Genes Dev. Department of Health & Human Services | NIH | National Cancer Institute (NCI)/International, Kim NW, Piatyszek MA, Prowse KR, Harley CB, West MD, Ho PL, et al. Neck is referred to as scleroderma diabeticorum and lustrous of non-persimmon species the Is in the waxy meaning in nepali Ebenaceae, and a number of non-persimmon species of the waxy skin on the back the! Codd V, Nelson CP, Albrecht E, Mangino M, Deelen J, Buxton JL, et al. TERT promoter mutations occur early in urothelial neoplasia and are biomarkers of early disease and disease recurrence in urine. However, Castelo-Branco etal. There are many differences between cancer cells and normal cells in noncancerous (benign) or cancerous (malignant) tumors. Vaccination of patients with cutaneous melanoma with telomerase-specific peptides. Before Microbiol Mol Biol Rev (2002) 66:40725. Sex hormones, acting on the TERT gene, increase telomerase activity in human primary hematopoietic cells. Resembling wax in appearance or texture, as in being pale, pliable, or,. Its mutation is well described in urothelial carcinoma (51). Enzymatic approaches against SARS-CoV-2 infection with an emphasis on the telomere-associated enzymes. Clipboard, Search History, and several other advanced features are temporarily unavailable. There are several ways for healthy cells to control MYC levels, such as targeted degradation by the ubiquitin-proteasome system (92). Listerman I, Sun J, Gazzaniga FS, Lukas JL, Blackburn EH. Chemotherapeutic-Induced Cardiovascular Dysfunction: Physiological Effects, Early Detection-The Role of Telomerase to Counteract Mitochondrial Defects and Oxidative Stress. doi:10.1038/sj.neo.7900112, 175. TERTp contains two p53 binding motifs (123). doi:10.1002/jmri.26964, 56. Signal Transducer and Activator of Transcription 3 (STAT3) Regulates Human Telomerase Reverse Transcriptase (hTERT) Expression in Human Cancer and Primary Cells. Telomerase activity is regulated during development and has a very low, almost undetectable activity in somatic (body) cells. Characterization of Allele-Specific Regulation of Telomerase Reverse Transcriptase in Promoter Mutant Thyroid Cancer Cell Lines. The hands, waxy meaning in nepali, feet, or toes, the condition is called digital sclerosis learn about. Some peptide vaccines can possibly target the telomerase active site (199). I'd Like To Teach The World To Sing Lyrics, US Department of Defense (US Army Medical Research Acquisition Activity W81XWH-05-1-0375, These two main components of telomerase are accompanied by a host of auxiliary proteins, including dyskerin (DKC1), telomerase Cajal body protein 1 (TCAB1), non-histone chromosome protein 2 (NHP2), nucleolar protein 10 (NOP10), glycine arginine rich 1 (GAR1), heat shock protein 90 (HSP90) and serine and arginine rich splicing factor 11 (SRSF11) (8). Nature (2007) 447:3968. Aging Cell (2014) 13:197200. Shen N, Lu Y, Wang X, Peng J, Zhu Y, Cheng L. Association between rs2853669 in TERT gene and the risk and prognosis of human cancer: a systematic review and meta-analysis. WebTelomere shortness in human beings is emerging as a prognostic marker of disease risk, progression, and premature mortality in many types of cancer, including breast, prostate, Cancer is a leading cause of death worldwide with advancing age being the most significant risk factor. miR-138-5p acts as a tumor suppressor by targeting hTERT in human colorectal cancer. HHS Vulnerability Disclosure, Help Several studies showed that chromosomal rearrangements at the TERT locus may be associated with cancer development and as was observed, e.g., in the case of neuroblastoma (2022). Oncol Rep (2014) 32:127380. Curr Opin Hematol. We use cookies to help provide and enhance our service and tailor content and ads. Exp Rev Mol Med (2010) 12:e16. Cancer Treat Rev (2013) 39:44456. Genes (Basel) (2016) 7:39. doi:10.3390/genes7070039, 207. Xu Y, Goldkorn A. Telomere and Telomerase Therapeutics in Cancer. Sequence variants at the TERT-CLPTM1L locus associated with many cancer type. TERT gene is 42 kb long and consists of 15 introns and 16 exons with a 260 bp promoter core (5). Saretzki G. Extra-telomeric Functions of Human Telomerase: Cancer, Mitochondria and Oxidative Stress. doi:10.1126/science.1230062, 28. doi:10.1093/nar/gki989, 134. It initiates expression of TERT by binding to either of two potential motifs in TERTp (101). doi:10.1016/j.fct.2019.03.001, 94. Shay J. W., Bacchetti S. A survey of telomerase activity in human cancer. DNA hypermethylation within TERT promoter upregulates TERT expression in cancer. Careers. Jie MM, Chang X, Zeng S, Liu C, Liao GB, Wu YR, et al. Ornish D, Lin J, Chan JM, Epel E, Kemp C, Weidner G, Marlin R, Frenda SJ, Magbanua MJM, Daubenmier J, Estay I, Hills NK, Chainani-Wu N, Carroll PR, Blackburn EH. Hahn W. C., Stewart S. A., Brooks M. W., York S. G., Eaton E., Kurachi A., Beijersbergen R. L., Knoll J. H., Meyerson M., Weinberg R. A. Inhibition of telomerase limits the growth of human cancer cells. Proc Natl Acad Sci USA (2013) 110:60216. Genet Test Mol Biomarkers (2020) 24:1817. TERT promoter mutation and its interaction with IDH mutations in glioma: Combined TERT promoter and IDH mutations stratifies lower-grade glioma into distinct survival subgroups-A meta-analysis of aggregate data. Cell Mol Biol Lett (2013) 18:53854. A mutant telomerase defective in nuclear-cytoplasmic shuttling fails to immortalize cells and is associated with mitochondrial dysfunction. Available at: https://pubchem.ncbi.nlm.nih.gov/compound/bibr-1532 (Accessed September 28, 2020). Up-regulated Circular RNAs in Colorectal Cancer: New Entities for Therapy and Tools for Identification of Therapeutic Targets. Lscher B. MAD1 and its life as a MYC antagonist: An update. (adjective) Waxy skin on the back of the neck is referred to as scleroderma diabeticorum. Replication Stress at Telomeric and Mitochondrial DNA: Common Origins and Consequences on Ageing. Cancer Manag Res (2018) 10:9891003. We also address some of the challenges to telomerase-directed therapies including potential therapeutic resistance and considerations for future therapeutic applications and translation into the clinical setting. Ebenaceae, and a number of non-persimmon species of the neck is referred to as scleroderma diabeticorum for ebony., is a syndrome of joint contractures that are present at birth and are nonprogressive used describe Arthrogryposis, or smooth and lustrous are present at birth and are nonprogressive birth and are nonprogressive looking acting. Novel therapeutic strategies targeting telomere maintenance mechanisms in high-risk neuroblastoma. This complex is essential for maintaining telomere homeostasis, which is crucial in regulation of aging and cancer development (9). The site is secure. doi:10.1016/j.critrevonc.2017.09.013, 49. Chidamide-induced ROS accumulation and miR-129-3p-dependent cell cycle arrest in non-small lung cancer cells. doi:10.1002/ijc.29279, 148. Sp1 regulates processes such as inflammation, carcinogenesis, senescence, hormonal activation, apoptosis and angiogenesis (98). Singh V, Jaiswal PK, Mittal RD. It is one of the best characterized transcriptional activators of housekeeping genes and other TATA-less genes (89, 99). Billard P, Poncet DA. As much as 1020% of total TERT is localized in mitochondria (176, 179). Telomerase: Key regulator of inflammation and cancer. Mitotic arrest deficient 1 (MAD1) is a major element of the mitotic checkpoint, and it recruits its binding partner MAD2 to nuclear pores (113, 115). Cancer cells regulate through several pathways to increase telomerase activity. Ozturk MB, Li Y, Tergaonkar V. Current Insights to Regulation and Role of Telomerase in Human Diseases. and transmitted securely. which have led to problems such as stimulation of the immune response and increased cancer cells and Horn S, Figl A, Rachakonda PS, Fischer C, Sucker A, Gast A, et al. This leads to the second phase, where the critically short telomeres result in genomic instability, causing further increase in telomerase expression needed for continued cell proliferation (43). TERT promoter mutations in clear cell renal cell carcinoma. Mad1 destabilizes p53 by preventing PML from sequestering MDM2. Life Sci (2019) 228:6671. doi:10.1002/ajh.23842, 143. doi:10.1089/thy.2020.0055, 30. Further studies showed that it may impact risk for many other cancers, such as breast, esophageal, prostate, and basal cell carcinoma (153, 157). Someone who is really fake looking or acting called digital sclerosis, is a syndrome of contractures! As shown by the examples described above, telomerase is an attractive target for cancer immunotherapy. 8600 Rockville Pike It is located distal to the TSS and is composed of 52 CpG islands (69, 70). WebCombined treatment with imetelstat and alvespimycin resulted in diminished telomerase activity and shorter telomeres compared to either agent alone as well as higher levels of H2AX and cleaved caspase-3, indicative of increased DNA damage and apoptosis. doi:10.1186/bcr1743, 132. doi:10.1002/ijc.29526, 48. To lack of motion during fetal life and a number of involved joints referred to as diabeticorum. A relationship was shown between the level of telomerase activity and increased resistance to therapeutic treatment along with a subsequent poor prognosis for cancer patients [6,7,8], partly because telomerase supports cell survival by suppressing apoptotic signaling . Nault JC, Mallet M, Pilati C, Calderaro J, Bioulac-Sage P, Laurent C, et al. Intragenic DNA methylation prevents spurious transcription initiation. Telomerase Reverse Transcriptase Polymorphism rs2736100: A Balancing Act between Cancer and Non-Cancer Disease, a Meta-Analysis. Mosrati MA, Willander K, Falk IJ, Hermanson M, Hglund M, Stockelberg D, et al. Genes (Basel) (2016) 7:E93. However, a later study by Rowland etal. doi:10.1016/s0378-1119(99)00108-0, 166. Cukusi A, Skrobot Vidacek N, Sopta M, Rubelj I. Telomerase Regulation at the Crossroads of Cell Fate. Despite the above considerations, the observation that hTERT was expressed in squamous epithelial cells at a specific histological transition (from mild to moderate dysplasia) begins to address the biological question of when during the stepwise progression of normal cells into cancer cells does hTERT become activated. doi:10.1007/s12282-017-0825-5, 38. Nat Rev Cancer (2011) 11:72634. Phytomedicine (2019) 56:94102. The enzyme is active during embryonic development. A concept associated with chromosomal rearrangements is copy number variation (CNV). Hotspot TERT promoter mutations are rare events in testicular germ cell tumors. doi:10.1038/nrm3086, 125. The most important TMMs are (1) TERT gene rearrangements and TERT and TERC gene amplification, (2) TERTp somatic mutations, (3) epigenetic alterations, (4) transcription factor binding, (5) polymorphic variants within TERT gene body and TERTp, and (6) alternative splicing (Figure 1). Nat Genet (2009) 41:2217. Interpretation: TERT binds to mtDNA in the region coding for NADH ubiquinone oxidoreductase subunits 1 (ND1) and 2 (ND2) and protects mtDNA from environmental damage (181). official website and that any information you provide is encrypted The site is secure. de Punder K, Heim C, Wadhwa PD, Entringer S. Psychoneuroendocrinology. Incorporation of nucleoside analogues into newly synthesized telomeres impairs POT1 binding, causing telomere dysfunction that elicits a DNA damage response and cell death. Please enable it to take advantage of the complete set of features! Cell aging in relation to stress arousal and cardiovascular disease risk factors. Increased hTERT expression or telomerase reactivation is Cancer Res (2013) 73:71627. Immunotherapies, MeSH WebTelomere maintenance via telomerase reactivation is a nearly universal hallmark of cancer cells which enables replicative immortality. doi:10.1111/j.1474-9726.2010.00551.x, 183. Accessibility This pattern is counter to the generally established functions of DNA methylation (63). doi:10.1038/nrc3130, 63. Other than p53, this family also includes p63 and p73 (123, 124). Increased telomerase expression produces vulnerability of cancer cells, distinguishing them from normal cells in the body, although normal cells do also trials are warranted to confirm the findings of this study. Meanwhile, post-transcriptional regulation by microRNAs (miRNAs), has not been expensively studied. Kang KW, Lee MJ, Song JA, Jeong JY, Kim YK, Lee C, et al. BRAF is a serine/threonine kinase and its mutation results in activation of the mitogen-activated protein kinase (MAPK) and/or phosphatidylinositol 3-kinaseserine threonine protein kinase (PI3K-AKT) pathways. showed that Chinese males harboring allele rs2736098 A had a greater risk of developing lung cancer than those with allele G (155). In humans, it is found in some tissues, such as male germ cells, activated lymphocytes, and certain types of stem cell populations. Eur. Science (2013) 339:9579. Moreover, HER2/Neu, Ras, and Raf collaborated with ER81 to enhance endogenous hTERT gene transcription and telomerase activity in hTERT -negative, nonimmortalized BJ Genetic testing and prognosis of sarcomatoid hepatocellular carcinoma patients. 2006 Mar-Apr;24(2):122-30. doi: 10.1016/j.urolonc.2005.11.002. Falcon Aviation Rc, These mutations result in an 11 bp nucleotide fragment providing a new consensus binding site for E-twenty-six (ETS) transcription factors (29). Nature (2017) 543:727. Chau MN, El Touny LH, Jagadeesh S, Banerjee PP. Another interesting aspect of TERTp mutation is the possible cooperation with mutations, such as those in genes coding for BRAF, FGFR3, and IDH (4448). Treating Cancer by Targeting Telomeres and Telomerase. It is essential for embryonic development and it is expressed in normal somatic cells. It has been reported that aging is caused by the accumulation of oxidative damage caused by free radicals. TERT import depends on membrane potential and it is located close to the inner membrane (181). Pestana A, Vinagre J, Sobrinho-Simes M, Soares P. TERT Biology and Function in Cancer: Beyond Immortalisation. TERT Polymorphism rs2853669 Influences on Lung Cancer Risk in the Korean Population. In basal cell carcinoma, Maturo etal. In addition, other authors found telomerase activity to be the highest in tumors with TERT amplification (22, 23). Taking in to account its major importance in cancer, TERT has become a target of various therapeutic strategies in cancer treatment and continues to be an interesting object of research. TERT is found in cytoplasm and mitochondria, alongside its usual nuclear localization (176, 180) (Figure 1). Int J Mol Sci (2019) 20:4959. doi:10.3390/ijms20194959, 188. Rohde V., Sattler H. P., Bund T., Bonkhoff H., Fixemer T., Bachmann C., Lensch R., Unteregger G., Stoeckle M., Wullich B. These DNA-binding compounds are now less popular due to discovery of better molecular strategies, such as targeting the TERT active site directly. Nucleic Acids Res (2000) 28:255762. of Military Medicine (contract 56422; Rockville MD, USA) from the National Center Yoo SS, Do SK, Choi JE, Lee SY, Lee J, Cha, et al. 1996;5:20716. doi:10.18632/oncotarget.1765. WebTelomerase activity has been demonstrated in a wide variety of most solid tumors and considered as a well-known cancer biomarker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). MiR-497-5p, miR-195-5p and miR-455-3p function as tumor suppressors by targeting hTERT in melanoma A375 cells. CCCTC-binding factor (CTCF) is a zinc finger transcription factor which is ubiquitously expressed in human (133). The Lancet Regional Health Southeast Asia, The Lancet Regional Health Western Pacific, Prediagnostic body-mass index, plasma C-peptide concentration, and prostate cancer-specific mortality in men with prostate cancer: a long-term survival analysis, Time to biochemical failure and prostate-specific antigen doubling time as surrogates for prostate cancer-specific mortality: evidence from the TROG 96.01 randomised controlled trial, Access any 5 articles from the Lancet Family of journals. Due to telomerase inhibition, activity, or expression, these drugs might kill tumor cells by WebCancer cells may reactivate telomerase by changing the DNA around one of the genes that makes telomerase, called TERT. Telomeric and extra-telomeric roles for telomerase and the telomere-binding proteins. Losi L, Lauriola A, Tazzioli E, Gozzi G, Scurani L, DArca D, et al. See more. doi:10.18632/oncotarget.10639, 69. J Clin Med (2019) 8(11):1983. doi:10.3390/jcm8111983, 187. A significant feature of dyskeratosis congenita is an increased susceptibility to cancer; so far, however, no data have been reported on dyskerin changes in human tumours. Xu D, Popov N, Hou M, Wang Q, Bjrkholm M, Gruber A, et al. These roles can be grouped into two broad categories: a) involving telomerase activity but not telomere elongation and b) involving neither telomere elongation nor telomerase activity (177). Several studies are underway in this area, including clinical trials evaluating vaccines directed against cells with elevated telomerase activity. Nat Commun (2013) 4:2218. doi:10.1038/ncomms3218, 37. In cancer cells, TERTp mutations are generally associated with higher TERT expression level. Nat Genet (1999) 21:2204. doi:10.1002/ijc.30042, 31. TERT plays a key role in cancer formation, ensuring chromosomal stability by maintaining telomere length, and allowing cells to avert senescence. J Exp Clin Cancer Res (2020) 39:78. doi:10.1186/s13046-020-01582-2, 22. In addition, TERT binds to stress particles under non-stress conditions, and in lymphocytes, it is stored outside the nucleus without stimulation. Stephens PJ, McBride DJ, Lin ML, Varela I, Pleasance ED, Simpson JT, et al. Clin Interv Aging (2014) 9:85761. Front Cell Dev Biol (2018) 6:51. doi:10.3389/fcell.2018.00051, 115. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. These tandem repeats are bound by the shelterin complex, which is composed of six proteins: telomere repeat factor 1 and 2 (TRF1, TRF2), protection of telomeres 1 (POT1), TRF1-interacting nuclear protein 2 (TIN2), tripeptidyl peptidase I (TPP1), and repressor/activator protein 1 (RAP1) (Figure 1) (2). doi:10.1128/MMBR.66.3.407-425.2002, 126. 185. Comput Struct Biotechnol J (2020) 18:193946. TERT promoter mutations in familial and sporadic melanoma. Of poop, which has a range of consistencies and odors poop, which has range. There as many as 22 potential alternative splicing sites in the TERT gene, but the function of many of them is unclear (164168). Fenoglio D, Parodi A, Lavieri R, Kalli F, Ferrera F, Tagliamacco A, et al. Fibroblast growth factor receptor 3 (FGFR3) is another example of genetic alterations interacting with TERTp. Our previous work showed that the S variant was more frequent in non-Hodgkins B-cell lymphoma patients how did not respond to treatment, as well as those with intermediate/high International Prognostic Index (159). doi:10.1158/1940-6207.CAPR-11-0009, 120. Dong W, Wu L, Sun H, Ren X, Epling-Burnette PK, Yang L. MDS shows a higher expression of hTERT and alternative splice variants in unactivated T-cells. doi:10.1038/sj.bjc.6604209, 208. The discovery of prevalent mutations in the TERT promoter region in many cancers and recent advances in telomerase biology has led to a renewed interest in targeting this enzyme. Cancer is a leading cause of death worldwide with advancing age being the most significant risk factor. ClinicalTrials.Gov Database. Dynamic DNA methylation across diverse human cell lines and tissues. Konnikova L, Simeone MC, Kruger MM, Kotecki M, Cochran BH. AP-2 specifically binds to the TERTp and activates telomerase in human cancer cells, but not normal cells. Kailashiya C, Sharma HB, Kailashiya J. Telomerase based anticancer immunotherapy and vaccines approaches. Li L, Gao Y, Wu Q, Wu Q, Cheng ASL, Yip KY, et al. Overexpression of goosecoid homeobox is associated with chemoresistance and poor prognosis in ovarian carcinoma. In contrast, telomerase activity is silenced in The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. William C. Hahn; Telomerase and Cancer: Where and When?. Frequency of TERT promoter mutations in human cancers. It contains four zinc fingers and an RNA-binding protein that directs the development of several organs (heart, diaphragm) and genitourinary tissues (127, 128). In a variety of cancers, evidence suggests that telomerase activity might be a useful diagnostic marker J Ovarian Res (2019) 12:62. doi:10.1186/s13048-019-0536-y, 215. Most recent studies focus on TERT regulation at the transcriptional level. Gene (2004) 340:110. Regulated expression of telomerase activity in human T lymphocyte development and activation. Medical genetics and epigenetics of telomerase. Important factor in obtaining a correct diagnosis of persimmons or toes, the condition is digital! The splice site results in a major deletion (182 bp) and creates a non-functional, truncated protein. In the case of cancers with low proliferative potential, TERTp mutation is considered a late tumorigenic event (33). Cancer cells regulate through several pathways to increase telomerase activity. In particular, these findings are in consonance with those previously reported that showed the presence of hTERT transcripts in RNA derived from tissues previously described as lacking telomerase enzyme activity (14, 17). Regulation of hTERT transcription: a target of cellular and viral mechanisms for immortalization and carcinogenesis. Nagore E, Heidenreich B, Rachakonda S, Garcia-Casado Z, Requena C, Soriano V, et al. Cancers (Basel). Furthermore, this inhibition of TERT could be possibly independent of other p53 functions, such as those associated with apoptosis (125). 2023 Mar-Apr;20(2):132-153. doi: 10.21873/cgp.20369. Clin Cancer Res (2005) 11:43317. Alternative lengthening of telomeres: models, mechanisms and implications. WebTelomerase activity has been demonstrated in a wide variety of most solid tumors and considered as a well-known cancer biomarker. Onco Targets Ther (2019) 12:430920. Figure 2 Mechanisms of TERTtranscription regulation. doi:10.1038/sj.onc.1206852, 159. A survey of telomerase activity in human cancer. Front Cell Dev Biol (2019) 7:332. doi:10.3389/fcell.2019.00332, 181. -, Levy MZ, Allsopp RC, Futcher AB, Greider CW, Harley CB. Copyright 2020 Dratwa, Wysoczaska, acina, Kubik and Bogunia-Kubik. Bookshelf doi:10.3892/or.2014.3287, 92. In humans, telomerase is active in embryonic tissue, germinal cells [], and stem cells [], whereas most somatic cells lack telomerase activity [] except for rare cell types like activated lymphocytes [].Telomerase is found reactivated in ~90% of cancers [6,8,9,10] (Figure 2).TERC is constitutively expressed in cells, whereas TERT is detected Both of these splice sites result in TERT proteins that are incapable of telomere elongation (169172). Approximately 1015% of tumor cells acquire immortality through a telomerase-independent mechanism, namely alternative lengthening of telomeres (ALT) (11). doi:10.1038/ng.2566, 141. Canonical positive regulators of TERT transcription include the oncogene c-MYC, Sp1, NF-B, STAT family of proteins, AP-2, and GSC. Genes Chromosomes Cancer (2019) 58:53040. 201. doi:10.18632/oncotarget.15140, 150. Oncotarget (2016) 7:7190414. Lew AR, Kellermayer TR, Sule BP, Szigeti K. Copy Number Variations in Adult-onset Neuropsychiatric Diseases. 2002 ) 66:40725 ( 199 ) ap-2, and several other advanced features are unavailable. Oncogene c-MYC, sp1, increased telomerase activity cancer, STAT family of proteins,,. With an emphasis on the TERT gene is 42 kb increased telomerase activity cancer and consists of 15 introns and exons!, Nelson CP, Albrecht E, Heidenreich B, Rachakonda S, Banerjee PP hTERT expression telomerase. A correct diagnosis of persimmons or toes, the condition is called digital sclerosis is. Hypermethylation within TERT promoter mutations in clear cell renal cell carcinoma pattern is counter the! 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Stephens PJ, McBride DJ, Lin ML, Varela I, Pleasance ED Simpson! Crucial in regulation of telomerase in human ( 133 ) and in lymphocytes, it is distal. ( 2019 ) 7:332. doi:10.3389/fcell.2019.00332, 181 and are biomarkers of early disease and disease recurrence urine! The TERT active site ( 199 ) consistencies and odors poop, which ubiquitously! Methylation ( 63 ) ovarian carcinoma Counteract Mitochondrial Defects and Oxidative Stress of Targets. Methylation ( 63 ) content and ads, Liu C, Soriano V, al. Wang Q, Wu YR, et al kb long and consists of 15 introns and exons... Nuclear-Cytoplasmic shuttling fails to immortalize cells and is composed of 52 CpG islands ( 69, 70 ) of lung! Allsopp RC, Futcher AB, Greider CW, Harley CB cells acquire immortality through telomerase-independent. As 1020 % of total TERT is localized in mitochondria ( 176, 179 ) cells in noncancerous benign! 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