Alternative Lengthening of Telomeres in Neoplasia

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (15 March 2023) | Viewed by 9020

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Laboratory of Genetics, Center of Clinical Research, Experimental Surgery and Translational Research Biomedical Research Foundation Academy of Athens (BRFAA), Athens, Greece
Interests: chromosome instability; telomere dysfunction; cancer, continuous growth
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Dear Colleagues,

Telomeres play a dual role in neoplasia. On one hand, these highly conserved repetitive nucleoprotein structures located at the tips of linear chromosomes safeguard somatic cells from tumorigenic mutations and thus prevent cancer. Nonetheless, most tumors bypass replicative senescence and support malignant cell growth via the activation of telomere maintenance mechanisms (TMM). Underpinning their important role in neoplasia, DNA damage responses lie at the epicenter of these seemingly contradictory but highly interrelated telomere functions. It is well established that the great majority of cancers sustain capacity for uncontrolled continuous cell proliferation through the activation of reverse transcriptase telomerase. However, approximately 10-15% of human neoplasms maintain their telomeres via at least two distinct homologous recombination-mediated pathways, termed Alternative Lengthening of Telomeres (ALT). Although much rarer and less well understood than telomerase activity, ALT is considered equally important, not only because it involves a subset of highly aggressive tumors, but also due to its putative engagement as a resistance mechanism that may burden all current and future onco-therapies based on telomerase suppression. During the past decade, significant progress has been made in understanding the underlying mechanisms of ALT. Epigenetic modifications, telomere-interacting factors, and homology-driven DNA damage repair has been implicated in the ALT pathway. These advances hold promise for the development of novel highly efficient therapies that target TMM in neoplasia. This thematic issue of Cancers is dedicated to presenting through comprehensive reviews and research articles the substantial progress in our knowledge of ALT, which is expected to be soon translated into novel clinical oncology applications.

Dr. Sarantis Gagos
Guest Editor

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Keywords

  • alternative lengthening of telomeres—ALT
  • telomere maintenance
  • replication stress
  • break-induced replication
  • mitotic DNA synthesis
  • homologous recombination
  • ALT-associated PML bodies
  • telomeric sister chromatid exchanges
  • telomeric C-circles
  • ATRX, DAXX, nuclear-receptor recruitment to telomeres

Published Papers (4 papers)

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Research

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13 pages, 1612 KiB  
Article
Alternative Lengthening of Telomeres Is Rare in Canine Histiocytic Sarcoma
by Theresa Kreilmeier-Berger, Heike Aupperle-Lellbach, Martin Reifinger, Nicolai Valentin Hörstke, Klaus Holzmann and Miriam Kleiter
Cancers 2023, 15(17), 4214; https://doi.org/10.3390/cancers15174214 - 22 Aug 2023
Viewed by 1790
Abstract
Cancer cells activate telomere maintenance mechanisms (TMMs) to overcome senescence and thus are targets for TMM-specific therapies. Telomerase-independent alternative lengthening of telomeres (ALT) is frequently utilized as a TMM in human sarcoma subtypes. Histiocytic sarcoma (HS) is a rare but aggressive tumor of [...] Read more.
Cancer cells activate telomere maintenance mechanisms (TMMs) to overcome senescence and thus are targets for TMM-specific therapies. Telomerase-independent alternative lengthening of telomeres (ALT) is frequently utilized as a TMM in human sarcoma subtypes. Histiocytic sarcoma (HS) is a rare but aggressive tumor of hematopoietic origin with unknown ALT incidence in humans. ALT has been identified in canine HS, a tumor type comparable to human HS that occurs with high rates in certain canine breeds such as Bernese mountain dogs (BMDs). This retrospective study characterized the frequency of ALT in BMD and non-BMD patients diagnosed with HS as surrogates for humans. Formalin-fixed paraffin-embedded tumor samples from 63 dogs at two centers, including 47 BMDs, were evaluated for their ALT activity and relative telomere content (TC) using a radiolabel C-circle assay (CCA). Known ALT-positive samples served as controls. CCA-positive cases were validated via FISH. Two BMD samples showed ALT activity of 1–14% compared to controls. All other samples were ALT-negative. The TC did not correlate with the CCA results. ALT positivity was validated by the appearance of ultrabright telomere foci. Low ALT activity was present in 4% of BMDs with HS and therefore does not appear to be a common target for therapeutic approaches but can have diagnostic value. Full article
(This article belongs to the Special Issue Alternative Lengthening of Telomeres in Neoplasia)
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12 pages, 1202 KiB  
Communication
Alternative Lengthening of Telomeres in Pediatric High-Grade Glioma and Therapeutic Implications
by Banlanjo Umaru, Satarupa Sengupta, Shiva Senthil Kumar and Rachid Drissi
Cancers 2023, 15(12), 3070; https://doi.org/10.3390/cancers15123070 - 06 Jun 2023
Cited by 1 | Viewed by 1379
Abstract
Pediatric high-grade gliomas (pHGGs), including diffuse intrinsic pontine glioma (DIPG), are highly aggressive tumors with dismal prognoses despite multimodal therapy including surgery, radiation therapy, and chemotherapy. To achieve cellular immortality cancer cells must overcome replicative senescence and apoptosis by activating telomere maintenance mechanisms [...] Read more.
Pediatric high-grade gliomas (pHGGs), including diffuse intrinsic pontine glioma (DIPG), are highly aggressive tumors with dismal prognoses despite multimodal therapy including surgery, radiation therapy, and chemotherapy. To achieve cellular immortality cancer cells must overcome replicative senescence and apoptosis by activating telomere maintenance mechanisms (TMMs) through the reactivation of telomerase activity or using alternative lengthening of telomere (ALT) pathways. Although the ALT phenotype is more prevalent in pHGGs compared to adult HGGs, the molecular pathway and the prognostic significance of ALT activation are not well understood in pHGGs. Here, we report the heterogeneity of TMM in pHGGs and their association with genetic alterations. Additionally, we show that sensitivity to the protein kinase ataxia telangiectasia- and RAD3-related protein (ATR) inhibitor and the ATR downstream target CHK1 is not specific to pHGG ALT-positive cells. Together, these findings underscore the need for novel therapeutic strategies to target ALT in pHGG tumors. Full article
(This article belongs to the Special Issue Alternative Lengthening of Telomeres in Neoplasia)
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Review

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18 pages, 1149 KiB  
Review
R-Loops at Chromosome Ends: From Formation, Regulation, and Cellular Consequence
by Yi Gong and Yie Liu
Cancers 2023, 15(7), 2178; https://doi.org/10.3390/cancers15072178 - 06 Apr 2023
Cited by 9 | Viewed by 2436
Abstract
Telomeric repeat containing RNA (TERRA) is transcribed from subtelomeric regions to telomeres. TERRA RNA can invade telomeric dsDNA and form telomeric R-loop structures. A growing body of evidence suggests that TERRA-mediated R-loops are critical players in telomere length homeostasis. Here, we will review [...] Read more.
Telomeric repeat containing RNA (TERRA) is transcribed from subtelomeric regions to telomeres. TERRA RNA can invade telomeric dsDNA and form telomeric R-loop structures. A growing body of evidence suggests that TERRA-mediated R-loops are critical players in telomere length homeostasis. Here, we will review current knowledge on the regulation of R-loop levels at telomeres. In particular, we will discuss how the central player TERRA and its binding proteins modulate R-loop levels through various mechanisms. We will further provide an overview of the consequences of TERRA-mediated persistent or unscheduled R-loops at telomeres in human ALT cancers and other organisms, with a focus on telomere length regulation after replication interference-induced damage and DNA homologous recombination-mediated repair. Full article
(This article belongs to the Special Issue Alternative Lengthening of Telomeres in Neoplasia)
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21 pages, 1231 KiB  
Review
The Molecular Mechanisms and Therapeutic Prospects of Alternative Lengthening of Telomeres (ALT)
by Eric J. Sohn, Julia A. Goralsky, Jerry W. Shay and Jaewon Min
Cancers 2023, 15(7), 1945; https://doi.org/10.3390/cancers15071945 - 23 Mar 2023
Cited by 3 | Viewed by 2941
Abstract
As detailed by the end replication problem, the linear ends of a cell’s chromosomes, known as telomeres, shorten with each successive round of replication until a cell enters into a state of growth arrest referred to as senescence. To maintain their immortal proliferation [...] Read more.
As detailed by the end replication problem, the linear ends of a cell’s chromosomes, known as telomeres, shorten with each successive round of replication until a cell enters into a state of growth arrest referred to as senescence. To maintain their immortal proliferation capacity, cancer cells must employ a telomere maintenance mechanism, such as telomerase activation or the Alternative Lengthening of Telomeres pathway (ALT). With only 10–15% of cancers utilizing the ALT mechanism, progress towards understanding its molecular components and associated hallmarks has only recently been made. This review analyzes the advances towards understanding the ALT pathway by: (1) detailing the mechanisms associated with engaging the ALT pathway as well as (2) identifying potential therapeutic targets of ALT that may lead to novel cancer therapeutic treatments. Collectively, these studies indicate that the ALT molecular mechanisms involve at least two distinct pathways induced by replication stress and damage at telomeres. We suggest exploiting tumor dependency on ALT is a promising field of study because it suggests new approaches to ALT-specific therapies for cancers with poorer prognosis. While substantial progress has been made in the ALT research field, additional progress will be required to realize these advances into clinical practices to treat ALT cancers and improve patient prognoses. Full article
(This article belongs to the Special Issue Alternative Lengthening of Telomeres in Neoplasia)
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