NMR Contribution to the comprehension of metabolic disorders in inflammatory and neoplastic hyper-proliferative disease

A progression model based on genetic alterations has been proposed for several types of tumours and in skin, the concept of cancerization field involves cluster of genetically altered cells in a chronically photo damaged skin without clinical evidence of neoplastic lesions1. Cutaneous Squamous Cell Carcinoma (CSCC) is a common skin cancer characterized by malignant proliferation of keratinocytes. CSCC usually arises from precursor lesions such as actinic keratosis (AKs), but can also grow de novo or on chronically inflamed skin. AKs are the most common skin lesion of disordered keratinocyte proliferation in the disease continuum of photodamaged skin that may lead to invasive CSCC. Although there is reason to believe AKs convert to CSCC, there is also some evidence against this. Most AKs do not progress to CSCC. Clinically, some CSCC appear to arise de novo in healthy skin and in support of this, different genetic abnormalities may underlie AKs and CSCC. Exploring the metabolome of cancer and precancerous lesions seems to be a parallel and effective way to understand the phenotypic changes associated with cancer progression. Metabolomics could reveal novel cancer biomarkers that might expand our current understanding of the multi-factorial disease. Nuclear Magnetic Resonance (NMR) spectroscopy, giving an accurate description of the molecular composition of a human tissue provides a “fingerprint” of the whole metabolome.2 Correlations between some metabolites and proliferative markers allow gaining insight into the relationship between cellular proliferation and metabolic changes associated with the presence of tumor and its aggressiveness.