysis. Ethnicity of all individual's samples was inferred using an approach based on inspection of differential germline variants genotype. First, by combining genotype data of individuals with known ethnicity a reference model is built; genotype data by the International HapMap Project was used. A target model is then created using genotype data from all 539 individuals in the somatic data set. Principal component analysis (PCA) is then performed by means of smart pca module 28 on aggregated target and reference models genotype data. Euclidean space defined by the first two PCA components is then inspected to, first, generate smallest convex sets identifying main ethnic groups (EUR, AFR, EAS, AMR, and  Transcriptome analysis and trigger score assessment. Benign (N = 63) and tumor (N = 319) prostate tissues RNA-seq data with available FASTA files 1,9,30 and matched genotype data were aligned to the reference genome hg19 using STAR aligner 31 and logarithm transformed (two based) RPKM+1 of each gene (UCSC knownGenes) were computed using mrfQuantifier 32 and were quintile normalized. For each functional variant, using matched normal RNA and genotype data, the fraction of modulated DNA repair and hormone-regulated genes was quantified from 459 sequenced transcripts (normalized RPKM greater or equal to 1 in at least one individual was required). Seven-hundred eighty-seven variants with monomorphic genotype in the benign samples set were excluded. Linear regression of RPKMs across genotype classes, also grouped based on dominant model or recessive model (dosage, dominant, or recessive test) was applied. Three genotype classes were required to apply the dosage test and minimum of 3% per class for  control cells are shown. c Real-time PCR validation of selected genes nominated by RNA-seq, ETV1, NT5C3A, and IGFBP3; dotted lines represent fold thresholds applied in RNA-seq analysis to identify deregulated transcripts (additional data and negative controls in Supplementary Fig. 12). Data are represented as mean ± s.d. of three technical replicates dominant and recessive. For each variant, the percentage of DNA repair and hormone-regulated genes was computed as the highest percentage of associated transcripts applying a false discovery rate (FDR) threshold of 5% and the corresponding number of associated DNA repair and hormone-regulated genes were then combined to compute the trigger score defined as follows:  Fig. 14); no association detected. For the 7p14.3 variant we then also performed genome-wide association analysis considering 18,758 sequenced transcripts (all transcripts with normalized RPKM greater or equal to 1 in at least one individual). Linear regression of RPKMs across genotype classes using dosage model was performed applying a FDR threshold of 5%. The variant was found genome-wide associated with other 1515 genes of which 723 (48%) show downregulation in presence of the minor allele while 792 (52%) present upregulation.
DNA repair and hormone-regulated genes associated with 7p14.3 variant (Supplementary Data 7) were tested for differential expression across SPOP mutant and SPOP wild-type prostate adenocarcinomas using the Mann-Whitney test statistics ( Supplementary Fig. 2, P-value cutoff set at 1%).
Trigger score and prostate tissue specificity. RNA-seq data of 183 individuals from 1000 Genomes Project with available FASTA files and matched genotype data were aligned to the reference genome hg19 using STAR aligner 31 and logarithm transformed (two based) RPKM+1 of each gene (UCSC knownGenes) were computed using mrfQuantifier 32 and were quintile normalized.
For each of the top selected trigger score variants (N = 300), we measured the trigger score prostate specificity by comparing the score computed from the benign prostate tissue samples and the score computed from the 1000 Genomes Project samples. We performed 100 random sampling of 63 individuals from the 1000 Genomes Project samples set (to mimic the prostate tissue sample size) and computed the trigger score for all top 300 variants. We then annotated a variant as non-global, if no positive score was observed across the 100 experiments; a global trigger score was annotated if at least one experiment provided a positive score. A total of 69 (23%) variants showed non-global scores, where the score was positive only in the prostate tissue dataset (see Supplementary Data 3). No association between variants MAF and global or non-global annotations was detected.
Genotype/phenotype association analysis. Genotype/phenotype association analysis was performed on the top selected trigger score variants (N = 300), after excluding variants with genotyping call rate <85% (N = 423) (Supplementary Data 5). Logistic regression analysis was used to test genotype/phenotype associations and was performed using PLINK 1.07 33 considering allelic, dominant and recessive models. Dominant and recessive models were tested for the minor allele. Association analyses were performed applying age and PSA correction as available. In order to minimize genotype/phenotype-FDR, we computed multiple rounds of discovery and validation by partitioning the whole data set in two subsets two hundred times for each somatic phenotype (lesions in SPOP, TMPRSS2-ERG, and FOXA1) by preserving the lesion incidence in each subset. Specifically, in each partition the genotype/phenotype association was tested for the top selected variants applying corrected P-value (FDR) cutoff at 20% and P-value cutoff at 5% for discovery and validation, respectively. A genotype/phenotype association was considered only if both thresholds were met. Variant 7p14.3 genotypes were tested for association with total number of tumor SNVs and with tumor genomic burden in 427 and 474 patients, respectively, (data availability as per cBioPortal), using Mann-Whitney statistics. The tumor genomic burden was measured as the fraction of the genome with absolute log2(ratio) of tumor over normal above conventionally used threshold (0.15) ( Supplementary Fig. 1).
Interactions between nodes that represent human proteins and with a confidence score greater than 0.7 were retained (all HPRD interactions were included because no score measure is associated to protein-protein interactions in that database). The resulting network contains 263,369 interactions and 16,002 human proteins. The PPI network involving 7p14.3 variant-associated genes was built from the reference PPI network and composed of 953 genes and 1755 interactions.
To determine how likely is that the fraction of the transcriptome modulated by a variant reflects in a PPI network with a connected component comparable to the 7p14.3 variant network component, which is made of 552 genes and 1717 interactions ( Supplementary Fig. 3), we built three distributions: (i) for each functional variant considered in the study (i.e., functional variants in active enhancers), the relative proportion of the biggest connected component present in the corresponding induced PPI network was calculated and a reference distribution was built; (ii) 10,000 random variants along the genome were selected (among all variants available in the Affymetrix SNP 6.0 platform) and the relative proportion of the biggest connected component present in corresponding induced PPI network was calculated for each variant to build a reference distribution; and (iii) using all genes from the reference PPI network (N = 16,002), 10,000 random sets of size 953 were generated and the reference distribution of the relative proportions of the biggest connected component present in the induced network was built. P-values were then computed for 7p14.3 variant-induced network using the three computed reference distributions (see Supplementary Fig. 4). Graphical visualization of PPI networks was performed using both igraph library 34 of R programming language and Cytoscape tool 35 Fig. 4 Two-variable model of genotype-environment interaction study. Three combinations of individual's genotypes (ancestral allele, cytosine) at a polymorphic regulatory region (PRR) and hormone levels (high, low) are represented as examples of the study rationale. a Heterozygous genotype of Individual 1 and high hormone levels maintain DNA damage repair efficiency; b in the presence of low hormone levels for the same individual, reduced transcription of DNA repair genes is expected, facilitating the emergence of early somatic events; c low hormone levels do not impair DNA damage repair efficiency of Individual 2 who inherited ancestral homozygous genotype at the site. Within sequences, green nucleotides indicate AR half motif; bold identifies the SNP locus in the regulatory region [C/T]. The described interaction is not relevant to hormone insensitive tissues. Based on the specific study results, we postulate that in case of the rs1376350 locus AR mediates repression activity partially through the negative regulation of CEBPB and its recruitment to the polymorphic regulatory locus where the minor allele demonstrates higher AR affinity NATURE COMMUNICATIONS | DOI: 10.1038/s41467-017-00046-0 ARTICLE NATURE COMMUNICATIONS | 8: 48 | DOI: 10.1038/s41467-017-00046-0 | www.nature.com/naturecommunications using ReactomePA R library 37 (version 1.14.4). Oncogenes and tumor suppressors (N = 57) targets enrichment was performed using permutation statistics based on target genes information from TRRUST database 15 .
TF DNA-binding sites analysis. We collected 4920 unique TF DNA-binding sites (TFBSs) consensus motifs from Jaspar 38 , HOMER 39 and HOCOMOCO 40 public databases and from TRANSFAC Professional database 41 . We run the transcription element search system (TESS) 42 on the variant locus against the compiled consensus motif collection to search for TFBSs. Both ancestral and minor alleles for 7p14.3 variant were separately tested considering 30 bp flanking regions (length of collected consensus motifs ranges between 5 and 30). For each tested TFBS consensus motif, the TESS tool provides a set of log-likelihood-ratio-based scores. Specifically, we used the score La, which represent the log-odds ratio of the match, and the score Lm, which represents the maximum possible log-odds ratio for a match from the given TFBS consensus motif. To select high confident results we restricted the TFBS matches to La scores that are statistically significant (P < 0.001) if compared with a distribution of score matches computed from random regions of the genome. Briefly, given a consensus motif of length N > 6, we selected 10,000 random regions of length N (preserving uniqueness of the selected regions sequence) across the human genome; for N < = 6 all possible sequences of length N are considered (e.g., the number of possible sequence of length 5 is 4 5 = 1024). Then, of those TFBS that have significant match (N = 32) in at least one of the two tested conditions (variant locus with ancestral or minor allele), only those with La/Lm score greater than 0.75 in at least one of the two conditions are finally retained (N = 7  31 and logarithm transformed (two based) RPKM+1 of each gene (UCSC knownGenes) were computed using mrfQuantifier 32 and were quintile normalized. The resulting expression data was used to identify variation in gene expression in edited vs. control cells in all treatment conditions (16 sample's combinations) and across treatment conditions for both edited and control cells separately (12 sample's combinations). For each combination, we considered transcripts with RPKM greater than 1 in at least one of the two samples (values below 1 are set to 1) and selected only those with absolute log2(ratio) equal or greater than 1. Concordance of deregulation in cells edited with A and B sgRNAs combinations is shown in Supplementary Fig. 17 and deregulated transcripts across experimental conditions in 731 bp edited cells (combination B) are reported in Supplementary Data 11. Evidence of deregulation enrichment was tested by comparing the abundance of deregulation in combinations B edited vs. control cells and in control vs. control or edited vs. edited cells ( Supplementary  Fig. 11). Hi-C data previously generated in RWPE1 prostate cells 18 was queried to test evidence of deregulation at chromosome 7 in correspondence of 7p14.3 Hi-C links (Fig. 3a, b). Hi-C links are defined as genomic regions with normalized Hi-C signal above the 90th percentile of the overall intra-chromosomal 7p14.3 normalized Hi-C signal distribution ( Supplementary Fig. 18).
Real-time qPCR. PC-3 cells were seeded in 6-well plate. Total RNA was extracted using the RNeasy kit (Qiagen) according to the manufacturer's instructions. Two-hundred nanogram of total RNA was retro-transcripted into cDNA using the Revert Aid First Strand cDNA Synthesis Kit (ThermoFisher Scientific). Then, qPCR reactions in real-time were performed using KAPA SYBR FAST Universal 2X qPCR Master Mix (Kapa Biosystems, Resnova) using the CFX384 or CFX96 Detection Systems (BioRad). Analysis of relative mRNA expression was performed using the ΔΔCt method with GAPDH (glyceraldehyde 3-phosphate dehydrogenase) as reference genes (primers sequences in Supplementary Data 10). RNA-seq validation of selected transcripts (Supplementary Data 10) was performed with qPCR including RAB1B, BAP1, and BCAP31 as negative controls. As control cells, we used PC-3 transfected with pSpCas9(1.1) 43 , sgRNA_scramble, and pGL4.14. After 72 h from transfection, cells were selected with Puromycin for 4 days and harvest for 4 weeks.