Abstract

Simple SummaryDid you ever wonder why some tissues can produce very aggressive types of cancer whereas others are apparently immune to this devastating disease? One of the most accepted theories in the scientific community states that tumors are fueled by small numbers of key master cells called cancer stem cells, which mediate tumor relapse and metastasis. Much effort has been made to identify these cells by the characterization of their defining markers, in an attempt to eliminate these cells selectively. However, many of these markers are also present in other healthy stem cells in the body, including those found in some tissues like the dental pulp, which is known to be highly resistant to carcinogenesis. This brings up the question of whether there is indeed a genuine marker that can be used to unequivocally identify cancer stem cells. We set out to address this question by a systematic comparison of healthy stem cells and cancer stem cells of different body locations, and we discuss some key factors that play a role in the resistance of certain types of stem cells to malignant transformation.The conversion of healthy stem cells into cancer stem cells (CSCs) is believed to underlie tumor relapse after surgical removal and fuel tumor growth and invasiveness. CSCs often arise from the malignant transformation of resident multipotent stem cells, which are present in most human tissues. Some organs, such as the gut and the brain, can give rise to very aggressive types of cancers, contrary to the dental pulp, which is a tissue with a very remarkable resistance to oncogenesis. In this review, we focus on the similarities and differences between gut, brain and dental pulp stem cells and their related CSCs, placing a particular emphasis on both their shared and distinctive cell markers, including the expression of pluripotency core factors. We discuss some of their similarities and differences with regard to oncogenic signaling, telomerase activity and their intrinsic propensity to degenerate to CSCs. We also explore the characteristics of the events and mutations leading to malignant transformation in each case. Importantly, healthy dental pulp stem cells (DPSCs) share a great deal of features with many of the so far reported CSC phenotypes found in malignant neoplasms. However, there exist literally no reports about the contribution of DPSCs to malignant tumors. This raises the question about the particularities of the dental pulp and what specific barriers to malignancy might be present in the case of this tissue. These notable differences warrant further research to decipher the singular properties of DPSCs that make them resistant to transformation, and to unravel new therapeutic targets to treat deadly tumors.

Highlights

  • Adult multipotent stem cells are responsible for renewing cell populations in the different organs of the body

  • By making a systematic comparison between normal and cancer stem cells of different embryonic origins, we have identified a set of differential markers that are all present in brain and gut CSCs but absent or at least not yet well defined in other healthy stem cells (Figure 2)

  • dental pulp stem cells (DPSCs) consistently express pluripotency core factors (SOX2, OCT4, NANOG, CD15, among others); they express adhesion proteins associated with metastasizing ability (CD44, CD90, CD166); they are highly responsive to signaling pathways (Wnt, TFG-ß) linked to oncogenesis; they are resistant to radiation; they resist anaerobiosis; they present hTERT activity, similar to many CSCs and contrary to many other healthy adult multipotent stem cells in the body

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Summary

Introduction

Adult multipotent stem cells are responsible for renewing cell populations in the different organs of the body. CD133 expression in CSCs has been related to aggressive phenotypes but, as shown by different reports, this CD133 marker is expressed by some healthy stem cell types such as ISCs and NSCs of the gut and the brain. It is precisely those organs, which give rise to very aggressive types of cancers, are the ones that apparently show a higher basal CD133 expression in their resident stem cells, contrary to loose connective tissues, and the dental pulp in particular. Because of the prominent expression of these markers in several types of healthy stem cells, such as MSCs and DPSCs, they could not be considered to be genuine markers of CSCs

Cytoplasmic Markers
Nuclear Proteins
Oncogenic Signaling
Telomerase Activity
Pathways and Obstacles to Malignant Transformation
Findings
Conclusions
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