Telomerase detection in the diagnosis and prognosis of cancer

Telomerase and drug resistance in cancer

It is well known that a decreased expression or inhibited activity of telomerase in cancer cells is accompanied by an increased sensitivity to some drugs (e.g., doxorubicin, cisplatin, or 5-fluorouracil). However, the mechanism of the resistance resulting from telomerase alteration remains elusive. There are theories claiming that it might be associated with telomere shortening, genome instability, hTERT translocation, mitochondria functioning modulation, or even alterations in ABC family gene expression. However, association of those mechanisms, i.e., drug resistance and telomerase alterations, is not fully understood yet. We review the current theories on the aspect of the role of telomerase in cancer cells resistance to therapy. We believe that revealing/unravelling this correlation might significantly contribute to an increased efficiency of cancer cells elimination, especially the most difficult ones, i.e., drug resistant.

Enhancing-effect of gold nanoparticles on DNA strand displacement amplifications and their application to an isothermal telomerase assay

AuNPs take the reliability of a typical isothermal DNA amplification assay to a new level of accuracy, specificity, and sensitivity.

Telomerase activity in response to mild oxidative stress

We have analysed telomerase activity to determine whether it can be modified when BCL-2 is endogenously overexpressed in response to a mild oxidative stress treatment as part of a survival mechanism, in contrast with an exogenous bcl-2 overexpression due to a retroviral infection. Endogenous bcl-2 overexpression was induced after a low oxidative insult of H2O2 in mice primary lung fibroblasts and L929 cell, whereas bcl-2 exogenous overexpression was performed using a retroviral infection in L929 cells. Telomerase activity was quantified in Bcl-2 overexpressing cells by the TRAP assay. When the cells were treated with different H2O2 concentrations, only those exposed to 50 μM showed increased telomerase activity. This correlates with BCL-2 expression as part of the endogenous response to mild oxidative stress. Oxidative stress generated during the toxic mechanism of chemotherapeutic drugs might induce BCL-2 increment, enhancing telomerase activity and reactivating the oncogenic process. Clinical trials should take into consideration the possibility of telomerase activation following increased BCL-2 expression when treating patients with ROS (reactive oxygen species) generation by anti-cancer drugs.

Targeting critical steps of cancer metastasis and recurrence using telomerase template antagonists

Metastasis, tumor relapse, and drug resistance remain major obstacles in the treatment of cancer. Therefore, more research on the mechanisms of these processes in disease is warranted for improved treatment options. Recent evidence suggests that the capability to sustain tumor growth and metastasis resides in a subpopulation of cells, termed cancer stem cells or tumor-initiating cells. Continuous proliferation and self-renewal are characteristics of stem/progenitor cells. Telomerase and the maintenance of telomeres are key players in the ability of stem and cancer cells to bypass senescence and be immortal. Therefore, telomerase inhibitors have the therapeutic potential for reducing tumor relapse by targeting cancer stem cells and other processes involved in metastasis. Herein we review the role of telomerase in the immortal phenotype of cancer and cancer stem cells, targeting telomerase in cancer, and discuss other opportunities for telomerase inhibitors to target critical steps in cancer metastasis and recurrence.

Detection of telomerase activity in gastric lavage fluid: a novel method to detect gastric cancer

BACKGROUND

Telomerase is a ribonucleoprotein polymerase that is essential for cell immortality. Recent studies have demonstrated that a high percentage of gastric cancer tissue expressed telomerase. This study describes the presence of telomerase activity in gastric lavage fluid in patients with gastric cancer.

METHODS

Gastric lavage fluid was collected during esophageogastroduodenoscopy in 70 patients: 25 with gastric cancer, 25 with peptic ulcer disease, and 20 with normal stomach. The fluid and biopsy samples were analyzed for telomerase activity by a polymerase chain reaction-based telomerase repeat amplification protocol. The findings were related to the histological results.

RESULTS

Telomerase activity was present in 24 of the 25 (96%) gastric cancer tissue and in 7 of the 25 tissue specimens from peptic ulcer or gastritis. In the gastric lavage fluid, telomerase was detected in 20 patients (80%) with gastric cancer, 7 patients (28%) with peptic ulcer, and none in normal subjects (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of gastric fluid telomerase expression in gastric cancer patients was 80%, 84%, 74%, and 88%, respectively.

CONCLUSIONS

The presence of telomerase activity is present in gastric lavage fluid of patients with gastric cancer as compared to those without, may represent a novel method for diagnosis of gastric cancer.