Main roads to melanoma

Abstract

The characterization of the molecular mechanisms involved in development and progression of melanoma could be helpful to identify the molecular profiles underlying aggressiveness, clinical behavior, and response to therapy as well as to better classify the subsets of melanoma patients with different prognosis and/or clinical outcome. Actually, some aspects regarding the main molecular changes responsible for the onset as well as the progression of melanoma toward a more aggressive phenotype have been described. Genes and molecules which control either cell proliferation, apoptosis, or cell senescence have been implicated. Here we provided an overview of the main molecular changes underlying the pathogenesis of melanoma. All evidence clearly indicates the existence of a complex molecular machinery that provides checks and balances in normal melanocytes. Progression from normal melanocytes to malignant metastatic cells in melanoma patients is the result of a combination of down- or up-regulation of various effectors acting on different molecular pathways.

Figure 1

Major pathways involved in melanoma. Pathway associated with N-RAS, BRAF, and mitogen-activated protein kinase (MAPK) as well as with CDKN2A and MITF are schematically represented. Arrows, activating signals; interrupted lines, inhibiting signals. BAD, BCL-2 antagonist of cell death; cAMP, cyclic AMP; CDK4, Cyclin-dependent kinase 4; CDKN2A, Cyclin-dependent kinase inhibitor of kinase 2A; ERK1/2, Extracellular-related kinase 1 or 2; IkB, inhibitor of kB protein; IKK, inhibitor-of-kB-protein kinase; MC1R, melanocortin-1-receptor; MITF, Microphthalmia-Associated Transcription Factor; MEK1/2, Mitogen-activated protein kinase-extracellular related kinase 1/2; PI3K, Phosphatidylinositol 3 kinase; PIP2, Phosphatidylinositol bisphosphate; PIP3, Phosphatidylinositol trisphosphate; PTEN, Phosphatase and tensin homologue.

Figure 2

Notch1 pathway. The diagram shows the mechanism of activation of the Notch receptor by a cell-cell interaction through specific trasmembrane ligands, followed by the translation of the intracellular domain of the Notch-1 receptor (NICD) and formation of a transcription-activating multimeric complex. CSL, citrate synthase like; HAT, histone acetyltransferase; MAML, mastermind-like protein; SKIP, Skeletal muscle and kidney-enriched inositol phosphatase.

Figure 3

iNOS pathway. The functional correlation between the IRF1-activating events (mainly, through an induction regulated by NF-kB, TNF-α, and INF-γ mediators) and expression levels of iNOS is shown. CALM, calmodulin; IkB, inhibitor of kB protein; IKK, inhibitor-of-kB-protein kinase; IRF1, interferon regulatory factor-1; LPS, lipopolysaccharide; NO, nitric oxide; STAT1, signal transducer and activator of transcription 1.