Decoding the ‘embryonic’ nature of embryonal rhabdomyosarcoma

Quercetin induces pannexin 1 expression via an alternative transcript with a translationally active 5' leader in rhabdomyosarcoma

Rhabdomyosarcoma (RMS) is a deadly cancer of skeletal muscle origin. Pannexin 1 (PANX1) is down-regulated in RMS and increasing its levels drastically inhibits RMS progression. PANX1 upregulation thus represents a prospective new treatment strategy for this malignancy. However, the mechanisms regulating PANX1 expression, in RMS and other contexts, remain largely unknown. Here we show that both RMS and normal skeletal muscle express a comparable amount of PANX1 mRNAs, but surprisingly the canonical 5′ untranslated region (5′ UTR) or 5′ leader of the transcript is completely lost in RMS. We uncover that quercetin, a natural plant flavonoid, increases PANX1 protein levels in RMS by inducing re-expression of a 5′ leader-containing PANX1 transcript variant that is efficiently translated. This particular PANX1 mRNA variant is also present in differentiated human skeletal muscle myoblasts (HSMM) that highly express PANX1. Mechanistically, abolishing ETV4 transcription factor binding sites in the PANX1 promoter significantly reduced the luciferase reporter activities and PANX1 5′ UTR levels, and both quercetin treatment in RMS cells and induction of differentiation in HSMM enriched the binding of ETV4 to its consensus element in the PANX1 promoter. Notably, quercetin treatment promoted RMS differentiation in a PANX1-dependent manner. Further showing its therapeutic potential, quercetin treatment prevented RMS in vitro tumor formation while inducing complete regression of established spheroids. Collectively, our results demonstrate the tumor-suppressive effects of quercetin in RMS and present a hitherto undescribed mechanism of PANX1 regulation via ETV4-mediated transcription of a translationally functional 5′ leader-containing PANX1 mRNA.

[Mesenchymal abdominal tumors in children]

Mesenchymal tumors in childhood comprise benign and malign entities and differ regarding typical sites of manifestation, age peak and clinical symptoms. In some cases biopsy is mandatory. If nephroblastoma is a possible diagnosis, biopsy must be avoided by all means in order to avoid biopsy tract metastasis. Imaging is used to narrow the differential diagnosis, describe the exact extent of the lesion and deliver complete staging. In pediatric patients sonography and MRI are the most important imaging modalities. Low-dose CT of the thorax serves for assessment of possible pulmonary metastases.