Abstract
Simple SummaryAmong the top ten deadly solid tumors are the two most frequent liver cancers, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma, whose development and malignancy are favored by multifactorial conditions, which include aberrant maturation of pre-mRNA due to abnormalities in either the machinery involved in the splicing, i.e., the spliceosome and associated factors, or the nucleotide sequences of essential sites for the exon recognition process. As a consequence of cancer-associated aberrant splicing in hepatocytes- and cholangiocytes-derived cancer cells, abnormal proteins are synthesized. They contribute to the dysregulated proliferation and eventually transformation of these cells to phenotypes with enhanced invasiveness, migration, and multidrug resistance, which contributes to the poor prognosis that characterizes these liver cancers.The two most frequent primary cancers affecting the liver, whose incidence is growing worldwide, are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA), which are among the five most lethal solid tumors with meager 5-year survival rates. The common difficulty in most cases to reach an early diagnosis, the aggressive invasiveness of both tumors, and the lack of favorable response to pharmacotherapy, either classical chemotherapy or modern targeted therapy, account for the poor outcome of these patients. Alternative splicing (AS) during pre-mRNA maturation results in changes that might affect proteins involved in different aspects of cancer biology, such as cell cycle dysregulation, cytoskeleton disorganization, migration, and adhesion, which favors carcinogenesis, tumor promotion, and progression, allowing cancer cells to escape from pharmacological treatments. Reasons accounting for cancer-associated aberrant splicing include mutations that create or disrupt splicing sites or splicing enhancers or silencers, abnormal expression of splicing factors, and impaired signaling pathways affecting the activity of the splicing machinery. Here we have reviewed the available information regarding the impact of AS on liver carcinogenesis and the development of malignant characteristics of HCC and iCCA, whose understanding is required to develop novel therapeutical approaches aimed at manipulating the phenotype of cancer cells.
Highlights
According to cancer incidence and mortality statistics worldwide registered by Globocan, in 2020, liver cancer was ranked sixth in incidence with 905,677 new cases (4.7% of new cases) but third regarding mortality with 830,180 deaths (8.3% of all cancer-related deaths)
Because aberrant splicing generates mRNA isoforms involved in liver cancer development and malignancy [1], several studies have attempted to establish a relationship between alternative splicing (AS) signatures and the prognosis of hepatocellular carcinoma (HCC) [2,3,4,5] and intrahepatic cholangiocarcinoma (iCCA) [6,7]
The reason is that this post-translational modification promotes hnRNPK nuclear translocation, which acting as a transcription factor, induces the expression of several proteins involved in cell proliferation, migration, and apoptosis inhibition
Summary
According to cancer incidence and mortality statistics worldwide (both genders, all ages) registered by Globocan (https://gco.iarc.fr/ accessed on 18 September 2021), in 2020, liver cancer was ranked sixth in incidence with 905,677 new cases (4.7% of new cases) but third regarding mortality with 830,180 deaths (8.3% of all cancer-related deaths). Because aberrant splicing generates mRNA isoforms involved in liver cancer development and malignancy [1], several studies have attempted to establish a relationship between alternative splicing (AS) signatures and the prognosis of HCC [2,3,4,5] and iCCA [6,7]. Re-splicing of mature mRNA in cancer cells promotes the activation of distant weak alternative splice sites, potentially generating mutation-independent diversity in cancer transcriptomes. This process might result from the impairment during carcinogenesis of a not-yet well-understood mechanism existing in normal cells to prevent potentially harmful mRNA re-splicing events [12]. The present review deals with the current understanding of the impact of AS on liver carcinogenesis and the development of malignant traits frequently found in HCC and iCCA
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