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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5247_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Preface
- •Contents
- •1.1 Introduction
- •1.5 Prostate Cancer
- •References
- •2.3.1 Smoking
- •2.3.2 Height
- •2.3.3 Physical Activity
- •2.1 Introduction
- •2.2.1 Incidence
- •2.2.2 Survival
- •2.2.3 Mortality
- •2.3.4 Coffee
- •References
- •3.1 Introduction
- •References
- •4.1 Introduction
- •4.2 Autophagy Flux
- •4.4 Apoptosis Mechanism
- •4.4.1 Intrinsic Pathway
- •4.4.2 Extrinsic Pathway
- •4.4.3 Perforin/Granzyme Pathway
- •4.6 Ferroptosis Machinery
- •References
- •5.1 Introduction
- •References
- •6.1 Introduction
- •6.8 Conclusion
- •References
- •7.1 Introduction
- •7.2.2 EZH2 Action Modes
- •References
- •8.1 Introduction
- •References
- •9.1 Introduction
- •9.4.1 Oncogenic lncRNAs
- •9.4.2 Tumor-Suppressive lncRNAs
- •References
- •10.1 Introduction
- •10.4 Prostate Cancer TME
- •10.7 Conclusion
- •References
- •11.1 Introduction
- •11.3 Chemoresistant Mediated by AR Axis
- •11.10 Conclusion
- •References
- •12.1 Introduction
- •12.2 Curcumin
- •12.3 Epigallocatechin Gallate (EGCG)
- •12.4 Emodin
- •12.5 Thymoquinone (TQ)
- •12.6 Genistein
- •12.7 Parthenolide
- •12.8 Conclusion
- •References
- •13.1 Introduction
- •13.7 Conclusion
- •References
- •14.1 Introduction
- •14.3.1 Polymer-Based Nanoparticles
- •14.3.2 Liposomes
- •14.3.3 Gold Nanoparticles
- •14.3.4 Quantum Dots (QDs)
- •14.3.5 Magnetic Nanoparticles (MNPs)
- •14.3.6 Mesoporous Silica Nanoparticles (MSNs)
- •14.3.7 Dendritic Polymers
- •14.4 Micelles
- •14.6 Conclusion
- •References

8 Prostate Cancer andPTEN/PI3K/AKT/mTOR Signaling
179
mTOR inhibitor) on the promotion of bone metastases, activation of osteoclasts,
and function of osteoblasts both in cell lines and in xenograft models of prostate
cancer bone metastases. It is worth noting that the inhibition of PI3K/mTOR led to
a declination in tumor development in both primary and bone metastatic locations,
as well as a substantial increase in survival rates with prostate cancer [50].
8.5 Perspectives andConclusion
The PI3K/AKT/mTOR signaling has been widely acknowledged as one of the primary pathways in tumor progression, playing a crucial role in cancer cell proliferation, growth, migration, and survival. Extensive research has been devoted to
developing specic inhibitors through the design and implementation of preclinical
and clinical studies. However, the increasing complexity of this pathway continues
to present challenges in effectively targeting it for therapeutic purposes. Despite the
existence of many powerful and selective drugs, the progress in targeting PI3K signaling therapeutically for cancer has been disheartening, with the majority of compounds failing to advance beyond phase II trials. Over the last decade, preclinical
investigations have elucidated the underlying factors contributing to this lack of
success, therefore offering a justication for the development of future pharmaceutical agents. The PI3K/AKT/mTOR pathway is commonly depicted as a sequential
series of events in which each component transmits the signal to downstream factors. However, recent evidence has revealed that this pathway exhibits extensive
network divergence and signicant intercommunication with other signaling cycles.
Consequently, the inhibitory effects of drugs on this pathway can be overridden,
leading to the restoration of active signaling through various mechanisms. These
factors encompass a range of mechanisms, including, but not limited to, the
increased expression of RTKs [51, 52], signaling redundancies, excessive inhibition, loss of function deletions of PTEN, activating point mutations in PI3K including the PIK3CA H1047RK, and interruption of inhibitory feedback loops that
restrict the effectiveness of treatments like the AKT activation triggered by rapamycin [53].
Consequently, it is unsurprising that the clinical efcacy of medications that specically target PI3K signaling as a standalone treatment for prostate cancer has so
far shown poor results. In spite of the existence of several active-site inhibitors or
allosteric inhibitors, as well as dual kinase and pan- or isoform-specic inhibitors,
the number of medicines authorized by the FDA and EMA remains limited, with
none specically indicated for prostate cancer treatment. On the other hand, the use
of additional substances in combination shows more potential as a strategy. However,
caution must be exercised when adding medications that have comparable bad
effects, as this might result in heightened toxicity. An example of this is the interaction between mTOR and PI3K inhibitors with traditional chemotherapy.
Nevertheless, promising results have been observed in a phase Ib/II clinical trial
evaluating the efcacy of GDC-0068 (ipatasertib), an ATP-competitive AKT

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inhibitor, in combination with abiraterone acetate for the treatment of metastatic
CRPC [54]. CRCP patients under consideration exhibit a state of constitutive activation in the PI3K/AKT/mTOR and AR signaling pathways, which is closely linked
to a very worse prognosis. Despite the generally favorable outcomes seen in this
trial, it is noteworthy that patients with PTEN loss exhibited a notable deceleration
in disease progression and a higher level of treatment tolerance. These encouraging
ndings have prompted the initiation of a subsequent randomized phase III research
focused on PTEN-null CRPC.While the outcomes of the aforementioned phase III
clinical trial are currently unavailable, the potential combination of GDC-0068/ipatasertib with abiraterone acetate has the potential to be a signicant study in the
treatment of PTEN-null CRPC patients. Furthermore, it may have implications for
the treatment of prostate cancer patients with a similar genetic prole during the
early stages of their disease. Hence, it is essential to comprehensively analyze the
genetic background and signaling circuitry in order to effectively devise therapeutic
interventions for prostate cancer.
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M. Seyed Karimi et al.

Chapter 9
Prostate Cancer andNoncoding RNAs:
AFocus onmiRNAs, lncRNAs,
andcircRNAs
AhmadNazari, ParisaOsati, SiavashSeifollahyFakhr, MahnazAkhoundAttar, NazaninPazhouheshFar, MortezaRajabi, MahshidSeyed Karimi,
NasimEbrahimi, MostafaHaji-Fatahaliha, andAmirRezaAref
Abstract Noncoding RNAs (ncRNAs) are a class of regulatory transcripts that
play important functions in the pathogenesis of several cancer types, including prostate cancer (PCa). Within the framework of prostate cancer, non-coding RNAs have
the capacity to function as either oncogenic or tumor-suppressive agents. ncRNAs
have the potential to participate in the prostate cancer progression by inuencing the
signaling of the androgen receptor (AR), the degradation process of AR via
A. Nazari
Tehran University of Medical Science, Tehran, Iran
P. Osati
Department of Chemical Engineering, Fouman Faculty of Engineering, College of
Engineering, University of Tehran, Tehran, Iran
S. S. Fakhr
Department of Biotechnology, Faculty of Applied Ecology, Agricultural Science and
Biotechnology, Campus Hamar, Inland Norway University of Applied Sciences, Hamar, Norway
M. Akhound-Attar
Department of Biology, Faculty of Sciences, Yazd University, Yazd, Iran
N. P. Far
Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical
Science, Islamic Azad University, Tehran, Iran
M. Rajabi
Department of Genetics, Faculty of Basic Science, Central Tehran Branch, Islamic Azad
University, Tehran, Iran
M. Seyed Karimi (*)
Department of Surgery and Anesthesiology, Shariati Hospital, Tehran University of Medical
Sciences, Tehran, Iran
N. Ebrahimi (*)
Division of Genetics, Department of Cell and Molecular Biology and Microbiology, Faculty
of Biological Science and Technology, University of Isfahan, Isfahan, Iran
Ltd. 2024
G. Sethi et al. (eds.), Prostate Cancer: Molecular Events and Therapeutic
Modalities, https://doi.org/10.1007/978-981-97-4612-5_9
183© The Author(s), under exclusive license to Springer Nature Singapore Pte

184
A. Nazari et al.
ubiquitin- proteasome pathways, or other critical signaling pathways. This chapter
provides a detailed review of the involvement of ncRNAs in the evolutionary processes of PCa, with a particular emphasis on their signicance in the development
of innovative biomarker proles and targets for cancer treatment.
Keywords Androgen receptor (AR) · Double-stranded RNAs (dsRNAs) · RNA
interference (RNAi) · Prostate cancer · CRISPR-Cas9
9.1 Introduction
The rst investigations into carcinogenesis mostly focused on genes that encode
proteins, since proteins are regarded as fundamental components of molecular biology [1]. The discovery of several noncoding RNA (ncRNAs) species has been facilitated by advancements in transcriptional sequencing methods. Furthermore,
extensive evidence has shown the involvement of several noncoding RNAs in various essential cellular processes and pathological conditions, particularly in cancer
[2]. ncRNAs may be classied into some distinct categories considering their
sequence length. The rst category comprises short noncoding RNAs (sncRNAs),
which are featured by their size being fewer than 200 nucleotides (nt). Examples of
sncRNAs include microRNAs (miRNAs) and Piwi-interacting RNAs (piRNAs).
The second group consists of long noncoding RNAs (lncRNAs), which include circular RNAs (circRNAs) and pseudogenes [2, 3]. miRNAs and lncRNAs have garnered signicant interest among the many types of ncRNAs [4–6].
miRNAs as a category of short ncRNAs are typically composed of 18–22 nt.
These molecules have a pivotal function in the regulation of several developmental
and physiological processes. Extensive research conducted over the last 20 years
has provided substantial evidence supporting the involvement of miRNAs in numerous health conditions [7–9]. A considerable count of miRNAs has been found in
more advanced eukaryotes, and research has shown that they exhibit a high degree
of conservation across different species. Their primary role is to negatively control
the expression of coding and noncoding genes at the post-transcriptional stage [7].
The discovery of lin-4 miRNA occurred in 1993, marking the rst identication of
a microRNA. The coming to light of the regulatory role of the short
M. Haji-Fatahaliha
Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences,
Tabriz, Iran
A. R. Aref (*)
Mass General Cancer Center, Department of Surgery, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, USA
Broad Institute of MIT and Harvard, Harvard Medical School, Cambridge, MA, USA
e-mail: aaref@mgh.harvard.edu

9 Prostate Cancer andNoncoding RNAs: AFocus onmiRNAs, lncRNAs, andcircRNAs
185
non-protein- coding RNA lin-4in the transcription of the lin-4 gene via its 3′-UTR
(untranslated region)was reported separately by two research teams [9, 10]. In a
subsequent study conducted by Fire and colleagues, the elucidation of the RNA
interference (RNAi) process in the worm Caenorhabditis elegans was revealed.
This was achieved by the observation of the impact of double-stranded RNAs (dsRNAs) on the RNAi activation mechanism and subsequent suppressing messenger
RNAs (mRNAs) [11]. Based on the data gathered subsequent to the identication of
this mechanism and the subsequent discovery of let-7, the rst mammalian miRNA,
it is now postulated that RNA interference (RNAi) is present in all animal species
[12, 13].
The early indication of the involvement of miRNAs in tumorigenesis was presented by Croce and his collaborators, who discovered a tumor-suppressive sequence
located at chromosome 13q14 [14]. The research conducted has shown a high frequency of deletions in the area indicated above among individuals diagnosed with
chronic lymphocytic leukemia. Additionally, it has been observed that this sequence
encodes two distinct miRNA genes, namely miR-16a and miR-15a. The miRNA
genes in question exhibit deletions or experience transcriptional downregulation in
blood-related tumors, such as chronic lymphocytic leukemia [14]. Subsequent
investigations have provided additional evidence indicating that both miR-15a and
miR-16a serve as tumor-suppressive miRNAs by promoting cell death via the
repression of an anti-apoptotic protein known as B-cell lymphoma 2 (Bcl-2).
Notably, Bcl-2 is found to be excessively expressed in blood-related tumors [15,
16]. These data were reafrmed by experimental studies, which demonstrated that
the removal of a cluster of tumors suppressive miRNAs in animal models replicated
the phenotypes associated with B-cell malignancies seen in humans. This nding
offers compelling support for the tumor-suppressor roles of these miRNAs [17, 18].
The invitro and invivo functional validation of miRNAs has contributed to a deeper
understanding of pathophysiological and physiological mechanisms in both regular
growth and pathological conditions in humans [19–21]. The aforementioned
research has shown a novel method of post-transcriptional regulation that exhibits
signicant dysregulation in cancerous cells [22, 23]. The dysregulation of miRNAs
in a spectrum of disorders, including infectious afictions, cardiovascular diseases,
and different types of human cancer, including prostate cancer (PCa), has been demonstrated using advanced high-throughput techniques like single-cell analysis, nextgeneration sequencing (NGS), and expression microarrays along with clustered
regularly interspaced short palindromic repeats (CRISPR) approaches [24–28]. The
prognostic, diagnostic, or theragnostic consequences of improperly expressed miRNAs may be determined using their expression proles [29]. The comprehensive
analysis of the miRNome at the genomic level enabled the precise differentiation of
various cancer types and the identication of the tissue from which poorly differentiated cancers originated [25, 30].
In contrast to miRNAs and other tiny ncRNAs, which typically consist of less
than 200 ribonucleotides, lncRNAs exhibit more heterogeneity in terms of length,
spanning from 200 to several thousand ribonucleotides [31, 32]. In contemporary
times, there is a growing acknowledgment that lncRNAs exhibit a higher degree of

186
regulation and are more precisely conned to certain cellular contexts as compared
to messenger RNAs (mRNAs) [33]. Despite little overall sequence similarity, these
elements exhibit frequent and evolutionarily conserved activities, secondary structures, and microhomology areas [34]. There is a growing body of data that supports
the participation of lncRNAs in the control of transcription and translation processes, as well as their association with many human disorders [35]. Notably,
lncRNAs have undergone thorough investigation within the realm of cancer [36].
This chapter aims to explain the distinctive attributes and signicant implications
of ncRNAs, including miRNA, lncRNA, and circRNA, in relation to prostate cancer
progression and its related mechanism in therapy resistance. The noncoding RNAs
mentioned have the capacity to serve as therapeutic targets in the treatment of medication resistance in prostate cancer (Fig.9.1).
A. Nazari et al.
9.2 miRNAs inProstate Cancer
The evidence has clearly demonstrated that any disruption in the expression level of
miRNAs, including the upregulation of oncogenic miRNAs and the downregulation
of tumor-suppressive miRNAs, can be associated with the initiation and progression
of prostate tumors [38]. Multiple studies have conrmed the correlation between
dysregulation in miRNA expression and the onset and development of metastatic
phenotype in prostate cancer. These miRNAs regulate key processes including
epithelial- to-mesenchymal transition (EMT), tumor proliferation, AR signaling,
metastasis, and apoptosis [39].
9.3 miRNAs andProstate Cancer Progression andInvasion
One of the miRNAs that has been investigated and shows promise is miR-18a, which
is a member of the miR-17–92 cluster. It is increased in PCa and acts as a promoter of
tumor growth [40, 41]. The miR-18a-5p overexpression induces the prostate cancer
cell growth via targeting solute carrier family 40 member 1 (SLC40A1), which is an
iron transporter [42]. Furthermore, miR-18a-5p has the ability to decrease the transcription of a pro-apoptotic protein known as serine/threonine kinase 4 (STK4), leading to an elevation in phosphorylated-protein kinase b (AKT) levels and ultimately
promoting the survival of tumor cells [43]. Additionally, it has been shown that the
miR-221/miR-222 oncogenic cluster is present at elevated levels in prostate cancer. A
suggested mechanism of miR-221/miR-222 action includes the reduction of p27kip1
expression, which then impacts the transcription of many genes contributed to the
progression of cell cycle and cell proliferation, including cyclin D1, cyclin A, and
S-phase kinase-associated protein 2 (Skp2) [44]. Additionally, it has been shown that
miR-122 has a role as a tumor-suppressor microRNA in the prostate cancer progression. The downregulation of this entity has been associated with overexpression of
ROCK2 protein [45]. In a separate investigation, it was revealed that reduced

9 Prostate Cancer andNoncoding RNAs: AFocus onmiRNAs, lncRNAs, andcircRNAs
187
Fig. 9.1 The biogenesis of several noncoding RNAs. The regulation of miRNA transcription is
controlled by RNA polymerase II. a)The primary microRNAs (pri-miRNAs) undergo a series of
sequential cleavage events to generate mature microRNAs (miRNAs) due to their transcriptional
origin. Ultimately, fully developed microRNAs (miRNAs) are integrated into the Argonaute protein, resulting in the formation of the miRNA-induced silencing complex (RISC). b)Based on the
information provided by diverse origin transcription sites, lncRNAs may be categorized into many
distinct categories, including intronic lncRNAs, exonic lncRNAs, promoter-associated lncRNAs,
and enhancer-associated lncRNAs.c) The majority of circRNAs originate from precursor mRNA
(pre-mRNA). CircRNAs are categorized into many categories based on their distinct compositions [37]
transcription of miR-122 was concomitant with heightened proliferation, suppressed
apoptosis, and enhanced resistance of prostate cancer to docetaxel. This effect was
presumably mediated via the regulation of pyruvate kinase M2 (PKM2) enzyme
expression [46]. Furthermore, it has been shown that the absence of the tumor-suppressor cluster (miR-16-1 and -15a) has a signicant impact on the prostate cancer
cell’s growth and survival. This effect is achieved via the regulation of many genes,
including CDK6, cyclin D1, cyclin E1, and BCL2 [47]. miR-204-5p has been extensively studied as a tumor suppressor that exerts its inuence on the formation of PCa
prostate cancer by regulating the levels of BCL2, Meis Homeobox 1 (MEIS1), and
Homeobox A10 (HOXA10) expression [48, 49].

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In addition, it is noteworthy that a tumor-suppressive family of miRNAs, known as
miR-200, plays a pivotal role in EMT regulation. The family comprises miR-200a/
b/c, -141, and -429. Research was conducted to examine the impact of miR-200c-3p
on the invasiveness of prostate cancer cells. The ndings revealed a considerable
downregulation of miR-200c-3p in human prostate cancer cell lines, such as PC3 and
DU145, in comparison to the normal prostatic epithelial cell line (RWPE1). The
inhibitory effects of miR-200c-3p on cell motility, cell migration, and cell invasion
have been suggested to occur via its targeting of zinc nger E-box binding homeobox
2 (ZEB2), which acts as a repressor of E-cadherin and a promoter of EMT [50]. The
inhibition of miR-200b in prostate cancer has been shown to downregulate epithelialmesenchymal transition, hinder growth, and impede metastasis via a route mediated
by ZEB1, which is comparable to previous ndings [51]. In a study, it was observed
that the downregulation of miR-141-3p plays a role in the metastasis and invasiveness
of prostate cancer by activating the nuclear factor kappa b (NF- κB) signaling pathway
[52]. Moreover, miR-141-3p enrichment enhances the stemness features in prostate
cancer stem cells (PCSCs) by inhibiting a group of genes associated with promoting
metastasis, such as Ras homologous (Rho) GTPases, EZH2, and CD44 [53].
Furthermore, the reduced expression of miR-204 5p was linked with disease progression and metastasis, in addition to its established function in regulating cell proliferation and cell death through the apoptosis pathway. Wa and colleagues demonstrated
that miR-204-5p exerts inhibitory effects on invasion, migration, and bone metastasis.
These effects are achieved through the suppression of NF-κB signaling, which is
accomplished by targeting three key proteins at the same time: tumor necrosis factor
receptor-associated factor 1 (TRAF1), TGF-β activated kinase 1 (MAP3K7) binding
protein 3 (TAB3), and mitogen- activated protein kinase kinase kinase 3 (MAP3K3)
[54]. Furthermore, many studies have provided insights into the signicant incorpora-
tion of the miR-34a tumor suppressor in the invasiveness of prostate cancer, with a
noticeable decrease in its expression reported in prostate tumors [55]. The study conducted by Liang and coworkers demonstrated the inhibitory impact of miR-34a on the
Wnt signaling pathway, leading to the suppression of migration and invasion associated with EMT in prostate tumors [56]. Liu’s team showed that miR-34a has a role in
the development of resistance to paclitaxel-based chemotherapy in prostate cancer
cells. This resistance is achieved by the direct inhibition of the JAG1/Notch1 axis [57].
Furthermore, Yan and coworkers (2015) provided evidence for the engagement of
miR-34a in the regulation of PCSCs and the process of metastasis by its direct repression of CD44 expression. In addition, a comprehensive analysis was conducted in a
recent study to thoroughly examine the participation of many microRNAs, such as
miR-185, miR-148, and miR-145in the regulation of the phenotype of PCSCs and
their contribution to the invasive and metastatic properties of prostate cancer [58, 59].
Zhiping and colleagues showed that miR-181a expression was signicantly elevated in metastatic prostate tumors in comparison to native prostate cancers. The
miR-181a upregulation has been seen to have a role in the acquisition of the EMT
phenotype. This is achieved by the increased levels of E-cadherin and other epithelial markers, in contrast to elevated levels of vimentin, N-cadherin, and Snail expression, which are mesenchymal indicators. The upregulation of miR-181 has been
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