Perspective article proposes assessing tissue repair and tumor promotion risk within a single testing framework

Perspective article proposes assessing tissue repair and tumor promotion risk within a single testing framework

On September 11, Adriana Paulina Gudiño Reyes published a perspective article on the recovery of normal tissues after cancer treatment. She proposes testing tissue repair alongside indicators that the intervention might support tumor growth.

Oncology endpoints track tumor burden, progression, and survival. Reyes adds a separate outcome: whether damaged normal tissue can regain its function.

Tissue repair and tumor adaptation can proceed through the same cellular signals. In an experiment on aged mice, activation of the Igf2 gene restored the liver's regenerative capacity, while an IGF1R receptor blocker reduced tumor burden in a hepatoblastoma model. In healthy growing mice, the same blocker reduced liver size and body weight. One growth pathway was involved in both tissue recovery and tumor growth, depending on the context.

Tissue repair engages inflammation, angiogenesis, and remodeling of the extracellular matrix, the structural environment between cells. In a tumor, the same processes occur among malignant, immune, and stromal cells.

"The same signaling network can support normal tissue repair while simultaneously helping a tumor survive, invade other tissues, or evade the immune response."

Reyes proposes moving from simpler models to more complex ones. The first step is to compare normal and tumor-derived human cells before damage, after damage, and during recovery. The next step adds stromal cells (the supportive tissue component) and immune cells. Organoids (three-dimensional tissue models) and co-cultures of multiple cell types allow testing of their interactions. Microphysiological systems, laboratory platforms that replicate aspects of tissue function, serve the same purpose.

At each level of model complexity, the author proposes comparing normal tissue recovery with tumor cell proliferation rate, tumor invasion into surrounding tissue, angiogenic signaling, genomic integrity, and treatment sensitivity.

As an example, Reyes examines supportive connective tissue cells from Wharton's jelly, the connective tissue of the umbilical cord. Their properties depend on the source, purity, culture conditions, passage number, genetic stability, sterility, and traceability from donor to sample. This information makes it possible to evaluate how a specific cell product behaves in proximity to a specific tumor.