Applications of telomerase in urologic oncology

Vertebrates have special structures at the ends of their chromosomes, known as telomeres, which are composed of 5- to 15-kb pairs of a guanine-rich hexameric repeat (TTAGGG)n. In normal somatic cells there is a progressive degradation of telomeres with aging. The cell can afford to lose only a finite number of these telomeres before significant sequences of the parent DNA are lost, resulting in chromosomal instability and cell death. However, germ-cell telomeres are maintained despite multiple rounds of replication. This suggests that they produce an enzyme that maintains their telomere length. This enzyme, a ribonucleoprotein, is called telomerase. In this review, we discuss the presence of telomerase activity in various human cancers and, in particular, in urologic tumors. We describe the potential clinical utility of detection of the presence of telomerase activity in cells from voided urine samples of patients with bladder cancer.