МОЛЕКУЛЯРНО-БИОЛОГИЧЕСКИЕ ХАРАКТЕРИСТИКИ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЙ

The review presents the main and additional features that distinguish tumor cells from normal tissue cells. They include sustained proliferative signaling, evasion from growth suppressors, resisting cell death, enabling replicative immortality, angiogenesis induction, and invasion and metastasis activation. Basis for the formation of these features is provided by tumor genome instability. Tumors are complex tissues that consist of different cell types interacting with each other as well as with normal cells. An important characteristic of tumor cells is the ability to interact with the tumor microenvironment and the formation of tumor stroma.В обзоре представлены основные и дополнительные признаки, отличающие опухолевую клетку от клетки нормальной ткани. Эти признаки включают в себя поддержание постоянной пролиферативной сигнализации, уклонение от действия опухолевых супрессоров, избегание апоптоза, увеличение времени жизни клетки, стимуляцию ангиогенеза, и активацию инвазии и метастазирования. Основу для формирования этих признаков предоставляет нестабильность опухолевого генома. Опухоли — это сложные ткани, которые состоят из различных типов клеток, взаимодействующих как друг с другом, так и с нормальными клетками. Важной характеристикой опухолевой клетки является способность к взаимодействию с клеточным микроокружением и формирование опухолевой стромы.

СТРУКТУРНО-ФУНКЦИОНАЛЬНЫЙ АНАЛИЗ ОПУХОЛЕВЫХ ГЕНОМОВ И РАЗРАБОТКА ТЕСТ-СИСТЕМ ДЛЯ РАННЕЙ ДИАГНОСТИКИ, ПРОГНОЗА ТЕЧЕНИЯ И ОПТИМИЗАЦИИ ТЕРАПИИ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЙ

The article discusses results of the structural and functional analysis of molecular genetic abnormalities in various malignant tumors. Investigations have discovered more than 20 new markers for sporadic breast cancer. Several of them formed the test system, allowing the diagnosis with a specificity of 100%. Appearance of TMPRSS2/ERG4 chimeric gene is a frequent tumor-specific event, its expression is correlated with more aggressive forms of prostate cancer, may serve as a molecular marker for tumor cells and androgen assessment of tumor response to hormonal therapy. The effective systems for the early diagnosis of cervix and endometrium cancer were developed as well. Mutations in the VHL, deletions of chromosome 3 and methylation of several genes can predict the course and selection of effective therapy of clear cell kidney cancer. a number of molecular markers were identified for early diagnosis and prognosis of recurrence of bladder cancer. For diagnosis, prognosis and treatment of brain tumors we developed an effective complex system of markers. Protocol of molecular genetics investigation reveals the cause of the disease by more than 90% of patients with retinoblastoma. In order to study abnormal methylation in tumor genomes an innovative technology AFLOAT has been developed that allows to efficiently identify new markers with diagnostic value. Test systems of molecular genetic and epigenetic markers for early diagnosis and prognosis as well as for cancer therapy optimization have shown to be effective, have been approved for use in clinical practice and are being introduced into practical healthcare.Рассматриваются результаты структурно-функционального анализа молекулярно-генетических нарушений при различных злокачественных опухолях. Исследования позволили обнаружить более 20 новых маркеров для спорадического рака молочной железы, из которых сформированы тест-системы, позволяющие проводить диагностику со специфичностью 100%. Образование химерного гена TMPRSS2/ERG4 является частым опухоль-специфическим событием, его экспрессия коррелирует с более агрессивными формами рака предстательной железы может служить молекулярным маркером  андрогенчувствительности опухолевых клеток и оценки ответа опухоли на гормональную терапию. Разработаны эффективные системы для ранней диагностики рака шейки матки и эндометрия. Мутации гена VHL, делеции хромосомы 3 и метилирование ряда генов позволяет прогнозировать течение и подбор эффективной терапии светлоклеточного рака почки. Для ранней диагностики, прогноза течения и рецидивирования рака мочевого пузыря определен целый ряд молекулярных маркеров. Для диагностики, прогноза и лечения опухолей мозга разработана эффективная комплексная система маркеров. Протокол молекулярно-генетического  исследования позволяет обнаружить причину заболевания более чем у 90% пациентов с ретинобластомой.  Для исследования аномального метилирования в опухолевых геномах разработана инновационная технология AFLOAT, позволяющая эффективно выявлять новые маркеры, имеющие диагностическое значение. Тест-системы молекулярно-генетических и эпигенетических маркеров для ранней диагностики, прогноза течения и оптимизации терапии злокачественных новообразований показали свою эффективность, получили разрешение на использование в клинической практике и в настоящее время активно внедряются в практическое здравоохранение.

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

МОЛЕКУЛЯРНЫЙ ПАТОГЕНЕЗ РАКА МОЧЕВОГО ПУЗЫРЯ

The review describes the current views on urothelial carcinoma carcinogenesis. Based on the up-todate genetic studies, molecular pathways determining the development of superficial and invasive bladder cancers are considered. It was demonstrated that the development of noninvasive bladder tumors occurred predominantly through oncogenes activation, while the genesis of invasive cancer is based on inactivation of tumor suppressor genes. Principal mechanisms of multiple and recurrent bladder tumors development are discussed including its monoclonal and oligoclonal models.One of the most promising nowadays approaches is the determination of new generation markers, such as molecular genetic abnormalities in the hereditary apparatus of the cell underlying its malignant transformation. Molecular markers' panels used for diagnostics, prognosis, and monitoring of urothelial carcinoma patients are analyzed.В  обзорной   статье  представлены  современные взгляды  на  канцерогенез уротелиальной карциномы. В свете современных генетических исследований рассмотрены молекулярные  пути, определяющие  развитие  поверхностного  и инвазивного рака мочевого  пузыря. Показано, что развитие  неинвазивных  опухолей мочевого  пузыря  происходит  преимущественно  по пути активации  онкогенов, тогда как генез инвазивного  рака идет по пути инактивации  генов-супрессоров опухолевого роста. Обсуждаются основные механизмы развития множественных и рецидивных  опухолей мочевого  пузыря, моноклональная и олигоклональная модели  развития.  Одним из наиболее  перспективных  направлений  представляется определение маркеров  нового типа, к которым относятся молекулярно-генетические  изменения  в наследственном  аппарате  клетки, лежащие в основе ее злокачественной трансформации. Авторы проводят анализ систем молекулярных маркеров,  используемых  для диагностики, прогноза  и мониторинга  пациентов с уротелиальной  карциномой

Abnormal hypermethylation of CpG dinucleotides in promoter regions of matrix metalloproteinases genes in breast cancer and its relation to epigenomic subtypes and HER2 overexpression

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) substantially contribute to the regulation of intercellular interactions and thereby play a role in maintaining the tissue structure and function. We examined methylation of a subset of 5'-cytosine-phosphate-guanine-3' (CpG) dinucleotides in promoter regions of the MMP2, MMP11, MMP14, MMP15, MMP16, MMP17, MMP21, MMP23B, MMP24, MMP25, MMP28, TIMP1, TIMP2, TIMP3, and TIMP4 genes by methylation-sensitive restriction enzyme digestion PCR. In our collection of 183 breast cancer samples, abnormal hypermethylation was observed for CpGs in MMP2, MMP23B, MMP24, MMP25, and MMP28 promoter regions. The non-methylated status of the examined CpGs in promoter regions of MMP2, MMP23B, MMP24, MMP25, and MMP28 in tumors was associated with low HER2 expression, while the group of samples with abnormal hypermethylation of at least two of these MMP genes was significantly enriched with HER2-positive tumors. Abnormal methylation of MMP24 and MMP25 was significantly associated with a CpG island hypermethylated breast cancer subtype discovered by genome-wide DNA bisulfite sequencing. Our results indicate that abnormal hypermethylation of at least several MMP genes promoters is a secondary event not directly functional in breast cancer (BC) pathogenesis. We suggest that it is elevated and/or ectopic expression, rather than methylation-driven silencing, that might link MMPs to tumorigenesis. © 2020 by the authors

Abnormal promoter DNA hypermethylation of the integrin, nidogen, and dystroglycan genes in breast cancer

Cell transmembrane receptors and extracellular matrix components play a pivotal role in regulating cell activity and providing for the concerted integration of cells in the tissue structures. We have assessed DNA methylation in the promoter regions of eight integrin genes, two nidogen genes, and the dystroglycan gene in normal breast tissues and breast carcinomas (BC). The protein products of these genes interact with the basement membrane proteins LAMA1, LAMA2, and LAMB1; abnormal hypermethylation of the LAMA1, LAMA2, and LAMB1 promoters in BC has been described in our previous publications. In the present study, the frequencies of abnormal promoter hypermethylation in BC were 13% for ITGA1, 31% for ITGA4, 4% for ITGA7, 39% for ITGA9, 38% for NID1, and 41% for NID2. ITGA2, ITGA3, ITGA6, ITGB1, and DAG1 promoters were nonmethylated in normal and BC samples. ITGA4, ITGA9, and NID1 promoter hypermethylation was associated with the HER2 positive tumors, and promoter hypermethylation of ITGA1, ITGA9, NID1 and NID2 was associated with a genome-wide CpG island hypermethylated BC subtype. Given that ITGA4 is not expressed in normal breast, one might suggest that its abnormal promoter hypermethylation in cancer is non-functional and is thus merely a passenger epimutation. Yet, this assumption is not supported by our finding that it is not associated with a hypermethylated BC subtype. ITGA4 acquires expression in a subset of breast carcinomas, and methylation of its promoter may be preventive against expression in some tumors. Strong association of abnormal ITGA4 hypermethylation with the HER2 positive tumors (p = 0.0025) suggests that simultaneous presence of both HER2 and integrin α4 receptors is not beneficial for tumor cells. This may imply HER2 and integrin α4 signaling pathways interactions that are yet to be discovered. © 2021, The Author(s)

Multi‐Omics Approach Points to the Importance of Oxylipins Metabolism in Early‐Stage Breast Cancer

The involvement of oxylipins, metabolites of polyunsaturated fatty acids, in cancer path-ogenesis was known long ago, but only the development of the high‐throughput methods get the opportunity to study oxylipins on a system level. The study aimed to elucidate alterations in ox-ylipin metabolism as characteristics of breast cancer patients. We compared the ultra‐high‐perfor-mance liquid chromatography‐mass spectrometry (UPLC‐MS/MS) oxylipin profile signatures in the blood plasma of 152 healthy volunteers (HC) and 169 patients with different stages of breast cancer (BC). To integrate lipidomics, transcriptomics, and genomics data, we analyzed a transcriptome of 10 open database datasets obtained from tissues and blood cells of BC patients and SNP data for 33 genes related to oxylipin metabolism. We identified 18 oxylipins, metabolites of omega‐3 or omega‐ 6 polyunsaturated fatty acids, that were differentially expressed between BCvsHC patients, includ-ing anandamide, prostaglandins and hydroxydocosahexaenoic acids. DEGs analysis of tissue and blood samples from BC patients revealed that 19 genes for oxylipin biosynthesis change their expression level, with CYP2C19, PTGS2, HPGD, and FAAH included in the list of DEGs in the analysis of transcriptomes and the list of SNPs associated with BC. Results allow us to suppose that oxylipin signatures reflect the organism’s level of response to the disease. Our data regarding changes in oxylipins at the system level show that oxylipin profiles can be used to evaluate the early stages of breast cancer. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Genome-wide methylotyping resolves breast cancer epigenetic heterogeneity and suggests novel therapeutic perspectives

Aim: To provide a breast cancer (BC) methylotype classification by genome-wide CpG islands bisulfite DNA sequencing. Materials & methods: XmaI-reduced representation bisulfite sequencing DNA methylation sequencing method was used to profile DNA methylation of 110 BC samples and 6 normal breast samples. Intrinsic DNA methylation BC subtypes were elicited by unsupervised hierarchical cluster analysis, and cluster-specific differentially methylated genes were identified. Results & conclusion: Overall, six distinct BC methylotypes were identified. BC cell lines constitute a separate group extremely highly methylated at the CpG islands. In turn, primary BC samples segregate into two major subtypes, highly and moderately methylated. Highly and moderately methylated superclusters, each incorporate three distinct epigenomic BC clusters with specific features, suggesting novel perspectives for personalized therapy. © 2019 Alexander Tanas et al