Cancer is a multistep process whereby genetic events that result in the activation of proto-oncogenes or the inactivation of tumor suppressor genes usurp physiologic programs mandating relentless proliferation and growth. Experimental evidence surprisingly illustrates that the inactivation of even a single oncogene can be sufficient to induce sustained tumor regression. These observations suggest the hypothesis that tumors become irrevocably addicted to the oncogenes that initiated tumorigenesis. The proposed explanation for this phenomenon is that activated oncogenes result in a signaling state in which the sudden abatement of oncogene activity balances towards proliferative arrest and apoptosis. Indeed, substantial evidence supports this hypothesis. Here, we propose an alternative, although not necessarily mutually exclusive, explanation for how oncogenes initiate and sustain tumorigenesis. We suggest that oncogene activation initiates tumorigenesis precisely because it directly overrides physiologic programs inducing a state of cellular amnesia, not only inducing relentless cellular proliferation, but also bypassing checkpoint mechanisms that are essential for cellular mortality, self-renewal, and genomic integrity. Because no single oncogenic lesion is sufficient to overcome all of these physiologic barriers, oncogenes are restrained from inducing tumorigenesis. Correspondingly, in a tumor that has acquired the complete complement of oncogenic lesions required to overcome all of these safety mechanisms, the inactivation of a single oncogene can restore some of these pathways resulting in proliferative arrest, differentiation, cellular senescence, and/or apoptosis. Thus, oncogenes induce cancer because they induce a cellular state of enforced oncogenic amnesia in which, only upon oncogene inactivation, the tumor becomes aware of its transgression.

译文

癌症是一个多步骤的过程,其中导致原癌基因激活或抑癌基因失活的遗传事件会破坏生理程序,从而迫使其持续增殖和生长。实验证据令人惊讶地表明,即使是单个癌基因的失活也足以诱导肿瘤持续消退。这些观察结果表明,肿瘤对引发肿瘤发生的癌基因不可撤销地上瘾的假设。对这种现象的拟议解释是,活化的癌基因导致信号传导状态,其中癌基因活性的突然减弱与增殖停滞和凋亡平衡。事实上,大量证据支持这一假设。在这里,我们提出了一种替代的,尽管不一定相互排斥的解释,以解释癌基因如何启动和维持肿瘤发生。我们建议癌基因激活启动肿瘤发生,正是因为它直接超越了诱导细胞失忆症状态的生理程序,不仅诱导细胞持续增殖,而且绕过了细胞死亡,自我更新和基因组完整性必不可少的检查点机制。由于没有单一的致癌病变足以克服所有这些生理障碍,因此抑制了癌基因诱导肿瘤发生。相应地,在获得克服所有这些安全机制所需的完整致癌病变的肿瘤中,单个癌基因的失活可以恢复其中一些途径,从而导致增殖停滞,分化,细胞衰老和/或细胞凋亡。因此,癌基因会诱发癌症,因为它们会诱导一种强制的致癌性遗忘的细胞状态,在这种状态下,只有在癌基因失活后,肿瘤才会意识到其侵袭。

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