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Urinary Exosomes from Bladder Cancer Patients Show a Residual Cancer Phenotype despite Complete Pathological Downstaging

Title: Urinary Exosomes from Bladder Cancer Patients Show a Residual Cancer Phenotype despite Complete Pathological Downstaging
Authors: Hiltbrunner, Stefanie; Mints, Michael; Eldh, Maria; Rosenblatt, Robert; Holmström, Benny; Alamdari, Farhood; Johansson, Markus; Veerman, Rosanne E.; Winqvist, Ola; Sherif, Amir; Gabrielsson, Susanne
Publisher Information: Umeå universitet, Urologi och andrologi; Division of Immunology and Allergy, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Urology, Södersjukhuset, Stockholm, Sweden; Department of Urology, Sundsvall Hospital, Sundsvall, Umeå University, Umeå, Sweden
Publication Year: 2020
Collection: Umeå University: Publications (DiVA)
Subject Terms: Clinical Medicine; Klinisk medicin
Description: Invasive urinary bladder cancer shows high recurrence rates after cystectomy even with apparent complete downstaging at cystectomy. Exosomes are nano-sized vesicles important in cell-cell communication, which have been hypothesized to contribute to cancer dissemination and recurrence. The aim of this study was to investigate if pro-carcinogenic exosomes could be detected in urine from histologically downstaged bladder cancer patients. 13 Patients were included in this study. Paired ureter and urine samples from nine patients underwent mass spectrometry, while samples from the remaining patients were used for exosome characterization. At cystectomy, exosomes were isolated from bladder and ureter urine, whereafter quantitative proteome profiling was performed. Urinary exosomes clustered based on whether they came from the bladder, with tumour contact, or the ureters, without tumour contact, even though all came from completely downstaged patients. Proteins overexpressed in exosomes derived from bladder urine contained several oncogenes and were mainly associated with tumour metabolism pathways. Although patients were histologically tumour-free at cystectomy, the bladder urine contained exosomes with a carcinogenic metabolic profile. This suggests a continuous release of exosomes from the bladder, which may promote recurrence at distant sites through metabolic rewiring, even after apparent complete downstaging. These exosomes, coming from either undetected cancer cells or partly transformed cells, are likely to increase the risk of metastasis and encourages cystectomy even in completely downstaged patients.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: Scientific Reports, 2020, 10:1; PMID 32249794; ISI:000563471200001
DOI: 10.1038/s41598-020-62753-x
Availability: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169580; https://doi.org/10.1038/s41598-020-62753-x
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.27BD6D2
Database: BASE