Epithelial–mesenchymal transition

Gray17

Epithelial–mesenchymal transition (EMT) is a complex biological process in which epithelial cells lose their cell polarity and cell-cell adhesion, and gain migratory and invasive properties to become mesenchymal stem cells; this is a process that is crucial for the development of many organs and the healing of wounds. It is also implicated in the progression of various diseases, including fibrosis and cancer metastasis.

Overview

EMT is characterized by a series of events that lead to the conversion of stationary epithelial cells into mobile mesenchymal cells. This process involves significant changes in the expression of genes, including the downregulation of epithelial markers such as E-cadherin, and the upregulation of mesenchymal markers such as N-cadherin and vimentin. These changes are orchestrated by a network of transcription factors, including SNAIL, SLUG, and TWIST, which repress epithelial marker expression and induce mesenchymal phenotype.

Function

The primary function of EMT is to allow epithelial cells to migrate to new locations during embryonic development, tissue regeneration, and wound healing. In the context of embryogenesis, EMT is essential for the formation of the mesoderm and the neural crest. In adult tissues, EMT contributes to wound healing by enabling epithelial cells to migrate and cover the wound site.

Pathological EMT

In addition to its roles in normal physiology, EMT is also involved in the pathology of several diseases. In cancer, EMT is a key process in the invasion and metastasis of cancer cells. By acquiring mesenchymal characteristics, cancer cells can detach from the primary tumor, invade surrounding tissues, and spread to distant organs. EMT is also implicated in the development of fibrosis, where excessive tissue remodeling leads to the pathological accumulation of fibrous tissue.

Regulation

The regulation of EMT is complex and involves multiple signaling pathways, including the TGF-β, Wnt, and Notch pathways. These pathways initiate the EMT process by activating transcription factors that reprogram epithelial cells into mesenchymal cells. Additionally, microRNAs (miRNAs) have been shown to play a crucial role in regulating EMT by targeting the transcripts of EMT-related genes.

Clinical Implications

Understanding the mechanisms of EMT has significant clinical implications, particularly in the development of therapeutic strategies for cancer and fibrotic diseases. Targeting the molecular pathways that regulate EMT could potentially inhibit cancer metastasis and fibrosis progression. However, therapeutic targeting of EMT must be approached with caution, as EMT also plays critical roles in normal physiological processes.

Conclusion

Epithelial–mesenchymal transition is a fundamental biological process that plays critical roles in development, tissue repair, and disease progression. Its regulation involves a complex network of signaling pathways and transcription factors. Further research into the mechanisms of EMT will provide deeper insights into its roles in health and disease, offering potential targets for therapeutic intervention.

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Epithelial–mesenchymal transition

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  Gray's Anatomy Plate 17

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  Epithelial to Mesenchymal Transition Comparison Chart

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  Epithelial–mesenchymal transition scheme

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  Platelets in cancer EMT