title: Lack of telomerase activity in lung carcinoids is dependent on human telomerase reverse transcriptase transcription and alternative splicing and is associated with long telomeres.
abstract: OBJECTIVE
  Preliminary evidence indicates that telomerase activity is significantly less expressed in typical carcinoids than in large cell neuroendocrine carcinomas or in small cell lung cancers. Knowledge of the mechanisms by which telomerase is differentially regulated in neuroendocrine lung tumors is important for a better understanding of the pathogenesis of these malignancies.
  
  
  METHODS
  We investigated telomerase activity in 86 neuroendocrine lung tumors and correlated the enzyme activity with the expression of the enzyme subunits [human RNA component (hTR), human telomerase reverse transcriptase (hTERT), and alternatively spliced hTERT variants], with the telomere-associated protein human protection of telomere-1, and with the telomere length pattern.
  
  
  RESULTS
  A significantly (P = 0.0001) lower frequency of telomerase-positive cases was found in typical carcinoids (14%) than in large cell neuroendocrine carcinomas (87%) and small cell lung cancers (92%). hTR was constitutively expressed in all carcinoids. Telomerase-negative carcinoids were characterized by the absence of any hTERT transcript, only displayed the beta(-) alternatively spliced variant, or concomitantly expressed the alpha(+)beta(+) full-length message with different combinations of alternatively spliced variants. However, in these tumors, a more abundant level of alternatively spliced transcripts than that of the alpha(+)beta(+) full-length transcript was generally found. No significant difference was observed in human protection of telomere-1 expression between telomerase-negative and telomerase-positive carcinoids. Telomeres were significantly (P < 0.05) longer in telomerase-negative carcinoids than in telomerase-positive carcinoids (median value, 9.15 versus 4.47 kb). However, alternative lengthening of telomeres, as shown by associated promyelocytic leukemia bodies, was not observed in these tumors.
  
  
  CONCLUSIONS
  Our results indicate that telomerase is repressed in most lung carcinoids and that hTERT transcription and alternative splicing play a role in such a negative regulation. Moreover, the absence of any telomerase maintenance mechanism may contribute to the favorable prognosis of this malignancy.
authors.affiliation: Department of Experimental Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori and Department of Thoracic Surgery, Istituto Clinico Humanitas, Milan, Italy. nadia.zaffaroni@istitutotumori.mi.it
authors.forename: Nadia
authors.initials: N
authors.lastname: Zaffaroni
authors.forename: Raffaella
authors.initials: R
authors.lastname: Villa
authors.forename: Ugo
authors.initials: U
authors.lastname: Pastorino
authors.forename: Rosalia
authors.initials: R
authors.lastname: Cirincione
authors.forename: Matteo
authors.initials: M
authors.lastname: Incarbone
authors.forename: Marco
authors.initials: M
authors.lastname: Alloisio
authors.forename: Maria
authors.initials: M
authors.lastname: Curto
authors.forename: Silvana
authors.initials: S
authors.lastname: Pilotti
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Daidone
mesh_terms: D017398:Alternative Splicing; D002276:Carcinoid Tumor / Q000201:enzymology / Q000235:genetics / Q000473:pathology*; D004268:DNA-Binding Proteins; D006801:Humans; D008175:Lung Neoplasms / Q000201:enzymology / Q000235:genetics / Q000473:pathology*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019098:Telomerase / Q000235:genetics* / Q000378:metabolism; D016615:Telomere / Q000201:enzymology / Q000235:genetics*; D014158:Transcription, Genetic
chemical_list: D004268:DNA-Binding Proteins; D012333:RNA, Messenger; D019098:Telomerase