Advances in Molecular Mechanisms of Kidney Disease: Integrating Renal Tumorigenesis of Hereditary Cancer Syndrome

Abstract

Renal cell carcinoma (RCC) comprises various histologically distinct subtypes, each characterized by specific genetic alterations, necessitating individualized management and treatment strategies for each subtype. An exhaustive search of the PubMed database was conducted without any filters or restrictions. Inclusion criteria encompassed original English articles focusing on molecular mechanisms of kidney cancer. On the other hand, all non-original articles and articles published in any language other than English were excluded. Hereditary kidney cancer represents 5-8% of all kidney cancer cases and is associated with syndromes such as von Hippel-Lindau syndrome, Birt-Hogg-Dubè syndrome, succinate dehydrogenase-deficient renal cell cancer syndrome, tuberous sclerosis complex, hereditary papillary renal cell carcinoma, fumarate hydratase deficiency syndrome, BAP1 tumor predisposition syndrome, and other uncommon hereditary cancer syndromes. These conditions are characterized by distinct genetic mutations and related extra-renal symptoms. The majority of renal cell carcinoma predispositions stem from loss-of-function mutations in tumor suppressor genes. These mutations promote malignant advancement through the somatic inactivation of the remaining allele. This review aims to elucidate the main molecular mechanisms underlying the pathophysiology of major syndromes associated with renal cell carcinoma. By providing a comprehensive overview, it aims to facilitate early diagnosis and to highlight the principal therapeutic options available.

Keywords: BAP1 tumor predisposition syndrome; Birt–Hogg–Dubè syndrome; fumarate hydratase deficiency; hereditary cancer syndromes; hereditary papillary renal cell carcinoma; kidney cancer; succinate dehydrogenase-B mutation; tuberous sclerosis complex; von Hippel–Lindau disease.

Figure 1

Molecular mechanism of von Hippen–Lindau disease [1,2,3].

Figure 2

Mutant VHL alleles associated with type 1, type 2A, type 2B, and type 2C VHL disease exhibit varying degrees of HIF deregulation [4].

Figure 3

Summary of principal molecular mechanisms of tumorigenesis of hereditary cancer syndrome.

Figure 4

Molecular mechanism of BRCA-1-associated protein-1 (BAP-1)-associated renal cell carcinoma (RCC) [5,6].