Le neuroblastome présente des manifestations cliniques et des pronostics très variables. Afin de déterminer au mieux le traitement le plus adapté à la pathologie, de nombreux outils pronostiques ont été définis28. La corrélation entre le niveau d’expression de la protéine HDGF et la malignité du neuroblastome pourrait faire de HDGF un nouveau facteur pronostique dans le neuroblastome.
De plus, le niveau d’expression de la protéine HDGF semble corréler avec la taille des tumeurs sympathiques in vivo. Une interférence avec l’expression de la protéine HDGF ralentit la croissance tumorale in vivo. HDGF pourrait donc être une cible thérapeutique intéressante à exploiter afin de freiner la croissance tumorale.
En effet, HDGF jouant un rôle pro-tumoral dans de nombreux cancers, le développement de molécules ciblant la protéine HDGF est une stratégie thérapeutique prometteuse. Partant de ce constat et des nombreuses découvertes faites sur le rôle de HDGF dans les cancers du poumon, Ren et ses collègues ont déposé en 2008 un brevet d’invention pour le développement de techniques d’interférence avec HDGF, à visée thérapeutique. En 2009, Ren et al. ont mis au point
Ubiquitination et dégradation de MYCN par le protéasome
P P PIP3 P P P P P P P P Aurora KinaseA PI3K PDK1 Akt mTOR CDK1 MYCN MYCN GSK3Ⱦ Transcription MYCN ALK RAS RAF MEK1/2 ERK1/2 Progression du cycle cellulaire HDGF
Figure 21. HDGF pourrait interagir fonctionnellement avec les oncogènes majeurs du neuroblastome ; ALK et MYCN. ±±± ͵Ȁǡ ±± ϐ indirectement sur la stabilisation de MYCN et sa translocation nucléaire.
un panel d’anticorps bloquant dont ils ont démontré l’efficacité, mais encore non commercialisés176. Cette démarche ou la recherche de petites molécules ciblant HDGF pourrait présenter un intérêt majeur dans le traitement de la pathologie neuroblastique pour laquelle l’accès à de nouvelles propositions thérapeutiques fait cruellement défaut.
B
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