EJMR
  • ICV 2015:77.31
  • ICV 2016:92.32
  • IF of EJMR :5.035(SJIF-2017)
  • IF of EJMR :5.07(SJIF-2018)

From the Editor’s Desk

Circulating Tumor Cells

     About 160 years ago (precisely in 1849) a Physcian thought that a few cells from a malignant tumor got shed off from the tumor and somehow entered the blood vessels, there by reaching other places and organs in the body.

     If those cells could survive and get planted, grow and proliferate in other places, a metastasis was created.

     This is the most important feature of a malignancy and in about 90% of the cases is the cause of death. As a historical rememberonce, the pathologist had seen a few abnormal cells in an organ of a cancer patient.

     These cells in circulation were named; “circulating tumor cells (CTC)” and for all practical purposes, these cells looked alike the original tumor cells in those times.

     There had been a lot of laps of time after which only, the importance of it became more clear, in terms of tumor behavior, clinical response and progression.

     Further studies and correlations down the line proved that the more advanced and big the primary tumor, circulating tumor cells were larger in member and, usually produced more drug resistance and frequent metastasis.

     This lead to the imagination that these circulating tumor cells have to be precisely identified, and treated so that there is no relapse of tumor. For tumor treatment, it also became important to study there CTCs in depths. Therefore the separation and isolation of these group of tumor cells became important. The first imagination taught the scientists to classify and separate there CTCs on the basis of physical properties like size, shape, later by electrical charge and magnetic attraction so on. A number of filters were designed and this lead to first separation, none the less crudest. In recent past the techniques of separation banked upon magnetic chips on which millions of surface antigens were coated, the blood was made to pass over them, which attracted cells containing antibodies.

     The epithelial cell surface marker, the most important being Epithelia Cell adhesion molecule (Ep-CAM) antibody was used for this purpose. However, not all the tumor cells or CTCs were sensitive to Epithelia Cell adhesion molecule (Ep CAM) antibodies and Epithelia Cell adhesion molecule (Ep-CAM) without technologies were developed.

     As the characterizations, separation and isolation techniques were being perfected on one side, the other areas of emphasis and researches were in the line of personalized medicine, by culturing these cells to chose precise and responsive medicine. Still other line of investigation were towards charactersing these CTCS, for molecular biology features, DNAs etc. This became essential because the CTCs of a single tumor were found being heterogonous. True to expectation, the analysis showed that the cells of even same tumor were different at molecular level. This implied using different approach for treatment by either mixed or different drugs.

     Therefore a simple looking innocently detached tumor cell that is a CTC was not at all that simple. Not only these had capacity to be actively moving, breaking the cell barrier but also endothelial barrier and entering the blood vessel, Moreover this cell was having all the armamentarium to disguise as to cheat on immune system to avoid engulfment from macrophages and T- lymphocytes and to ward off the effects of chemoperaputic agents.

     These cells, in presence of appropriate response, through signaling pathways, got converted into myo-ephithelial cells via Myo - epithelial - transmission. Thus this myo- epithelial transmission cell was capable of moving easily within the solid tumor mass. It also got all helps from tumor “microenvironment” but at present the process is still not fully clear.

     Why this cell was not killed when it reached to a new environment or a different organ as mets. What caused it to attach there? How and what helped it to find a new NICHE?

     Not all the things are still clear and the research is going on and on. The difficulties were not limited to these single cells circulating mets, but scientists discovered that some mets CTCs travelled as cluster of these cells. These cluster contained not only tumor cells but associated mesenchyme, platelets, leucocytes etc as well. These clusters, although could not pass very minute and narrow vessels (microvasculatures), but of course, wherever they could move, had more chances of survival.

     It was helpful to both, the intrinic attack by the innate immune system, and also from the chemotherapy.

     Thus, now we also have the CLUSTERS of CTCs. These cluster of CTCs have different behavior, composition heterogeneity etc.

     All present, the isolation of CTCs, precise characterization of these cells and molecular biology studies are going on single cells CTCs as well as on the clusters of circulating cells. Many truths are emerging indicating that we can surmount these difficulties and once achieved, the future appears bright.

For Direct manuscript Submission to Editorial office mail to ejmreditor1@gmail.com

Table of Content

Era's Journal of Medical Research: Volume-4 Number-2

PICTURE GALLERY

News
  • SJIF 2018 = 5.07
  • Due to some unavoidable circumstances the PhD. entrance examination has been postponed from 29.07.2017 to 05.08.2017.... Read more...
  • M.B.B.S student Mr. Paarth Garg awarded Cancer Research Training Exchange Fellowship for Italy." Read more...
  • Admission Notice on Vacant Seats 2017... Read more...
  • Era's Lucknow Medical College & Hospital ranked 2nd among top Medical Colleges of India - An INDIA TODAY (Nielsen Survey 2017)... Read more...
  • International Institute of organized Research I2OR Awards 2017.... Read more...
  • Laboratory for Stem Cell & Restorative Neurology, ELMC&H collaborated with the University of Queensland, Australia... Read more...
  • P.G. Course Fee Details.... Read more...
  • List of successful undergraduate students for ICMR-STS' 2017 Fellowship.... Read more...
  • Best Poster Award Phoenix 2017, International Medical Student Conference Mangalore.... Read more...
  • All India physiology quiz competition award.... Read more...
  • 2nd Revised Basic Course Workshop in Medical Education & Technology.... Read more...
  • MoU signed between Era’s Lucknow Medical College & Hospital and Institute of Nano Science and Technology, Mohali.... Read more...
  • ELMC&H student Mr. Parth Garg reaching International Boundaries.... Read more...
  • Foundation program for MBBS students batch-2016 was organised on 15&17 October 2016.... Read more...
  • Dr. Ritika Srivastava got 2nd prize at COSDERMINDIA - 2016 at Mumbai.... Read more...
  • Mr. Parth Garg got first prize at BIMSSCON 2016 at Dhaka, Bangladesh for his work on "Fate of MSCs in OGD induced hypoxia.... Read more...
  • Revised Basic Course Workshop for faculty development was organised during 28-30 September 2016.... Read more...