Pathways to cancer via the caretakers The process of
DNA replication inherently places cells at risk of acquiring mutations. Thus, caretaker genes are vitally important to cellular health. Rounds of cell replication allow fixation of mutated genes into the
genome. In genetic knock-out and rescue experiments, restoration of a caretaker gene from the mutated form to the wildtype version does not limit tumorigenesis. This is because caretaker genes only indirectly contribute to the pathway to cancer. Cells deficient in a
DNA repair process tend to accumulate unrepaired
DNA damages. Cells defective in
apoptosis tend to survive even with excessive DNA damage, thus permitting
replication of the damaged DNA and consequently carcinogenic
mutations. Some key caretaker proteins that contribute to cell survival by acting in DNA repair processes when the level of damage is manageable, become executioners by inducing apoptosis when there is excess DNA damage. Inactivation of caretaker genes is environmentally equivalent to exposing the cell to mutagens incessantly. For example, a mutation in a caretaker gene coding for a DNA repair pathway that leads to the inability to properly repair DNA damage could allow uncontrolled cell growth. This is the result of mutations of other genes that accumulate unchecked as a result of faulty gene products encoded by the caretakers. In addition to providing genomic stability, caretakers also provide chromosomal stability. Chromosomal instability resulting from dysfunctional caretaker genes is the most common form of genetic instability that leads to cancer in humans. In fact, it has been proposed that these caretaker genes are responsible for many hereditary predispositions to cancers. In individuals predisposed to cancer via mutations in caretaker genes, a total of three subsequent
somatic mutations are required to acquire the cancerous phenotype. In the presence of competent gatekeeper genes, mutations of other genes do not lead to on-going growth imbalances. Mutations altering these genes lead to irregular growth regulation and differentiation. Gatekeeper genes are in fact specific to the tissues in which they reside.
Apoptosis, or induced cell suicide, usually serves as a mechanism to prevent excessive cellular growth. Gatekeeper genes regulate apoptosis. However, in instances where tissue growth or regrowth is warranted, these signals must be inactivated or net tissue regeneration would be impossible. Thus, mutations in growth-controlling genes would lead to the characteristics of uncontrolled cellular proliferation,
neoplasia, while in a parallel cell that had no mutations in the gatekeeper function, simple cell death would ensue. Stromal cell abnormalities arising from gene products coded by faulty landscaper genes could induce abnormal cell growth on the
epithelium, leading to
cancer of that tissue. Biochemical cascades consisting of
signaling proteins occur in the ECM and play an important role to the regulation of many aspects of cell life. Landscaper genes encode products that determine the composition of the membranes in which cells live. For example, large molecular weight
glycoproteins and
proteoglycans have been found to in association with signaling and structural roles. There exist proteolytic molecules in the ECM that are essential for clearing unwanted molecules, such as growth factors,
cell adhesion molecules, and others from the space surrounding cells. It is proposed that landscaper genes control the mechanisms by which these factors are properly cleared. Different characteristics of these membranes lead to different cellular effects, such as differing rates of cell proliferation or differentiation. If, for example, the ECM is disrupted, incoming cells, such as those of the immune system, can overload the area and release chemical signals that induce abnormal
cell proliferation. These conditions lead to an environment conducive to
tumor growth and the cancerous phenotype. == Gatekeepers, caretakers, and cellular aging ==