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Biased signaling in drug discovery and precision medicine 药物发现和精准医疗中的偏倚信号。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-02 DOI: 10.1016/j.pharmthera.2025.108804
Ren-Lei Ji, Ya-Xiong Tao
Receptors are crucial for converting chemical and environmental signals into cellular responses, making them prime targets in drug discovery, with about 70% of drugs targeting these receptors. Biased signaling, or functional selectivity, has revolutionized drug development by enabling precise modulation of receptor signaling pathways. This concept is more firmly established in G protein-coupled receptor and has now been applied to other receptor types, including ion channels, receptor tyrosine kinases, and nuclear receptors. Advances in structural biology have further refined our understanding of biased signaling. This targeted approach enhances therapeutic efficacy and potentially reduces side effects. Numerous biased drugs have been developed and approved as therapeutics to treat various diseases, demonstrating their significant therapeutic potential. This review provides a comprehensive overview of biased signaling in drug discovery and disease treatment, highlighting recent advancements and exploring the therapeutic potential of these innovative modulators across various diseases.
受体对于将化学和环境信号转化为细胞反应至关重要,使其成为药物发现的主要目标,约70%的药物靶向这些受体。偏倚信号,或功能选择性,已经彻底改变了药物开发,使受体信号通路的精确调节。这一概念在G蛋白偶联受体中更为牢固地建立起来,目前已应用于其他类型的受体,包括离子通道、受体酪氨酸激酶和核受体。结构生物学的进步进一步完善了我们对偏置信号的理解。这种有针对性的方法提高了治疗效果,并有可能减少副作用。许多偏倚药物已被开发并批准作为治疗各种疾病的疗法,显示出其巨大的治疗潜力。本文综述了偏倚信号在药物发现和疾病治疗中的全面概述,重点介绍了偏倚信号的最新进展,并探索了这些创新调节剂在各种疾病中的治疗潜力。
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引用次数: 0
Annexin A1 in neurological disorders: Neuroprotection and glial modulation 神经系统疾病中的膜联蛋白A1:神经保护和神经胶质调节。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2025.108809
Luiz Philipe de Souza Ferreira , Rafael André da Silva , Pâmela Pacassa Borges , Luana Filippi Xavier , Pablo Scharf , Silvana Sandri , Sonia M. Oliani , Sandra H.P. Farsky , Cristiane D. Gil
Neurological disorders, such as neurodegenerative and neuroinflammatory diseases, have contributed significantly to global disability, even considering the rising life years expectations. Therefore, prevention, early diagnosis, and therapeutic alternatives have been essential to avoid the future collapse of health public systems. Annexin A1 (ANXA1), a Ca2 + −dependent protein, is a promising therapeutic candidate for neurological disorders. ANXA1, found in neurons and glia, displays roles in physiological and pathological processes. Despite ANXA1 undoubtedly maintains the blood-brain barrier (BBB) integrity, this review will focus on ANXA1 roles in neurons and glial cells. In neurons, the cytoplasmic expression of ANXA1 is associated with apoptosis, while its nuclear translocation is linked to ischemic neuronal death. Interactions with S100A11, the Tat-NTS peptide, and other molecules, modulate this translocation, suggesting potential therapeutic interventions. ANXA1 expressed on microglia modulates inflammation and efferocytosis. Post-translational modifications, such as SUMOylation, guide the role of ANXA1 in microglia polarization and neuroprotection. In addition, ANXA1 in astrocytes responds to inflammatory stimuli by influencing cytokine release. A comprehensive understanding of the intricate mechanisms of ANXA1 in neurons and glial cells reveals promising therapeutic strategies to alleviate neuronal damage in neurological diseases.
神经系统疾病,如神经退行性疾病和神经炎症性疾病,是造成全球残疾的重要原因,即使考虑到预期寿命年数的增加。因此,预防、早期诊断和替代治疗对于避免公共卫生系统未来崩溃至关重要。膜联蛋白A1 (ANXA1)是一种Ca2 + 依赖性蛋白,是一种很有前途的神经系统疾病治疗候选者。在神经元和神经胶质中发现的ANXA1,在生理和病理过程中发挥作用。尽管ANXA1无疑维持了血脑屏障(BBB)的完整性,但本文将重点讨论ANXA1在神经元和神经胶质细胞中的作用。在神经元中,ANXA1的胞质表达与细胞凋亡有关,而其核易位与缺血性神经元死亡有关。与S100A11、Tat-NTS肽和其他分子的相互作用调节这种易位,提示潜在的治疗干预。小胶质细胞表达的ANXA1调节炎症和efferocycytes。翻译后修饰,如SUMOylation,指导ANXA1在小胶质细胞极化和神经保护中的作用。此外,星形胶质细胞中的ANXA1通过影响细胞因子的释放来响应炎症刺激。对神经元和神经胶质细胞中ANXA1复杂机制的全面了解揭示了缓解神经系统疾病中神经元损伤的有希望的治疗策略。
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引用次数: 0
Uncovering the intricacies of O-GlcNAc modification in cognitive impairment: New insights from regulation to therapeutic targeting 揭示认知障碍中 O-GlcNAc 修饰的复杂性:从调控到靶向治疗的新见解。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108761
Jianhui Wang , Ning Jiang , Feng Liu , Chenran Wang , Wenxia Zhou
O-linked β-N-acetylglucosamine (O-GlcNAc) represents a post-translational modification that occurs on serine or threonine residues on various proteins. This conserved modification interacts with vital cellular pathways. Although O-GlcNAc is widely distributed throughout the body, it is particularly enriched in the brain, where most proteins are O-GlcNAcylated. Recent studies have established a causal link between O-GlcNAc regulation in the brain and alterations in neurophysiological function. Alterations in O-GlcNAc levels in the brain are associated with the pathogenesis of several neurogenic diseases that can lead to cognitive impairment. Remarkably, manipulation of O-GlcNAc levels demonstrated a protective effect on cognitive function. Although the precise molecular mechanism of O-GlcNAc modification in the nervous system remains elusive, its regulation is fundamental to multiple neural and cognitive functions, fluctuating levels during normal and pathological cognitive processes. In this review, we highlight the significant functional importance of O-GlcNAc modification in pathological cognitive impairments and the potential application of O-GlcNAc as a promising target for the intervention or amelioration of cognitive impairments.
O-连接β-N-乙酰葡萄糖胺(O-GlcNAc)是一种翻译后修饰,发生在各种蛋白质的丝氨酸或苏氨酸残基上。这种保守的修饰与重要的细胞通路相互作用。虽然 O-GlcNAc 广泛分布于人体各处,但它在大脑中的含量尤其丰富,因为大脑中的大多数蛋白质都是 O-GlcNAcylated 蛋白质。最近的研究证实,大脑中的 O-GlcNAc 调节与神经生理功能的改变之间存在因果关系。大脑中 O-GlcNAc 水平的改变与多种神经源性疾病的发病机制有关,这些疾病可导致认知障碍。值得注意的是,控制 O-GlcNAc 水平对认知功能有保护作用。尽管神经系统中 O-GlcNAc 修饰的确切分子机制仍难以捉摸,但其调控对多种神经和认知功能至关重要,并在正常和病理认知过程中波动。在这篇综述中,我们强调了 O-GlcNAc 修饰在病理认知障碍中的重要功能意义,以及将 O-GlcNAc 作为干预或改善认知障碍的潜在靶点的应用前景。
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引用次数: 0
Biased signaling in GPCRs: Structural insights and implications for drug development 偏置信号在gpcr:结构的见解和药物开发的意义。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108786
Yuanyuan Ma, Brandon Patterson, Lan Zhu
G protein-coupled receptors (GPCRs) are the largest family of cell surface receptors in humans, playing a crucial role in regulating diverse cellular processes and serving as primary drug targets. Traditional drug design has primarily focused on ligands that uniformly activate or inhibit GPCRs. However, the concept of biased agonism—where ligands selectively stabilize distinct receptor conformations, leading to unique signaling outcomes—has introduced a paradigm shift in therapeutic development. Despite the promise of biased agonists to enhance drug efficacy and minimize side effects, a comprehensive understanding of the structural and biophysical mechanisms underlying biased signaling is essential. Recent advancements in GPCR structural biology have provided unprecedented insights into ligand binding, conformational dynamics, and the molecular basis of biased signaling. These insights, combined with improved techniques for characterizing ligand efficacy, have driven the development of biased ligands for several GPCRs, including opioid, angiotensin, and adrenergic receptors. This review synthesizes these developments, from mechanisms to drug discovery in biased signaling, emphasizing the role of structural insights in the rational design of next-generation biased agonists with superior therapeutic profiles. Ultimately, these advances hold the potential to revolutionize GPCR-targeted drug discovery, paving the way for more precise and effective treatments.
G蛋白偶联受体(gpcr)是人类最大的细胞表面受体家族,在调节多种细胞过程中起着至关重要的作用,是主要的药物靶点。传统的药物设计主要集中在均匀激活或抑制gpcr的配体上。然而,偏倚激动剂的概念——配体选择性地稳定不同的受体构象,导致独特的信号转导结果——已经在治疗发展中引入了范式转变。尽管偏倚激动剂有望提高药物疗效并减少副作用,但对偏倚信号传导的结构和生物物理机制的全面了解是必不可少的。GPCR结构生物学的最新进展为配体结合、构象动力学和偏置信号的分子基础提供了前所未有的见解。这些见解与表征配体功效的改进技术相结合,推动了几种gpcr的偏配体的发展,包括阿片样物质、血管紧张素和肾上腺素能受体。这篇综述综合了这些发展,从偏倚信号的机制到药物发现,强调了结构洞察在合理设计具有优越治疗效果的下一代偏倚激动剂中的作用。最终,这些进展有可能彻底改变gpcr靶向药物的发现,为更精确和有效的治疗铺平道路。
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引用次数: 0
Is there a place for natural agents with anti-inflammatory and antioxidative properties in critically ill patients? Potential usefulness of Xanthohumol 具有抗炎和抗氧化特性的天然药物在危重患者中是否有一席之地?黄腐酚的潜在用途。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108766
Wojciech Dabrowski , Carmen Andrea Pfortmueller , Katarzyna Kotfis , Andrzej Jaroszynski , Mariusz Gagos , Wlodzimierz Plotek , Manu L.N.G. Malbrain
Multi-organ dysfunction is a major issue in critically ill patients, where a significant inflammatory response appears to be the primary factor driving the degree of organ impairment, which correlates with the extent of organ injury. The management of inflammation requires a multidisciplinary approach, including antibiotics for infection control, circulatory and respiratory support, and correction of coagulation abnormalities. However, the use of anti-inflammatory treatments is typically restricted to a selected group of medications, with their effectiveness remaining the subject of extensive debate. Xanthohumol (Xn), a natural compound extracted from hops, possesses strong anti-inflammatory and antioxidative properties, with a mild anti-coagulation effect. Its biological activity is related to the inhibition of different inflammatory pathways, reduction in cytokine production and secretion, and an increase in antioxidative enzyme activity. This review examined the potential use of Xn as an adjuvant in the treatment of various pathologies in critically ill patients.
多器官功能障碍是危重患者的一个主要问题,其中明显的炎症反应似乎是驱动器官损害程度的主要因素,而器官损害程度与器官损伤的程度相关。炎症的管理需要多学科的方法,包括抗生素感染控制,循环和呼吸支持,纠正凝血异常。然而,抗炎治疗的使用通常仅限于选定的一组药物,其有效性仍然是广泛争论的主题。黄腐酚(Xn)是一种从啤酒花中提取的天然化合物,具有很强的抗炎和抗氧化特性,具有温和的抗凝血作用。其生物活性与抑制不同的炎症途径,减少细胞因子的产生和分泌,增加抗氧化酶活性有关。本综述探讨了Xn作为一种辅助治疗危重患者各种病理的潜在用途。
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引用次数: 0
Biased agonism at free-fatty acid receptor-4 (FFA4/GPR120) 游离脂肪酸受体-4 (FFA4/GPR120)的偏激激动作用。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108784
Razan L. Teyani , Nader H. Moniri
Free-fatty acid receptor-4 (FFA4), previously known as GPR120, is a G protein-coupled receptor (GPCR) activated by medium-to-long chain free fatty acids (FFAs), including saturated, monounsaturated, and polyunsaturated fats, many of which (e.g., omega-3 fatty acids) are critical contributors to human health and disease. FFA4 is widely expressed across human tissues, and its activation supports a range of physiological functions, including the release of gastrointestinal incretin hormones like glucagon-like peptide-1 (GLP-1), regulation of pancreatic hormone secretion, peripheral glucose uptake, adipose regulation, and anti-inflammatory responses in macrophages. Due to its pivotal role in energy metabolism and inflammation, FFA4 has emerged as a major target in drug discovery. Historically, FFA4 signaling was linked to the Gαq/11 family of intracellular heterotrimeric G proteins, which mediate its GLP-1 releasing effects. However, emerging evidence indicates that FFA4 can signal through other Gα proteins in various cellular contexts. Notably, its anti-inflammatory effects are also dependent on interactions with β-arrestin proteins, further broadening the receptor's signaling versatility. This review explores the concept of biased agonism at FFA4, emphasizing how this receptor selectively signals through distinct transduction pathways, including Gα proteins and β-arrestins. We also examine the key structural elements of FFA4 that govern its interactions with different signaling partners, the elucidation of which has laid the groundwork for the development of biased agonists aimed at selectively modulating these FFA4-mediated pathways for therapeutic application.
游离脂肪酸受体-4 (FFA4),以前称为GPR120,是一种G蛋白偶联受体(GPCR),由中长链游离脂肪酸(FFAs)激活,包括饱和、单不饱和和多不饱和脂肪,其中许多(例如ω -3脂肪酸)是人类健康和疾病的关键因素。FFA4在人体组织中广泛表达,其激活支持一系列生理功能,包括胃肠胰促胰岛素激素的释放,如胰高血糖素样肽-1 (GLP-1),调节胰腺激素分泌,外周葡萄糖摄取,脂肪调节和巨噬细胞的抗炎反应。由于其在能量代谢和炎症中的关键作用,FFA4已成为药物发现的主要靶点。历史上,FFA4信号通路与细胞内异三聚体G蛋白的Gαq/11家族有关,介导其GLP-1释放作用。然而,新出现的证据表明,FFA4可以在各种细胞环境下通过其他Gα蛋白发出信号。值得注意的是,它的抗炎作用也依赖于与β-抑制蛋白的相互作用,进一步扩大了受体的信号多功能性。这篇综述探讨了FFA4的偏倚激动作用的概念,强调了该受体如何通过不同的转导途径(包括Gα蛋白和β-阻滞蛋白)选择性地发出信号。我们还研究了FFA4控制其与不同信号伙伴相互作用的关键结构要素,其阐明为开发旨在选择性调节这些FFA4介导的治疗应用途径的偏倚激动剂奠定了基础。
{"title":"Biased agonism at free-fatty acid receptor-4 (FFA4/GPR120)","authors":"Razan L. Teyani ,&nbsp;Nader H. Moniri","doi":"10.1016/j.pharmthera.2024.108784","DOIUrl":"10.1016/j.pharmthera.2024.108784","url":null,"abstract":"<div><div>Free-fatty acid receptor-4 (FFA4), previously known as GPR120, is a G protein-coupled receptor (GPCR) activated by medium-to-long chain free fatty acids (FFAs), including saturated, monounsaturated, and polyunsaturated fats, many of which (e.g., omega-3 fatty acids) are critical contributors to human health and disease. FFA4 is widely expressed across human tissues, and its activation supports a range of physiological functions, including the release of gastrointestinal incretin hormones like glucagon-like peptide-1 (GLP-1), regulation of pancreatic hormone secretion, peripheral glucose uptake, adipose regulation, and anti-inflammatory responses in macrophages. Due to its pivotal role in energy metabolism and inflammation, FFA4 has emerged as a major target in drug discovery. Historically, FFA4 signaling was linked to the Gαq/11 family of intracellular heterotrimeric G proteins, which mediate its GLP-1 releasing effects. However, emerging evidence indicates that FFA4 can signal through other Gα proteins in various cellular contexts. Notably, its anti-inflammatory effects are also dependent on interactions with β-arrestin proteins, further broadening the receptor's signaling versatility. This review explores the concept of biased agonism at FFA4, emphasizing how this receptor selectively signals through distinct transduction pathways, including Gα proteins and β-arrestins. We also examine the key structural elements of FFA4 that govern its interactions with different signaling partners, the elucidation of which has laid the groundwork for the development of biased agonists aimed at selectively modulating these FFA4-mediated pathways for therapeutic application.</div></div>","PeriodicalId":402,"journal":{"name":"Pharmacology & Therapeutics","volume":"266 ","pages":"Article 108784"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Essential role of sulfide oxidation in brain health and neurological disorders 硫化物氧化在大脑健康和神经系统疾病中的重要作用。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108787
Eiki Kanemaru, Fumito Ichinose
Hydrogen sulfide (H2S) is an environmental hazard well known for its neurotoxicity. In mammalian cells, H2S is predominantly generated by transsulfuration pathway enzymes. In addition, H2S produced by gut microbiome significantly contributes to the total sulfide burden in the body. Although low levels of H2S is believed to exert various physiological functions such as neurotransmission and vasomotor control, elevated levels of H2S inhibit the activity of cytochrome c oxidase (i.e., mitochondrial complex IV), thereby impairing oxidative phosphorylation. To protect the electron transport chain from respiratory poisoning by H2S, the compound is actively oxidized to form persulfides and polysulfides by a mitochondrial resident sulfide oxidation pathway. The reaction, catalyzed by sulfide:quinone oxidoreductase (SQOR), is the initial and critical step in sulfide oxidation. The persulfide species are subsequently oxidized to sulfite, thiosulfate, and sulfate by persulfide dioxygenase (ETHE1 or SDO), thiosulfate sulfurtransferase (TST), and sulfite oxidase (SUOX). While SQOR is abundantly expressed in the colon, liver, lung, and skeletal muscle, its expression is notably low in the brains of most mammals. Consequently, the brain's limited capacity to oxidize H2S renders it particularly sensitive to the deleterious effects of H2S accumulation. Impaired sulfide oxidation can lead to fatal encephalopathy, and the overproduction of H2S has been implicated in the developmental delays observed in Down syndrome. Our recent findings indicate that the brain's limited capacity to oxidize sulfide exacerbates its sensitivity to oxygen deprivation. The beneficial effects of sulfide oxidation are likely to be mediated not only by the detoxification of H2S but also by the formation of persulfide, which exerts cytoprotective effects through multiple mechanisms. Therefore, pharmacological agents designed to scavenge H2S and/or enhance persulfide levels may offer therapeutic potential against neurological disorders characterized by impaired or insufficient sulfide oxidation or excessive H2S production.
硫化氢(H2S)是一种众所周知的神经毒性环境危害。在哺乳动物细胞中,H2S主要由转硫途径酶产生。此外,肠道微生物组产生的H2S显著增加了体内硫化物的总负荷。虽然低水平的H2S被认为具有多种生理功能,如神经传递和血管运动控制,但高水平的H2S会抑制细胞色素c氧化酶(即线粒体复合体IV)的活性,从而损害氧化磷酸化。为了保护电子传递链免受H2S的呼吸中毒,该化合物通过线粒体常驻硫化物氧化途径被活性氧化形成过硫化物和多硫化物。该反应由硫化物:醌氧化还原酶(SQOR)催化,是硫化物氧化的初始和关键步骤。过硫物质随后被过硫双加氧酶(ETHE1或SDO)、硫代硫酸盐硫转移酶(TST)和亚硫酸盐氧化酶(SUOX)氧化为亚硫酸盐、硫代硫酸盐和硫酸盐。虽然SQOR在结肠、肝脏、肺和骨骼肌中大量表达,但在大多数哺乳动物的大脑中其表达明显较低。因此,大脑氧化H2S的能力有限,使其对H2S积累的有害影响特别敏感。硫化物氧化受损可导致致命的脑病,硫化氢的过量产生与唐氏综合症中观察到的发育迟缓有关。我们最近的发现表明,大脑氧化硫化物的能力有限,加剧了它对缺氧的敏感性。硫化物氧化的有益作用可能不仅是通过H2S解毒介导的,还可能是通过形成过硫化物介导的,过硫化物通过多种机制发挥细胞保护作用。因此,设计用于清除H2S和/或提高过硫化物水平的药理学药物可能对以硫化物氧化受损或不足或硫化氢生成过多为特征的神经系统疾病提供治疗潜力。
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引用次数: 0
Non-vesicular extracellular RNA: A potential drug target to intervene cell-cell communication 非囊泡细胞外RNA:干预细胞间通讯的潜在药物靶点。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108774
Takeshi Tomita
The importance of non-vesicular extracellular RNA in the mammalian system is becoming increasingly apparent. Non-vesicular extracellular RNA is defined as RNA molecules not included in a lipid bilayer such as exosomes. Because non-vesicular extracellular RNA is not protected from RNases and is therefore rapidly degraded, they were not easily captured by conventional biofluid analyses. Recent publications showed that some non-vesicular extracellular RNAs are relatively stable in biofluids or tissue culture media, and they have unique biological functions. Major RNAs (rRNA, mRNA, and tRNA) and other non-cording RNAs play important roles in transcription or translation in the cell. In contrast, non-vesicular extracellular RNA has functions related to intercellular communication rather than protein synthesis. This review discusses the basics of non-vesicular extracellular RNA, including its definition, purification, receptors, and future prospects as a drug target.
非囊泡细胞外RNA在哺乳动物系统中的重要性正变得越来越明显。非囊泡细胞外RNA被定义为不包括在脂质双分子层中的RNA分子,如外泌体。由于非囊泡细胞外RNA不受RNA酶的保护,因此会迅速降解,因此传统的生物流体分析不容易捕获它们。最近的出版物表明,一些非囊泡细胞外rna在生物液体或组织培养基中相对稳定,并且具有独特的生物学功能。主要rna (rRNA、mRNA和tRNA)和其他非编码rna在细胞中发挥着重要的转录或翻译作用。相反,非囊泡细胞外RNA的功能与细胞间通讯有关,而不是蛋白质合成。本文综述了非囊泡细胞外RNA的基本知识,包括其定义、纯化、受体和作为药物靶点的未来前景。
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引用次数: 0
Recent advances in development and delivery of non-viral nucleic acid therapeutics for brain tumor therapy 用于脑肿瘤治疗的非病毒核酸疗法的开发和输送的最新进展。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108762
Donat Kögel , Achim Temme , Achim Aigner
High grade gliomas (HGG) are a group of CNS tumors refractory to currently existing therapies, which routinely leads to early recurrence and a dismal prognosis. Recent advancements in nucleic acid-based therapy using a wide variety of different molecular targets and non-viral nanocarrier systems suggest that this approach holds significant potential to meet the urgent demand for improved therapeutic options for the treatment of these tumors. This review provides a comprehensive and up-to-date overview on the current landscape and progress of preclinical and clinical developments in this rapidly evolving and exciting field of research, including optimized nanocarrier delivery systems, promising therapeutic targets and tailor-made therapeutic strategies for individualized HGG patient treatment.
高级别胶质瘤(HGG)是一类对现有疗法难治的中枢神经系统肿瘤,通常会导致早期复发和预后不良。利用各种不同的分子靶点和非病毒纳米载体系统进行核酸治疗的最新进展表明,这种方法具有巨大的潜力,可以满足治疗这些肿瘤的迫切需求。这篇综述全面概述了这一快速发展、令人兴奋的研究领域目前的临床前和临床研究进展,包括优化的纳米载体递送系统、有前景的治疗靶点以及针对 HGG 患者个体化治疗的定制治疗策略。
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引用次数: 0
Combinational CAR T-cell therapy for solid tumors: Requisites, rationales, and trials CAR - t细胞联合治疗实体肿瘤:条件、原理和试验。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-01 DOI: 10.1016/j.pharmthera.2024.108763
Kyohei Misawa , Hina Bhat , Prasad S. Adusumilli , Zhaohua Hou
Chimeric antigen receptor (CAR) T-cell therapy has achieved potent antitumor efficacy in hematological malignancies; however, because of limitations in CAR T-cell recruitment, infiltration, activation, and functional persistence in the tumor, its efficacy in solid tumors has been suboptimal. To overcome these challenges, combinational strategies that include chemotherapy, radiation therapy, or immune checkpoint inhibitor agent therapy with CAR T-cell therapy are being investigated. The established functional characteristics of the abovementioned therapies provide a rationale for the use of a combinational approach with CAR T cells. Chemotherapy reshapes the peritumoral stroma, decreases the immunosuppressive cell population, and promotes a proinflammatory milieu, all of which allow for increased recruitment, infiltration, and accumulation of CAR T cells. Radiation therapy promotes a chemokine gradient, which augments tumor infiltration by CAR T cells and further increases expression of tumor-associated antigens, allowing for increased activation of CAR T cells. Immune checkpoint inhibitor agent therapy inactivates T-cell exhaustion pathways—most notably, the PD1/PDL1 pathway—thereby improving the functional persistence of CAR T cells and promoting endogenous immunity. In this review, we discuss the requisites and rationales for combinational therapy, and we review 25 ongoing phase I and II clinical trials, of which 4 use chemotherapy, 3 use radiation therapy, 11 use immunotherapy, and 7 use another agent. While safety, efficacy, and improved outcomes are the primary goals of these ongoing studies, the knowledge gained from them will help pave the way for subsequent studies focused on optimizing combinational regimens and identifying predictive biomarkers.
嵌合抗原受体(CAR) t细胞治疗在血液系统恶性肿瘤中取得了有效的抗肿瘤疗效;然而,由于CAR - t细胞在肿瘤中的募集、浸润、激活和功能持久性的局限性,其在实体瘤中的疗效一直不理想。为了克服这些挑战,正在研究包括化疗、放射治疗或免疫检查点抑制剂治疗与CAR - t细胞治疗在内的联合策略。上述疗法的既定功能特征为CAR - T细胞联合疗法的使用提供了理论依据。化疗重塑肿瘤周围基质,减少免疫抑制细胞群,促进促炎环境,所有这些都允许CAR - T细胞增加募集、浸润和积累。放射治疗促进趋化因子梯度,这增加了CAR - T细胞对肿瘤的浸润,进一步增加了肿瘤相关抗原的表达,从而增加了CAR - T细胞的活化。免疫检查点抑制剂治疗使T细胞衰竭途径失活——最明显的是PD1/PDL1途径——从而改善CAR - T细胞的功能持久性并促进内源性免疫。在这篇综述中,我们讨论了联合治疗的必要条件和基本原理,并回顾了25个正在进行的I期和II期临床试验,其中4个使用化疗,3个使用放射治疗,11个使用免疫治疗,7个使用其他药物。虽然安全性、有效性和改善的结果是这些正在进行的研究的主要目标,但从中获得的知识将有助于为后续研究铺平道路,重点是优化组合方案和识别预测性生物标志物。
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引用次数: 0
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Pharmacology & Therapeutics
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