Telomerase activity in human brain tumours

Clinical significance of telomerase activity in the non-cancerous epithelial region of oesophageal squamous cell carcinoma

BACKGROUND

The aim of this study was to examine telomerase activity in affected and adjacent tissue in patients with oesophageal squamous cell carcinoma (SCC).

METHODS

Telomerase activity was measured in oesophageal SCC cells, normal oesophageal culture cells, primary cancer tissues and adjacent normal tissues from patients with oesophageal SCC using a polymerase chain reaction-based assay.

RESULTS

All oesophageal SCC cells had telomerase activity, whereas normal cultured cells showed no activity. All 57 cancer tissues showed telomerase activity compared with only five (10 per cent) of 50 normal tissues. Cancer cells infiltrating the vessels of mucosal or submucosal tissues in non-cancerous regions were detected in four of five telomerase-positive normal tissues, whereas such infiltration was detected in only three of 45 telomerase-negative normal tissues.

CONCLUSION

In patients with oesophageal SCC, measurement of telomerase activity in normal epithelium is a highly sensitive method of detecting the microinvasion of cancer cells.

Different mechanisms of synovial hyperplasia in rheumatoid arthritis and pigmented villonodular synovitis: the role of telomerase activity in synovial proliferation

OBJECTIVE

To elucidate the involvement of telomerase activity in the pathogenesis of rheumatoid arthritis (RA) and pigmented villonodular synovitis (PVS).

METHODS

Peripheral blood lymphocytes (PBL), synovial infiltrating lymphocytes, and synoviocytes were isolated from peripheral blood samples and synovial tissue obtained from 18 patients with RA, 9 with PVS, 12 with osteoarthritis (OA), and 10 with knee joint trauma. Cellular telomerase activity was measured by the telomeric repeat amplification protocol assay. In RA patients, the telomerase activity level in synovial infiltrating lymphocytes was assessed for correlations with histologic features in rheumatoid synovium.

RESULTS

A high level of telomerase activity was detected in the PBL and synovial infiltrating lymphocytes from RA patients and in the synoviocytes from PVS patients, whereas the enzyme activity was expressed at a low-to-borderline level in the PBL and synovial lymphocytes from OA, PVS, and trauma patients and was absent in the synoviocytes from RA as well as OA and trauma patients. In RA patients, the telomerase activity level in synovial infiltrating lymphocytes was significantly correlated with the intensity of synovial lining hyperplasia, microvessel proliferation, lymphocyte infiltration, and percentage of synovial cells positive for proliferating cell nuclear antigen in rheumatoid synovium.

CONCLUSION

Telomerase activation in lymphocytes may provide insights into the progression of synovitis and synovial proliferation in RA. Moreover, the enzyme may be implicated in the proliferation of synoviocytes in PVS.

Telomerase expression in intracranial tumours: prognostic potential for malignant gliomas and meningiomas

AIM

To evaluate the diagnostic value of telomerase expression in intracranial tumours.

METHODS

98 surgical specimens from different neoplasms were analysed by the telomeric repeat amplification protocol (TRAP) and the presence of telomerase compared with the histological diagnosis and the proliferation index.

RESULTS

A high degree of positivity for telomerase activity was found in glioblastomas and atypical/anaplastic meningiomas. Telomerase activity was poorly detected in anaplastic astrocytomas.

CONCLUSIONS

The TRAP assay seems to be a valuable index for identifying meningeal tumours with aggressive behaviour.

Exogenous expression of p16INK4a is associated with decrease in telomerase activity

In this study, gene transfection was used to determine whether the exogenous expression of p16INK4a modulated the biological characteristics of glioblastoma cells. The human glioblastoma cell line U87MG was doubly transfected with the plasmids pVgRXR and pIND harboring the wild-type p16 gene. The expression of p16INK4a in the resulting transfectants was regulated by the addition of the ecdysone homologue, muristerone A. When the cells expressed p16INK4a, their growth capacity was reduced and morphological changes such as an increase in cell size and cellular flattening were observed. The analysis of cell cycle regulation provided evidence that cells expressing p16INK4a were inhibited from entry into the cell cycle, as assessed by Ki-67 antigen expression. In addition, it was observed that the exogenous expression of p16INK4a was associated with decrease in telomerase activity.

Telomeric lengths and telomerase activity in liposarcomas

To assess the role of telomerase in the development of liposarcomas, we measured telomerase activity in 36 malignant and seven benign lipomatous neoplasias from 34 patients. A sensitive polymerase chain reaction-based telomerase assay (the telomeric repeat amplification protocol) was applied. Shortening or elongation of telomeric repeat fragment lengths, as measured by using hybridization with a telomere-specific oligonucleotide probe, was correlated with the presence of telomerase activity. The latter was demonstrable in 69% of malignant tumors. Benign tumors can be distinguished from malignant neoplasias on the basis of telomerase activity. However, telomerase expression seems to be characteristic of poorly differentiated liposarcomas. Myxoid/round cell liposarcomas exhibited a higher telomerase activity level than the classical low-grade variants. Telomerase activity was not correlated with age at the time of diagnosis or with sex. In most cases, telomerase-positive tumors showed higher proliferation indices than did neoplasias lacking telomerase. All eight recurrences expressed telomerase activity, reflecting a close association of telomerase with the biological behavior of liposarcomas. Our findings suggest that telomerase may play a key role in the establishment and progression of malignant lipomatous tumors.

Part I. Telomerase levels in human metastatic brain tumors show four-fold logarithmic variability but no correlation with tumor type or interval to patient demise

Telomerase expression has been found in the majority of human neoplasms at their primary sites and, in some tumor types, has been correlated with patient prognosis. In part one of this two-part study, we investigated whether telomerase was expressed ubiquitously in metastases to the brain and whether varying levels of expression existed or correlated with patient prognosis. A second aim of this study was to acquire data on brain metastases preliminary to the investigation of whether the telomerase assay could be used for the detection of tumor cells in cerebrospinal fluid (CSF). We investigated 35 brain metastases utilizing the sensitive telomeric repeat amplification protocol (TRAP) assay coupled with densitometric quantitation of telomerase levels on frozen, banked tissue specimens. Specimens metastatic to the brain analyzed in this study included melanoma, adenocarcinoma, hepatocellular carcinoma, germ cell neoplasm, squamous cell carcinoma, osteogenic sarcoma, and secondary lymphoma. Telomerase was found in 32 of 35 metastases. Quantitation of the telomerase products showed a fourfold logarithmic variation, following standardization of protein concentrations. Levels of telomerase expression showed no statistical correlation with either tumor subtype or interval from date of procedure to patient demise. Interestingly, in two patients with two metastatic samples each taken at discordant times, the telomerase levels were higher in the metastasis specimen taken closer to the time of demise. This suggests a possible increase in telomerase level within a given patient's neoplasm as the disease became more advanced, although too few cases were available to reach a firm conclusion in this regard. We conclude that most brain metastases express telomerase, albeit at widely varying levels, which are not clearly correlated with patient survival. These results influence the potential utility of telomerase analysis for the detection of small numbers of metastatic tumor cells in CSF, as addressed in the companion manuscript.

Telomerase activity in human chorionic villi and placenta determined by TRAP and in situ TRAP assay

Telomerase activity (TA) was analysed in human chorionic villi and placenta in normal and abnormal pregnancy using the telomeric repeat amplification protocol (TRAP) and in situ TRAP assay. Twenty chorionic villi specimens and 25 placenta specimens from normal pregnancies were examined as well as placenta specimens from 10 cases of intrauterine growth retardation (IUGR; nine asymmetric and one symmetric). TA was detected in 18 of the 20 (90 per cent) chorionic villi specimens and in 18 of the 25 (72 per cent) placenta specimens from normal pregnancy. However, no or only weak TA was exhibited in the placenta specimens of the nine asymmetric IUGR cases. In situ TRAP assay detected TA in trophoblastic cells from normal pregnancy, but not in trophoblastic cells from cases of asymmetric IUGR.

Telomerase in cancer: clinical applications

The biology of telomeres and telomerase has been the subject of intensive investigative effort since it became evident that they play a significant role in two important biological processes, the loss of cellular replicative capacity inherent to organismal ageing and the unrestricted cell proliferation characteristic of carcinogenesis. Telomere shortening in normal cells is a result of DNA replication events, and reduction beyond a critical length is a signal for cellular senescence. One of the cellular mechanisms used to overcome proliferative restriction is the activation of the enzyme telomerase, which replaces the loss of telomeric DNA that occurs at each cell division. Studies have demonstrated that tumours have shorter telomeres than normal tissue and that telomerase is activated in up to 90% of all human cancers while it is present only in a limited range of normal adult tissues. The role of telomerase in the extension of the cellular replicative lifespan has recently been shown by ectopic expression of the enzyme, being consistent with the oncogenesis model whereby the acquisition of an 'immortal' phenotype is a requirement for advanced tumour progression. In this article we review the present knowledge of telomeres and telomerase in cancer and discuss the potential use of this enzyme as a diagnostic and prognostic tumour marker and as a target for cancer therapy.

Increased telomerase activity in intrahepatic cholangiocellular carcinomas induced by N-nitrosobis(2-oxopropyl)amine in hamsters

Telomerase activities in intrahepatic cholangiocarcinomas induced by N-nitrosobis(2-oxopropyl)amine (BOP) in female hamsters were determined using a telomeric repeat amplification protocol (TRAP) assay followed by densitometric quantification. Each determination was repeated to confirm the results and telomerase activity was also detected by gel electrophoresis. An increase was evident in all of 10 cholangiocarcinomas examined, with levels ranging from 2.48 to 4.40 times the normal liver value by densitometric quantification. This finding of a consistent increase suggests that telomerase activation is involved in the development of intrahepatic cholangiocarcinomas and immortalization of cancer cells.

Telomerase activity in lung cancer cell lines and tissues

Using TRAP assay, we studied the activity of the telomerase in the lung cancer cell lines, and lung cancer and normal tissues in which expression appears to be related to the immortality of cancer cells. All the human lung cancer cell lines and the majority of human lung cancer tissues (78%) expressed telomerase activity, but this was undetectable in normal human lung tissues. Positivity for telomerase activity in lung cancer cell lines was higher than in lung cancer tissues; this result implies the expression of telomerase activity may play a crucial role in the development or progression of lung cancer, and also suggests that improved method of detection may lead to the higher positivity for telomerase activity in primary lung cancer tissues. To determine whether there is a definite causal relationship between telomerase and cancer, and to develop new anti-cancer agents which inhibit telomerase, further study is needed.

Synthetic 2'-O-methyl-modified hammerhead ribozymes targeted to the RNA component of telomerase as sequence-specific inhibitors of telomerase activity

Telomerase is a ribonucleoprotein that synthesizes tandem arrays of the hexameric DNA sequence TTAGGG at chromosome termini using its RNA component as a template. As most normal cells lack telomerase activity, a progressive shortening of chromosome length occurs with each cell division because of incomplete DNA replication. Cell senescence ensues when a critical telomere length is reached, but importantly, senescence bypass and life span extension occur in normal cells transfected with functional telomerase activity. Almost 90% of all tumors express telomerase activity, implying that telomerase is an important determinant in tumor progression and cell immortalization. However, the exact role and regulation of the individual components of the telomerase complex are not fully understood and would benefit from the availability of specific inhibitors. In this study, we investigated the potential use of chemically stabilized, catalytic RNA molecules (hammerhead ribozymes) to inhibit telomerase activity by cleaving the RNA component in a sequence-specific manner. Catalytically competent (active) hammerhead ribozymes containing 2'-O-methyl ribonucleotides for enhanced biologic stability and designed to be complementary to the RNA component of human telomerase exhibited dose-dependent inhibition of telomerase activity in human glioma U87-MG cell lysates with an IC50 of around 0.4 microM. Catalytically incompetent (inactive) ribozymes or mismatched ribozymes with reduced hybridization capability to telomerase RNA did not inhibit telomerase activity, as detected by a PCR-based telomeric repeat amplification protocol (TRAP) assay. In vitro cleavage reactions using short substrates and RT-PCR analyses of the full-length RNA substrate in U87-MG cell lysates confirmed a sequence-specific catalytic cleavage of the targeted RNA component of telomerase. Exogenously administrable, synthetic ribozymes may have important uses in further understanding the role and regulation of this ribonucleoprotein in normal and diseased tissues as well as in the potential therapy of telomerase-positive tumors.

Lack of telomerase in desmoids occurring sporadically and in association with familial adenomatous polyposis

BACKGROUND

Telomerase activity may be required for unlimited growth of cells and is repressed in most somatic tissues, but is detectable in immortal cell lines, germ cells, many malignancies and some benign lesions. Desmoids are proliferative, locally invasive, non-metastasizing fibromatous tumours which rarely regress. They occur frequently in familial adenomatous polyposis (FAP), causing significant morbidity and death. Telomerase activity was assayed in desmoids from patients with and without FAP to assess the role of telomerase in the development of these lesions, and its potential as a prognostic marker and possible target for treatment.

METHODS

Protein extracts from 11 desmoids from nine patients with FAP, and ten desmoids from ten patients without FAP, were analysed for telomerase activity by the telomeric repeat amplification protocol, a sensitive polymerase chain reaction-based assay. Six fibrosarcomas and a fibrosarcoma cell line were used as positive controls; all displayed telomerase activity.

RESULTS

No telomerase activity was detected in any of the 21 desmoids studied.

CONCLUSION

These results indicate that desmoid tumours are one of the intriguing exceptions to the emerging view that re-expression of telomerase activity accompanies the development of preneoplastic and neoplastic tissues, and suggest that alternative mechanisms may operate in these proliferative neoplasms.

Telomerase expression in gliomas including the nonastrocytic tumors

Telomerase is a ribonucleoprotein that consists of a RNA component for synthesizing telomeric DNA repeats onto chromosome ends, so that telomere length can be maintained; telomerase activation in general signifies immortalization of cells. Because the telomerase activity of only a few cases of nonastrocytic gliomas and low-grade astrocytic gliomas have been examined before, telomerase activity from a broad spectrum of astrocytic and nonastrocytic gliomas were examined in this study. A total of 119 brain tumor samples, including 16 pilocytic astrocytomas, one dysembryoplastic neuroepithelial tumor (DNT), two pleomorphic xanthoastrocytomas (PXA), 15 ependymomas, 21 oligodendrogliomas, 13 grade II astrocytomas, 13 anaplastic astrocytomas, and 38 glioblastoma multiforme tumors (GBM), were studied, using a polymerase chain reaction (PCR)-based telomeric repeat amplification protocol assay. All pilocytic astrocytomas, DNT, PXA, and myxopapillary ependymomas were telomerase negative. Three of 13 (15.4%) classical ependymomas, 2 of 14 (14.3%) grade II oligodendrogliomas, and three of seven (42.9%) anaplastic oligodendrogliomas had detectable telomerase activity. The frequency of telomerase expression in ependymomas and oligodendrogliomas was lower than those observed in astrocytic tumors: fibrillary astrocytoma, 23.1%; anaplastic astrocytoma, 23.1%; and GBM, 26.3%. The mean age of telomerase-positive GBM patients (61.7 years) was significantly higher than that of telomerase-negative GBM patients (47.8 years, P=.002). These results suggest that telomerase activation may occur early in glial tumorigenesis, and astrocytomas may have mechanisms of immortalization other than telomerase activation.

Detection of telomerase expression in fine-needle aspirations and fluids

The cytologic examination of fine-needle aspirates and fluid specimens is plagued by a persistent false negative rate. The rate of false negative results will be decreased if sensitive molecular assays can be developed to detect cytologically malignant cells. The current study investigated telomerase expression as a potential marker of malignancy, using the telomeric repeat amplification protocol (TRAP) in fine-needle aspirates and fluid specimens. TRAP was performed on 24 fine-needle aspirate and 24 fluid specimens from different body sites and of different histological diagnoses. We found that 6 of 12 fine-needle aspirate specimens that were cytologically positive for malignant cells expressed telomerase activity, while no specimens that were cytologically suspicious for malignancy, atypical, or negative tested positive for telomerase activity. Of the fluid specimens, 4 of 6 cytologically positive cases and 1 of 18 cytologically negative cases expressed telomerase. Seven of eight telomerase negative, cytologically positive specimens contained only rare malignant cells in a very bloody background. Peripheral blood contamination is a possible pitfall in the TRAP assay, as applied in the current study, because the assay is standardized to protein concentration that may be derived from lysed red blood cells. We conclude that with further technical refinement, the TRAP assay could become a useful adjunct in the cytologic examination of fine-needle aspirates and fluid samples.

The correlation of telomerase and IL-10 with leukemia transformation in a mouse model of chronic lymphocytic leukemia (CLL)

Telomerase activity is upregulated in activated and malignant lymphocytes. We studied the correlation of telomerase and IL-10 to leukemia transformation in the NZB mouse model of human chronic lymphocytic leukemia (CLL). Telomerase levels increased from early to late leukemic stages, likewise IL-10 gene expression levels increased with the leukemic progression. The inverse relationship of telomerase and IL-10 levels to the survival of NZB mice was also established. Our data suggested that telomerase and IL-10 were involved in transformation in the murine model of CLL and the detection of telomerase activities might be of value in the prediction of CLL progression.

Telomerase activity in 144 brain tumours

Unlimited proliferation in immortalized cells is believed to be highly dependent on the activity of telomerase, a ribonucleoprotein that synthesizes telomeric repeats onto chromosome ends. Using a polymerase chain reaction-based telomeric repeat amplification protocol (TRAP) assay, we analysed telomerase activity in 99 benign and 45 malignant brain tumours. The TRAP assay results were quantitated by normalizing the telomerase activity of each specimen to that of human glioma cell line T98G to obtain the relative telomerase activity. Telomerase activity was also assessed visually from the autoradiograms as being positive or negative. One hundred and sixteen tumours with negative telomerase activity had null relative telomerase activity, whereas 28 tumours with positive telomerase activity had relative telomerase activities of 12-84.3% (mean 0% vs 36.1 +/- 19.3%, P < 0.0001). Thus, quantification of telomerase activity confirmed the results of the visual evaluation of telomerase activity on autoradiograms. Based on the assessment, malignant brain tumours had a higher positive rate of telomerase activity than benign tumours (57.8% vs 2.0%, P < 0.001). These data indicate that positive telomerase activity is strongly associated with malignant brain tumours and is rather rare in benign tumours, such as neurinomas or meningiomas.

Telomerase activity in human gliomas

OBJECTIVE

Telomerase activity, which is undetectable in most mature normal tissues, has been identified in many types of human cancers, including neuroblastomas and oligodendrogliomas. These findings suggest that a novel mechanism in addition to activation of oncogenes and inactivation of tumor suppressor genes may play an important role in tumorigenesis. The goal of the present study was to assess and correlate the telomerase activity in astrocytic gliomas of different grades.

METHODS

Telomere repeat amplification protocol and Southern blot hybridization with telomere-specific probes were used to detect telomerase activity and to measure terminal restriction fragment length, respectively.

RESULTS

Telomerase activity was detected in 3 of 9 (33%) low-grade astrocytomas (World Health Organization Grade II), 5 of 11 (45%) anaplastic astrocytomas (World Health Organization Grade III), 36 of 41 (89%) glioblastomas multiforme (World Health Organization Grade IV), 3 of 4 (75%) oligodendrogliomas, and none of 4 normal brain specimens.

CONCLUSION

We demonstrated that telomerase activity is absent in normal brain tissues while present in most glioma samples (72%). The frequency of such activity increases with malignancy. These results suggest that telomerase activity may be used as a tumor marker and that the activation of telomerase may correlate with initiation and malignant progression of astrocytic tumors.

Increased telomerase activity and absence of p53 mutation in oligoastrocytomas induced by N-ethyl-N-nitrosourea in rats

The question of whether the changes in telomerase activity and/or the alteration of the p53 gene are involved in the development of oligo-astrocytomas induced by N-ethyl-N-nitrosourea (ENU) in rats was addressed. Telomerase activity levels of oligo-astrocytomas, including early neoplastic lesions, were significantly increased as compared to the normal controls, correlating with the degree of malignancy. In contrast, no mutations of p53 exons 5-7 were found in early neoplastic lesions or oligo-astrocytomas. These results indicate that the activation of telomerase occurs during astrocytoma carcinogenesis and contributes to the development of brain tumors, but the alterations of p53, at least on exons 5-7, may not be involved in this process.

Telomerase expression shows differences across multiple regions of oligodendroglioma versus high grade astrocytomas but shows correlation with Mib-1 labelling

AIMS/BACKGROUND

Telomerase is an enzyme that is expressed in most human neoplasms and is associated with tumour immortality. Determination of the point in neoplastic transformation at which telomerase is expressed may aid the understanding of tumour pathogenesis and progression. Despite numerous reports on telomerase, few studies have investigated its expression in high grade glial tumours. These studies, performed on archival banked, single brain tumour specimens, have shown conflicting results for oligodendrogliomas and unexpectedly negative results for telomerase expression in high grade astrocytomas, with one third to one half of glioblastoma multiformes being negative.

METHODS

34 rapidly banked glioma specimens taken from patients undergoing gross total surgical resection of their tumours were studied. Telomerase expression was assessed across 3-8 sampled regions from each tumour by the telomeric repeat amplification protocol (TRAP) assay. Matched mirror image tissue samples were taken for histological analysis of tissue adequacy, statistical correlation of telomerase with tumour histological features, Mib-1 (a marker for cell cycling) labelling, and p53 immunohistochemistry.

RESULTS

All five well differentiated oligodendrogliomas were homogeneously telomerase negative and two of three untreated anaplastic oligodendrogliomas were homogeneously positive. In contrast, 10 of 14 high grade astrocytomas showed heterogeneity for telomerase expression across the multiple regions sampled. All glioblastoma multiformes and two of three anaplastic astrocytomas showed at least one region positive for telomerase. When test samples were individually assessed in both oligodendrogliomas and high grade astrocytomas, telomerase expression was associated with Mib-1 labelling (p < 0.001). For the entire group, telomerase expression was associated with grade of tumour, age of patient, and vascular endothelial proliferation (all p < 0.001).

CONCLUSIONS

This regional study clarifies that all glioblastoma multiformes are at least focally positive and that telomerase expression correlates with tumour grade in oligodendrogliomas. Homogeneity versus heterogeneity for telomerase expression across multiple regions of oligodendrogliomas versus high grade astrocytomas may provide important preclinical data on the use of antitelomerase agents in these adult glial tumours.

Detection of telomerase activity in breast masses by fine-needle aspiration

BACKGROUND

Telomerase is an RNA-dependent DNA polymerase that compensates for the telomere shortening that occurs in its absence. Reactivation of telomerase is thought to be an important step in cellular immortalization, and recent studies have indicated that telomerase activity is often detected in primary human malignancies. The clinical implications of telomerase activity in human tumors are currently under investigation.

METHODS

Eighty-nine samples (46 FNAs and 43 gross tissue biopsies) from 44 patients with breast masses were analyzed prospectively for the presence of telomerase activity by a modification of the telomere repeat amplification protocol (TRAP). All samples were obtained directly from the excised mass at the time of specimen removal in the operating room.

RESULTS

Telomerase activity was detected in 17 of 19 (90%) FNA samples and 15 of 18 (83%) invasive breast cancer tissue biopsies. Telomerase was also detected in 9 of 16 (56%) FNAs and 8 of 15 (53%) tissue biopsies from 16 fibroadenomas. Other benign proliferative lesions (n = 5) did not have detectable telomerase activity in either FNA or tissue specimens. FNA-TRAP results correlated with the gross tissue specimen TRAP results in 95% of all cases.

CONCLUSION

The FNA-TRAP assay for telomerase detection is a highly sensitive and accurate method for the detection of telomerase activity in breast masses. Future application of these techniques should facilitate evaluation of telomerase as a tumor marker in the clinical management of breast and other solid malignancies.

Low frequency of positive telomerase activity in a chromophobe subtype of renal cell carcinoma

PURPOSE

In malignant tumors, telomerase reactivation plays an important role in the acquisition of cellular immortality. We evaluated the telomerase activity in renal cell carcinomas (RCCs) with special reference to their clinicopathologic features.

MATERIALS AND METHODS

Telomerase activity was examined in 47 RCCs and 9 RCC cell lines by telomeric repeat amplification protocol assay (TRAP). The telomere lengths were assessed by Southern analysis of terminal restriction fragments (TRFs) generated by Hinfl-digested DNA.

RESULTS

Thirty-six (77%) of the 47 RCCs and all 9 RCC cell lines showed telomerase activity, whereas no activity was detected in any of 30 normal kidneys. When the tumors were histopathologically classified, only one (17%) of the 6 chromophobe cell carcinomas was telomerase-positive. This frequency was significantly low (p < 0.001) when compared with those in clear cell RCCs (93%; 26/28). In 40 of the 47 patients, DNA from the tumor tissues and the paired normal kidneys was available for analysis of the TRF lengths. No tumor showed elongated TRF length compared to its paired normal kidney. Regarding the relationship between telomere length and telomerase activity, 23 (74%) of the 31 telomerase-positive RCC and 6 (67%) of the 9 telomerase-negative RCC exhibited reduced TRF. There was no significant correlation between the telomere reduction and telomerase activity.

CONCLUSION

The mechanism for preventing telomere shortening may differ according to RCC subtype. Alternatively, telomerase-negative tumors may have yet to reach the immortal stage when they progress to clinical cancer. The telomerase activity status may contribute to the biological potential and the prognosis of RCCs.

New quinolones, ofloxacin and levofloxacin, inhibit telomerase activity in transitional cell carcinoma cell lines

It has been demonstrated that some quinolone antibiotics inhibit cell proliferation in vitro. This study showed that ofloxacin and levofloxacin, two well-known new quinolones, had an inhibitory effect on the proliferation of transitional cell carcinoma cell lines at high concentrations (>200 microg/ml). At relatively low concentrations (10-100 microg/ml), however, there was no apparent antiproliferative effect. Despite this, decreased absorbance in the MTT assay was observed at low concentrations and telomerase activity was significantly decreased. These results suggest that the antiproliferative effect of both ofloxacin and levofloxacin may be related to impairment of telomerase activity by some unknown mechanism.

Telomerase in human development and cancer

A potentially rate-limiting step in cancer progression is the conversion of a normal human cell into one capable of indefinite proliferation. There are at least two different cellular mechanisms that must be overcome before immortalization occurs. The first step generally requires inactivation of the pathways involving two tumor-suppressor genes, p53 and pRB, and the second step almost always involves the reactivation of the ribonucleoprotein enzyme telomerase. Telomerase synthesizes hexameric repeats (TTAGGG) onto telomeric ends, thereby compensating for telomeric losses that in its absence occurs at each cell division. Telomerase is present in human embryonic tissues, is not detected in most adult tissues, but is upregulated or reactivated in almost 90% of all human cancers. In the present article, I review the telomere-telomerase theory of aging and cancer including the roles of telomerase during human development, in differentiation, and in cancer. Research into the regulation of this enzyme may lead to methods to facilitate the accurate diagnosis of cancer and to the development of novel antitelomerase cancer therapeutics.

Preclinical and clinical strategies for development of telomerase and telomere inhibitors

BACKGROUND

Telomerase is an important enzyme whose activity has been convincingly demonstrated in humans recently. It is required for maintenance of ends of chromosomes (telomeres) during cell division. Since its presence has been selectively demonstrated in dividing cells including tumor cells, it has generated considerable excitement as a potential anti-cancer strategy.

DESIGN

In this article, we review the current relevant biology of the enzyme, the challenges encountered in the preclinical phase of target development and the current efforts that focus on telomeres and telomerase as therapeutic targets. We also speculate on the potential toxicities and mechanisms of resistance that may be encountered during use of such therapies.

Expression of telomerase RNA, telomerase activity, and telomere length in human gliomas

To understand the mechanisms of telomere maintenance in human gliomas, telomerase activity, telomerase RNA expression and telomere length of surgically excised glioma samples were analyzed. Sixty-five percent of gliomas exhibited telomerase activity, the occurrence of which was not related to their histological malignancy scale. Not only the telomerase-positive gliomas, but also the telomerase-negative gliomas and normal brain expressed telomerase RNA, suggesting that the presence of telomerase RNA component does not indicate the presence of telomerase activity. Compared with telomerase-positive gliomas, telomerase-negative gliomas had long heterogeneous telomeric terminal restriction fragments. These data suggest that in addition to the telomerase-dependent mechanism, a telomerase-independent mechanism for telomere maintenance may be present in human gliomas.

Increased telomerase activities in human pancreatic duct adenocarcinomas

Telomerase is a key enzyme with regard to immortalization of cancer cells and increased activity has been demonstrated in various human malignant neoplasms. Since little is known of its role in pancreatic cancers, we investigated changes in telomerase activity in human pancreatic duct adenocarcinomas and compared the frequency of increased telomerase activity with the presence of K-ras gene mutations. The samples were obtained from 38 pancreatic duct adenocarcinomas and 7 tumor surrounding tissues at surgical resection. Telomerase activity was examined by telomeric repeat amplification protocol assay and terminal restriction fragment (TRF) length was examined by Southern analysis. K-ras mutation was examined by means of polymerase chain reaction-single strand conformation polymorphism analysis. Among 38 pancreatic carcinomas, 32 (84%) exhibited increased telomerase activities with no apparent relation to the histological type of tumor, tumor size, regional lymphnode involvement and distant metastasis or clinical stage. In tissue surrounding the tumor, telomerase activity was not detected. TRF length tended to be reduced in pancreatic carcinomas. Mutations of K-ras gene were found in 24 out of the 38 (63%) cases. Among the 38 cases, 14 showed increased telomerase activity without K-ras mutation and 4 cases showed K-ras mutation without telomerase activity. These results suggest that increased telomerase activity might be a sensitive genetic diagnostic marker and could be a target for future therapy of pancreatic duct carcinomas.

Significant correlation of telomerase activity in thyroid papillary carcinomas with cell differentiation, proliferation and extrathyroidal extension

Telomerase activity was examined by telomeric repeat amplification protocol assay in thyroid disease states, including adenomas and carcinomas, and correlated with clinicopathological features. Of a total of 26 papillary carcinomas, 16 cases (61.5%) were positive, with the poorly differentiated subtype being predominant (P < 0.05). A significantly more shortened terminal restriction fragment length (P < 0.05), higher incidence of extrathyroidal extension (P < 0.001), and more elevated Ki-67 labeling indices (P < 0.002) were also found in telomerase-positive than in telomerase-negative papillary carcinomas. Of four follicular carcinomas, 3 cases (75.0%) were positive. Positive telomerase activity in follicular adenomas (9/23 cases, 39.1%) and lymphocytic thyroiditis (12/22 cases, 54.5%) appeared to be mainly caused by infiltrating lymphocytes. However, three cases of atypical adenoma with relatively increased Ki-67 labeling indices were positive, suggesting a possibility of malignant potential. The good correlations with extrathyroidal invasiveness, Ki-67 labeling indices and poor differentiation of papillary carcinomas, established by multivariate analysis, suggest that this parameter might have potential application in the estimation of tumor progression and prognosis, and in clinical management.

Telomerase activity in human benign prostate tissue and prostatic adenocarcinomas

Telomerase adds a hexanucleotide telomeric sequence to the chromosomal ends during replication and is postulated to play a role in cellular senescence and immortalization. Thirty-four human prostate tissues (18 malignant; 16 benign) were analyzed for telomerase activity by a sensitive nonradioactive polymerase chain reaction (PCR)-based method using the TRAP-eze telomerase detection kit (Oncor, Inc., Gaithersburg, MD). Telomerase activity in the homogenized tissue extracts was correlated with tumor grade, pathologic stage, and DNA ploidy. Specimens that exhibited the 36 bp internal control band and a ladder of products with 6-base increments starting with 50 nucleotides were considered positive. Fourteen (78%) of 18 prostatic adenocarcinomas (PACs) and only 2 (13%) of 16 benign prostate tissues exhibited telomerase activity. Our results indicate that, in contrast to most benign prostate tissues, telomerase activity can be detected in the majority of PACs and appears to be independent of tumor grade, stage, or DNA ploidy. Telomerase expression is occasionally detected in benign prostatic tissues bordering PACs and may result from either the presence of undetected tumor foci in these stored specimens or the proliferative response of the benign elements to adjacent cancer.

The significant role of telomerase activity in human brain tumors

BACKGROUND

In this study, telomerase activity in human brain tumors was analyzed.

METHODS

Telomerase activity was examined in 41 brain tumor cases (20 of glioblastoma multiformes [GBMs] [14 primary tumors and 6 recurrent tumors], 3 anaplastic astrocytomas [AAs], 4 low grade astrocytomas [LGAs] [World Health Organization Grade 2], 2 oligodendrogliomas [OGs], 9 meningiomas [MNs], and 3 metastatic brain tumors [MBTs]) by means of telomeric repeat amplification protocol assay. The activity of telomerase was compared with histologic diagnosis, the MIB-1 proliferative cell index (PCI), and the patient's prognosis.

RESULTS

Twelve of 20 GBMs, 2 of 2 OGs, and 3 of 3 MBTs demonstrated telomerase activity. AAs, LGAs, and MNs exhibited no activity. No clear correlations were confirmed in GBMs between telomerase activity and the MIB-1 PCI data. However, the telomerase activity tended to correlate with the patient's prognosis.

CONCLUSIONS

These results suggest that telomerase activity may be an important marker of brain tumor malignancy. Furthermore, the change from negative activity to positive activity in the recurrent tumors appeared to be a useful prognosticator for malignant astrocytic tumor.

Telomere control of replicative lifespan

The replicative capacity of cells may limit the lifespan of key systems in the body. It has long been known that normal human cells have a finite lifespan when placed in cell culture, and their lifespan is dependent on the age of the individual donor. The mechanism of the genetic program that times this process has been elusive. The telomere hypothesis of cell aging proposes that the length of the telomeric repeat array at chromosomal termini can time replication number and signal cell cycle arrest when critical telomere lengths are obtained. The erosion of telomeric DNA in normal tissues appears to be due to the lack of expression of components of the telomere maintenance system. Telomerase, the key enzyme involved in telomere replication, is not expressed in somatic tissues, but is expressed in germ cells, where telomere length is stably maintained, so that viable chromosomes can be transmitted to the next generation. Evidence is reviewed that correlates telomere length, telomerase activity, and the manipulation of telomere length with cell replicative capacity and cellular immortalization. Strong circumstantial evidence exists that indicates a role for telomere biology in the control of replicative capacity and in tumorigenesis.

Telomerase activity in benign and malignant thyroid tumors

Thyroid nodules are found in 5% to 10% of the population. While these nodules carry only a 5% to 10% risk of malignancy, tests that complement fine-needle aspiration (FNA) cytology in preoperative diagnosis and risk stratification are lacking. Telomerase is a ribonucleoprotein polymerase with activity found in many malignant tissues, but absent from most normal adult tissue. In this study, we have investigated telomerase activity in 24 thyroid tumors, 14 matched adjacent thyroid tissues, and 3 chronic thyroiditis tissue samples. Using a telomeric repeat amplification protocol (TRAP) assay on frozen tissue, telomerase activity was detected in 11 of 20 thyroid carcinomas, including 10 of 14 papillary carcinomas and a Hurthle cell carcinoma. Telomerase activity was not detected in 4 benign adenomas, 3 follicular carcinomas, or a single case each of medullary and anaplastic thyroid carcinoma. Telomerase activity was detected in 3 of 14 samples of adjacent thyroid tissue from patients with thyroid tumors. Interestingly, all 3 cases of adjacent thyroid tissue that tested positive had a moderate to marked degree of chronic inflammation. In addition, 3 of 3 samples from chronic thyroiditis specimens tested positive for telomerase activity. When tumor invasiveness (vascular and/or capsular) was compared with telomerase activity in papillary carcinomas, only 1 of 4 telomerase-negative tumors was invasive, while 6 of 10 of telomerase-positive tumors were invasive. Moreover, 6 of 7 invasive papillary carcinomas had telomerase activity. In summary, this is the first report of telomerase activity in thyroid tissue and nodules. This activity was detected in a large percentage of papillary thyroid carcinomas, but not benign adenomas, follicular carcinomas, or most normal thyroid tissue. Telomerase activity may also correlate with tumor invasiveness. Further studies will focus on larger numbers of tumors, metastatic tissue, and undifferentiated carcinomas, as well as application of this assay to products from fine-needle aspirates as a potential diagnostic and prognostic marker in thyroid neoplasms.

Telomeres and telomerase: biological and clinical importance

We review the present knowledge of telomeres and telomerase with special attention to their role in cell proliferation, cellular senescence, and human aging. We summarize the functional aspects of telomerase in cancer, as well as its role as a useful diagnostic and prognostic tumor marker, and discuss possible approaches to telomerase inhibition as a target for cancer therapy.

Telomerase activity in ordinary meningiomas predicts poor outcome

Telomerase, the enzyme that stabilizes telomere length, is reactivated with almost all cancer types, and it may be necessary for unlimited cell proliferation. Assessment of malignancy in ordinary meningiomas is inconclusive because no clear-cut correlation exists between aggressive clinical behavior and histological features or karyotypic abnormalities. We analyzed telomerase activity in 52 cases of meningioma by using the highly sensitive telomeric repeat amplification protocol and then compared clinical behavior in telomerase-positive and -negative ordinary meningiomas. Twenty-six of the 52 tumors (50%) had detectable telomerase activity. Twenty-one of the 22 neoplasms classified as malignant or atypical (95%) had detectable telomerase activity, and these tumors generally had a poor outcome. Interestingly, 5 of 30 ordinary (morphologically benign) meningiomas (17%) also showed detectable telomerase activity. Of the 5 patients with telomerase-positive ordinary meningiomas, 3 had rapid regrowth of the tumor despite gross total resection. The remaining 2 patients also had other primary malignancies. We observed a highly significant correlation in ordinary meningiomas between the presence of telomerase activity and a poor prognosis for the patient (P = .0002). Telomerase activity in benign meningiomas is clinically relevant because the presence of the enzyme suggests that these benign-appearing tumors may contain a population of immortal cells. The detection of telomerase activity may help to identify benign meningiomas that would be more likely to continue to grow and to recur clinically if surgical resection were incomplete.

Multiple pathways for the regulation of telomerase activity

The ends of vertebrate chromosome are composed of large tracts of a repeated sequence, TTAGGG, which are known as telomeres. Normal somatic cells progressively lose telomeric repeats with each successive cell division due to incomplete replication. Immortal and cancer cells compensate for telomeric loss by expressing the enzyme telomerase, an RNA-dependent DNA polymerase that maintains telomere length. Telomerase activity has been detected in almost 90% of all human cancers. Telomerase activity is generally absent in normal somatic tissues but is detected in adult testes, activated lymphocytes, and lower levels are expressed in proliferative cells of renewal tissues. Telomerase activity is downregulated in cells that exit the cell cycle via either terminal differentiation or (reversible) quiescence. Inhibition of telomerase activity in tumour cells may provide an effective way to treat cancer by potentially reducing the recurrence of tumours due to occult micro-metastases. An understanding of the pathways involved in telomerase regulation will be important for determining the most practical means of inhibiting its activity.

A survey of telomerase activity in human cancer

Research on the association of the ribonucleoprotein enzyme, telomerase, with human cancer has expanded rapidly in recent years. Essentially all major types of cancer have been screened and the presence of telomerase activity has been detected in the vast majority of cases. In this article we provide a summary, in table form, of the current data.

Shortened telomere length and increased telomerase activity in hamster pancreatic duct adenocarcinomas and cell lines

Recently, shortened telomere length and increased telomerase activity have been demonstrated in various human cancers. In the study reported here, we ascertained whether gene changes are characteristic of pancreatic cancers. Hamster duct carcinomas and cell lines were investigated by Southern blot analysis for telomere restriction fragment (TRF) length and by the telomeric repeat amplification protocol (TRAP) assay for telomerase activity. Comparison with normal pancreas and spleen revealed shortened TRF length and markedly increased telomerase activity in primary pancreatic duct carcinomas induced by the rapid-production model as well as in a transplantable carcinoma and the cell lines. The enzyme level was 86.0-215.7 times the low levels found in control pancreas and spleen tissues. Late-passage Syrian hamster embryo cells, known to be immortalized and tumorigenic, had shorter TRFs than the original cells in primary culture did. These results indicate that hamster pancreatic duct carcinoma cells are immortalized, with the potential for proliferation ad infinitum, and provide a model for basic therapeutic research into the substances targeting telomerase.

Telomerase activity and in situ telomerase RNA expression in malignant and non-malignant lymph nodes

AIMS/BACKGROUND

Telomerase, an enzyme associated with cellular immortality, is expressed by most malignant tumours, but is inactive in normal somatic cells except for male germ cells and proliferating stem cells. Thus, the measurement of telomerase activity in tissue samples may provide useful diagnostic and prognostic information. The aim of this study was to determine whether telomerase expression is useful for the detection of occult malignant cells in lymph nodes.

METHODS

Telomerase activity was compared with histological findings in 123 surgically removed lymph nodes submitted for routine or frozen section diagnosis. Telomerase activity was measured using a modified, semi-quantitative PCR-based telomeric repeat amplification protocol (TRAP). The assay was adapted for single 5 microns OCT embedded cryostat sections. In either fresh tissues or cryostat sections, normalised activity was linear when compared with protein concentration. Furthermore, using an in situ hybridisation method, the human telomerase RNA (hTR) component was measured in a subset of negative and positive nodes.

RESULTS

Most (96%) of the 97 histologically negative nodes expressed low levels of activity (mean value of positive samples = 3.0 units/microgram protein) which may be derived from activated lymphocytes that express telomerase activity. All 26 malignant nodes (17 metastases, nine lymphomas) expressed telomerase (mean value = 17.8 units/microgram protein). The rank order levels between the two groups differed significantly (p = 0.0002). In situ results showed clearly that the hTR was expressed relatively highly in metastatic cancer cells and at lower levels in germinal centres of secondary follicles.

CONCLUSIONS

Although expression of telomerase by activated lymphocytes may limit its usefulness, measurement of enzyme activity combined with detection of hTR using in situ hybridisation may assist in the histopathological diagnosis of lymph nodes.

Telomerase in the early detection of cancer

Although there is justifiable optimism regarding telomerase activity and early detection of cancer, it is important to point out that there is much that remains to be understood and additional validation studies will be required before knowledge of telomerase activity will be useful in decisions regarding patient management. A key question is whether we will be able to distinguish those cancers that are going to progress from those cancers that are not by detecting telomerase activity. Molecular staging using markers such as telomerase activity in combination with other molecular markers may be particularly useful in this regard. Basic scientists and clinicians must work together if this strategy is to mature. Telomerase inhibitors in the treatment of cancer are awaited with great anticipation.

Expression of human telomerase RNA is an early event of stomach carcinogenesis

Expression of human telomerase RNA (hTR) and telomerase activity in gastric cancer and corresponding non-cancerous mucosa were studied. Telomerase activity was detected in 23 (88%) of 26 carcinoma tissues. Although all tumor specimens and non-cancerous mucosa expressed various levels of hTR, 21 (81%) of 26 cases expressed hTR at a higher level in the tumor than that in the corresponding mucosa. All 8 gastric carcinoma cell lines also expressed hTR at high levels. Nine (35%) of 26 non-cancerous mucosa showed telomerase activity and all of them contained intestinal metaplasia. The incidence of telomerase-positive mucosa in grade 2 intestinal metaplasia was significantly higher than that in grade 0 or grade 1 intestinal metaplasia, whereas hTR overexpression was found in grade 0 or grade 1 intestinal metaplasia as well as grade 2 intestinal metaplasia. The degree of Helicobacter pylori infection increased in parallel with the level of hTR expression and telomerase positivity. These results overall suggest that Helicobacter pylori infection may be a strong trigger for hTR overexpression in intestinal metaplasia, and this may lead to telomerase reactivation.

Telomerase activity in bladder carcinoma and its implication for noninvasive diagnosis by detection of exfoliated cancer cells in urine

BACKGROUND

Telomerase is an enzyme that can reconstitute the ends (telomeres) of chromosomes after cell division and thus circumvent the cumulative damage that occurs in normal adult somatic cells during successive mitotic cycles. Recently, it has been proposed that this enzyme should, therefore, be detectable in immortal malignant cells but not in their normal counterparts, which stop dividing and senesce. Accordingly, telomerase activity has been reported in many types of malignant tumors, including those of the gastrointestinal tract, breast, and lung but little information was available regarding its status in bladder carcinoma or in exfoliated cancer cells.

METHODS

In the current study, telomerase activity was examined by a polymerase chain reaction-based assay designated TRAP (telomeric repeat amplification protocol) in tissue samples from 56 bladder carcinomas, 17 nonneoplastic bladder lesions, and 2 dysplastic lesions of the urinary tract. The feasibility of identifying cancer patients by the detection of telomerase activity in exfoliated cancer cells in the urine was also investigated. Such activity was assayed in centrifuged urine cell pellets from 26 bladder carcinoma patients and from 83 patients with no evidence of malignant disease.

RESULTS

Evidence of telomerase was detected in solid tissue specimens from 48 of the 56 bladder carcinomas (86%) regardless of tumor stage or differentiation, whereas it was not found in any normal bladder tissue specimen. However, it was present in the dysplastic bladder lesions as well as in nearly all Stage I well differentiated carcinomas, suggesting that its activation occurs for the early stages of carcinogenesis and could perhaps be a useful marker for the detection of early primary or recurrent bladder tumors. Telomerase activity was detected with various signal intensities in urine specimens from 16 of the 26 patients with bladder carcinoma (62% sensitivity), whereas only 3 of 83 nonmalignant urine samples showed any activity (96.4% specificity); this was very weak.

CONCLUSIONS

These results suggest that telomerase could be a good diagnostic marker for the early noninvasive identification of patients with bladder carcinoma by facilitating the detection of exfoliated immortal cancer cells in their urine.

A rapid, useful and quantitative method to measure telomerase activity by hybridization protection assay connected with a telomeric repeat amplification protocol

Telomerase, a ribonucleoprotein enzyme, is expected to be a new marker for cancer diagnosis. TRAP (the telomeric-repeat amplification protocol) developed by Kim et al. is a sensitive method to detect telomerase activity. Telomerase activity is detected by TRAP in most malignant cells in vivo and in vitro, but it is not found, or found only in very low amounts, in normal somatic cells and tissues. TRAP and its modified protocols are, however, not always suitable for measuring the activity of a large number of clinical samples to diagnose cancer, because they generally require a time-consuming detection step such as gel electrophoresis with radioactive materials. To improve the procedure for mass diagnosis, we applied a hybridization protection assay (HPA) to replace the detection step. HPA, which employs an acridinium-ester-labelled probe, is radioactivity-free, easy to handle without electrophoresis, quick, and applicable to a quantitative format. In this work we have established and demonstrated the advantages of TRAP/HPA. The telomerase activity of various primary and established cells, differentiating cancer cells, and normal and tumour colorectal and liver tissues was quantitatively analysed by TRAP/HPA. The results indicate that HPA combined with TRAP is a rapid and simple method, easy to handle and quantify, for the clinical diagnosis of cancer.

Detection of telomerase activity in exfoliated cancer cells in colonic luminal washings and its related clinical implications

Telomerase is a ribonucleoprotein capable of replacing telomeric DNA sequences that are lost at each cell division. Under normal circumstances, it is active in rapidly dividing embryonic cells and in stem cell populations but not in terminally differentiated somatic cells. Much attention has recently focused on the hypothesis that activity of this enzyme is necessary for cells to become immortal. This predicts that telomerase activity should be detectable in malignant cells and tissues but not in their normal counterparts, which slowly senesce and die. In accordance with this notion, telomerase activity has been reported in a wide range of malignancies, including those of the gastrointestinal tract, breast and lung. In the present study, we used a polymerase chain reaction (PCR)-based assay for telomerase activity, designated the "telomeric repeat amplification protocol (TRAP)', to examine initially 35 colonic carcinomas, their corresponding normal tissues and 12 inflammatory bowel disease (IBD) lesions. We detected strong enzyme activity in 32 (92%) of the 35 colon carcinomas while there was no activity in 30 (86%) of 35 matched normal colonic tissue specimens and only very weak activity in the remainder. Four of seven specimens of ulcerative colitis and two of five Crohn's disease lesions were negative, and the rest were only weakly positive. These results led us to examine whether telomerase could be detected in carcinoma cells exfoliated into the colonic lumen. We assayed lysates of exfoliated cells in luminal washings from colectomy specimens of 15 patients with colon carcinoma and nine with IBD. Telomerase activity was detected in washings from 9 (60%) of the 15 colon carcinoma cases but not in any from cases with IBD, suggesting that it can be a good marker for the detection of colon carcinoma, possibly even in non-invasively obtained samples.

Telomeres and telomerase in normal and malignant haematologic cells

Telomeres, the ends of eukaryotic chromosomes are structural and functional units composed of proteins and repetitive DNA sequences. Telomeres protect the ends of chromosomes from DNA loss caused by incomplete replication of 3' ends. The obligatory loss of terminal sequence with each cell division leads to telomere shortening, and is counteracted in germline cells by an enzymatic activity termed telomerase that resynthesizes telomeric DNA de novo. Telomere length and telomerase activity have been measured by several groups in both normal and malignant blood and marrow cells. Telomere length decreases with age in normal blood and bone marrow, despite the presence of a detectable telomerase activity. In most hematologic malignancies telomere length is short and telomerase activity is enhanced, compatible with the late activation of the enzyme in tumour development. The implications of these findings for tumour pathogenesis, diagnosis, and treatment are discussed.

Increased telomerase activity in hyperplastic nodules and hepatocellular carcinomas induced by a choline-deficient L-amino acid-defined diet in rats

Activation of telomerase has been reported in several human cancers, including hepatocellular carcinomas (HCCs). We investigated telomerase activity during hepatocarcinogenesis induced by a choline-deficient L-amino acid-defined (CDAA) diet in rats. Male F344 rats were given a CDAA diet or a choline-supplemented L-amino acid-defined (CSAA) diet from 6 weeks of age for 75 weeks, and subgroups were killed 10 weeks, 50 weeks and 75 weeks after the beginning of the experiment. Hyperplastic nodules and HCCs were noted in rats fed a CDAA diet for 50 weeks and 75 weeks, respectively. Normal control liver specimens were obtained from 6-week-old rats. Telomerase activity was assessed by using a telomeric repeat amplification protocol (TRAP). Normal liver and background parenchyma of rats fed either of the diets for 10 weeks or 50 weeks showed weak telomerase activity. In contrast, markedly increased levels were demonstrated in hyperplastic nodules and HCCs. These results suggest that increased telomerase activity may be a biological feature of preneoplastic lesions that evolve to HCCs in rat liver.

Telomere associations in desmoplastic infantile ganglioglioma

A four and a half year old male was diagnosed with desmoplastic infantile ganglioglioma. To our knowledge, the cytogenetics of this tumor have never been reported. In our analysis of 40 cells, no consistent clonal abnormalities were observed; however, the majority of cells (25 of 40) showed structural rearrangements (telomere associations) resulting in dicentrics and other derivative chromosomes. Breakpoints most often observed included 17q25 (6 of 40), 19p13.3 (4 of 40), 17p13 (3 of 40), 14q32 (3 of 40), 11q25 (3 of 40), 9p24 (2 of 40), 5q35 (2 of 40), and 22q13 (2 of 40).

Telomerase: anti-cancer target or just a fascinating enzyme?

Telomerase activity is upregulated in most types of malignant tumor. Highly selective small molecule inhibitors will be needed to understand the biological basis for this observation and to determine if telomerase is a viable target for chemotherapy.

Detection of telomerase activity in malignant and nonmalignant skin conditions

Telomeres are the end regions of linear chromosomes, and in normal somatic cells the lengths of telomeres shorten with successive cell divisions. Telomerase, a ribonucleoprotein enzyme, maintains the length of telomeres in immortal and germline cells. Although present in human fetal tissues, shortly after birth telomerase activity is not detectable except in germline cells, hematopoietic cells, and most human primary tumors. In the present study we show telomerase activity to be present in 73 of 77 basal cell carcinomas, 15 of 18 nonmetastatic cutaneous squamous cell carcinomas, and 6 of 7 cutaneous melanomas, contrasting with extremely low levels detected in sun-protected skin. Sun-damaged skin, psoriatic lesional skin, and skin from lesions of poison ivy dermatitis, however, have increased levels of telomerase activity compared to sun-protected skin, although less than that detected in tumor tissue. Because telomerase activity can be found in inflammatory lesions of the skin, this indicates that telomerase activity does not always correlate with the malignant phenotype. In addition, we show that telomerase activity is localized to the epidermis of newborn foreskin, which suggests that telomerase is expressed constitutively by cells in the epidermis. Finding higher levels of telomerase activity in sun-exposed skin compared to nonexposed skin suggests that environmental factors may modulate telomerase activity.