Cardiovascular conditions leading to heart attacks and strokes are treated quite separately from common cancers of the prostate, breast or lung, but now turn out to involve some of the same critical mechanisms at the molecular level.
This in turn provides clues to more effective therapies for both cancer and cardiovascular diseases, but requires researchers in these distinct fields to come together. The seeds were sown for closer cooperation between these two groups at a recent workshop organised by the European Science Foundation (ESF), which also highlighted the striking progress already made in understanding key common mechanisms underlying both disease categories.
The workshop kicked off by considering one of the most important molecular processes common to a number of cancers and cardiovascular disease, involving the pathway known as the endothelin axis. The endothelium is the thin layer of cells lining every blood vessel of the body from the smallest capillaries to the largest arteries and even the heart itself. This layer separates the blood from the vessel walls and the smooth muscles whose contractions restrict and control blood flow. These muscle contractions are controlled by proteins called endothelins manufactured by the endothelium cells, and if there are too many of them blood flow is restricted too much, leading to hypertension (high blood pressure) and participating in other conditions such as acute coronary syndrome and stroke. However some endothelins are also signalling molecules promoting growth and retarding the natural process of apoptosis (cell death) involved in eliminating cells. Some tumour cells, for example in ovarian carcinoma, exploit endothelins to suppress their death while migrating to other parts of the body in the metastasis process, enabling the tumour to spread, usually with fatal results.
Understanding the endothelin axis and its role in both cancer and cardiovascular disease is now increasing as a result of collaboration between these two medical research fields spawned by the ESF workshop and similar events elsewhere in the world. But until recently the role of endothelins had been studied mostly in the context of cardiovascular disease rather than cancer, according to M. Giovanna Trivella, the ESF workshop's convenor from the Institute of Clinical Physiology at the National Research Council of Italy (CNR) in Pisa.
Conversely, angiogenesis, which is the sprouting of new blood vessels from existing ones, has been studied mostly for its role in tumour growth, and not so much as a possible therapy for heart disease by developing new blood vessels to replace existing damaged ones. Yet the same underlying molecular pathways are at work in both cases, with great potential for synergy between the two research camps.