Kirkwood J M, Farkas D L, Chakraborty A, Dyer K F, Tweardy D J, Abernethy J L, Edington H D, Donnelly S S, Becker D
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Mol Med. 1999 Jan;5(1):11-20.
In the setting of familial melanoma, the presence of atypical nevi, which are the precursors of melanoma, is associated with a nearly 100% risk of developing primary melanoma by age 70. In patients with sporadic melanoma, it is estimated that 40-60% of melanomas develop in contiguous association with atypical nevi. Currently, the only way to prevent atypical nevi from progressing to melanoma is to monitor and excise them as soon as they exhibit changes in their clinical features. Activation of the transcription factor, Stat3, has been linked to abnormal cell growth and transformation as well as to interferon alpha (IFN-alpha)-mediated growth suppression in vitro.
To determine whether IFN-alpha, used for adjuvant therapy of high-risk, resected melanoma, induces changes in Stat3 in atypical nevi, patients with a clinical history of melanoma who have multiple atypical nevi were treated for 3 months with low-dose IFN-alpha. Thereupon, the new technology of microscopic spectral imaging and biochemical assays such as electrophoretic mobility shift assays (EMSAs) and immunoblot analysis were used for the study of atypical nevi, obtained before and after IFN-alpha treatment.
The results of the investigations provided evidence that, as a result of systemic IFN-alpha treatment, Stat1 and Stat3, which are constitutively activated in melanoma precursor lesions, lose their ability to bind DNA, and as shown in the case of Stat3, become dephosphorylated.
Unlike primary and metastatic melanomas, melanoma precursor lesions cannot be established as cell cultures. Thus, the only way to explore pathways and treatment regimens that might help prevent progression to melanoma is within the context of a melanoma precursor lesion study conducted prospectively. The findings presented here suggest that down-regulation of the transcription factors Stat1 and Stat3 by systemic IFN-alpha treatment may represent a potential pathway to prevent the activation of gene(s) whose expression may be required for atypical nevus cells to progress to melanoma.
在家族性黑色素瘤的情况下,非典型痣作为黑色素瘤的前体,到70岁时发生原发性黑色素瘤的风险接近100%。在散发性黑色素瘤患者中,估计40%-60%的黑色素瘤与非典型痣连续相关。目前,防止非典型痣进展为黑色素瘤的唯一方法是一旦它们的临床特征出现变化就进行监测并切除。转录因子Stat3的激活与异常细胞生长和转化以及体外干扰素α(IFN-α)介导的生长抑制有关。
为了确定用于高危、已切除黑色素瘤辅助治疗的IFN-α是否会诱导非典型痣中Stat3的变化,对有黑色素瘤临床病史且有多个非典型痣的患者用低剂量IFN-α治疗3个月。随后,使用微观光谱成像新技术以及电泳迁移率变动分析(EMSA)和免疫印迹分析等生化检测方法对IFN-α治疗前后获得的非典型痣进行研究。
研究结果提供了证据,表明全身IFN-α治疗后,在黑色素瘤前体病变中持续激活的Stat1和Stat3失去了结合DNA的能力,并且如Stat3的情况所示,发生了去磷酸化。
与原发性和转移性黑色素瘤不同,黑色素瘤前体病变无法建立细胞培养。因此,探索可能有助于预防进展为黑色素瘤的途径和治疗方案的唯一方法是在前瞻性进行的黑色素瘤前体病变研究的背景下。此处呈现的研究结果表明,全身IFN-α治疗下调转录因子Stat1和Stat3可能代表一种潜在途径,以防止非典型痣细胞进展为黑色素瘤可能所需的基因激活。