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Carbonic anhydrase IX (CAIX) is strongly induced by hypoxia and its overexpression is associated with poor therapeutic outcome in cancer. Here, we report that hypoxia promotes tumour heterogeneity through the epigenetic regulation of CAIX. Based on hypoxic CAIX expression we identify and characterize two distinct populations of tumour cells, one that has inducible expression of CAIX and one that does not. The CAIX+ve population is enriched with cells expressing cancer stem cell markers and which have high self-renewal capacity. We show that differential CAIX expression is due to differences in chromatin structure. To further investigate the relationship between chromatin organization and hypoxic induction of CAIX expression we investigated the effect of JQ1 an inhibitor of BET bromodomain proteins and A366 a selective inhibitor of the H3K9 methyltransferase G9a/GLP. We identified that these drugs were able to modulate hypoxic CAIX expression induction. This further highlights the role of epigenetic modification in adaption to hypoxia and also in regulation of heterogeneity of cells within tumours. Interestingly, we identified that the two subpopulations show a differential sensitivity to HDAC inhibitors, NaBu or SAHA, with the CAIX positive showing greater sensitivity to treatment. We propose that drugs modulating chromatin regulation of expression may be used to reduce heterogeneity induced by hypoxia and could in combination have significant clinical consequences.

Original publication




Journal article



Publication Date





19413 - 19427


EMT, carbonic anhydrase IX, hypoxia, stem cells, tumour heterogeneity, Animals, Antigens, Neoplasm, Carbonic Anhydrase IX, Carbonic Anhydrases, Cell Hypoxia, Cell Line, Tumor, Enzyme Induction, Female, HCT116 Cells, Heterografts, Histone Deacetylase Inhibitors, Humans, Isoenzymes, MCF-7 Cells, Male, Mice, Mice, Inbred BALB C, Mice, Nude, Neoplastic Stem Cells