Department of Physiology and McKusick Nathans Institute for Genetic Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Cancer Res. 2011 May 15;71(10):3573-81. doi: 10.1158/0008-5472.CAN-10-4489. Epub 2011 Apr 5.
Epidemiologic results tend to suggest that adults with Down syndrome have a reduced incidence of cancer, but some studies have reached the opposite conclusion. In this study, we offer direct biological evidence in support of the notion that Down syndrome reduces incidence of multiple types of cancer. Previous studies showed that introduction of the Apc(Min) mutation into the Ts65Dn mouse model of Down syndrome by interbreeding caused formation of intestinal adenomas at a significantly reduced incidence compared with control (euploid) animals that did not have trisomy. To a large degree, this reduction was determined to reflect an increased dosage of the Ets2 tumor repressor gene due to trisomy. Studies of tumor grafts using Ts65Dn suggested angiogenesis as a mechanism that mediated reduced tumor growth, metastasis, and mortality in individuals with Down syndrome. To confirm and extend these findings, we employed the complex cancer mouse model NPcis, which is heterozygous for the Trp53 and Nf1 genes and through LOH develops lymphomas, sarcomas, or carcinomas with 100% penetrance. In this aggressive model, trisomy did not prevent cancer, but it nevertheless extended host survival relative to euploid littermates. However, protection in this case was not attributable to either Ets2 dosage or to reduced angiogenesis. Together, our findings indicate that the genetic complexity underlying Down syndrome supports multiple mechanisms that contribute to reduced mortality from cancer.
流行病学研究结果表明唐氏综合征患者的癌症发病率降低,但也有一些研究得出了相反的结论。本研究提供了直接的生物学证据,支持唐氏综合征降低多种癌症发病率的观点。先前的研究表明,通过杂交将 Apc(Min)突变引入唐氏综合征的 Ts65Dn 小鼠模型中,与不具有三体性的对照(正常二倍体)动物相比,肠道腺瘤的形成发病率显著降低。在很大程度上,这种降低可归因于由于三体性而导致的 Ets2 肿瘤抑制基因的剂量增加。使用 Ts65Dn 的肿瘤移植研究表明,血管生成是介导唐氏综合征个体中肿瘤生长、转移和死亡率降低的机制。为了证实和扩展这些发现,我们采用了复杂的癌症小鼠模型 NPcis,该模型杂合性 Trp53 和 Nf1 基因,并通过 LOH 发展出淋巴瘤、肉瘤或具有 100%外显率的癌。在这种侵袭性模型中,三体性并不能预防癌症,但它确实延长了宿主的生存时间,相对于正常二倍体的同窝仔鼠而言。然而,这种保护并非归因于 Ets2 剂量或血管生成减少。总之,我们的研究结果表明,唐氏综合征的遗传复杂性支持多种机制,这些机制有助于降低癌症死亡率。