Title Izražaj mRNA HIF1A i proteina GLUT1, HIF-1α i VEGF-A u karcinomima bubrega
Title (english) The Expression of mRNA HIF1A and GLUT1, HIF-1α and VEGF-A proteins in renal cancers
Author Ante Strikić
Mentor Sandra Zekić Tomaš (mentor)
Committee member Branka Petrić Miše (predsjednik povjerenstva)
Committee member Snježana Tomić (član povjerenstva)
Committee member Merica Glavina Durdov (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2024-07-30, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pathology
Universal decimal classification (UDC ) 616 - Pathology. Clinical medicine
Abstract Unutar relativno rijetkog kliničkog entiteta raka bubrega, izdvaja se više patoloških dijagnoza, među kojima po učestalosti dominiraju svijetlostanični, papilarni, i kromofobni karcinom. Nova klasifikacija raka bubrega poseban naglasak stavila na razlikovanje rijetkih podtipova raka bubrega na osnovu molekularnog profiliranja. Molekularni mehanizam najčešćeg podtipa raka bubrega, svijetlostaničnog, počiva na disregulaciji VHL gena i njegovog ciljnog proteina pVHL, čija je uloga razradnja HIF-1α. U stanju hipoksije, HIF1α se stabilizira, inhibira se njegova degradacija što dovodi do njegovog nakupljanja unutar stanica i njegove aktivacije. Stabilizirani i akumulirani HIF-1α dovodi do aktiviranja transkripcije VEGF gena, ključnog gena za angiogenezu te GLUT1, proteina za transport glukoze. Okoliš brzorastućeg tumora u stanju je relativne hipoksije, stoga je neoangiogeneza uvjet za podržavanje tumorskog rasta, prilagodbu tumora i metaboličku promjenu u aerobnu glikolizu. Klinički prognostički alati ne uzimaju u obzir niti histološki tip, niti patomorfološke osobine tumora, a terapijske mogućnosti u liječenju raka bubrega donedavno su bile ograničene na peroralnu terapiju usmjerenu na tirozin -kinaze receptora za čimbenik rasta vaskularnog endotela ili na bevacuzimab, monoklonalno protutijelo usmjereno na čimbenik rasta vaskularnog endotela, obzirom da je VEGF bio jedina prepoznata terapijska meta, a specifično onkološko liječenje rezervirano samo za metastatske stadije. Nove imunoterapijske opcije temelje se na PD-1 ili PD L1 izražaju unutar tumora ili tumorskog mikrookoliša. U ovom istraživanju prikazan je izražaj HIF-1A gena i njegovog ciljnog proteina HIF-1α, te njegovih nizvodnih meta -VEGF-a i GLUT1 u tri najčešća tipa karcinoma bubrega. Značajno veća nuklearni izražaj HIF-1α uočena je u pRCC u usporedbi s ccRCC, dok nije bilo značajne razlike u izražaju proteina VEGF-A između analiziranih histoloških podtipova RCC. GLUT1 je više izražen kod ccRCC nego kod pRCC i chRCC, ali nije bilo razlike u izražaju GLUT1 ovisno o gradusu tumora RCC-a, niti veličine tumora. Kvantitativna lančana reakcija polimeraze reverzne transkripcije za HIF1A nije pokazala statističku razliku između histoloških tipova. Većina do sada objavljenih studija u obzir je uzimala samo svijetlostanični tip raka bubrega, u ovoj studiji obuhvaćeni su papilarni i kromofobni rak bubrega. Različiti rezultati analiziranih parametara dokazuju razlike onkogeneze među različitim tipovima raka bubrega. Prospektivna studija koja bi kombinirala i onkološke ishode u rezultatima, dodatno može pojasniti značaj analiziranih biljega u kliničkoj praksi među različitim tipovima raka bubrega.
Abstract (english) Within the relatively rare clinical entity of kidney cancer, several pathological diagnoses can be distinguished, among which clear cell, papillary, and chromophobe carcinoma dominate in terms of frequency. The new classification of kidney cancer places special emphasis on distinguishing rare subtypes of kidney cancer based on molecular profiling. The molecular mechanism of the most common subtype of kidney cancer, clear cell, rests on the dysregulation of the VHL gene and its target protein pVHL, whose role is the production of HIF-1α. In hypoxic conditions, HIF1α is stabilized, its degradation is inhibited, which leads to its accumulation inside cells and its activation. Stabilized and accumulated HIF-1α leads to the activation of transcription of the VEGF gene, a key gene for angiogenesis, and GLUT1, a protein for glucose transport. The environment of a fast-growing tumor is in a state of relative hypoxia, therefore neoangiogenesis is a condition for supporting tumor growth, tumor adaptation and metabolic change to aerobic glycolysis. Clinical prognostic tools do not take into account either the histological type or the pathomorphological features of the tumor, and therapeutic options in the treatment of kidney cancer were until recently limited to oral therapy directed at vascular endothelial growth factor receptor tyrosine kinases or at bevacuzimab, a monoclonal antibody directed at the factor growth of the vascular endothelium, given that VEGF was the only recognized therapeutic target, and specific oncological treatment was reserved only for metastatic stages. New immunotherapy options are based on the expression of PD-1 receptor or PD-L1 expression within the tumor or tumor microenvironment. In this study, the expression of the HIF-1A gene and its target protein HIF-1α, as well as its downstream targets - VEGF and GLUT1, in the three most common types of kidney cancer was shown. A significantly higher nuclear expression of HIF-1α was observed in pRCC compared to ccRCC, while there was no significant difference in VEGF-A protein expression between the analyzed histological subtypes of RCC. GLUT1 is more expressed in ccRCC than in pRCC and chRCC, but there was no difference in GLUT1 expression depending on the grade of the RCC tumor, nor the size of the tumor. No statistical difference ih HIF1A expression between histological types using quantitative reverse transcription polymerase chain reaction was shown. The different results of the analyzed parameters prove the differences of oncogenesis among different subtypes of kidney cancer. Most of the studies published so far considered only the clear cell type of kidney cancer, this study included papillary and chromophobe kidney cancer. The different results of the analyzed parameters prove the differences of oncogenesis among different types of kidney cancer. A prospective study that would combine oncological outcomes in the results can additionally clarify the significance of the analyzed markers in clinical practice among different types of kidney cancer.
Keywords
neoplazme bubrega
ljudski HIF1A protein
prijenosnik glukoze tip 1
vaskularni endotelni faktor rasta A
Keywords (english)
Kidney Neoplasms
Human HIF1A protein
Glucose Transporter Type 1
Vascular Endothelial Growth Factor A
Language croatian
URN:NBN urn:nbn:hr:171:265658
Study programme Title: Biology of Neoplasms Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-08-29 09:34:40