Mechanisms of Oncogenesis Flashcards

1
Q

What is cancer?

A

Cancer is the name for a group of diseases characterised by:
- Abnormal cell proliferation
- Tumour formation
- Invasion of neighbouring normal tissue
- Metastasis to form new tumours at distant sites
Approximately 85% of cancer occur in epithelial cells-carcinomas
Cancers derived from mesoderm cells (bone and muscle) are sarcomas
Cancers found in glandular tissue are called adenocarcinomas

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2
Q

What are the hallmarks of cancer?

A
Sustaining proliferative signalling 
Evading growth suppressors
Avoiding immune destruction
Enabling replicative immortality
Tumour-promoting inflammation
Activating invasion and metastasis
Inducing angiogenesis
Genome instability and mutation
Resisting cell death
Deregulating cellular energetics
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3
Q

What is the evidence for cancer being a disease of the genome?

A

Carcinogens cause alterations to the DNA - Mutations
DNA from tumours has been shown to contain many alterations from point mutations to deletions
The accumulation of mutations over time represents the multi-step process that underlies carcinogenesis
This accumulation occurs only after the cells defence mechanism of DNA repair have been evaded
In cases if severe damage cell apoptosis is induced
Many mechanisms exist for blocking carcinogenesis but
over burdening the system increases the possibility
that cells will escape surveillance
The longer we live the more time there is for DNA to accumulate
mutations that may lead to cancer
Cancer is more prevalent as lifespan has increased

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4
Q

How do tumours develop?

A

Somatic mutations constitute almost all mutations in tumour cells
All cells in a primary tumour arise from a single cell, initiation of the development of cancer is clonal
Only one of the 1014 cells in body need to be transformed to create a tumour
Continued accumulation of mutations
Tumour cells can ‘evolve’- subclonal selection allowing a growth advantage and explain the heterogeneity of cells in a tumour
Dependent on interaction with other tumour cells and the tumour microenvironment

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5
Q

How does a normal cell become a tumour cell?

A

A cell will proliferate in response to different factors
Processes such as apoptosis will keep proliferation in check
Regulation of all those points in differentiation pathway is important
Mutations in the genes that regulate those processes means that cells will continue to divide which will give you an increase in cell number which eventually leads to a clinically detectable tumour

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6
Q

What is the difference between oncogenes and tumour suppressor genes?

A

Normal genes regulate growth
Normal genes that can be activated to be oncogenic are called proto-oncogenes
An oncogene is a proto-oncogene that has been mutated in a way that leads to signals that cause uncontrolled growth- i.e., cancer.
- This is like pushing down on the gas pedal
Tumour suppressor genes inhibit both growth and tumour formation
- They act as braking signals during phase G1 of the cell cycle, to stop or slow the cell cycle before S phase
- If tumour-suppressor genes are mutated, the normal brake mechanism will be disabled, resulting in uncontrolled growth, i.e. cancer

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7
Q

What are the 3 assumptions that come with multistage carcinogenesis?

A
  • Malignant transformation of a single cell is sufficient to give rise to a tumour
    • Any cell in a tissue is as likely to be transformed as any other of the same type
    • Once a malignant cell is generated the mean time to tumour detection is generally constant
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8
Q

What is the first model of carcinogenesis- ‘mutational’?

A

Cancer is a multi step process that includes initiation, promotion and progression.
Chemical carcinogens can alter any of these process to induce their carcinogenic effects
The presence of multiple mutations in critical genes is a distinctive feature of cancer cells and supports that cancer arises through the accumulation of irreversible DNA damage.
In the majority of instances chemical carcinogens can induce this DNA damage and act in a genotoxic manner.

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9
Q

What are the classes of carcinogens and some examples?

A
Chemical:
	- 10 groups: polycyclic aromatic hydrocarbons, aromatic amines, azo dyes, nitrosamines, carbamates, halogenated compounds, alkylating agents
Physical:
	- Radiation- ionising and ultraviolet
	- Asbestos
Heritable:
	- Predisposition
Viral:
	- Hepatitis B
	- Epstein Barr
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10
Q

How can chemical carcinogens induce cancer?

A

Four of the major groups polycyclic aromatic hydrocarbons, aromatic amines, nitrosamines and alkylating agents
exert their effects by adding functional groups to DNA bases called DNA adducts
One example is coal tar, which contains benzo[a]pyrene, a polycyclic hydrocarbon
Benzo[a]pyrene is commonly found in cigarette smoke (together with 81 other carcinogens)!
BP ranks high in the measure of how easy it enters into cells
Not a carcinogen until it gets in your body where it gets converted into bezo(a)pyrene epoxide which causes G to T transversions

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11
Q

What is the Ames test?*

A

A test to determine the mutagenic activity of chemicals by observing whether they cause mutations in sample bacteria.

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12
Q

What are physical carcinogens? How can radiation act as a physical carcinogen?

A

Unlike chemical carcinogens, physical carcinogens act by imparting energy into the biological material
Energy—-> Changes in bonding of molecules——> Biological effects
Radiation is the primary physical agent
Several types of radiation can act as carcinogens:
1. Ionising radiation (X-rays, nuclear radiation), UV radiation cause damage
2. DNA breaks, Pyrimidine dimers causing failed repair
3. Translocation mutations

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13
Q

What is meant by heritable carcinogens?

A

DNA damage is a risk factor for cancer development
Accounts for 5% of all cancers
An inherited germline mutation, has an increased risk of developing certain tumours but are rarely involved in causing cancer immediately
In most known hereditary malignant syndromes the elevated cancer risk is due to a mutation of a single gene (monogenic hereditary diseases)
The affected genes concerned usually have a controlling function on the cell cycle or the repair of DNA damage
A deficiency in DNA repair would cause more DNA damages to accumulate, and increase the risk for cancer

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14
Q

What are some syndromes predisposing someone to cancer?

A
DNA repair defects:
	- ataxia telangiectasia
	- Bloom’s syndrome
	- Fanconi’s anaemia
	- Li-Fraumeni syndrome
	- Lynch type II
	- xeroderma pigmentosum
Chromosomal abnormalities:
	- Down’s syndrome
	- Klinefelter’s syndrome
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15
Q

How can ataxia-telangiectasia predispose someone to cancer?

A

Ataxia telangiectasia- neuromotor dysfunction, dilation of blood vessels,
telangiectasia = spider veins
- Mutation in ATM gene, codes for a serine/threonine kinase that is recruited and activated by
- dsDNA breaks leading to cell cycle arrest, DNA repair and apoptosis -cell cycle arrest
- Cancer predisposition: lymphoma, leukaemia and breast cancer

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16
Q

How can Bloom’s syndrome predispose someone to cancer?

A

Bloom’s Syndrome -short stature, rarely exceed 5 feet tall, skin rash that develops after exposure to the sun

- Mutation in BLM gene that provides instructions for coding a member of the RecQ helicase family that help maintain the structure and integrity of DNA
- Cancer predisposition: skin cancer. basal cell carcinoma and squamous cell carcinoma.
17
Q

How can Lynch type predispose someone to cancer?

A

Lynch type- LS doesn’t cause any symptoms. Sometimes the first sign that a person has LS is when the symptoms of bowel and womb cancer develop.

- Mutations in DNA mismatch repair (MMR) genes, notably MLH1,     MSH2, MSH6 and PMS2.
- Cancer predisposition: colorectal cancer
18
Q

What are the properties required for a virus to be tumorigenic?

A

Stable association with cells
- chromosomal integration
- episome
Must not kill cells
- non-permissive host (virus cannot replicate)
- suppression of viral lytic cycle
- viral release by budding
Must evade immune surveillance of infected cells
- immune suppression
- viral antigens not expressed at cell surface

19
Q

What are the viruses associated with human cancer?

A

DNA viruses
- Epstein-Barr virus Burkitt’s lymphoma, nasopharyngeal carcinoma
- papilloma viruses cervical carcinoma, warts
- hepatitis B and C hepatoma
RNA retroviruses
- HTLV-I Adult T-cell leukaemia, lymphoma

20
Q

What is Model 2 of carcinogenesis?

A

Genome instability
Knudson suggested that multiple hits were required to cause cancer. So for example if the first mutated allele was inherited the second mutation would lead to cancer. In the sporadic forms of the tumour both mutations had to take place and hence this could explain the difference of age at diagnosis
At least two events are necessary for carcinogenesis and that the cell with the first event must survive in the tissue long enough to sustain a second event.

21
Q

What is Model 3 of carcinogenesis?

A

Non-genotoxic
Non-genotoxic is characterized by an emphasis on non-genotoxic effects
Several important modulators of cancer risk (diet, obesity, hormones and insulin resistance) do not seem to act through a structural change in DNA but rather through functional changes including epigenetic events.
There is, however, a group of carcinogens that induce cancer via non-genotoxic mechanisms. Non-genotoxic carcinogens have been shown to act as:
- tumour promoters (1,4-dichlorobenzene),
- endocrine-modifiers (17β-estradiol),
- receptor-mediators (2,3,7,8-tetrachlorodibenzo-p-dioxin),
- immunosuppressants (cyclosporine) or
- inducers of tissue-specific toxicity and inflammatory responses (metals such as arsenic and beryllium)
Although little is known about this group of carcinogens it is known that in a high proportion of them, multiple pathways need to be altered for cancer induction

22
Q

What is Model 4 of carcinogenesis?

A

Darwinian
Carcinogenesis by Mutation and Selection-Model of Clonal Expansion
The role of the environment in selecting cells that have some acquired advantage
1. Sequential accumulation of mutations due to exposure to carcinogens
2. Tumour cells will be selected for ability to grow and invade
3. Selection will include resistance to therapy
4. Some mutations may be deleterious for tumour but those are few and far between

23
Q

What is Model 5 of carcinogenesis?

A

Tissue Organisation
To understand the changes that occur during cancer it is important to understand the principles of cell and tissue organisation and mechanisms that control growth and structure.
Tissues - Groups of cells with similar function are known as tissues: epithelial, connective muscle and nervous

24
Q

What are the two main theories about the forces driving carcinogenesis?

A

These are the somatic mutation theory (SMT) and the tissue organization field theory (TOFT).
SMT:
- cancer is derived from a single somatic cell that has successively accumulated multiple DNA mutations
- those mutations damage the genes which control cell proliferation and cell cycle
- Thus, according to SMT, neoplastic lesions are the results of DNA-level events
- single catastrophic event triggering carcinogenesis
TOFT:
- Carcinogenesis is primarily a problem of tissue organization
- carcinogenic agents destroy the normal tissue architecture thus disrupting cell-to-cell signaling and compromising genomic integrity
- the DNA mutations are random and the effect, not the cause, of the tissue-level events.
- carcinogenesis as general deterioration of the tissue microenvironment due to extracellular causes

25
Q

How does the immune system respond to cancer?

A
The immune system will:
	- Protect from virus-induced tumours
	- Eliminate pathogens
	- Identify and eliminate tumour cells
Leading to immune surveillance 
Despite this tumours can still arise- concept of cancer immunoediti
26
Q

What is cancer immunoediting?

A

The three Es
Elimination:
- The immune system is able to eradicate developing tumours
Equilibrium:
- When incomplete removal is present tumour cells remain dormant and enter equilibrium.
- The immune system exerts a potent and relentless pressure that contains the tumour.
- During this phase some of the tumour may mutate or give rise to genetic variants that survive, grow and enter the next phase
- (Longest of the phases, around 20 years)
Escape:
- The expanding tumour populations becomes clinically detectable