Zhang Zuojing, Wang Wei, Zhang Yuxin, You Xingji, Wu Jingxiang
Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
School of Medicine, Shanghai University, Shanghai, China.
Front Oncol. 2023 Feb 22;13:1031128. doi: 10.3389/fonc.2023.1031128. eCollection 2023.
Esophageal cancer-related gene-4 (ECRG4), a 148-amino acid propertied and new tumor suppressor, is initially cloned from the normal esophageal epithelium. ECRG4 was found to be expressed not only in esophageal tissues but also in cardiomyocytes. Previous studies demonstrated that ECRG4 is constitutively expressed in esophageal epithelial cells, and its degree of downregulation is directly proportional to prognosis in patients with esophageal cancer. In the heart, ECRG4 shows greater expression in the atria than in the ventricles, which accounts for its heterogeneity. Downregulation of ECRG4 expression level correlates with esophageal cancer, as well as myocardial injuries and arrhythmias. As a result, this review summarizes the possible susceptibility gene, ECRG4 and its associated molecular mechanisms in cancer patients with atrial fibrillation and myocardial injury. The review begins by describing ECRG4's biological background, discusses its expression in the cardiovascular system, lists the clinical and animal research related to the downregulation of ECRG4 in atrial fibrillation, and focuses on its potential role in atrial fibrillation. Downregulation of ECRG4 may increase the risk of atrial fibrillation by affecting ion channels, MMPs expression and inflammatory response. We will then discuss how ECRG4 can be used in the treatment of tumors and arrhythmias, and provide a novel possible strategy to reduce the occurrence of perioperative cardiovascular adverse events in patients with tumors such as esophageal cancer and gastric cancer.
食管癌相关基因4（ECRG4）是一种含148个氨基酸的特性新肿瘤抑制因子，最初从正常食管上皮中克隆得到。研究发现ECRG4不仅在食管组织中表达，在心肌细胞中也有表达。既往研究表明，ECRG4在食管上皮细胞中呈组成性表达，其下调程度与食管癌患者的预后直接相关。在心脏中，ECRG4在心房中的表达高于心室，这解释了其异质性。ECRG4表达水平的下调与食管癌以及心肌损伤和心律失常相关。因此，本综述总结了可能的易感基因ECRG4及其在房颤和心肌损伤癌症患者中的相关分子机制。综述首先描述了ECRG4的生物学背景，讨论了其在心血管系统中的表达，列出了与房颤中ECRG4下调相关的临床和动物研究，并重点关注其在房颤中的潜在作用。ECRG4的下调可能通过影响离子通道、基质金属蛋白酶表达和炎症反应增加房颤风险。然后我们将讨论ECRG4如何用于肿瘤和心律失常的治疗，并提供一种新的可能策略，以减少食管癌和胃癌等肿瘤患者围手术期心血管不良事件的发生。
