by Jennifer Mackey

Wilm

s’ Tumor

o NEPHROBLASTOMA in childreno Discovered by Max Wilms in 1899oWT1 is a tumor suppressoro10-15% due to WT1 inactivation

Kidney MRI(Scott et al., 2001)

BUT, MUTATED WT1 IS ALSO FOUND IN OTHER CANCERS!!

BUT, MUTATED WT1 IS ALSO FOUND IN OTHER CANCERS!!

AND AS WE WILL SEE - IT IS NOT ALWAYS A TUMOR SUPPRESSOR!!!

WT1 is alternatively spliced to make many protein isoforms

(Wagner, K.D. et al., 2003)

WT1 is a transcription factor

(Scholz, H. et al., 2005)

(Exon 9)(Exon 5)

WT1 is a transcription factor

WT1’s normal biological functions

o Development of genitourinary systemo Development of kidneyo Adult kidneyo Heart developmento Neuron development?

WT1-/- • dies E12-birth• no kidneys• no gonads•severe abnormalities of retinal development

wt KO(Kreidberg et al., 1993)

WT1-/- • dies E12-birth• no kidneys• no gonads•severe abnormalities of retinal development

WT1+/-

• increased mortality due to adult onset nephrotic syndrome & renal failure

WT1 is required for kidney development

(Scholz, H. et al., 2005)

ADULT KIDNEY

http://en.wikipedia.org/wiki/Image:Gray1128.png

(Scharnhorst, V. et al., 2001)

WT1 is part of a transcriptional regulatory networkThat is critical for kidney development

(Scharnhorst, V. et al., 2001)

WT1 is part of a transcriptional regulatory networkThat is critical for kidney development

WT1 TARGET GENES INVOLVED IN KIDNEY DEVELOPMENT:

Amphiregulin: stimulates uretic bud

BCL-2: encodes antiapoptotic protein

E-cadherin: mesenchyme condensation

REMEMBER: WT1 = differentiation

WT1 = PROLIFERATION!!

Wilms tumor• Most are sporadic and unilateral• 10-15% of sporadic have WT1 inactivation• Most others have high levels of WT1 expression• ~10% are bilateral and/or multifocal

http://www.sainte-justine.org/

Wilms tumor• Most are sporadic and unilateral• 10-15% of sporadic have WT1 inactivation• Most others have high levels of WT1 expression• ~10% are bilateral and/or multifocal

WAGR (Wilms’ tumor, Aniridia, Genitourinary abnormalities, Mental retardation)• Germline deletion• Predisposition to WT

http://en.wikipedia.org/wiki/Image:BlackEyesAniridia.jpg

Wilms tumor• Most are sporadic and unilateral• 10-15% of sporadic have WT1 inactivation• Most others have high levels of WT1 expression• ~10% are bilateral and/or multifocal

WAGR (Wilms’ tumor, aniridia, genitourinary abnormalities, mental retardation)• Germline deletion• Predisposition to WT

Denys-Drash Syndrome (DDS)• Germline mutations (missense mutation in zinc finger domain)• Dominant-negative activity• Predisposition to WT

Wilms tumor• Most are sporadic and unilateral• 10-15% of sporadic have WT1 inactivation• Most others have high levels of WT1 expression• ~10% are bilateral and/or multifocal

WAGR (Wilms’ tumor, aniridia, genitourinary abnormalities, mental retardation)• Germline deletion• Predisposition to WT

Denys-Drash Syndrome (DDS)• Germline mutations (missense mutation in zinc finger domain)• Dominant-negative activity• Predisposition to WT

Frasier Syndrome•Germline point mutation in the intron 9 donor splice site•Loss of KTS (-) = ratio disturbed•WT very rare!

Acute myeloid leukemia(AML): WT1 overexpressed in leukemic blasts

http://en.wikipedia.org/wiki/Image:Auer_rods.PNG

Acute myeloid leukemia(AML): WT1 overexpressed in leukemic blasts

Breast cancer: expression of WT1 detected in majority of BC’s evaluated

www.hopeforcancer.com/BreastCancer.html

Acute myeloid leukemia(AML): WT1 overexpressed in leukemic blasts

Breast cancer: expression of WT1 detected in majority of BC’s evaluated

Renal cell carcinoma: overexpression of WT1 in tubular epithelial cells in adulthood

http://en.wikipedia.org/wiki/Image:RCC.jpg

80% of tumors can be treated successfully!!!

REFERENCESKreidberg, Jordan A. et al. 1993. WT-1 Is Required for Early Kidney Development. Cell 74: 679-691.

Loeb, David M. and Saraswati Sukumar. 2002. The Role of WT1 in Oncogenesis: Tumor Suppressor or Oncogene? International Journal of Hematology 76: 117-126.

Scharnhorst, Volkher et al. 2001. WT1 proteins: functions in growth and differentiation. Gene 273: 141-161.

Scholz, Holger and Karin M. Kirschner. 2005. A Role for the Wilms’ Tumor Protein WT1 in Organ Development. Physiology 20: 54-59.

Scott, Carly M. et al. 2001. Wilms' Tumor: A Primary Care Case Study And Differential Diagnosis. The Internet Journal of Advanced Nursing Practice 5: Number 1.

Wagner, K-D et al. 2003. The complex life of WT1. Journal of Cell Science 116: 1653-1658. Wagner et al. 2006. Intermediate filament protein nestin is expressed in developing kidney and heart and might be regulated by the Wilms’ tumor suppressor WT1. American Journal of Physical Regul Integr Comp Physiology 291: R779-R787.