中药复方BBYNG对乳腺癌骨转移小鼠的作用观察

目的透过对中药复方BBYNG与西药双磷酸盐OSTAC的动物实验研究,观察中药治疗骨转移的疗效。方法参照文献建立高发骨转移的小鼠乳腺癌动物模型后,分别对不同组别的荷瘤小鼠灌喂相当于临床病人服用剂量的BBYNG或OSTAC,对比观察荷瘤小鼠的肿瘤生长、活动状态、生存时间、骨转移及骨破坏的程度等。结果BBYNG可减慢荷瘤小鼠的肿瘤生长,但不能显著缩小肿瘤的体积;可减轻肿瘤骨转移引起的活动障碍和骨破坏,延长生存时间。此结果与作者已进行的临床观察结果相似。结论BBYNG有减轻动物模型肿瘤引起的骨转移和骨破坏、延长荷瘤小鼠生存时间的作用;值得推广应用及开展用于预防肿瘤骨转移的探讨,并深化对其作用机理的研究。     

骨髓脂肪组织调控癌细胞骨转移作用机制研究进展

70%～80%晚期乳腺癌、前列腺癌患者会发生癌细胞骨转移,继而导致骨质疏松等溶骨性或成骨性病症。癌细胞骨转移需要经历四个阶段——定植、休眠、再活化、增殖与侵袭,但骨转移的发生机制尚不完全清楚,相关研究集中在癌细胞与骨微环境的相互作用机制。骨髓脂肪组织(bone marrow adipose tissue,BMAT)是近来的一个研究热点,对循环癌细胞有着高吸引力。BMAT通过旁分泌形式调控癌细胞骨转移,促进其定植、能量代谢等病理生理进程,并通过调控骨吸收与微血管生成间接影响休眠癌细胞的再活化与增殖,促进骨转移"恶性循环"。乳腺癌与前列腺癌在骨转移进程前期具有相似机制,因此该综述以乳腺癌、前列腺癌骨转移为切入点,梳理癌细胞骨转移发生机制,整理归纳BMAT对骨转移的调控机制,旨在为癌细胞骨转移发生机制及临床治疗提供新的思路。     

乳腺癌双膦酸盐辅助治疗临床研究进展

乳腺癌是女性发病率和死亡率最高的恶性肿瘤,复发和远处转移仍是导致患者死亡的首位原因,而双膦酸盐作为一种骨质吸收抑制剂,能够抑制破骨细胞介导的骨质吸收,在多种实体肿瘤骨转移及多发性骨髓瘤等恶性疾病所致的骨相关事件治疗中起重要作用。近年来大量体外、体内实验表明双膦酸盐还具有抑制肿瘤细胞生长、粘附、播散和侵润,降低肿瘤细胞膜稳定性、促进肿瘤细胞凋亡等直接抗肿瘤作用以及抑制肿瘤血管生成、激活免疫细胞对肿瘤细胞的杀伤等间接抗肿瘤作用,基于这些基础研究结果已经开展了一系列针对双膦酸盐辅助治疗乳腺癌的临床试验研究,本文就近年相关临床试验研究进展做简要综述。     

微流控芯片在乳腺癌骨转移研究中的应用

乳腺癌骨转移患者死亡率高达70%～80%,目前缺乏有效的治疗药物.微流控芯片技术能够有效模拟骨组织的生化和生物物理微环境,便捷地实现模拟骨微环境中乳腺癌骨转移的研究,这将为探索乳腺癌骨转移的细胞和分子机制、进而进行抗乳腺癌骨转移药物高通量筛选提供有价值的技术方法和平台.本综述简要介绍了乳腺癌骨转移的分子机制和治疗药物研究现状,详细阐述了乳腺癌骨转移的微流控芯片模型,分析了基于微流控芯片技术进行抗乳腺癌骨转移药物高通量筛选的优势和挑战,旨在为乳腺癌骨转移机制研究和药物筛选提供参考.     

DLC1在肿瘤进程中的新角色

原发肿瘤向重要器官,如骨、肺、脑、肝等的转移是恶性肿瘤患者死亡的主要原因。对于女性而言,乳腺癌是发病率较高的一类恶性肿瘤。早期乳腺癌通过合理治疗可实现根治,但晚期会发生原位癌向多器官的转移。其中,大约70%的晚期乳腺癌会发生骨转移。在乳腺癌骨转移过程中,转化生长因子β(TGFβ)-甲状旁腺激素样激素(PTHLH)通路发挥着关键性的调控作用,但对这一通路活性本身受哪些因子的影响方面现在知之甚少。因此,中国科学院上海生命科学研究院健康科学研究所胡国宏课题组利用多种肿瘤转移模型,探索影响TGFβ-PTHLH通路活性的因素,最终发现DLC1在乳腺癌骨转移过程中起关键性的负调控作用。DLC1功能的行使依赖于它失活RHO-ROCK通路,继而抑制TGFβ诱导的SMAD3连接区磷酸化。DLC1对后者的抑制降低了TGFβ诱导的PTHLH的转录和分泌,从而减少了骨转移微环境中的成熟破骨细胞,最终阻碍了乳腺癌的破骨性转移。该项研究首次证明DLC1-RHO信号通路在调控乳腺癌骨转移微环境中具有重要作用,也为临床上治疗乳腺癌骨转移提供了新思路。     

探究靶向FTO下调的miRNA及其对乳腺癌细胞生物学行为的调节

该文筛选了靶向抑制FTO的miRNA并探究其乳腺癌细胞生物学行为的影响。通过生物信息学的方法筛选出了影响乳腺癌患者生存的m6A去甲基化酶FTO后,再通过CCK-8实验验证了FTO的下调能够抑制乳腺癌细胞的增殖,随后预测出靶向FTO的miRNA—miR-504-5p,RT-qPCR和Western blot实验检测了乳腺癌细胞MCF-7和MDA-MB-231中miRNA-504-5p对FTO表达水平的影响,双荧光素酶报告基因实验验证了miRNA-504-5p与FTO的结合关系,采用CCK-8、Transwell小室实验、流式细胞术等探究了miRNA-504-5p mimic(类似物)通过调控FTO对乳腺癌细胞增殖、迁移、凋亡和细胞周期的影响。实验结果表明,低表达FTO的乳腺癌患者相较于高表达FTO的乳腺癌患者具有更高的生存概率,miRNA-504-5p作为潜在的靶向FTO的miRNA,能够在mRNA与蛋白水平抑制FTO的表达,并且miR-504-5p在FTO 3'-UTR的5 927–5 933位点处与FTO靶向结合,miR-504-5p能通过下调FTO抑制乳腺癌细胞的增殖与迁移并促进乳腺癌细胞的凋亡,使细胞阻滞在G_0/G_1期。综上所述,该研究发现了miR-504-5p能下调FTO的表达,抑制乳腺癌细胞的增殖与迁移,促进乳腺癌细胞的凋亡,使乳腺癌细胞的细胞周期阻滞。这可以为乳腺癌的分子机制探究与治疗提供潜在的参考价值。     

乳腺癌双膦酸盐辅助治疗临床研究进展

乳腺癌是女性发病率和死亡率最高的恶性肿瘤,复发和远处转移仍是导致患者死亡的首位原因,而双膦酸盐作为一种骨质吸收抑制剂,能够抑制破骨细胞介导的骨质吸收,在多种实体肿瘤骨转移及多发性骨髓瘤等恶性疾病所致的骨相关事件治疗中起重要作用。近年来大量体外、体内实验表明双膦酸盐还具有抑制肿瘤细胞生长、粘附、播散和侵润,降低肿瘤细胞膜稳定性、促进肿瘤细胞凋亡等直接抗肿瘤作用以及抑制肿瘤血管生成、激活免疫细胞对肿瘤细胞的杀伤等间接抗肿瘤作用,基于这些基础研究结果已经开展了一系列针对双膦酸盐辅助治疗乳腺癌的,陆床试验研究,本文就近年相关临床试验研究进展做简要综述。     

肿瘤骨转移动物模型研究进展

骨转移是乳腺癌、前列腺癌及肺癌等肿瘤的常见并发症,是预后不良的独立危险因素。肿瘤骨转移动物模型是研究骨转移发生机制及评价治疗策略的重要工具。现对骨转移动物模型的研究进展进行综述。     

骨唾液酸蛋白在乳腺癌骨转移中的研究进展

骨唾液酸蛋白（Bonesialoprotein,BSP）是细胞外基质中一种高度磷酸化和糖基化分泌性蛋白,它是多种癌症（乳腺癌,前列腺癌和肺癌等）进程中的重要参与者。乳腺癌细胞转染实验和裸鼠移植模型证明过表达BSP可以促进乳腺癌细胞骨转移。BSP抗体和反义核酸均可有效抑制乳腺癌细胞骨转移的发生,故BSP有可能成为一种新的诊断和治疗乳腺癌骨转移的靶蛋白。     

骨唾液酸蛋白基因沉默抑制乳腺癌细胞与骨基质粘附

旨在探索骨唾液酸蛋白 (Bone sialoprotein,BSP) 基因沉默对亲骨转移乳腺癌细胞 (MDA-MB-231BO) 与骨基质粘附能力的影响,为以BSP为靶点的乳腺癌骨转移预防和靶向治疗提供实验依据。体外检测BSP基因沉默对乳腺癌细胞与小鼠骨基质粘附能力的影响,MTS法检测细胞增殖能力;扫描电镜观察骨片表面肿瘤细胞粘附情况和骨吸收状况;ELISA法检测骨基质细胞粘附培养上清中TGF-β1和RANKL表达分泌量差异;左心室注射法构建裸鼠骨转移模型,检测不同细胞株在裸鼠体内转移能力。结果提示BSP     

Osteoblasts suppress high bone turnover caused by osteolytic breast cancer in-vitro

The skeleton is the most common site of breast cancer metastasis, which can occur in up to 85% of patients during their lifetime. The morbidity associated with bone metastases in patients with breast cancer includes pathological fractures, bone pain, hypercalcaemia, and spinal cord compression. When breast cancer metastasizes to bone, the balance of bone resorption (mediated by osteoclasts) and bone formation (mediated by osteoblasts) favors bone resorption, which leads to net bone destruction (i.e., osteolysis). Anti-resorptive agents such as bisphosphonates are commonly used to treat bone resorption in osteoporosis or osteolytic cancer patients. However, bisphosphonates by themselves are unable to rebuild lost bone tissue, and can cause severe side effects. In this study, we developed a bovine bone explant culture system and have observed that murine osteoblasts can modulate the activity of osteotropic human breast cancer cells on this substrate. Using markers of bone metabolism, we observe diminished bone turnover in organ culture following the addition of exogenous osteoblasts. The data presented in this study supports further investigation into the use of cytotherapies to limit breast cancer mediated osteolysis.     

Clinical usefulness of bisphosphonates in oncology: treatment of bone metastases, antitumoral activity and effect on bone resorption markers

The present article overviews the role of bisphosphonates for the treatment and prevention of bone metastases and their antiangiogenic effects and antitumoral activity. The skeleton is a frequent and clinically relevant site of metastasis in cancer patients. The major events related to bone metastases include bone pain, bone loss, hypercalcemia, spinal cord compression, and fractures. On the basis of their radiographic features, bone metastases are classified as osteoblastic, osteoclastic, or mixed. The primary goals of treatment of bone metastases are reduction of the risk of pathological fractures and other skeletal-related events, and pain control. Bisphosphonates are used to prevent pathological fractures by inhibition of osteoclasts. Recent studies suggest that bisphosphonates have some direct antitumoral activity, mainly mediated through the blockade of angiogenic pathways. Further clinical studies are needed to determine the optimal treatment duration, timing and schedule of bisphosphonates, assess their role as adjuvant therapy for the prevention of bone metastases, and establish their antiangiogenic activity in association with standard cytotoxic and hormonal drugs for treatment of patients with advanced disease.     

Modelling Circulating Tumour Cells for Personalised Survival Prediction in Metastatic Breast Cancer

Ductal carcinoma is one of the most common cancers among women, and the main cause of death is the formation of metastases. The development of metastases is caused by cancer cells that migrate from the primary tumour site (the mammary duct) through the blood vessels and extravasating they initiate metastasis. Here, we propose a multi-compartment model which mimics the dynamics of tumoural cells in the mammary duct, in the circulatory system and in the bone. Through a branching process model, we describe the relation between the survival times and the four markers mainly involved in metastatic breast cancer (EPCAM, CD47, CD44 and MET). In particular, the model takes into account the gene expression profile of circulating tumour cells to predict personalised survival probability. We also include the administration of drugs as bisphosphonates, which reduce the formation of circulating tumour cells and their survival in the blood vessels, in order to analyse the dynamic changes induced by the therapy.We analyse the effects of circulating tumour cells on the progression of the disease providing a quantitative measure of the cell driver mutations needed for invading the bone tissue. Our model allows to design intervention scenarios that alter the patient-specific survival probability by modifying the populations of circulating tumour cells and it could be extended to other cancer metastasis dynamics.     

Stimulation of host bone marrow stromal cells by sympathetic nerves promotes breast cancer bone metastasis in mice

Bone and lung metastases are responsible for the majority of deaths in patients with breast cancer. Following treatment of the primary cancer, emotional and psychosocial factors within this population precipitate time to recurrence and death, however the underlying mechanism(s) remain unclear. Using a mouse model of bone metastasis, we provide experimental evidence that activation of the sympathetic nervous system, which is one of many pathophysiological consequences of severe stress and depression, promotes MDA-231 breast cancer cell colonization of bone via a neurohormonal effect on the host bone marrow stroma. We demonstrate that induction of RANKL expression in bone marrow osteoblasts, following β2AR stimulation, increases the migration of metastatic MDA-231 cells in vitro, independently of SDF1-CXCR4 signaling. We also show that the stimulatory effect of endogenous (chronic stress) or pharmacologic sympathetic activation on breast cancer bone metastasis in vivo can be blocked with the β-blocker propranolol, and by knockdown of RANK expression in MDA-231 cells. These findings indicate that RANKL promotes breast cancer cell metastasis to bone via its pro-migratory effect on breast cancer cells, independently of its effect on bone turnover. The emerging clinical implication, supported by recent epidemiological studies, is that βAR-blockers and drugs interfering with RANKL signaling, such as Denosumab, could increase patient survival if used as adjuvant therapy to inhibit both the early colonization of bone by metastatic breast cancer cells and the initiation of the "vicious cycle" of bone destruction induced by these cells.     

Targeted overexpression of BSP in osteoclasts promotes bone metastasis of breast cancer cells

Bone is one of the most common sites of breast cancer metastasis while bone sialoprotein (BSP) is thought to play an important role in bone metastasis of malignant tumors. The objective of this study is to determine the role of BSP overexpression in osteolytic metastasis using two homozygous transgenic mouse lines in which BSP expression is elevated either in all the tissues (CMV-BSP mice) or only in the osteoclasts (CtpsK-BSP mice). The results showed that skeletal as well as systemic metastases of 4T1 murine breast cancer cells were dramatically increased in CMV-BSP mice. In CtpsK-BSP mice, it was found that targeted BSP overexpression in osteoclasts promoted in vitro osteoclastogenesis and activated osteoclastic differentiation markers such as Cathepsin K, TRAP and NFAT2. MicroCT scan demonstrated that CtpsK/BSP mice had reduced trabecular bone volume and bone mineral density (BMD). The real-time IVIS Imaging System showed that targeted BSP overexpression in osteoclasts promoted bone metastasis of breast cancer cells. The osteolytic lesion area was significantly larger in CtpsK/BSP mice than in the controls as demonstrated by both radiographic and histomorphometric analyses. TRAP staining demonstrated a twofold increase in the number of osteoclasts in the bone lesion area from CtpsK/BSP mice compared with that from wild type mice. We conclude that host tissue-derived BSP also plays important roles in breast cancer metastasis through inducing tumor cell seeding into the remote host tissues. Furthermore, osteoclast-derived BSP promotes osteoclast differentiation in an autocrine manner and consequently promotes osteolytic bone metastasis of breast cancer.     

Pamidronate in the treatment of bone metastases from breast cancer

Bone metastases afflict over 70% of patients with advanced breast cancer, resulting in impaired quality of life and significant clinical problems. Until appearance of the bisphosphonates there was no specific therapeutic treatment available to manage the symptoms of osteolytic bone metastases. Bisphosphonates are stable chemical analogues of pyrophosphate, and inhibit osteoclast-mediated bone resorption, the treatment is effective in reducing skeletal morbidity in breast cancer with fewer skeletal related events, reduced pain and analgesic consumption, and improved quality of life. As a result, bisphosphonates should now be part of the routine management of metastatic bone disease and multiple myeloma. Promising data have resulted in considerable interest in the possible adjuvant use of bisphosphonates. Pamidronate is an easy to use potent inhibitor of osteolysis, given in conjunction with standard anticancer therapies effectively relieves bone pain and improves performance status. Monthly pamidronate infusions for one or two years in addition to standard anticancer therapy reduce by more than one third the yearly frequency of skeletal-related events. The authors report their practice in which 119 breast cancer patients metastatic to bone received 90-120 mg pamidronate infusion/cycle in addition to standard breast cancer therapy every 3-4 weeks.