Oxidative stress accelerates repeat sequence instability and base substitutions promoting gastrointestinal driver mutations in MSH2 deficient mice

Oxidative stress promotes repeat-associated mutagenesis, which manifests as MSI and base substitutions in MMR-deficient intestinal tissues, thereby enhancing the mutator phenotype and increasing the overall mutation burden. This process can be sensitively captured using our rpsL assay, which serves as a functional indicator of MMR deficiency and replication instability in normal tissues before tumor formation. This increases the likelihood of driver mutations in oncogenes and tumor suppressor genes, ultimately accelerating early tumorigenesis. This study demonstrated that MSH2 is essential for maintaining genome stability under oxidative conditions and functions as a key suppressor of oxidative stress-induced tumorigenesis.