RESUMEN

El mesotelioma pleural maligno es un tumor con una incidencia relativamente baja, en donde gran parte de su carcinogénesis involucra factores epigenéticos que mantienen su heterogeneidad; y en ocasiones, son un blanco terapéutico, o bien un obstáculo a la efectividad en los tratamientos actuales. Esta revisión resume los principales mecanismos de desregulación epigenética involucrados en la patogenia del mesotelioma pleural maligno, tales como la hipermetilación mediada por ADNmetiltransferasas de distintos genes supresores de tumores, así como su relación con la exposición a fibras de asbesto que es el principal factor de riesgo. Su génesis se relaciona a inflamación crónica por radicales libres que culmina en alteraciones cromosómicas, inestabilidad genómica y expresión de genes que promueven la invasión tumoral y angiogénesis. Existen otras vías independientes de metilación que producen silenciamiento génico como el complejo Polycomb y la mutación de la vía SWI/ SNF. Por último, se mencionan otros mecanismos epigenéticos como la hipometilación con pérdida de impronta y activación de genes CG que inducen respuestas inmunológicas, así como la acetilación, desacetilación y desmetilación en el contexto de la cromatina e histonas. Todo lo previo con el objetivo de saber el uso clínico en cuanto al diagnóstico y tratamiento actual epigenético.

PALABRAS CLAVE

Mesotelioma pleural maligno, asbesto, epigenética, hipermetilación, inestabilidad genómica.

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