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Reply to the reviewers
We thank the reviewers for their time and constructive comments on our manuscript.
Reviewer #1 recognizes the importance of the question we address (namely, the early consequences of Wilms' tumour inducing mutations on kidney development in two models for different Wilms' tumour initiating mutations) and provides useful suggestions for improvement of the manuscript.
Reviewer #2 raises the concern regarding the novelty of the study. We appreciate these comments and this implies the necessity of mainly textual changes we have to do to highlight the novel aspects of our study and findings and their significance in the revision of the manuscript.
Reviewer #3 offers a generally positive assessment of the data, while suggesting that the work may be interpreted primarily from a developmental perspective rather than a Wilms' tumour-focused one. In the revision there is need to better emphasize how these perspectives are closely interconnected in the context of Wilms' tumour biology.
Reviewer #1 (Evidence, reproducibility and clarity (Required)):
This manuscript addresses an important gap in Wilms tumor (WT) biology: what are the earliest pathogenic events following WT driver mutation induction, and how do these early developmental trajectories differ across genotypes? The authors provide a carefully staged and comparative analysis of two WT-associated genetic contexts-conditional Wt1 loss (using lineage-specific Cre drivers targeting nephrogenic (Six2-Cre) versus stromal (Foxd1-Cre) compartments, as well as a temporally controlled Wt1CreERT2 model targeting both lineages upon tamoxifen induction) and inducible LIN28B overexpression, and relate the resulting developmental phenotypes to two CSC marker paradigms derived from patient-based studies. A major strength is the precise, time-resolved description of the earliest initiating phenotypes (E12.5 and E18.5, with additional postnatal analysis for LIN28B) and the direct side-by-side comparison of how each genotype perturbs nephrogenesis. The authors conclude that Wt1 loss (especially in the nephrogenic lineage) leads to a severe developmental block accompanied by a disturbance of lineage identity ("lineage confusion"), whereas LIN28B overexpression causes a disturbed transition between uninduced and induced nephron progenitor cell (NPC) states, producing blastemal-like regions that persist postnatally. Using immunostaining for NCAM1, SIX2, CITED1, and ALDH1A2, the authors map marker combinations during normal kidney development and across mutant contexts, and propose that tumor-initiating alterations, most clearly in the LIN28B model, and more suggestively in the Wt1CreERT2 (Wt1CE) context, promote the emergence of a CSC-like population inferred to co-express all four markers (NCAM1+SIX2+CITED1+ALDH1A2+), a state not observed in normal kidneys.
We thank Reviewer #1 for this correct and complete summary of our manuscript. This reviewer recognizes the current gap in our understanding of the origins of Wilms' tumors and appreciates the approach we have chosen to start filling this gap using two different mouse models.
Overall, this study provides a particularly clear direct comparison of the earliest tumor-initiating events triggered by distinct WT-relevant driver alterations. While the manuscript does not yet offer a detailed molecular mechanistic framework explaining why these two mutations produce such divergent developmental and marker-state outcomes (which would further strengthen the work), the careful comparison and the conclusions drawn from it are meaningful and make an important contribution to our understanding of the developmental processes that can lead to Wilms tumor initiation.
We thank this reviewer for recognizing the importance of a direct comparison of the early consequences of two different Wilms' tumour mutations. We agree we do not yet provide a mechanistic framework for these differences. Although these studies are on-going, they are outside the scope of this manuscript.
*Major comment: 1. A central and highly emphasized conclusion of this manuscript is that tumor-initiating alterations induce a CSC-like population co-expressing all four markers (NCAM1, SIX2, CITED1, and ALDH1A2), and that this state is not observed during normal kidney development. Because this "quadruple-positive" population is a key mechanistic take-home message and closely linked to the overall conceptual model, the manuscript would be substantially strengthened by a direct, same-cell demonstration of co-expression of all four markers, rather than inference from consecutive sections. The authors state that they were unable to do so due to a technical limitation, namely, antibody host-species constraints that prevent co-detection of CITED1 and ALDH1A2 within the same section. *
We agree that not being able to show co-expression of all 4 CSC markers is a serious limitation for the interpretation of our data. The reviewer suggests the following alternatives:
*Several feasible approaches could address this limitation for example: - Identify an alternative antibody reagent from a different host species. *
The 'problematic' antibodies are the ones staining for ALDH1A2 and CITED1, which are both Rabbit IgG. Alternative antibodies for ALDH1A2 are all raised in rabbit, so these will not solve this problem. For CITED1 we have now identified a biotin-conjugated antibody which could be used in additional co-staining. We propose to test this antibody for the revision of this manuscript.
*- RNAscope / smFISH for in situ single-cell co-detection. *
We are aware of these techniques as alternative for antibody staining. However, we have no experience with these techniques, nor do we have access to the required technologies. After discussions with collaborators with much experience in this technique, we realized the combination of the potential extensive optimization and costs does not make this a suitable alternative for the limited samples we have available.
*- Single-cell RNA-seq (scRNA-seq) to test whether a bona fide quadruple-positive transcriptional state exists. *
This could be an option but is itself a huge project and therefore outside the scope of this manuscript. We note that the known scarcity in single cell data might still complicate the detection of each marker in individual cells, especially for low-expressed TFs like Six2 and Cited1.
*Overall, resolving this technical limitation would markedly increase confidence in one of the manuscript's most important claims and strengthen the proposed genotype-phenotype/CSC-marker framework
*
_As discussed above, we propose the t_ry the biotin-conjugated CITED1 antibody__
- It is somewhat unexpected that the Six2-specific Wt1 deletion appears to produce a more severe phenotype than the tamoxifen-inducible Wt1CreERT2 approach, which is intended to target a broader Wt1-derived lineage (both nephrogenic and stromal). The Discussion offers several plausible, non-mutually exclusive explanations for this observation (e.g., timing, recombination efficiency/mosaicism, and the rescue contribution of "escaping" wild-type cells). It would be helpful to support at least one of these explanations experimentally. For example, the authors could quantify the extent of "escape" (percentage of non-recombined cells within the lineage) across embryos/timepoints to validate that mosaicism is indeed the cause of the milder phenotype. *
We can address this experimentally by making use of the tdTomato Cre reporter that was included in our model which allows us to follow the fate of mutated and non-mutated cells in the lineage. We propose to combine Six2 antibody staining with the tdTomato signal to quantify the percentage of cells that has maintained Six2 expression and is therefore likely an escaping cell/nephron.
Minor comments 1. Please clarify whether the difference shown in Fig. 2C is statistically significant, and report n, error bars/variation, the statistical test used, and p-values (if applicable).
These details will all be added.
- The authors note the presence of some SIX2+; tdTomato+ cells in Foxd1GC control kidneys. Given the expected stromal restriction of Foxd1 lineage labeling, please clarify the likely explanation and, if possible, indicate how frequent this is.
*
The reviewer here points to the important question regarding the origin and potential overlap between the stromal and nephrogenic lineages. This is not only an important but highly relevant question for origin and biology of Wilms' tumours, but also for normal kidney development. Kobayashi et al (2014) reported some contribution of the Foxd1 lineage in the Six2 lineage. Also Magella et al (2018) found some signs for this, as did a recent pre-print (Haghighitalab et al. 2026). There is even data suggesting that (part of) the renal stromal is derived from the paraxial instead of intermediate mesoderm in chicken (Guillaume et al. 2009) with some supportive data from mouse development as well (Levinson et al. 2005). The latter is especially interesting given the commonly found ectopic muscle differentiation in WT1-mutant Wilms' tumours (Miyagawa et al. 1998; Schumacher et al. 2003; Gadd et al. 2012). However, if a common, potentially Foxd1+/Six2+ double positive, progenitor exists, it will in the normal developing kidney be present before E11.5 and therefore the data in our current manuscript, or the unpublished scMultiome data, is not informative for this. We propose to discuss this in detail in the Discussion of the manuscript, and speculate on its relevance for Wilms' tumours.
It is somewhat unexpected that Six2-specific Wt1 deletion appears to produce a more severe phenotype than the tamoxifen-inducible Wt1CreERT2 approach, which is intended to target a broader Wt1-derived lineage. The Discussion offers several plausible, non-mutually exclusive explanations (e.g., timing and/or recombination efficiency/mosaicism and the contribution of "escaping" cells). it would be helpful to support at least one of these explanations experimentally, for example by quantifying the extent of "escape" across embryos/timepoints and tamoxifen dosing.
This was addressed above.
*4. A careful proofreading pass is needed to ensure text-figure consistency, particularly for arrow annotations. For example, the Results text refers to "Fig. 1F, arrows," but arrows are not apparent in that panel. Likewise, the Results text mentions a "white filled arrow" in Fig. 2H, whereas the figure appears to show only open arrows. Please align the wording with the annotations actually shown in the figures. *
We apologize for these errors and thank the reviewer for pointing them out. These, and all other textual and graphical errors, will be corrected in the new version of the manuscript.
__Reviewer #1 (Significance (Required)): __
Overall, this study provides a particularly clear direct comparison of the earliest tumor-initiating events triggered by distinct WT-relevant driver alterations. While the manuscript does not yet offer a detailed molecular mechanistic framework explaining why these two mutations produce such divergent developmental and marker-state outcomes (which would further strengthen the work), the careful comparison and the conclusions drawn from it are meaningful and make an important contribution to our understanding of the developmental processes that can lead to Wilms tumor initiation.
We thank the reviewer for this comment, and like to emphasize that this is precisely the scope we intended with the current manuscript.
Reviewer #2 (Evidence, reproducibility and clarity (Required)):
*Wilm's Tumor, a pediatric kidney cancer, is associated with gain or loss of activity of a number of genes including the loss of activity of the nucleic acid binding protein WT1 and gain of activity (enhanced expression at the mRNA level) of the RNA binding protein Lin28 which negatively impacts the maturation of the miicroRNA let-7, elevating levels of let-7 targets. Previous mouse studies have examined the impact of loss of Wt1 throughout within the nephron progenitor and interstitial cell compartments in capping mesenchyme that is thought to be the source of the tumor and of broad elevated expression in all kidney progenitors. *
*In this manuscript, the authors have refined the loss of Wt1 to nephron or stromal progenitors and compared the phenotype to loss of Wt1 in both lineages examining cultured kidneys over a 72 hr period, in addition to uncultured kidneys examined at e18.5. A similar analysis was performed on Lin28 mutants. The analysis itself consisted of video imaging, limited immunostaining and histochemistry. *
Reviewer #2 provides, in our opinion, a very limited overview of the contents of our manuscript. Our work presented here shows:
- A detailed analysis of effects of Wt1 loss or activation of LIN28B in the following systems:
- 5 embryonic kidneys
- 5 embryo kidneys
- P19 postnatal kidneys (for the LIN28B model)
- In vitro cultured kidneys.
-
Time-laps analysis of in vitro cultured kidneys
-
In the case of the Wt1 knockout this was studied in nephrogenic, stromal, and the combination of nephrogenic and stromal lineages
- Whereas our previous work (Berry et al. 2015) focused on different stages of nephron development, we now focus on the different lineages.
- For the first time we study the different marker sets for Wilms' tumour cancer stem cells in their developmental context. Important take-home messages for this are:
- The two published maker sets behave different in the normal developing kidney, and no cell types or developmental stages exist in the normal developing kidney that expresses all four markers
-
In contrast, after either of the two Wilms' tumour mutations are induced, we have strong, though not yet conclusive, evidence that this event induces cells that are positive for all four CSC markers, suggesting these quadruple-positive cells could be the functional CSCs. This mutation-dependent appearance of the CSCs would be a complete different mechanism for the origin of CSCs than believed for, for instance, leukemia and colorectal cancer, where an existing cell type with stem- or progenitor cell characteristics which already express the CSC markers picks up the tumour initiating mutations and thus starts behaving as CSC. The cascade our data suggests for the Wilms' tumour CSCs is much more complex.
-
To our knowledge this is the first direct and side-by-side comparison of the early effects of different Wilms' tumour mutations. This analysis clearly shows the differences in underlying biology for these two situations, and this can have important consequences for interpretation of patients data (which was historically almost always generated without knowing the initiating mutation) and opens the possibility of mutation-specific therapeutic possibilities and requirements. This is funcamentally different from the current patient stratification based on clinical outcome (favorable vs non-favorable histology) or very general molecular markers with clear biological consequences (like chr 1p status).
- With respect to the mutation-dependent accumulation of CSC markers, although in both Wt1 and LIN28B models this seems to be happening, for the LIN28B model this seems to be the result of a simple developmental block, whereas for the Wt1 mutants this appears to be a lineage conversion phenotype. This is again something that has to our knowledge never been suggested for the origin of CSCs and even in the context of normal kidney development is almost unprecedented.
- We optimize the use of the Wt1CreERT2 driver to target different lineages in the developing kidney using different timepoints for tamoxifen treatment. Not only does this have technical use, it also illustrates the complex role of Wt1 in the earliest stages of kidney development.
Although the data presented are descriptive and do not yet provide a complete molecular mechanism, we believe they offer novel, unexpected and important insights that merit publication. We acknowledge that these aspects may not have been sufficiently clear in the original version of the manuscript, and therefore not being picked up by the reviewer. In response to Reviewer #2 comments, we propose a thorough rewrite of the Discussion of the manuscript to emphasize these aspects more.
*While wholly qualitative and largely observational and descriptive, the limited data are of good quality and the conclusions drawn are reasonable. *
We thank the reviewer for their compliments on the quality and conclusions of the data. While we acknowledge the reviewer's characterization of the study as quantitative and descriptive, we respectfully do not consider this to diminish its suitability for publication. We believe the dataset provides substantial and meaningful insights (definitely not limited), and we have clarified and expanded upon the novel aspects and significance of our findings as outlined above.
*For the Wt1 study, most interesting would be in the loss of Wt1 from the NPC lineage. Clearly, there is already a significant phenotype at the time of study (E12.5) hence there is no strong insight into the earliest effects of Wt1 loss and how this might contribute to tumor formation. Quite what happens to these cells phenotypically is unclear given the limited set of markers used to look at the cells. Specific removal of Wt1 from the stromal lineage generates a milder phenotype, indicating a role for Wt1 there, but without a mechanistic analysis of the resultant products, the underlying mechanisms remain unclear. *
As discussed in our response to reviewer #1, we agree on the lack of mechanism in the current study but emphasize here as well that although this is the topic of the on-going follow-up studies this is outside the scope of the current manuscript. We refer to the same response for our proposal for additional experiments for the revised version of the manuscript.
*Wt1 removal from both lineages generated a phenotype less severe than removal from nephron progenitors (and previous data on "double lineage removal" with a Nestin1 cre), an indication that the genetic approach was not up to the task. *
Respectfully, we would like to emphasize the practical challenges associated with the use of genetically modified mouse models for developmental (and other) studies. We doubt there are many Cre drivers that do exactly what they were intended to do, do only that, and at full 100% efficiency. Many Cre drivers are, when originally described, only described for the cell type they were intended for, and any other activities or limitations are missed or ignored. One could rightfully argue that is bad science, but unfortunately this is often the reality and the starting point for many in vivo analyses. And these are only the complications regarding the behaviour of the Cre driver, and does not even touch on issues like the biological processing of tamoxifen, and the stability of already existing mRNA and protein of the gene of interest in the context of, in this case, a rapidly developing organ. Simply dismissing technical complications as 'not up to the task' is in our opinion not the way forward for studying the origin of diseases.
What is important, and what we demonstrate, is the realization of the limitations of a system, test them and where possible take them into account in the interpretation of data. In this case, instead of hiding the incompleteness of the Cre activity, we actually demonstrate this using retained staining of Wt1 and discuss this in the context of the different phenotypes. We have carefully tried not to overinterpret our data, and note that this reviewer does not give any specifics where this could be affecting our manuscript.
We also like to stress that in the context of Wilms' tumour development the incomplete activity of this Cre driver could even increase the relevance of this model, since the early stages of Wilms' tumourigenesis in the (future) patient happen in a few mutant cells in the context of a further normal developing kidney. The effect of the normal cells in our model that we speculate about could also be important in the patient, we just don't have the technical possibilities to test this yet.
*In some sense, one could regard this work as a pilot study, looking to optimize expensive and time-consuming mouse experiments to maximize insight (ie choose optimum model, address most informative time points, decide on analytical approaches). As a stand-alone paper, the work may not significantly advance our understanding of the topic. *
As argued above, in our opinion this does not do justice to the work we describe in our manuscript.
For example, can simple loss of Wt1 tells us anything about Wt? Yes Wt1 is lost in a subset, but even in these there are additional genetic mutations.
Of course even in WT1-mutant tumours there will be additional mutations found in the tumour. In fact, it has been known for a long time that WT1-mutant Wilms' tumours select for oncogenic mutations in β-catenin with a surprising preference for specific mutations affecting Ser45. However, it is clear that in these tumours the loss of WT1 is the first, rate-limiting step (Fukuzawa et al. 2004; Li et al. 2004; Zirn et al. 2006; Uschkereit et al. 2007). These β-catenin mutations are selected for in an already WT1-mutant context. If we want to understand the full biology of the WT1 mutant tumours including the β-catenin mutation, we will first need to understand the effect of only losing WT1 because that is what provide the selective pressure for the next step (oncogenic mutation in β-catenin). The work described here is an essential first step in that.
- For Lin12, there is no significant advance beyond the studies of the Daly lab. *
As argued above, this is not correct. The following aspects were not covered in the original paper describing this model:
- The in vitro analysis of control and LIN28B embryonic kidneys, including the time-lapse analysis demonstrating how the phenotype develops over time
- The expression of the Wilms' tumour cancer stem cell markers and how these change as a result of the LIN28B activation
- The direct comparison to the Wt1 loss phenotypes, and the demonstration these different mutations lead to fundamentally different biological phenotypes despite both eventually being classified as Wilms' tumours.
I have no useful suggestions for improvement which would require a completely different approach to the problem from the start.
We respect this reviewer's opinion, but based on the above we do not agree and maintain a different interpretation.
Reviewer #2 (Significance (Required)):
*The authors set out the goal in the introduction - to obtain a better understanding of the origins of Wilm's tumor. There doesn't appear to be an insight of cancer relevant significance beyond earlier studies. *
Our work studies the very first steps in the development of Wilms' tumours. It will never be possible to study this in the (future) patient as these happen around wk 8-10 of pregnancy. By instead analyzing this in mouse models we show fundamental biological differences between different Wilms' tumour inducing mutations which is for sure relevant for patients, the interpretation of patient data (or more the difficulties with interpreting patient data if the initiating mutation or tumour class is not known). Moreover, the data provides new insights in the Wilms' tumour cancer stem cells, a preferred target for any therapy, and suggests the combination of all four known markers might be required to identify and study the true WT CSC. In our opinion such findings provide extremely relevant insights for the field.
*To a readership now/too used to analysis at genome scales (genomic, transcription), this study might appear modest. *
While we agree that genome-wide approaches can provide valuable insights, this doesn't mean that work that doesn't use them cannot provide important insights nor does it mean that every piece of work that does use them provides any new insights. We respectfully emphasize that the merit of a study should be assessed based on the data presented and their interpretation, rather than on the techniques that were used to obtain them.
The target audience is unclear.
Our target audience for this manuscript is everybody who is interested, for whatever reason, in the biology of Wilms' tumours.
Reviewer #3 (Evidence, reproducibility and clarity (Required)):
*Wilms tumor arises from disrupted kidney development. Progenitor-like populations and cancer stem cell (CSC) fractions have been described in patient tumors, but how specific mutations alter embryonic programs to generate these states remains unresolved. *
*Pop et al. model genotype-phenotype relationships during kidney embryogenesis. Using Six2- and Foxd1-driven Cre lines, they test the effects of Wt1 loss-of-function and Lin28b gain-of-function in nephron and stromal progenitors. Through explant imaging, histology, and immunofluorescence, they define mutation-specific effects on ureteric branching, cap mesenchyme organization, stromal composition, and nephron differentiation. *
*Lineage-restricted Wt1 deletion produces distinct outcomes depending on whether nephron progenitors, stromal progenitors, or both are targeted. Lin28b overexpression causes delayed nephrogenesis and lobular organization resembling human Wilms tumor morphology, with expansion of blastemal-like populations. *
This is a correct summary of this part of our data.
These genetic removals of Wt1 and overexpression of Lin28b are useful for the field in understanding where and how Wt1 functions and whether Lin28b could be a model for Wilms' tumor.
We agree that our data on Wt1 loss focusses on the role of Wt1 in normal kidney development, how its loss disrupts normal kidney development and how this could be important for Wilms' tumourigenesis. This includes but goes beyond being only relevant for the function of Wt1, it informs on the biology of WT1-mutant Wilms' tumours.
There is in our mind no doubt whether the LIN28B model is a model for Wilms' tumours. Activating mutations in LIN28B are found in human patient tumours, and already in the original publication of this model (Urbach et al. 2014) it was convincingly shown that the phenotype in the kidneys after less than 3 weeks (when the animals have to be culled animal welfare reasons) represents early stages of Wilms' tumours. Our data presented here confirms this, and extends it with respect to the behavior of the CSC markers and the comparison to the Wt1 loss phenotypes.
Whether the use of previously defined markers NCAM and Aldeflour serve the authors well or is a distraction is to be determine but it is unclear how useful these have been for understanding WT biology thus far. The authors describe these in the developing kidney in explants and in vivo.
*Overall, the data support the view that distinct mutations generate different forms of lineage derailment but it is unclear how this links to Wilms tumor. It is better suited to dsescribe the role of an interesting protein Wt1 in kidney development and lineages therein. Connecting it to tumor biology would require further scrutiny of tumors. *
Since CSCs are, according to the cancer stem cell model, the cells in a tumour that should preferentially be targeted, the exact identification of the CSC markers is directly important for the treatment of tumours. Our data analyzes two different sets of CSC markers, we show these cells label non-overlapping cell types in the normal kidney but that after mutation induction their expression changes and potentially become co-expressed in a single cell type (see our response to Reviewer #1 for more details on this). Identifying the developmental origins of CSCs in a tumour that is the direct result of disturbance of normal embryonic development (Hohenstein et al. 2015; Li et al. 2021) can be used as an entry point into understanding the biology of these tumours. Based on this we argue that although our analysis is on embryonic kidneys, their implications are highly relevant for the actual tumours and their treatment. We propose to further emphasize this in the Introduction and Discussion of our manuscript.
*The study shows that removal of Wt1 in the stromal compartment has distinct phenotypes, which could be important for Wilms tumor biology as this is an poorly understood part of this tumor. *
As already discussed in our response to Reviewer #1, we agree this is a potential important and poorly understood part of Wilms' tumours, directly for WT1 mutant tumours which are stromal-predominant, but potentially also for other tumours. We propose to further address this in the Discussion of the manuscript.
*Major comments: *
-
- This manuscripts uses elegant genetics to scrutinize the role of Wt1 and Lin28b. These stand out as difficult to conduct experiments and are of high value. *
We thank this Reviewer's appreciation for the design, challenges and value of our data.
In contrast, the section on ALDH1A2 and ALDEFLUOR activity is less integrated with the developmental framework.
We discussed our reasons for focusing on the normal developmental context of the cells expressing the CSC markers in the previous section. Since the originally described CSC marker was activity for the AldeFluor enzymatic assay (Pode-Shakked et al. 2013) which we could not use on sections or kidney rudiments, we had to conclusively identify which ALDH isozyme is responsible for this signal in this context. There is much inconsistency about this in the literature, and whichever isozyme is important in these tumours might not be the causative factor in other tumours where AldeFluor labels the CSCs. We therefore use previously published microarray data from the group that originally identified the NCAM1/ AldeFluor combination as Wilms' tumour CSCs to identify ALDH1A2 as the culprit in this cancer type. With this knowledge we could move our analyses to antibodies, allowing co-staining with the other markers. Note that if the signal in these CSCs would have been the result of ALDH1A1 or ALDH1A3 which we show are expressed in the developing ureteric bud, the implications of this for the biology of the tumours would be totally different. We propose to discuss this aspects and its importance in more detail in the revised manuscript.
*Much is unclear here e.g, antibody validation, rationale for performing these assays in explants rather than in vivo tissue, and the shift in Aldh1a2 staining pattern between E12.5 and E18.5, including reported nuclear localization.
*
We need to correct the reviewer on this remark, part of our data is using in vivo samples (E12.5 and E18.5) as well as cultured kidney rudiments. We will clarify which technique we use in the legends of the figures. We prefer to use this combination of techniques for several reasons: 1) the additional 3D information obtained from kidney rudiments can help with identifying specific developmental stages in the developing kidney; 2) due to the different fixation more antibodies work reliably in cultured rudiments than on paraffin frozen sections; 3) this is an important extra factor in the validation of antibodies; and 4) the possibility of culturing kidney rudiments on a time-lapse imaging system allows us to study phenotypes over time (this also greatly reduces the number of animals we need to study multiple timepoints in a developing system, an important aspect for the 3Rs). A good example of this in the timelapse data shown for the nephrogenic Wt1 knockout. The extreme outwards migration of the mutant cells (we show this using the tdTomato reporter) could only be identified in timelapse experiments, but is fully consistent with the sections of the corresponding E12.5 and E18.5 in vivo sections.
We have no explanation for the shift to nuclear localization for ALDH1A2. We are not aware of any other publications showing this. We cannot rule out this is a technical artifact but based on all other expression data obtained with this antibody and their consistency with other publication we don't think this is very likely.
*It is unclear how the manuscript is strengthened by this component. NCAM1 is referenced in the context of Wilms tumor CSCs, but unlike the rest of the manuscript which is mechanistic, it is unclear whether NCAM1 represents a mechanistic node in tumor initiation or merely a surface marker used for cell isolation? If NCAM1 functions just as a proxy for a progenitor-like state rather than a driver of tumor biology surely Wilms tumors will be full of progenitors or blastemal cells and many surface markers. It is unclear what strong evidence shows NCAM1 to be useful, this distinction should be stated. *
Cancer stem cells are defined based in functional characteristics, i.e. the capability of reconstituting a complete tumour with all of its complexity after transplantation in immune-compromised mice. The markers are usually, indeed, merely proxy markers for a specific cell type in the tumour with this functional capacity. The same can be said in this case for the AldeFluor activity, it is used as CSC marker for many cancer types but we are not aware of any data on a functional role for this pathway in any of them. It would be a really interesting experiment to combine our models with an additional conditional knockout for Ncam1 or Aldh1a2 to see if the phenotype we describe here changes. The genetics of such an experiment with so many alleles are however horrendous, would come with an enormous surplus of animals and would take too long for the average project.
The developmental framework presented argues that mutation-specific lineage derailment underlies tumor formation. Marker identity alone does not define pathogenesis. Perhaps reorganize this section to align it with the lineage-confusion model or removing it altogether would make the manuscript punchier?
- *
We propose to rewrite these parts to make this more clear.
- *
- The manuscript is highly focused on the nephrogenic compartment yet removes Wt1 from the stroma as part of one of the main lines of experiments. At several occasions, stromal changes are described qualitatively but using quantitative terms. As such, the manuscript currently comes across as having a bit of a black box where we cannot see the stroma beyond H&E stains. Could there additional antibody stains for stromal markers e.g., Pdgfra, Pdgfrb, or Meis1 to better visualize this compartment and perhaps enable quantification of changes?*
We agree this lack of additional stromal markers is a limitation of the current manuscript. Our reason for so far not including these was our doubts on the usefulness and relevance for the complete renal stroma of many commonly used markers. The scarceness of detailed studies on the developing stroma was a big part of this doubt. Some preliminary tests show that Meis1 is not exclusively found in the developing stroma of the mouse kidney but is also expressed in early stages of the nephrogenic lineage, and is therefore not a good marker for this purpose. Pdgfra and Pdgfrb however seem to be expressed throughout the complete stroma and not in the other lineages. __We propose to analyze these two additional markers for the revised manuscript. __
*Minor comments: *
*Page 4, Lines 89-95: Remove the repeated sentence beginning "Although best known as a transcription factor...". *
*Page 8, Line 164: Arrows referenced in Figure 1F are not visible. *
*Page 8, Lines 164-166: The sentence may refer to Figure 1G; this figure is not otherwise cited. *
*Page 18, Lines 413-414: (Pode-Shakked et al., 2013) is cited twice. *
*Figure 2C: Error bars are missing. Indicate number of biological replicates. *
*Gene nomenclature should be consistent throughout the manuscript. A mouse protein/gene is Six2/Six2. *
*Use precise language when referring to protein detection rather than "expression." *
*Standardize corticomedullary orientation across figures. *
*Page 7, Lines 160-161: Provide immunostaining supporting WT1+/Tdtomato− stromal identity. Co-staining with Foxd1 would clarify lineage assignment. *
*At E18.5 in the Six2-driven Wt1 mutant, WT1 signal is absent despite earlier stromal WT1+ cells. Clarify the fate of these cells. *
*Comment on the lower recombination efficiency observed in Wt1CE at E11.5. *
*Page 14, Lines 321-322: Determine how long CITED1 persists in WTCE mice. Co-staining with later differentiation markers would clarify whether progenitor retention coexists with nephron maturation. *
Page 15, Lines 352-353: Clarify whether the sentence describing blastemal-like regions should reference Figure 5D.
We thank the reviewer for these correction and other minor comments. We will address them in the revised manuscript. With respect to the remark regarding the gene nomenclature, until recently we were also under the assumption that mouse proteins only have the first character as capital. However, to our surprise we recently realized the official mouse nomenclature states that the protein (but not the gene) is in fact in all capitals. We refer for this to section 1.5.2 at https://www.informatics.jax.org/mgihome/nomen/gene.shtml.
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