Department of Medical Education, Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA 18509, USA.
Med Hypotheses. 2019 Dec;133:109381. doi: 10.1016/j.mehy.2019.109381. Epub 2019 Aug 23.
Organismal death does not immediately end gene expression. Studies of postmortem gene expression in zebrafish and mice and in the myocardium, liver, prostate, pericardial fluid, and blood of human cadavers have identified genes whose expression is increased after organismal death. Cancer can be considered a form of "un-death" since excessively proliferating cells are typically unusually resistant to apoptosis (programmed cell death), and are subject to strong selective pressure for "uncontrolled life." The changes in gene expression observed in organismal death, particularly in mammals (mice and humans), can be compared to that observed in human neoplasia, and the comparison of these expression patterns can inform us about human cancer. Here we present a hypothesis based on the following three tenets: (a) there will be distinct and opposing patterns of gene expression between the postmortem state and cancer with respect to key physiological outputs such as growth, apoptosis, invasion, and prognosis; (b) cancer cells considered more aggressive (e.g., derived from a metastasis and/or resistant to agents that suppress growth or induce apoptosis) will exhibit expression of relevant genes more unlike that of the postmortem condition while less aggressive neoplastic cells will exhibit gene expression more similar to the postmortem condition; and (c) targeting gene expression in cancer to produce a more postmortem-like pattern will promote less tumorigenic and less aggressive cell phenotypes. To evaluate components (a) and (b) of our hypothesis, we focus on previously published gene expression data from colorectal cancer (CRC) and colonic adenoma cells and compare that to postmortem expression data. This preliminary analysis in general supports our hypothesis, with more aggressive neoplastic cell types exhibiting gene expression patterns most unlike that found in the postmortem condition; this suggests that cancer and the postmortem condition represent opposing ends of a gene expression spectrum in the balance between life and death. Subsequently, we discuss the possibilities for further testing of the hypothesis, particularly for part (c), and we also discuss the possible implications of the hypothesis for cancer therapeutics.
生物体死亡并不会立即终止基因表达。对斑马鱼和小鼠死后的基因表达以及人类尸体的心肌、肝脏、前列腺、心包液和血液的研究表明,有些基因在生物体死亡后表达增加。癌症可以被认为是一种“不死”的形式,因为过度增殖的细胞通常对细胞凋亡(程序性细胞死亡)有很强的抵抗力,并且受到“失控生命”的强烈选择性压力。在生物体死亡时观察到的基因表达变化,特别是在哺乳动物(小鼠和人类)中,可以与人类肿瘤中观察到的变化进行比较,对这些表达模式的比较可以为我们提供有关人类癌症的信息。在这里,我们提出了一个基于以下三个原则的假设:(a)在关键生理输出(如生长、凋亡、侵袭和预后)方面,死后状态与癌症之间的基因表达将存在明显且相反的模式;(b)被认为更具侵袭性的癌细胞(例如,来源于转移和/或对抑制生长或诱导凋亡的药物有抗性)将表现出与死后状态更不相似的相关基因表达,而侵袭性较低的肿瘤细胞将表现出与死后状态更相似的基因表达;(c)针对癌症中的基因表达,使其产生更类似于死后的模式将促进更具肿瘤发生能力和侵袭性的细胞表型。为了评估我们假设的(a)和(b)部分,我们专注于先前发表的结直肠癌(CRC)和结肠腺瘤细胞的基因表达数据,并将其与死后表达数据进行比较。这项初步分析总体上支持我们的假设,更具侵袭性的肿瘤细胞类型表现出与死后状态最不相似的基因表达模式;这表明癌症和死后状态代表了生与死之间基因表达谱的对立两端。随后,我们讨论了进一步测试该假设的可能性,特别是对(c)部分,我们还讨论了该假设对癌症治疗的可能影响。