Abstract. The repeated replication of cells shortens telomeres, culminating in their instability, after which most cells cease to replicate and die. However, a small fraction of the cells become immortalized by maintaining telomeres with activated telomerase activity. It has been proposed that WRN helicase encoded by the WRN gene, the causative gene of Werner syndrome (WS), is required for immortalization by the telomeric crisis pathway (TCP) in a system that uses lymphoblastoid cell lines transformed by the Epstein-Barr virus. Taken together, these characteristics indicate that WRN helicase is also required for the immortalization of epithelial cells by TCP and consequent carcinogenesis, suggesting that the tumorigenesis of epithelial cells by TCP is suppressed in WS lacking the WRN helicase function. Notably, in WS the pathway of alternative lengthening of telomeres without activation of telomerase activity has been suggested to be involved in immortalization and tumorigenesis. This factor is consistent with the abundance of non-epithelial cancers in WS in that the ratio of epithelial to non-epithelial cancers is approximately 1:1 in WS patients compared to 10:1 in the general population. A hypothetical scheme showing the role of WRN helicase in immortalization by means of the supposed 'breakage-fusionbridge cycle' of chromosomes at telomeric crisis is described.
IntroductionThe Werner syndrome (WS) is an autosomal recessive disorder causing symptoms of premature aging (1). The causative gene of WS is the WRN gene encoding for WRN protein, a DNA helicase (2). Another characteristic feature of this disorder is a much higher incidence of rare cancers (3). Non-epithelial tumors, including soft-tissue sarcoma and benign meningioma, are associated with WS, as shown by 124 case reports of neoplasia of WS patients from Japan, and 34 case reports from outside Japan between 1939 and August 1995. Notably, the ratio of epithelial to non-epithelial cancers was approximately 1:1 in WS patients compared to 10:1 in the general population. Two telomere maintenance mechanisms, telomerase activation (4) and alternative lengthening of telomeres (ALT) (5,6) exist. In human tumors of the general population over 80% of carcinomas maintain telomeres by telomerase activation, whereas various types of sarcomas elongate telomeres by means of ALT in the absence of telomerase activity (7). In tumors in WS patients, however, evidence has shown that the telomerase activation pathway by telomeric crisis is blocked, while the ALT pathway is enhanced (8-10), supporting the high incidence of rare cancers in WS.
Role of WRN gene in immortalization by means of telomeric crisis pathwayThe repeated replication of cells shortens telomeres, culminating in their instability, after which most cells cease to replicate and die. However, a small fraction of the cells become immortalized by maintaining telomeres with activated telomerase activity, known as the telomeric crisis pathway (TCP) (11)(12)(13)