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Poly (ADP-ribose) polymerase (PARP) inhibitors as chemosensitizing compounds for the treatment of drug resistant cancers 聚(adp -核糖)聚合酶(PARP)抑制剂作为化疗增敏化合物治疗耐药癌症
Pub Date : 2019-09-20 DOI: 10.31083/J.JMCM.2019.03.0303
S. Narayanan, Q. Teng, J. Koya, Jing-Quan Wang, Y. Assaraf, C. Ashby, Zhe-Sheng, Chen
Poly (ADP-ribose) polymerase (PARP) proteins mediate various cellular processes such as DNA repair, regulation of transcription, protein-protein interaction, expression of inflammatory genes and programmed cell death. PARP proteins have a key role in DNA repair and recent findings have established the role of PARP inhibitors as potent chemotherapeutic drugs. Among the 18 members, PARP1 and PARP2 have been identified as the main targets for the development of pharmacological inhibitors to enhance the cytotoxic efficacy of established anticancer drugs. Furthermore, certain PARP1 and PARP2 inhibitors are being used in combination with other drugs for the treatment of various types of cancer. In different drug resistant cancer cell types, PARP inhibitors have been identified as compounds that reverse the resistance to topoisomerase inhibitors, DNA alkylating and methylating drugs by enhancing the DNA damage induced by these agents. In BRCA mutant cells, with abnormal homologous recombination (HR) repair mechanism, BER (Base Excision Repair Pathway) is responsible for survival of the cells. PARP enzymes play a major role in BER and PARP inhibitors effectively target BRCA mutant cells sparing normal cells via the concept of synthetic lethality, producing minimal toxicity to PARP inhibitors also have a significant role in treating pancreatic adenocarcinoma and castration-resistant prostate cancer. The aim of the current paper is to provide a review on PARP inhibitors and their application in the treatment of various cancer cells which are resistant to standard chemotherapeutic drugs. Keywords
聚(adp -核糖)聚合酶(PARP)蛋白介导多种细胞过程,如DNA修复、转录调节、蛋白-蛋白相互作用、炎症基因表达和程序性细胞死亡。PARP蛋白在DNA修复中起关键作用,最近的研究结果已经确定PARP抑制剂作为有效的化疗药物的作用。在这18个成员中,PARP1和PARP2已被确定为开发药物抑制剂的主要靶点,以增强已建立的抗癌药物的细胞毒作用。此外,某些PARP1和PARP2抑制剂正与其他药物联合用于治疗各种类型的癌症。在不同的耐药癌细胞类型中,PARP抑制剂已被确定为通过增强这些药物诱导的DNA损伤来逆转对拓扑异构酶抑制剂、DNA烷基化和甲基化药物的耐药性的化合物。在BRCA突变细胞中,具有异常同源重组(HR)修复机制,BER (Base Excision repair Pathway)负责细胞的存活。PARP酶在BER和PARP抑制剂中发挥重要作用,通过合成致死性的概念有效靶向BRCA突变细胞,保留正常细胞,对PARP抑制剂产生最小的毒性,在治疗胰腺腺癌和去势抵抗性前列腺癌中也有重要作用。本文就PARP抑制剂及其在治疗对标准化疗药物耐药的各种癌细胞中的应用作一综述。关键字
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引用次数: 6
Immunotherapy in pediatric brain tumors: considerations, challenges and future directions 儿童脑肿瘤的免疫治疗:考虑、挑战和未来方向
Pub Date : 2019-09-20 DOI: 10.31083/J.JMCM.2019.03.0302
S. Eline, V. Jasper, Hulleman Esther
Tumors of the central nervous system (CNS) are the main cause of cancer-related death in children. While improvements in survival rates for various childhood cancers have been obtained over the last decades, little progress has been made for pediatric brain tumors. In addition, current conventional treatment gives rise to severe long term toxicity, which underpins the burning need for the development of novel therapeutic modalities. Immunotherapy was shown to be successful in both adult solid tumors and pediatric hemato-oncology, and may be an option for pediatric CNS malignancies. However, pediatric brain tumors have a strong immunosuppressive microenvironment, which is considered a major hurdle for effective immunotherapy. The low mutational burden of these tumors may compromise immunotherapy for this patient group even further. The possibility to directly apply the current immune modulating therapies directly into the tumor, however, opens new options for immunotherapy in this population. This review covers immunotherapeutic approaches including immune checkpoint inhibition, chimeric antigen receptor T (CAR-T) cell therapy, therapeutic cancer vaccines, and oncolytic virotherapy. We review their effect on the immunosuppressive tumor microenvironment, summarize current trials, and discuss future directions. We conclude that immunotherapy holds promise for children with CNS malignancies, especially when combined with different (immune) therapeutic strategies.
中枢神经系统(CNS)肿瘤是儿童癌症相关死亡的主要原因。虽然在过去的几十年里,各种儿童癌症的存活率有所提高,但儿童脑肿瘤的治疗进展甚微。此外,目前的传统治疗方法会产生严重的长期毒性,因此迫切需要开发新的治疗方法。免疫疗法在成人实体瘤和儿童血液肿瘤中都是成功的,并且可能是儿童中枢神经系统恶性肿瘤的一种选择。然而,儿童脑肿瘤具有很强的免疫抑制微环境,这被认为是有效免疫治疗的主要障碍。这些肿瘤的低突变负担可能会进一步影响对该患者群体的免疫治疗。然而,直接将当前的免疫调节疗法直接应用于肿瘤的可能性,为这一人群的免疫治疗开辟了新的选择。本文综述了免疫治疗方法,包括免疫检查点抑制、嵌合抗原受体T (CAR-T)细胞治疗、治疗性癌症疫苗和溶瘤病毒治疗。我们回顾了它们对免疫抑制肿瘤微环境的影响,总结了目前的试验,并讨论了未来的发展方向。我们得出结论,免疫疗法对患有中枢神经系统恶性肿瘤的儿童有希望,特别是当与不同的(免疫)治疗策略相结合时。
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引用次数: 0
The use of biological glue (Starsil® Hemostat) in robotic partial nephrectomy: a safety and efficacy study 生物胶(Starsil®止血剂)在机器人部分肾切除术中的应用:安全性和有效性研究
Pub Date : 2019-09-20 DOI: 10.31083/J.JMCM.2019.03.0213
Zisman Ariel, Nativ Omri, Malshy Kamil, Sadeh Omer, A. Tareq, Shabataev Valentin, Hoffman Azik, Mullerad Michael, E. Gilad
Introduction: Robotic partial nephrectomy (RPN) is a relatively safe nephron sparing surgery (NSS) approach for the treatment of small renal masses (cT1). However, a major perioperative complication is extensive bleeding and blood loss necessitating blood transfusion. This complication is most challenging during the intraoperative setting and requires proper tumor bed closure. Recently several biological tissue adhesives have been tested to decrease intraoperative bleeding. A novel adhesive, Starsil® Hemostat is a plant-derived polysaccharide that can be applied directly to a bleeding wound to achieve hemostasis. The aim of our current study was to perform an evaluation of the safety and efficacy of this novel hemostat in patients undergoing RPN. Methods: This prospective single arm study included twenty patients with T1a-T1b renal masses who underwent RPN between the years 20172018. Renal masses were classified according to size, exophytic/endophytic properties and anatomic location into low, moderate and high complexity cases as described by the R.E.N.A.L nephrometry score. Starsil® Hemostat was applied by a feeding tube through a laparoscopic port after tumor excision. Perioperative data were collected, including blood loss during surgery, blood product transfusion rates, short and long-term adverse events and surgeon satisfaction using a visual analog scale (VAS 1-10). Results: Twenty RPN surgeries were completed using the Starsil® Hemostat. The average age was 61.8 ±14.3. Average maximal tumor diameter was 3.8 cm (range 1.55.7). The calculated mean R.E.N.A.L nephrometry score was 8.4 (range 5-12). Mean blood loss during surgery was 346 mL (range 50-1400 mL). Mean surgeon satisfaction (VAS 1-10) with bleeding control was 8.3, when recorded 24 hours post operation. In 17/20 procedures (85%), bleeding control was good (VAS 9-10) and only 2 patients required blood transfusion. None of the patients developed an allergic reaction. No adverse events related to the adhesive product were noted in the post-surgical follow up period. Conclusion: Tumor bed closure during NSS with the adhesive STARSIL® Hemostat is safe, feasible and easy to use. It has the potential to reduce blood loss and transfusion rate in patients undergoing RPN. Keywords
机器人部分肾切除术(RPN)是一种相对安全的保留肾元手术(NSS)治疗小肾肿块(cT1)的方法。然而,围手术期的主要并发症是大量出血和失血,需要输血。这种并发症在术中最具挑战性,需要适当的肿瘤床闭合。最近已经测试了几种生物组织粘接剂来减少术中出血。一种新型粘合剂,Starsil®止血剂是一种植物来源的多糖,可直接应用于出血伤口以实现止血。我们当前研究的目的是评估这种新型止血药在RPN患者中的安全性和有效性。方法:这项前瞻性单臂研究纳入了2017 - 2018年间接受RPN治疗的20例T1a-T1b肾肿块患者。根据肾肿块的大小、外生/内生性质和解剖位置,按照R.E.N.A.L肾测量评分将其分为低、中、高复杂性病例。Starsil®止血钳在肿瘤切除后通过腹腔镜口的饲管应用。采用视觉模拟量表(VAS 1-10)收集围手术期数据,包括术中出血量、血制品输血率、短期和长期不良事件以及外科医生满意度。结果:使用Starsil®止血钳完成RPN手术20例。平均年龄61.8±14.3岁。肿瘤平均最大直径3.8 cm(范围1.55.7)。计算的平均R.E.N.A.L肾测量评分为8.4分(范围5-12)。手术期间平均失血量为346 mL(范围50-1400 mL)。术后24小时记录的平均外科医生满意度(VAS 1-10)为8.3。在17/20例手术中(85%),出血控制良好(VAS 9-10),只有2例患者需要输血。没有患者出现过敏反应。术后随访期间未发现与粘接剂相关的不良事件。结论:黏附式STARSIL®止血钳在NSS术中缝合肿瘤床安全、可行、使用方便。它有可能减少RPN患者的失血量和输血率。关键字
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引用次数: 1
KIT and PDGFRA inhibitor avapritinib (BLU-285) overcomes ABCB1- and ABCBG2-mediated MDR in cancer cells KIT和PDGFRA抑制剂avapritinib (BLU-285)克服ABCB1-和abcbg2介导的肿瘤细胞耐药
Pub Date : 2019-09-20 DOI: 10.31083/J.JMCM.2019.03.0301
Pranav Gupta, Yunali V. Ashar, Q. Teng, Z. Lei, Bryan Chen, Sandra E. Reznik, J. Wurpel, Zhe-Sheng, Chen
The development of multidrug resistance (MDR) due to the overexpression of ATP-binding cassette (ABC) transporters remains one of the major obstacles to the success of chemotherapy in clinics. It is of paramount importance to identify novel drug combinations that could inhibit the multidrug efflux of ABC transporters and enhance the chemo-sensitivity of substrate anticancer drugs. In this study, we evaluated avapritinib, a KIT and PDGFRA blocker, for its reversal effects on the drug sensitivity of ABCB1 and ABCG2 overexpressing cells. Our results show that avapritinib significantly enhanced the cytotoxicity of the substrates of both ABCB1 and ABCG2. Mechanistic studies revealed that avapritinib enhances the intracellular accumulation of the substrates of ABCB1 or ABCG2 by directly decreasing their efflux from the cells overexpressing ABCB1 or ABCG2. Moreover, avapritinib did not change the expressional levels or translocation of ABCB1 or ABCG2 protein from the cell membrane to the cytoplasm and stimulates the ATP cleaving activity of both ABCB1 and ABCG2. Taken together, our results open new avenues for the use of avapritinib as cancer chemotherapy, when used in combination with the substrates of ABCB1 or ABCG2.
由于atp结合盒(ABC)转运体的过度表达而导致的多药耐药(MDR)的发展仍然是临床上化疗成功的主要障碍之一。寻找能够抑制ABC转运体多药外排并增强底物抗癌药物化学敏感性的新药物组合至关重要。在本研究中,我们评估了KIT和PDGFRA阻滞剂avapritinib对ABCB1和ABCG2过表达细胞的药物敏感性的逆转作用。我们的研究结果表明,阿伐替尼显著增强ABCB1和ABCG2底物的细胞毒性。机制研究表明,阿伐替尼通过直接减少ABCB1或ABCG2过表达细胞的外排来增强ABCB1或ABCG2底物在细胞内的积累。此外,阿伐替尼不改变ABCB1或ABCG2蛋白从细胞膜到细胞质的表达水平或易位,并刺激ABCB1和ABCG2的ATP切割活性。综上所述,我们的研究结果为阿伐替尼与ABCB1或ABCG2底物联合使用作为癌症化疗开辟了新的途径。
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引用次数: 0
Retinoids offer new and promising cancer therapeutic avenues 类维生素a提供了新的和有前途的癌症治疗途径
Pub Date : 2019-04-20 DOI: 10.31083/j.jmcm.2019.02.9161
Xin Cao, Quanlin An, Y. Assaraf, Xiangdong Wang
All trans-retinoic acid (ATRA) as well as several key retinoids including tamibarotene, acyclic retinoid (ACR), and WYC-209, have made a major progress in both preclinical cancer therapeutics as well as in the clinical setting regarding the treatment of leukemia and solid tumors via their important impacts on cancer stem cell differentiation or apoptosis. ATRA exerts its antitumor activity by binding to retinoic acid receptors, which in turn specifically bind to DNA as a heterodimer with the retinoid X receptors, at promoter regions known as retinoic acid response elements. The impressive new studies and clinical achievements with retinoids as key pre-clinical research tools and antitumor agents, are summarized and discussed in the current paper. The ongoing clinical trial of tamibarotene, which is the first agent targeting super-enhancers-containing cancers, could provide a new treatment modality for acute myeloid leukemia patients. A recent clinical study for evaluation of the preventive effects of ACR on second primary hepatocellular carcinoma (HCC) demonstrated that the oral administration of ACR for 12 months, significantly reduced HCC recurrence. WYC-209 strongly inhibited cell proliferation of different tumor repopulating cells (TRCs), a highly tumorigenic subpopulation of mouse melanoma cells, and also blocked > 80% of B16 TRCs' lung metastases in wild-type C57BL/6 mice, without any apparent toxicity. These remarkable findings reveal that retinoids constitute a promising class of antitumor agents for the treatment of both hematological malignancies and solid tumors. Keywords
所有反式维甲酸(ATRA)以及包括他米巴罗汀、无环类维甲酸(ACR)和WYC-209在内的几种关键类维甲酸通过对癌症干细胞分化或凋亡的重要影响,在白血病和实体肿瘤的临床前治疗和临床治疗中取得了重大进展。ATRA通过与视黄酸受体结合发挥其抗肿瘤活性,而视黄酸受体又在称为视黄酸反应元件的启动子区域特异性地以异二聚体的形式与类视黄酸X受体结合DNA。本文对以类维生素a为主要临床前研究工具和抗肿瘤药物的最新研究和临床成果进行了总结和讨论。tamibarotene是首个针对含有超级增强剂的癌症的药物,正在进行的临床试验可能为急性髓系白血病患者提供一种新的治疗方式。最近一项评估ACR对第二原发性肝细胞癌(HCC)预防作用的临床研究表明,口服ACR 12个月可显著减少HCC复发。WYC-209强烈抑制不同肿瘤再生细胞(TRCs)的细胞增殖,TRCs是小鼠黑色素瘤细胞的高致瘤性亚群,并且在野生型C57BL/6小鼠中阻断B16 TRCs肺转移的bbb80 %,无明显毒性。这些显著的发现表明,类维甲酸是治疗血液系统恶性肿瘤和实体肿瘤的有前途的一类抗肿瘤药物。关键字
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引用次数: 4
The role of developmental signaling pathways in non-small cell lung carcinoma 发育信号通路在非小细胞肺癌中的作用
Pub Date : 2019-04-20 DOI: 10.31083/j.jmcm.2019.02.151
Darko Durovski, O. Randazzo, G. Peters, E. Giovannetti
Darko Durovski1,2, Ornella Randazzo1,5, Godefridus J. Peters1,3 and Elisa Giovannetti1,4,∗ 1Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, VU University, Amsterdam 1081HV, The Netherlands 2Amsterdam University College, Amsterdam 1098XG, The Netherlands 3Department of Biochemistry, Medical University of Gdansk, Gdansk 80-4161, Poland 4Cancer Pharmacology Lab, AIRC Start Up Unit, Fondazione Pisana per la Scienza, Pisa 56017, Italy 5Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo 90123, Italy
Darko Durovski1,2, Ornella Randazzo1,5, Godefridus J. Peters1,3, Elisa giovvannetti1, 1荷兰阿姆斯特丹UMC自由大学阿姆斯特丹癌症中心肿瘤内科学系,阿姆斯特丹1081HV; 2荷兰阿姆斯特丹大学学院,阿姆斯特丹1098XG; 3波兰格但斯克医科大学生物化学系,格但斯克80-4161;4意大利比萨科学基金会AIRC启动单元癌症药理学实验室,比萨56017;化学与制药科学与技术(STEBICEF),意大利巴勒莫大学90123
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引用次数: 1
ALIX protein analysis: storage temperature may impair results ALIX蛋白分析:储存温度可能影响结果
Pub Date : 2019-04-20 DOI: 10.31083/j.jmcm.2019.02.7161
Lopes-Rodrigues Vanessa, P. Cristina, S. Diana, Osório Hugo, G. Yehuda, T. Raquel, M. Vasconcelos
Porto, 4099-003 Porto, Portugal 4Department of Biological Sciences, FFUP-Faculty of Pharmacy of the University of Porto, 4050-313 Porto, Portugal 5Department of Oncology, FMUP–Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal 6IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, 4200-465 Porto, Portugal 7The Fred Wyszkowski Cancer Research Laboratory, Department of Biology, Technion-Israel Institute of Technology, 3200000
4波尔图大学生物科学系,波尔图大学药学院,波尔图4050-313;5波尔图大学医学院,波尔图4200-319;6波尔图大学分子病理与免疫学研究所,波尔图4200-465;7以色列理工学院生物学系Fred Wyszkowski癌症研究实验室,3200000
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引用次数: 5
Naphthol-derived Betti bases as potential SLC6A14 blockers 萘酚衍生的Betti碱作为潜在的SLC6A14阻滞剂
Pub Date : 2019-04-20 DOI: 10.31083/j.jmcm.2019.02.7181
P. Adrián, R. Alexis, A. Roderick, Demanuele Kaylie, X. F. Miguel, Bosica Giovanna, M. José
Betti bases (aminobenzylnaphthols) have not been studied extensively to explore their possible pharmacological applications. Our group prepared a small and focused library of twenty-three Betti bases from the multicomponent reaction of 2-naphthol with primary or secondary cyclic amines and representative aromatic aldehydes. The compounds were prepared in 52-90% yield using environmentally friendly procedures. The E-factor and the atom economy for our process were 3.92 and 94%, respectively. The study of the anti-proliferative activity against human solid tumor cell lines pointed out that these Betti bases represent privileged scaffolds and could be used for the development of pharmacologically-active compounds in cancer therapeutics. The 50% growth inhibitory (GI50) values of the most potent compounds were in the low micromolar range. Fourteen of these Betti bases were less active in HBL-100 breast cancer cells than towards the breast cancer cell line T-47D. A subset of these Betti bases was further tested against the human breast cancer cell lines MCF-7 and MDA-MB-453. The results indicated a correlation in the sensitivity of T-47D cells to Betti bases. We explored computationally the interaction of the Betti bases with SLC6A14, a Na+and Cl−dependent influx transporter of both neutral and cationic amino acids that is overexpressed in T-47D cells. SLC6A14 is inhibited by α -methyl-tryptophan, which blocks cell growth via deprivation of amino acid influx. The docking studies indicated that our Betti bases might behave as tryptophan mimetics, blocking this solute carrier transporter and inducing the anti-proliferative effects. Importantly, these Betti bases showed good cytotoxic selectivity towards cancer cells with no activity against normal human fibroblast cells BJhTERT.
Betti碱(氨基苯萘酚)尚未被广泛研究以探索其可能的药理应用。本课题组从2-萘酚与伯胺或仲环胺和代表性芳香醛的多组分反应中制备了一个小而集中的23个Betti碱基文库。采用环境友好的方法,以52-90%的收率制备了这些化合物。该工艺的e因子和原子经济性分别为3.92和94%。对人实体肿瘤细胞系的抗增殖活性的研究表明,这些Betti碱基是优越的支架,可用于开发具有药理活性的肿瘤治疗药物。最有效化合物的50%生长抑制(GI50)值均在低微摩尔范围内。其中14个Betti碱基在HBL-100乳腺癌细胞中的活性低于对乳腺癌细胞系T-47D的活性。这些Betti碱基的一个子集进一步测试了对人类乳腺癌细胞系MCF-7和MDA-MB-453的作用。结果表明T-47D细胞对Betti碱基的敏感性存在相关性。我们通过计算探索了Betti碱基与SLC6A14的相互作用,SLC6A14是一种在T-47D细胞中过表达的中性和阳离子氨基酸的Na+和Cl -依赖内流转运体。SLC6A14受到α -甲基色氨酸的抑制,它通过剥夺氨基酸内流来阻止细胞生长。对接研究表明,我们的Betti碱基可能具有色氨酸模拟物的作用,阻断这种溶质载体转运体并诱导其抗增殖作用。重要的是,这些Betti碱基对癌细胞表现出良好的细胞毒性选择性,而对正常的人成纤维细胞BJhTERT没有活性。
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引用次数: 12
A new LDL-masked liposomal doxorubicin overcomes drug resistance in osteosarcoma 一种新的低密度脂蛋白掩盖脂质体阿霉素克服骨肉瘤耐药
Pub Date : 2019-01-20 DOI: 10.31083/j.jmcm.2019.01.6161
Gazzano Elena, Kopecka Joanna, D.B. Carolina, C. Costanzo, R. Chiara
One of the chemotherapeutic drugs in the first-line treatment of osteosarcoma is doxorubicin (dox). However, its anticancer efficacy is limited by the overexpression of the multidrug efflux transporter P-glycoprotein (Pgp) which extrudes doxorubicin, disrupts drug accumulation and thus hinders the cytotoxic activity of dox. The drug extrusion activity of Pgp is enhanced by the presence of cholesterol within the plasma membrane. Pgp expression is up-regulated by multiple transcription factors including hypoxia inducible factor-1α (HIF-1α). Decreasing Pgp expression and drug efflux activity may enhance the efficacy of doxorubicin against drug resistant osteosarcoma. To achieve this goal, we treated two human dox-sensitive cell lines (U-2OS and Saos-2), and their sublines displaying increasing Pgp levels and dox resistance, with a non-toxic dose of atorvastatin. This statin was able to decrease the biosynthesis of farnesyl pyrophosphate (FPP) and cholesterol, two key metabolites that were markedly increased in drug resistant sublines. By reducing the FPP levels, atorvastatin decreased the Ras/ERK1/2/HIF-1α axis and down-regulated Pgp expression. Moreover, by decreasing cholesterol biosynthesis atorvastatin increased the levels of low density lipoprotein receptor (LDLR), that was also progressively increased in the dox-resistant sublines. Taking advantage of this findings, we treated dox-resistant osteosarcoma with atorvastatin followed by treatment with dox encapsulated in liposomes decorated with an LDLRbinding peptide, hence facilitating binding to, and endocytosis via LDLR. This treatment strategy induced high retention of dox in dox-resistant cells, reduced cell viability in vitro and displayed growth inhibition of dox-resistance in mouse xenograft model. Hence, we propose the combination of statins plus LDL-decorated liposomal dox as a novel treatment strategy for Pgp-expressing multidrug resistant osteosarcomas.
阿霉素(dox)是一线治疗骨肉瘤的化疗药物之一。然而,其抗癌功效受到多药外排转运蛋白p -糖蛋白(Pgp)的过度表达的限制,Pgp挤压阿霉素,破坏药物积累,从而阻碍阿霉素的细胞毒性活性。Pgp的药物挤压活性因存在于质膜内的胆固醇而增强。Pgp的表达被包括缺氧诱导因子-1α (HIF-1α)在内的多种转录因子上调。降低Pgp表达和药物外排活性可能会提高阿霉素治疗耐药骨肉瘤的疗效。为了实现这一目标,我们用无毒剂量的阿托伐他汀处理了两种人类dox敏感细胞系(U-2OS和Saos-2),它们的亚系显示Pgp水平增加和dox抗性。这种他汀类药物能够减少法尼酯焦磷酸(FPP)和胆固醇的生物合成,这两种关键代谢物在耐药亚群中显着增加。通过降低FPP水平,阿托伐他汀降低Ras/ERK1/2/HIF-1α轴,下调Pgp表达。此外,通过降低胆固醇的生物合成,阿托伐他汀增加了低密度脂蛋白受体(LDLR)的水平,这在犬抗药亚群中也逐渐增加。利用这一发现,我们用阿托伐他汀治疗dox-resistant osteosarcoma,然后用包裹有LDLRbinding peptide修饰的脂质体治疗dox,从而促进与LDLR的结合和通过LDLR的内吞作用。该处理策略诱导dox在dox耐药细胞中高度保留,降低了体外细胞活力,并在小鼠异种移植模型中显示出对dox耐药的生长抑制。因此,我们提出他汀类药物加ldl修饰脂质体dox作为表达pgp的多药耐药骨肉瘤的新治疗策略。
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引用次数: 0
Cryoablation for recurrent renal tumors after primary nephron-sparing surgery using an innovative liquid nitrogen-based cryogenic device 采用创新的液氮低温装置对原发性肾保留手术后复发性肾肿瘤进行冷冻消融
Pub Date : 2019-01-20 DOI: 10.31083/j.jmcm.2019.01.7261
Shprits Sagi, S. Robert, Croitoru Simona, Dorfman Karina, Avitan Ofir, B. Zaher, Zisman Amnon, Nativ Ofer
The growing use and improvement of imaging modalities has resulted in increased detection of renal tumors. The gold standard treatment of small renal masses is nephronsparing surgery. Such surgical intervention is associated with significant rate of local failure. The currently accepted treatment for local failure after nephron-sparing surgery is radical nephrectomy which is associated with very high complication rate as well as loss of functional renal parenchyma. The aim of the current study was to evaluate the safety, technical feasibility, oncologic success and functional preservation of percutaneous cryoablation using a new liquid nitrogen-based cryogenic device in patients with tumor recurrence after nephron-sparing surgery. We present seven patients with tumor recurrence after nephron-sparing surgery who underwent percutaneous cryoablation using ProSenseTM (IceCure Medical Ltd, Caesarea, Israel) under computerized tomography guidance. None of the treated tumor lesions demonstrated contrast enhancement or growth on follow up imaging indicating a 100% oncologic success. Only three adverse events were recorded, all were classified as low grade and resolved spontaneously. In conclusion, percutaneous cryoablation using the novel ProSenseTM device for recurrent renal tumors following nephron-sparing surgery is feasible and effective, with excellent renal function preservation and without major complications.
越来越多的使用和改进的成像方式导致肾脏肿瘤的检测增加。小肾肿块的金标准治疗是肾保留手术。这种手术干预与显著的局部失败率相关。对于保留肾的手术后局部衰竭,目前公认的治疗方法是根治性肾切除术,但根治性肾切除术的并发症发生率很高,并伴有功能性肾实质的丧失。本研究的目的是评估一种新型液氮低温装置在肾保留手术后肿瘤复发患者中经皮冷冻消融的安全性、技术可行性、肿瘤学成功和功能保存。我们报告了7例肾保留手术后肿瘤复发的患者,他们在计算机断层扫描指导下使用ProSenseTM (IceCure Medical Ltd, Caesarea, Israel)进行经皮冷冻消融。治疗后的肿瘤病变均未在随访影像中显示造影剂增强或生长,这表明肿瘤治疗100%成功。仅记录了3例不良事件,均为低级别并自行消退。综上所述,新型ProSenseTM装置经皮冷冻消融治疗肾肿瘤保留肾单位手术后复发是可行和有效的,具有良好的肾功能保存和无重大并发症。
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Journal of molecular medicine and clinical applications
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