Молекулярные механизмы полового диморфизма в канцерогенезе

Заболеваемость злокачественными новообразованиями нерепродуктивных органов, как карциномами, так и саркомами, и смертность от них у мужчин в 1,5 раза выше, чем у женщин. В основе этого лежат генетические различия, на которые накладываются закономерности эпигенетической регуляции экспрессии генов половых хромосом, определяющие половые различия в процессах дифференцировки тканей и гормонального статуса организма. по сравнению с Y-хромосомой на Х-хромосоме млекопитающих находится в несколько десятков раз больше генов, кодирующих основные регуляторы пролиферации, метаболизма, иммунитета и ингибирования опухолевого роста, а также X-сцепленных микроРНк, влияющих на транскрипционные факторы и перекрестную регуляцию другими некодирующими РНк. В результате образуется профиль экспрессии генов по женскому и мужскому типам, обусловливающий фенотипические различия. этот факт наряду с тем, что в женских клетках в некоторых важнейших генах второй инактивированной X-хромосомы происходит снятие эпигенетической репрессии и, соответственно, удвоение уровня экспрессии, может в значительной степени объяснить «половое неравенство» в канцерогенезе. Существенный вклад в это различие вносят влияние половых гормонов и неравенство в выраженности противоопухолевого иммунитета. Детальное исследование молекулярных механизмов, лежащих в основе полового диморфизма в канцерогенезе, будет существенным вкладом в фундаментальную онкологию, практику диагностики, прогноза и персонализированного лечения злокачественных новообразований с учетом особенностей их течения у мужчин и женщин. Особенно актуальны такие исследования в отношении недостаточно изученных сарком мягких тканей, соотношение частоты возникновения которых у мужчин и женщин сильно варьирует в зависимости от гистологического подтипа опухоли.

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