Apoptosis and chemotherapy for bladder cancer.
OBJECTIVE
We discuss the role of apoptosis, that is gene directed self-destruction of a cell, in the response of bladder transitional cell carcinoma cells to chemotherapy.


METHODS
A directed MEDLINE literature search of apoptosis, bladder cancer and chemotherapy was performed to extract relevant information for review. The characteristics of apoptotic cells were defined and the methods in common use to detect these traits is described. The role of the key mediators of the apoptotic process in bladder cancer is discussed in the context of chemosensitivity and disease stage. The importance of the apoptosis induction after chemotherapy is highlighted.


RESULTS
On stimulus by appropriate external or internal signals a cell may alter the expression of genes encoding for proteins associated with the apoptotic process. The development of apoptosis depends on the balance between pro-apoptotic and anti-apoptotic proteins. Key alterations in genes and proteins related to apoptosis within bladder cancer result in a shift away from the default state of apoptosis toward a cell with increased survival properties that is chemoresistant.


CONCLUSIONS
Much current research in bladder cancer is aimed at restoring chemosensitivity by shifting the cell toward a pro-apoptotic phenotype. Successful translation of this work into clinical practice may improve survival in patients in whom prognosis is currently poor.
McKnight
John Joseph
JJ
Department of Urology, Belfast City Hospital, and Uro-oncology Group, Queen's University, Belfast, Northern Ireland. ijohnmcknight@yahoo.ie
Gray
Samuel B
SB
O'Kane
Hugh F
HF
Johnston
Samuel R
SR
Williamson
Kate E
KE
D017209:Apoptosis; D006801:Humans; D018124:Receptors, Tumor Necrosis Factor / Q000502:physiology; D016159:Tumor Suppressor Protein p53 / Q000502:physiology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology*
D018124:Receptors, Tumor Necrosis Factor; D016159:Tumor Suppressor Protein p53