Prostate cancer is increasingly prevalent in our aging Western society. Despite recent advances in the detection of early prostate cancer, there remains little effective therapy for patients with locally advanced or meta-static disease. The majority of patients with advanced disease respond initially to androgen ablation therapy; however, most go on to develop androgen-independent tumors that are inevitably fatal. To seek a deeper understanding of the cellular origins of cancer, the normal pathways of cellular differentiation and tissue renewal must be understood.

Central to this understanding is an appreciation of the nature of stem cells that must be present in each renewable tissue compartment. These are cells that self-renew with each division and commit others of their progeny to differentiate into one or more of the mature cell types that define each tissue. Classically, stem cells have been studied in tissues that undergo rapid cell turnover, such as bone marrow, skin, and the gastrointestinal tract (1-3). Now, however, it has been recognized that stem cells are also present in tissues that normally undergo very limited regeneration or turnover, such as the prostate. The ultrastructural studies of Mao and Angrist (4), Dermer (5), and Heatfield et al. (6) and the experimental evidence from androgen cycling studies of Brandes (7) and Isaacs and Coffey (8) argue for the existence of stem cells in prostate epithelium.

This review focuses on more recent data, on expression patterns of genes in the proliferation compartment, and on recent attempts to characterize and isolate the stem and transit-amplifying cells of the prostate epithelium. We also discuss emerging evidence on the plasticity of adult stem cells and the concept that stem cell biology could provide new insights into the biology of prostate cancer.

From: Adult Stem Cells Edited by: K. Turksen © Humana Press Inc., Totowa, NJ

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