Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Jun 26, 2020; 12(6): 406-421
Published online Jun 26, 2020. doi: 10.4252/wjsc.v12.i6.406
Defining lung cancer stem cells exosomal payload of miRNAs in clinical perspective
Beatrice Aramini, Valentina Masciale, Khawaja Husnain Haider
Beatrice Aramini, Valentina Masciale, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy
Khawaja Husnain Haider, MPharm, PhD, Sulaiman AlRajhi Univeristy, AlQaseem 52736, Saudi Arabia
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Beatrice Aramini, MD, PhD, Assistant Professor, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Via Largo del Pozzo n. 71, Modena 41124, Italy. beatrice.aramini@unimore.it
Received: January 16, 2020
Peer-review started: January 16, 2020
First decision: April 7, 2020
Revised: April 29, 2020
Accepted: May 27, 2020
Article in press: May 27, 2020
Published online: June 26, 2020
Abstract

Since the first publication regarding the existence of stem cells in cancer [cancer stem cells (CSCs)] in 1994, many studies have been published providing in-depth information about their biology and function. This research has paved the way in terms of appreciating the role of CSCs in tumour aggressiveness, progression, recurrence and resistance to cancer therapy. Targeting CSCs for cancer therapy has still not progressed to a sufficient degree, particularly in terms of exploring the mechanism of dynamic interconversion between CSCs and non-CSCs. Besides the CSC scenario, the problem of cancer dissemination has been analyzed in-depth with the identification and isolation of microRNAs (miRs), which are now considered to be compelling molecular markers in the diagnosis and prognosis of tumours in general and specifically in patients with non-small cell lung cancer. Paracrine release of miRs via “exosomes” (small membrane vesicles (30-100 nm), the derivation of which lies in the luminal membranes of multi-vesicular bodies) released by fusion with the cell membrane is gaining popularity. Whether exosomes play a significant role in maintaining a dynamic equilibrium state between CSCs and non-CSCs and their mechanism of activity is as yet unknown. Future studies on CSC-related exosomes will provide new perspectives for precision-targeted treatment strategies.

Keywords: Cancer, Cancer stem cells, Exosomes, Lungs, miRNA, Microvesicles, Non-small cell lung cancer

Core tip: The role of cancer stem cells (CSCs) in tumour aggressiveness, progression, recurrence and resistance to cancer therapy is well appreciated. However, therapeutic strategies to target CSCs for cancer therapy has still not progressed sufficiently, particularly in terms of exploring the mechanism of dynamic interconversion between CSCs and non-CSCs. Similar to other cells, CSCs also release exosomes loaded with microRNAs (miRs) as part of their paracrine activity. Our review focusses on the exosomal payload of miRs released by cancer cells and their role in the diagnosis as well as prognosis of lung cancer patients.