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Management of Bladder Cancer  \nMagdalena Wilczak 1,2, Magdalena Surman 1 and Małgorzata Przybyło 1, *  \nCitation: Wilczak, M.; Surman, M.; Przybyło, M. Altered Glycosylationin Progression and Management of Bladder Cancer. Molecules 2023, 28, 3436. [https://doi.org/10.3390/](https://doi.org/10.3390/)  \nmolecules28083436  \nAcademic Editor: Anthony S. Serianni  \nReceived: 24 February 2023  \nRevised: 5 April 2023  \nAccepted: 11 April 2023  \nPublished: 13 April 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Glycoconjugate Biochemistry, Faculty of Biology, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9 Street, 30-387 Krakow, Poland; [magdalena.wilczak@doctoral.uj.edu.pl](magdalena.wilczak@doctoral.uj.edu.pl) (M.W.); [magdalena.surman@uj.edu.pl](magdalena.surman@uj.edu.pl) (M.S.)  \n2 Doctoral School of Exact and Natural Sciences, Jagiellonian University, Prof. S. Łojasiewicza 11 Street, 30-348 Krakow, Poland  \n* [Correspondence: malgorzata.przybylo@uj.edu.pl](Correspondence: malgorzata.przybylo@uj.edu.pl)  \nAbstract: Bladder cancer (BC) is the 10th most common malignancy worldwide, with an estimated 573,000 new cases and 213,000 deaths in 2020 . Available therapeutic approaches are still unable to reduce the incidence of BC metastasis and the high mortality rates of BC patients. Therefore, thereis a need to deepen our understanding of the molecular mechanisms underlying BC progression to develop new diagnostic and therapeutic tools. One such mechanism is protein glycosylation. Numerous studies reported changes in glycan biosynthesis during neoplastic transformation, resulting in the appearance of the so-called tumor-associated carbohydrate antigens (TACAs) on the cell surface. TACAs affect a wide range of key biological processes, including tumor cell survival and proliferation, invasion and metastasis, induction of chronic inflammation, angiogenesis, immune evasion, and insensitivity to apoptosis. The purpose of this review is to summarize the current information on how altered glycosylation of bladder cancer cells promotes disease progression and to present the potential use of glycans for diagnostic and therapeutic purposes.  \nKeywords: bladder cancer; extracellular vesicles; glycosaminoglycans; Lewis's antigen; mucins; N-glycosylation; O-glycosylation; T antigen; Tn antigen; tumor glycosylation  \n1. Introduction  \nBladder cancer (BC) is the 10th most common malignancy worldwide, which accounts for 3% of global cancer diagnoses. The highest incidence rate of BC is observed in men in Southern and Western Europe and in North America [1] . According to GLOBOCAN, the estimated number of new BC cases in 2020 reached 573,000, and there were 213,000 new BC-related deaths [2] . BC is a highly heterogeneous cancer with a spectrum ranging from low-grade non-invasive tumors with good prognosis but high recurrence rate up to highgrade muscle-invasive tumors with a poor prognosis. Histologically, BC is classified into two categories: urothelial, which is diagnosed in more than 90% of cases, and non-urothelial, including squamous cell carcinoma, adenocarcinoma, and small cell carcinoma [3,4] . Based on invasiveness, BC is classified into non-muscle-infiltrating bladder cancer (NMIBC, 70% of cases) and muscle-infiltrating bladder cancer (MIBC, 30% of cases) . Different therapeutic strategies for BC are applied based on the BC category. In the case of NMIBC, transurethral resection of bladder tumor (TURBT) is the most common strategy, followed by intravesical chemotherapy or immunotherapy, while in MIBC, cystectomy is use","cbCaiq9540oGxQqP","https://ap.wps.com/l/cbCaiq9540oGxQqP","pdf",3560297,31,"English","# Abstract\n# Keywords\n# 1. Introduction\n# 2. Alteration in Glycosylation Observed in Cancer","[{\"question\":\"Why is bladder cancer progression difficult to control with current therapies?\",\"answer\":\"Current treatments do not sufficiently reduce metastasis and mortality, partly because bladder cancer commonly recurs after transurethral resection and can redevelop into more invasive and metastatic disease.\"},{\"question\":\"How does altered glycosylation contribute to bladder cancer biology?\",\"answer\":\"Altered glycosylation produces tumor-associated carbohydrate antigens that affect survival and proliferation, promote invasion and metastasis, induce chronic inflammation, support angiogenesis, enable immune evasion, and reduce apoptosis sensitivity.\"},{\"question\":\"What diagnostic or therapeutic roles do glycans play in this review?\",\"answer\":\"The review summarizes evidence that glycans on bladder cancer cells and related extracellular vesicles could be used as tools for diagnosis and as potential therapeutic targets.\"}]","Altered Glycosylation in Progression and Management of Bladder Cancer | PDF",1790243457,78]