Strejczek Agata, Woszczyk Dawid, Urbaniak Helena, Różańska Martyna, Robak Michał, Matuszewska Zofia, Barciszewska Anna-Maria
Medical Faculty, Karol Marcinkowski University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland.
Intraoperative Imaging Unit, Chair and Clinic of Neurosurgery and Neurotraumatology, Karol Marcikowski University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland.
Int J Mol Sci. 2021 May 6;22(9):4925. doi: 10.3390/ijms22094925.
Medulloblastoma (MB) is one of the most frequent and malignant brain tumors in children. The prognosis depends on the advancement of the disease and the patient's age. Current therapies, which include surgery, chemotherapy, and irradiation, despite being quite effective, cause significant side effects that influence the central nervous system's function and cause neurocognitive deficits. Therefore, they substantially lower the quality of life, which is especially severe in a developing organism. Thus, there is a need for new therapies that are less toxic and even more effective. Recently, knowledge about the epigenetic mechanisms that are responsible for medulloblastoma development has increased. Epigenetics is a phenomenon that influences gene expression but can be easily modified by external factors. The best known epigenetic mechanisms are histone modifications, DNA methylation, or noncoding RNAs actions. Epigenetic mechanisms comprehensively explain the complex phenomena of carcinogenesis. At the same time, they seem to be a potential key to treating medulloblastoma with fewer complications than past therapies. This review presents the currently known epigenetic mechanisms that are involved in medulloblastoma pathogenesis and the potential therapies that use epigenetic traits to cure medulloblastoma while maintaining a good quality of life and ensuring a higher median overall survival rate.
髓母细胞瘤（MB）是儿童中最常见且恶性程度最高的脑肿瘤之一。其预后取决于疾病进展和患者年龄。目前的治疗方法包括手术、化疗和放疗，尽管效果显著，但会产生严重的副作用，影响中枢神经系统功能并导致神经认知缺陷。因此，这些治疗方法会大幅降低生活质量，而这在发育中的机体中尤为严重。所以，需要毒性更小且更有效的新治疗方法。最近，关于髓母细胞瘤发生所涉及的表观遗传机制的知识有所增加。表观遗传学是一种影响基因表达但可被外部因素轻易改变的现象。最知名的表观遗传机制是组蛋白修饰、DNA甲基化或非编码RNA的作用。表观遗传机制全面解释了复杂的致癌现象。与此同时，它们似乎是治疗髓母细胞瘤的潜在关键，相较于过去的疗法，并发症更少。本综述介绍了目前已知的参与髓母细胞瘤发病机制的表观遗传机制，以及利用表观遗传特征治疗髓母细胞瘤的潜在疗法，同时维持良好的生活质量并确保更高的总体中位生存率。
