Часть 2 (1121000), страница 66

Файл №1121000 Часть 2 (B. Alberts, A. Johnson, J. Lewis и др. - Molecular Biology of The Cell (5th edition)) 66 страницаЧасть 2 (1121000) страница 662019-05-09СтудИзба
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This instability can take variousforms. Some cancer cells are unable to repair certain types of DNA damage or tocorrect replication errors of various kinds. These cells tend to accumulate morepoint mutations or other DNA sequence changes than do normal cells. Othercancer cells fail to maintain either the number or the integrity of their chromosomes, and they consequently accumulate gross abnormalities in their karyotype that are visible at mitosis (Figure 20-f 3).

The genetic instability is furtheramplified when some of the DNA changes alter epigenetic control mechanismsin ways that produce extra heterochromatin and DNA methylation. And epigenetic changes by themselves, arising accidentally and independently of priorgenetic changes,may also lead-in principle at least-to destabilization of normal patterns of cellular inheritance by facilitating other changes either at thegenetic or the epigenetic level. From an evolutionary perspective, none of thisshould be a surprise: anything that increasesthe probability of random changesin gene function that are heritable from one cell generation to the next is likelyto speed the evolution of a clone of cells toward malignancy.Although the epigenetic changes in cancer cells have not been so thoroughly analyzed, a great deal is now knor,rmabout the genetic changes. Different tumors-even those from the same tissues-can show different kinds ofgenetic instability, caused by heritable alterations in any one of a large numberof so-called DNA maintenance genesinvolved in propagating DNA or chromosomes.

It is rare for a person to inherit a mutation in one of these genes, butthose people that do so have a raised incidence of cancer, confirming that a lossof genetic stability can cause cancer. Generally, such destabilizing mutationsCANCERASA MICROEVOLUTIONARYPROCESS, .r , .. l,r :, :. . ,. .i , , , .

1 2 | 5from aFigure20-13 Chromosomesbreasttumor displayingabnormalitiesinstructureand number,Chromosomeswere preparedfrom a breasttumor cell inspreadon a glassslide,andmetaphase,stainedwith (A)a generalDNAstainor(B)a combinationof fluorescentstainsthat coloreachnormalhumanchromosomedifferently.The staining(displayedin falsecolor)showsmultipleincludinga doublytranslocations,translocatedchromosome(whitearrow)madeup of two piecesof chromosome8(brown)and a pieceof chromosome17(purple).Thekaryotypealsocontains48 chromosomes,insteadof the normal46. (Courtesyof JoanneDavidsonandPaulEdwards.)(A)(B)are not inherited but arise de nouo in the clone of cells in which a tumor develops, helping the cancer cell to accumulate mutations much more rapidly thanits neighbors.

Recent analysesshow that the cells in a variety of human cancersexperience single nucleotide substitutions at a rate that is 10-20 times higherthan the rate observed in normal cells.As a result, the sequencing of more than10,000 genes in a set of breast and colorectal cancers reveals that cancer cellshave accumulated enough mutations to cause an amino acid change in the proteins of roughly 100 genes.Most are random changes that affect different genesin different individual tumors. But a subset of genes are found to be repeatedlymutated in a particular t!?e of cancer, suggestingthat alterations in as many as20 genes are needed to drive tumor progression.Genetic instability does not in itself give a cell a selectiveadvantage.It seemsthat there is some optimum level of genetic instability for the development ofcance! making a cell mutable enough to evolve rapidly, but not so mutable thatit accumulates too many harmful changes and dies.

To be favored by selection,a genetically unstable cell must acquire properties that confer some competitiveadvantage.CancerousGrowthOften Dependson DefectiveControlof CellDeath,CellDifferentiation,or BothJust as an increased mutation rate per cell can raise the probability of cancer, socan any circumstance that increasesthe number of proliferating cells availablefor mutating. People who are clinically obese, for example, have a stronglyincreased risk of many types of cancer,compared with people of normal weight;and this is presumably due, in part at least, to an increase in both the number ofcells in the body and the rate at which these cells divide when overnourished oroverstimulated by growth factors.The same principle applies to both cancer initiation and cancer progression: the bigger the clone of altered cells resultingfrom an early inherited change, the greater the chance that at least one ofthesecells will undergo an additional mutation or epigenetic change that will allowthe cancer to progress.Thus, at every stage in the development of cancer, anycondition that helps the altered cells to increase in number favors the progression of the tumor.An early mutation or epigenetic change can have this effect by increasingthe rate at which a clone of cells proliferates, as we discuss in detail later.

Suchchanges,howeve! are not the only-or necessarilythe most important-mechanism for increasing cell number. In normal adult tissues,especiallythose at riskof cancer, cells may proliferate continually; but their numbers remain steadybecause cell production is balanced by cell loss, as part of the body's homeostatic control mechanisms. Programmed cell death by apoptosis'ttsually plays anessential part in this balance, as we discuss in Chapters 18 and 23.

If too many12",6 Chapter20:CancerHOMEOSTASISa!cllcells are generated,the rate of apoptosis increasesto dispose of the surplus. oneof the most important properties of many types of cancer cells is that they fail toundergo apoptosis when a normal cell would do so. This greatly contributes tothe growth of a tumor (Figure 20-14).Inherited changes can also increase the size of a clone of mutant cells byaitering their ability to differentiate, as illustrated by the situation in the uterinecervix, discussedearlier.\A/hena stem cell in the basal layer divides, each daughter cell has a choice-it can either remain a stem cell or commit to a pathwayIeading to differentiation; the committed cells initially proliferate and then stopdividing and terminally differentiate (the committed, proliferating cells arecalled transit amplfuing cells).If the differentiation program is blocked at somestage,proliferating cells accumulate, contributing to the progression from lowgrade intraepithelial neoplasia of the cervix to high-grade intraepithelial neoplasia and malignant cancer (see Figure 20-9).

Similar considerations apply tothe development of cancer in other tissues that rely on stem cells, such as theskin, the lining of the gut, and the hemopoietic system. Several forms ofleukemia, for example, seem to arise from a disruption of the normal program ofdifferentiation, such that a committed progenitor of a particular type of bloodcell eventually becomes able to divide indefinitely, instead of undergoing terminal differentiation in the normal way and dying after a limited number of celldivisions (as discussedin Chapter 23).Thus, the accumulation of mutations and epigenetic changes that lead todefects in the normal controls of cell division, apoptosis, and differentiation canall contribute to the development and progression of cancers.CancerCellsAre UsuallyAlteredin TheirResponsesto DNADamageand OtherFormsof StressAs just discussed,many normal cells permanently stop dividing when they differentiate into specialized cells.

Differentiation, however, is not the only reasonthat proliferating cells stop dividing; they can also do so in responseto stressorto damage to their DNA. As described in chapter 17,normal cells contain a set ofcheckpoint control mechanisms. These arrest the cell cycle temporarily whensomething goes a\,'ly, providing time to correct the problem. Chromosomebreakage and other types of damage to DNA generate intracellular signals thatactivate these checkpoint mechanisms, causing a normal cell to halt its cycle,andthereby giving it a chance to repair the damage before it attempts to progressthrough the cycle and divide. And if the damage is irreparable, a normal cell,rather than forge ahead and generate daughters with a damaged genome, willeither permanently withdraw from the cell cycle or commit suicide by apoptosis.cancer cells usually acquire mutations and epigenetic changes that inactivate such responsesto DNA damage.

From the selfish standpoint of the cancerFigure20-14 Both increasedcelldivisionand decreasedapoptosiscancontributeto tumorigenesis.In normaltissues,apoptosisbalancescelldivisiontomaintainhomeostasis.<GCCC>Duringthe developmentof cancer,eitheranincreasein celldivisionor an inhibitionofapoptosiscan leadto the increasedcellnumbersimportantfor tumorigenesis.Cellsfatedto undergoapoptosisareshown in gray.LLZL[q a8eauUaq] urp]urgul sllaouels aq;'afleauq aqlJo f,l]slre]Jereqosllec pezIeIJ-ads aqt olur elprluaJaJJlp^[pnluala pup dlarnsuaga a]eIeJIToJd]eql (silel fiuI-.!ldrue lrsueJt eqt) sllal ecnpoJd sllec uels 8utpptp,,i.pto1s 'arer :t(qcreralq E sBpazueSro.{pcrd,,i1 ere sllac eqt 'e8eeull IIeo f,l}slodouaq eqt s€ qons telouJnlilac ]lnpE IeuJou e ul'EZ reldBqJ uI ssnsslp e1!\svIIaJ lEl]uelsqns qll^ a3eau11slle) uals re)ue) ro uollelndodlleus vsulelulPWsrounl (ue1q1'do1spporvr sllaf,IeruJou ueqm suolllpuof,'pasn d8alerlsJapun aleragqord ol anulluoc slleJ Jeoueo eql leql sl lpsal eqleql Jo ssalpre8ag 'spue auosotuoJqJ Supe8uola JoJ sluslueqoeru e]€uJelleeAIoAaslles JaJueJ Jaqlo ]a 'peuauol{s seJeluolal lleql se JoJ pelseles eJeMleql sa8upl{f,crleuaSldaro JIleuaBJo Unsal e se &nnce aq} parrnbce a^Bq sllef,alqercardde lnoqll^a sllal uI paleu€tro JaJuBcJatueJ aq] dlp1IlJBaspJa111oleleql q8noqtle 'sas€oreqlo u1 ,fiprpce slql a^eq leql slleo ruels uI paleur8rro rac-uec aql asnecaqr(1pulJgaseJeluolelule]ule1ll,{.eu s11acJeJUEJeql 'sasPoeluos'a1era;t1ordu1 'paddecun eruoJaq ro ueuoqs ]ou op saJeruolal Jlaql leql os'aJueJseuesa^lleJlldeJLaql se ,fiyrpce eseJeuolal ulelurcul uago sllal Jecuef,'slleJ JaJuuf, uI uouledgf,se ol ,{$e}erls Jaq}oue sV ^ olaq ssnlslp IIBqs e1vrsE-uroo ^Je^ eJBpup tJeJJesrql aneq ,{ertqled ggd aqt alelllJeul luql suouetnlN'paddecun eruoJeq saJeruolalueq^ uala alcdc o1 enulluo3 sllef, aql teql os IoJl-uoc lurod4caqs er{l alqesrp 13q} sesueqJ cuauaSrda pue cqauaS arnbce ,taq}'lsrtC 's.,{e^Vrolli\l ul ecua3seuas1ac annuotldeJ plo^e sllal JeJuEc uEunH'uorssarSordJolunl JoJsaqrunpoddo snoruJoue apnord eslmJaqlo p1nolvruedsa;q 3uo1 dlarrrleredluoodlaq of eJuecseuas1ac altlecqdeJ peau suglunqJno asneJaq JelueJluanard'JaIrrBqslqlteq] pasodord uaaq sEq 1I{3el aroJeraqlpue atereJllord,'(aqrsP saJe-ruolel IBruJoupue l1nuce eseJeluola]uleluleru 'lserluof, [q 's1ac ]uepor aruos'sJorun] a3re1ruro; 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