Telomerase is a ribonucleoprotein consisting of an RNA component (hTR) that serves as atemplate for the addition of telomeric sequences at the ends of chromosomes and a proteincomponent catalytic activity of reverse transcriptase (hTERT). The reactivation of telomerase in 90%of cancers compensates the shortening of telomeres, allowing the immortalization and survival oftumor cells. This canonical role of telomerase is now well documented. However recent studiessuggest that telomerase may have other functions beyond its role in maintaining telomere length intumorigenesis and / or tumor progression.In neuroblastoma (NB), increased levels of telomerase activity (TA) is associated withadvanced disease and poor prognosis. Indeed, several studies have shown that aggressiveneuroblastomas have a high level of TA while favourable tumors, have little or no TA. Therefore, lowtelomerase activity appears to be linked with regression or maturation of NB as it can be seen in theparticular group of 4S stage neuroblastoma. These observations suggest that telomerase may play acrucial role in the development of NB.To better understand the involvement of telomerase in the aggressive phenotype of malignantneuroblasts and drug resistance, we characterized the phenotypic and genotypic changes induced byinhibition of telomerase via ectopic expression of a mutant dominant negative catalytically inactive(DN-hTERT) in a metastatic chemoresistant NB cell line IGR-N-9. Our results show that theexpression of this mutant induces a stromal-type cell differentiation a sensitization to apoptosis inresponse to three cytotoxic agents (cisplatin, staurosporine, TRAIL). The chemosensitization is not theresult of telomere shortening but probably f a modulation of the expression of certain genes involved inthe apoptotic response (re-expression of caspase 8 and wild-type p53), suggesting a noncanonicalfunction of telomerase Furthermore, we showed that hTERT actively regulates the expression ofMYCN. Indeed, ectopic expression of the inactive mutant causes a loss of supernumerary copies ofMYCN leads to the extinction of the expression of the protein, whereas overexpression of wild hTERTincreases the number of copies of the MYCN gene. The elimination of MYCN protein could be a signof a loss of the aggressiveness of the tumor cells as evidenced by the decreased expression of NSE(a marker of poor prognosis of NB) and induction of CD44 in DN-hTERT cells.Overall, our findings thus demonstrate a new role of telomerase independent of its canonicalfunction of telomere elongation in the acquisition of the malignant phenotype and drug resistance inNB. These results are important in terms of knowledge of the biology of NB and therapeuticpossibilities. Indeed, our data suggest that inhibition of telomerase as an anticancer strategy is anapproach that has a particular interest in cases of stage 4 NB in which the survival rate of patientsremains very inadequate despite the therapeutic more intensive.
