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Mitochondria are far more than the "powerhouse" of the cell as they
have classically been described. In fact, mitochondria biological
activities have progressively expanded to include not only various
bioenergetic processes but also important biosynthetic pathways,
calcium homeostasis and thermogenesis, cell death by apoptosis,
several different signal transduction pathways mainly related to
redox control of gene expression and so on. This functional and
structural complexity may undergo important derangements so to
justify the definition of 'mitochondrial medicine', which should
include all the clinical consequences of congenital or acquired
mitochondrial dysfunctions. There are actually a growing number of
studies which assign a significant pathogenic role to damaged
mitochondria in different diseases: ischemia/reperfusion injury,
neurodegenerative diseases, cancer with its dramatic sequelae (i.e,
metastasis), metabolic syndrome, hyperlipidemias, just to mention a
few of the most important pathologies. In this context, a further
aspect that should not be disregarded is the interaction of
pharmacological agents with mitochondria, not only in regard of the
toxicological aspects but, above all, of the potential therapeutic
applications. In fact, it is interesting to note that, while the
properties of different so-called "mitoxicants" are well-known, the
subtle linkages between drugs and mitochondria is still in need of
a real pharmacological and therapeutic control at the clinical
level. This lack of consideration can often lead to an
underestimation of unwanted toxic effects but also of desirable
therapeutic activities. A reevaluation of the potential clinical
role of mitochondria could give a new light on some yet obscure
aspects of human pathophysiology.
In recent years, cancer stem cells have been recognized as
important component in carcinogenesis and they seem to form the
basis of many (if not all) tumor types. Cancer stem cells or
"cancer cell like stem cells" have been isolated from various
cancers of different origin (blood, breast, brain, skin, head and
neck, thyroid, cervix, lung, retina, colon, pancreas and so on).
Cancer stem cells - rare cells with indefinite proliferative
potential that drive the formation and growth of tumours- seem to
show intriguing relationships with physiological stem cells.
Specifically, these cancer cells show significant similarities in
the mechanisms that regulate self-renewal of normal stem cells.
Moreover, tumour cells might directly arise from normal stem cells.
Further, the cellular biology of cancer stem cells show a lot of
similarities with normal stem cells.
In recent years, cancer stem cells have been recognized as
important component in carcinogenesis and they seem to form the
basis of many (if not all) tumor types. Cancer stem cells or
"cancer cell like stem cells" have been isolated from various
cancers of different origin (blood, breast, brain, skin, head and
neck, thyroid, cervix, lung, retina, colon, pancreas and so on).
Cancer stem cells - rare cells with indefinite proliferative
potential that drive the formation and growth of tumours- seem to
show intriguing relationships with physiological stem cells.
Specifically, these cancer cells show significant similarities in
the mechanisms that regulate self-renewal of normal stem cells.
Moreover, tumour cells might directly arise from normal stem cells.
Further, the cellular biology of cancer stem cells show a lot of
similarities with normal stem cells.
At present there are a growing number of biomolecules under
investigation to understand their potential role as cancer
biomarker for diagnostic, prognostic and therapeutic purposes.
Intriguingly, the state of art on cancer biomarkers research shows
interesting and promising results together to clamorous failures.
Also from a clinical point of view, there are contradictory results
on routine clinical use of the present cancer biomarkers. Some
patients may be simply monitored in their course by a periodic
blood sample, but sometimes this monitoring shows dramatic limits.
A lot of patients show serious and extensive relapses without
significant change in serum concentrations of biomarkers tested.
Often the physician who should utilize these biomarker does not
entirely know their limits and the total potential applications as
well and sometimes this knowledge is influenced by economical and
marketing strategies. This limited and "polluted" knowledge may
have dramatic consequences for patient. The aim of this book is to
diffuse all aspects of cancer biomarkers, from their biochemical
peculiarities to all clinical implications by passing through their
physiology and pathophysiology. This critical approach towards old
and new cancer biomarkers should foster a deepened and useful
understanding of the diagnostic and prognostic index of these
fundamental parameters of laboratory medicine and in the same time
facilitating the research of new and more sensitive-specific
signals of the cancer cell proliferation.
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