Part of the goal of Bioscience Bootcamp is to make sure that students have a broad understanding of research. Hence, we periodically summarize papers outside our field of study for the class. The following is my summary of a paper on cancer research. (Annoted summary, paired-down from a one hour presentation I gave. A few facts have been glossed over to make it less boring).
Specific Killing of BRCA2-deficient tumors with inhibitors of poly(ADP-ribose) polymerase. Bryant, et al. (2005) Nature 434PARP1 and PARP2 proteins aid in the repair of single strand breaks in DNA, which in a cell occur on the order of 10,000 times per day. If this PARP repair mechanism is inactivated, single strand breaks become double strand breaks, which eventually results in cell death. Despite the importance of this PARP repair mechanism, PARP1 null mice are “viable, fertile and do not develop early onset tumors.” This is likely due to the ability of cells to repair double strand breaks.
How do they do this? Via
BRCA2 recombinational repair. Deficiencies in this gene lead to deficiencies in DNA double strand break repair, leading to tumor growth (which is why BRCA2 is implicated in hereditary breast cancer). Cell death, however, does not occur because other repair pathways are still intact. So, the authors hypothesize that inhibiting PARP mediated repair in BRCA2 null cells will greatly reduce DNA repair, leading to cell death rather than tumor growth.
(I am glossing over an important fact here, that individuals carrying the BRCA2 deficiency are somatically heterozygous, but homozygous in the tumour. So BRCA2 repair is only deficient in tumours, not the rest of the body. Google two-hit hypothesis if you want an explanation.)
Through a series of experiments, the authors showed that; PARP inhibitors induce death in homologous repair deficient cell cultures; PARP1 rather than PARP2 is the key protein in causing cell death through PARP inhibition; and double strand breaks increase if PARP is inhibited. Here is a model (from their paper) of what they think is occurring.
The thought process is this.
1) PARP inhibition alone isn't dangerous
2) Inhibit PARP and you increase double strand breaks i.e. collapsed replication forks
3) Increase double strand breaks in BRCA2 deficient cells and you cause cell death
4) This would only affect tumour cells because somatic cells retain their BRCA2 repair activity.
End result, a new treatment for cancer that uses the tumour cell's own metabolism to destroy it.
What happens when they try this in a whole animal? Well, they implanted tumors in the thighs of mice and then treated them systemically with PARP inhibitors and got the following (again from the paper):
Those black triangles show the decrease in tumour size in a mouse with a BRCA2 null tumour and a five day systemic administration (day 27-32) of PARP inhibitor. No tumour was present at the time of autopsy. This was the most dramatic case, but there was also decreased tumour size in the other mice. None of the controls showed spontaneous decrease.
These data are a couple of years old and more work has been done since then. In fact my understanding is that this form of treatment is undergoing clinical trials in the UK now. It is not a cure to breast cancer, as PARP inhibition could not kill all tumor cells. But because of its well tolerated nature, this treatment could be used in addition to standard treatment to increase the odds of successful cancer treatment greatly.