JC virus: a biomarker for colorectal cancer?

JC virus: a biomarker for colorectal cancer?

Medical Hypotheses (2002) 59(6), 667–669 ª 2002 Published by Elsevier Science Ltd. doi:10.1016/S0306-9877(02)00166-4, available online at http://www.i...

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Medical Hypotheses (2002) 59(6), 667–669 ª 2002 Published by Elsevier Science Ltd. doi:10.1016/S0306-9877(02)00166-4, available online at http://www.idealibrary.com

JC virus: a biomarker for colorectal cancer? F. F. Shadan, C. Cunningham, C. R. Boland Department of Medicine and Comprehensive Cancer Center, UCSD, School of Medicine, California, USA

Summary Chromosomal instability (CIN) is present in most colorectal cancers, though the mechanism for these genetic aberrations is unclear. An explanation may lie in the possible link between JC virus (JCV) Mad-1 strain, found in colorectal cancers, and aneuploid neoplasia. It is proposed here to test the hypothesis that detection of JCV in colorectal cancer patients may serve as a clinically useful biomarker for the presence of colorectal tumors. This may be tested by looking for any correlation that may exist between JCV DNA, viral proteins, and anti-JCV anti-sera detected in samples of stool, blood, and urine obtained from patients with colorectal neoplasm compared with normal age-matched controls. ª 2002 Published by Elsevier Science Ltd. INTRODUCTION Colorectal cancer is a major cause of morbidity and mortality. The study of carcinogenesis in colorectal cancer model systems has been fundamental to our understanding of tumor biology. A paradigm has emerged in which every neoplasm is associated with some type of genomic instability to account for all of the mutations and genetic aberrations observed (1–4). Two distinct pathways have been described that lead to genomic instability. One pathway, accounting for approximately 15% of colorectal cancers has been attributed to the loss of the DNA mismatch repair (MMR) system, resulting in microsatellite instability (MSI). In the majority of colorectal cancers, the instability observed is at the chromosomal level, in the form of losses, gains, and rearrangements of whole chromosomes, thus resulting in aneuploidy and polyploidy. This form of genomic instability is referred to as chromosomal instability (CIN) (1–5).

CIN would inactivate the cell cycle checkpoint controls that normally arrest cellular growth and trigger apoptosis in response to DNA damage (3–10). Classic examples of this process are the inactivation of the p53 and retinoblastoma (Rb) tumor suppressor genes that lead to genomic instability. Mutations of p53, Rb, and related genes can be found in a major proportion of colorectal cancers. Historically, the inactivation of p53 and Rb has been demonstrated through the formation of complexes with the large transforming antigen (T-antigen) (11–14). T-antigen is the product of an oncogene encoded by the polyomavirus family of small DNA tumor viruses. Polyomaviruses have been implicated in a variety of neoplastic changes observed in humans and in animal models (15–43). JCV, which is highly homologous to both BK and to SV-40, has been associated with bladder, brain, lymphoid, and colorectal tumors. SV-40 has been associated with brain tumors and with pleural mesotheliomas. BK polyomavirus has been associated with pancreatic, renal, muscle, skeletal, lung, and brain tumors.

JC virus has the potential to cause cancer in humans The cause of chromosomal instability (CIN) remains unknown. We postulate that any mechanism(s) underlying Received 31 July 2001 Accepted 1 November 2001 Correspondence to: C.R. Boland, UCSD School of Medicine, La Jolla, CA, USA. E-mail: [email protected]

A putative link between JC virus infection and human colorectal cancer Recent evidence raises the possibility that the Mad-1 strain of JCV may play a causal role in colorectal carcinogenesis. It has been shown that the human gastrointestinal tract, and in particular the colon, serves as a major reservoir of JCV Mad-1 DNA sequences (44–46). At

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least 10-fold greater viral copies have been detected in human colon cancer cells compared to matched normal controls. JCV DNA sequences have been isolated from human colon cancer xenografts grown on nude mice. The aneuploid colorectal cancer cell line, SW480, which has been regarded as a prototype for CIN, carries Mad-1 DNA sequences and expresses T-antigen (47,48). The Mad-1 strain infects normal human colon cells in culture (48). The infected cells express T-antigen and exhibit severe CIN. They appear to be dedifferentiated and immortal. These findings raise the possibility that the Mad1 strain may be involved in the etiology of colon cancer. To determine the clinical significance of these findings and to explore the possibility that JCV detection may ultimately serve as a biomarker for colorectal cancer we propose to test whether detection of Mad-1 correlates with the presence of colorectal tumors. CONCLUSION Colorectal cancer is a major cause of morbidity and mortality. The etiology of CIN, a major pathway in the development of colorectal cancer remains unknown. Preliminary evidence raises the possibility that JCV, and in particular the Mad-1 strain, may play an etiological role in this process. A link between Mad-1 and the development of colorectal cancer has yet to be established. It is proposed to test the hypothesis that Mad-1 correlates with the presence of colorectal tumors. Prospective studies can be designed to determine whether any correlation exists between JCV infection and the development of colorectal tumors. If such a link is established, then measurement of parameters such as viral DNA, proteins, or antiviral antibodies may ultimately serve as clinically useful biomarkers for the presence of colorectal tumors. REFERENCES 1. Fearon E. R., Vogelstein B. A genetic model for colorectal tumorgenesis. Cell 1990; 61: 759. 2. Lengauer C., Kinzler K. W., Vogelstein B. Genetic instability in colorectal cancers. Nature 1997; 396: 623. 3. Cahill D. P., Lengauer C., Yu J., Riggins G. J., Willson J. K., Markowitz S. D., Kinzler K. W., Vogelstein B. Mutations of mitotic checkpoint genes in human cancers. Nature 1998; 392: 300. 4. Brattain M. G., Fine W. D., Khaled F. M., Thompson J., Brattain D. E. Heterogeneity of malignant cells from a human colonic carcinoma. Cancer Res 1981; 41: 1751. 5. Branch P., Hampson R., Karran P. DNA mismatch binding defects, DNA damage tolerance, and mutator phenotype in human colorectal carcinoma cell lines. Cancer Res 1995; 55: 2304–2309. 6. Lal G., Gallinger S. Familial adenomatous polyposis. Semin Oncol 2000; 18: 314. 7. Goss K. H., Groden J. Biology of the adenomatous polyposis coli tumor suppressor. J Clin Oncol 2000; 18(9): 1967.

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Medical Hypotheses (2002) 59(6), 667–669