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Explain Knudson's two-hit model of cancer.

Explain Knudson's two-hit model of cancer.

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The Knudson hypothesis, also known as the two-hit hypothesis, is the hypothesis that most tumor suppressor genes require both alleles to be inactivated, either through mutations or through epigenetic silencing, to cause a phenotypic change. this two hit hypothesis correlated to the indirectly identification of cancer-related genes.

Knudson performed a statistical analysis on cases of retinoblastoma, a tumor of the retina that occurs both as an inherited disease and sporadically. He noted that inherited retinoblastoma occurs at a younger age than the sporadic disease. In addition, the children with inherited retinoblastoma often developed the tumor in both eyes, suggesting an underlying predisposition.

Knudson suggested that two "hits" to DNA were necessary to cause the cancer. In the children with inherited retinoblastoma, the first mutation in what later came to be identified as the RB1 gene, was inherited, the second one acquired. In non-inherited retinoblastoma, instead two mutations, or "hits", had to take place before a tumor could develop, explaining the later onset.

It was later found that the development of cancer depended both on the mutation of proto-oncogenes (genes that stimulate cell proliferation) and on the inactivation of tumor suppressor genes, which are genes that keep proliferation in check. Knudson's hypothesis refers specifically, however, to the heterozygosity of tumor suppressor genes. An inactivation of both alleles is required, as a single functional tumor suppressor gene is usually sufficient.

Related ideas

Field cancerization may be an extended form of the Knudson hypothesis. This is the phenomenon of various primary tumors developing in one particular area of the body, suggesting that an earlier "hit" predisposed the whole area for cancer.

The exact function of some tumor suppressor genes is not currently known (e.g. MEN1, WT1), but based on these genes following the Knudson "two-hit" hypothesis, they are strongly presumed to be suppressor genes.

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