溶瘤腺病毒治疗肿瘤的研究进展

溶瘤腺病毒是一种改造过的能够选择性地在肿瘤细胞中复制,并能够杀死肿瘤细胞的腺病毒,目前已经应用于肿瘤治疗中。但是因为肿瘤的复杂性以及高突变性,所以提高溶瘤腺病毒对肿瘤的有效性,选择性和安全性成为了主要的研究方向。能够在体内正常表达shRNA、细胞因子、自杀基因、基质修饰蛋白等治疗性基因的溶瘤腺病毒具有比单纯的溶瘤腺病毒更强的抗肿瘤活性。而具有肿瘤特异性启动子,尤其是双调控启动子的溶瘤腺病毒对肿瘤细胞具有更强的选择性杀伤作用。另外用脂质体、PEG聚合物、纳米颗粒、多肽等包裹的溶瘤腺病毒能够减少病毒的免疫原性以及对肝脏的毒性,增强了全身给药途径的抗肿瘤活性。特别是用PEG连上抗体、小肽、细胞因子和配体,能显著提高溶瘤腺病毒的选择性。因此,整合病毒载体与非病毒载体的优点并与免疫治疗相结合,是一个很有希望的提高病毒靶向治疗效果的策略。     

增殖型腺病毒的改良及应用

增殖型腺病毒能在肿瘤细胞中复制并裂解肿瘤细胞,释放出的子代病毒再感染邻近肿瘤细胞直至完全杀灭肿瘤,却不影响正常细胞的功能。同时,增殖型腺病毒还是一种有效的基因治疗载体,可通过病毒自身增殖提高目的基因的拷贝数,从而更高效率地表达外源性治疗基因,增强抗肿瘤效应。本文着重介绍增殖型腺病毒载体改良和应用的最新进展,并对其研究前景进行展望,以期对增殖型腺病毒的发展有所帮助。     

肿瘤自杀基因治疗中的“旁观者效应”

肿瘤自杀基因治疗中的“旁观者效应”伍志坚（第一军医大学生物化学教研室,广州５１０５１５）关键词旁观者效应自杀基因基因治疗在肿瘤的基因治疗研究中,将“自杀基因（ｓｕｉｃｉｄｅｇｅｎｅ）”导入肿瘤细胞以激活自杀机制的策略占有重要地位。这类自杀基因包括单纯...     

表达双功能融合蛋白（sCAR-EGF）腺病毒载体的构建及其活性检测

为了提高腺病毒载体用于基因治疗的靶向性,采用PCR和体外连接的方法构建了柯萨奇病毒-腺病毒受体(Coxsackievirus-AdenovirusReceptor)胞外段sCAR和表皮生长因子(Epidermalgrowthfactor)EGF融合基因,然后将此融合基因插入穿梭质粒pDC315。利用Ad-MAX腺病毒系统,将重组质粒pDC315-sCAR-EGF与腺病毒骨架质粒pBHGloxΔE13cre共同转染AD-293细胞,成功包装出一种复制缺陷型腺病毒Ad5-CMV-sCAR-EGF。经PCR鉴定该病毒含有sCAR-EGF融合基因片段,Westernblotting证实该病毒能表达sCAR-EGF融合蛋白。体外试验证实该病毒感染细胞所产生的融合蛋白能够引导携带报告基因的腺病毒Ad5-CMV-luc高水平感染肿瘤细胞,为高水平表达EGFR的肿瘤的靶向性基因治疗提供了新的手段。     

构建溶瘤腺病毒的策略

溶瘤腺病毒是通过遗传工程改造的腺病毒,具有溶细胞复制周期的特性和特异靶向肿瘤细胞和裂解肿瘤细胞的功能。溶瘤腺病毒通过复制、释放子代病毒感染邻近肿瘤细胞。现在对腺病毒生活周期的认识水平,可以对其基因组进行改造从而使其特异性裂解肿瘤细胞而不杀伤正常细胞,并且构建了多种溶瘤腺病毒。本文主要概述了溶瘤腺病毒的三种构建策略:剔除腺病毒在正常细胞中复制所必需而在肿瘤细胞中不需要的某些基因;利用肿瘤特异性启动子控制病毒复制所必需的基因;对腺病毒衣壳蛋白进行基因修饰,达到特异性结合肿瘤细胞的目的。     

腺病毒载体在肿瘤靶向性基因治疗中的应用

近年来,腺病毒载体广泛应用于恶性肿瘤的靶向性基因治疗。对传统腺病毒载体的改造主要有以下策略：(1)通过改变腺病毒的嗜性(tropism),使之具有感染宿主细胞的靶向性;(2)在转录水平控制外源性基因的表达;(3)可选择性裂解肿瘤细胞的有复制能力的腺病毒(replication-competent adenovirus,RCA)。更多安全、高效的靶向性腺病毒载体将应用于肿瘤基因治疗中。     

条件复制腺病毒的构建

条件复制腺病毒是针对第一代复制缺陷型腺病毒在临床应用中存在的问题而构建的能在肿瘤细胞特异复制的基因治疗载体。该从其构建机制、构建方式及效力评价等方面论述了为实现特异性高效复制所应考虑的诸多方面的问题,如特异性启动子的选择,基因重组方案的设计,以及相应的效力评价体系的构建等。     

溶瘤腺病毒在肿瘤靶向治疗中的研究进展

溶瘤腺病毒是一组通过基因工程构建的腺病毒、能够选择性在肿瘤细胞中完成感染-复制周期,从而特异性地杀伤、溶解肿瘤而不伤及其他正常细胞、组织,其作用机制包括:通过基因的缺失突变、插入特异性启动子、以及通过病毒结构蛋白的修饰等方面,实现肿瘤靶向治疗作用。本文就相关研究及进展进行综述。     

E1/E3缺失型腺病毒载体引起细胞周期G_2/M阻滞

腺病毒载体广泛应用于基因治疗和转基因研究 ,目前常用的E1 E3缺失型复制缺陷腺病毒载体虽然失去了病毒复制必需的E1基因 ,但载体上的其它病毒基因仍能在宿主细胞内表达 .为研究这些基因对细胞的毒性作用 ,选择了 3种携带没有明显细胞毒性外源基因的腺病毒载体 ,观察感染 2种肿瘤细胞后细胞核形态改变 ,并用流式细胞仪检测细胞周期及凋亡情况 .发现大剂量重组缺陷型腺病毒感染细胞后引起细胞变圆 ,核增大 ,细胞周期阻滞于G2 M期 ,继而染色质凝聚 ,细胞发生坏死或凋亡 ;各种腺病毒载体造成G2 M阻滞所需感染量不同 ,但都随时间延长和感染量增加而加重 .这些结果提示腺病毒基因对细胞的影响是多方面的 ,在以此类病毒载体进行基因转移和基因治疗的研究中 ,精确滴定病毒滴度和转导效率非常重要 ,腺病毒基因表达造成的毒副作用给此类研究增加了变数     

溶瘤腺病毒在肿瘤靶向治疗中的研究进展

溶瘤腺病毒是一组通过基因工程构建的腺病毒、能够选择性在肿瘤细胞中完成感染-复制周期,从而特异性地杀伤、溶解肿瘤而不伤及其他正常细胞、组织,其作用机制包括：通过基因的缺失突变、插入特异性启动子、以及通过病毒结构蛋白的修饰等方面,实现肿瘤靶向治疗作用。本文就相关研究及进展进行综述。     

肿瘤基因治疗的研究进展

肿瘤是严重影响人类身体健康的重大疾病之一,肿瘤的发生发展是一个复杂的涉及到众多基因的过程,肿瘤的基因治疗也已经成为肿瘤治疗的研究热点之一。目前,肿瘤基因治疗的策略主要包括以下几个方面:基因沉默治疗、抑癌基因治疗、免疫基因治疗、自杀基因疗法、抑制肿瘤血管生成基因治疗、肿瘤多药耐药基因治疗、抗端粒酶疗法和多基因联合疗法等。我们简要地对上述策略及相关研究进展进行综述。     

Gene therapy in cancer

Gene therapy, recently frequently investigated, is an alternative treatment method that introduces therapeutic genes into a cancer cell or tissue to cause cell death or slow down the growth of the cancer. This treatment has various strategies such as therapeutic gene activation or silencing of unwanted or defective genes; therefore a wide variety of genes and viral or nonviral vectors are being used in studies. Gene therapy strategies in cancer can be classified as inhibition of oncogene activation, activation of tumor suppressor gene, immunotherapy, suicide gene therapy and antiangiogenic gene therapy. In this review, we explain gene therapy, gene therapy strategies in cancer, approved gene medicines for cancer treatment and future of gene therapy in cancer. Today gene therapy has not yet reached the level of replacing conventional therapies. However, with a better understanding of the mechanism of cancer to determine the right treatment and target, in the future gene therapy, used as monotherapy or in combination with another existing treatment options, is likely to be used as a new medical procedure that will make cancer a controllable disease.     

胃癌的基因治疗进展

基因治疗是近年来治疗肿瘤的新方法,因治疗策略的不同而发展为2个分支:一是分子肿瘤治疗,包括肿瘤抑制基因治疗、自杀基因治疗、反义基因治疗、抑制肿瘤血管形成的治疗、免疫基因治疗;二是virotherapy。简要综述了肿瘤基因治疗的各种方法及其在胃癌治疗中的应用和发展前景。     

Therapeutic genes for cancer gene therapy

Cancer still represents a disease of high incidence and is therefore one major target for gene therapy approaches. Gene therapy for cancer implies that ideally selective tumor cell killing or inhibition of tumor cell growth can be achieved using nucleic acids (DNA and RNA) as the therapeutic agent. Therefore, the majority of cancer gene therapy strategies introduce foreign genes into tumor cells which aim at the immunological recognition and destruction, the direct killing of the target cells or the interference with tumor growth. To achieve this goal for gene therapy of cancer, a broad variety of therapeutic genes are currently under investigation in preclinical and in clinical studies. These genes are of very different origin and of different mechanisms of action, such as human cytokine genes, genes coding for immunstimulatory molecules/antigens, genes encoding bacterial or viral prodrug-activating enzymes (suicide genes), tumor suppressor genes, or multidrug resistance genes.     

A novel approach using transcomplementing adenoviral vectors for gene therapy of adrenocortical cancer.

Current therapies for adrenocortical carcinomas do not improve the life expectancy of patients. In this study, we tested whether a gene-transfer therapy based upon a suicide gene/prodrug system would be effective in an animal model of the disease. We employed E4- and E1A/B-depleted, herpes simplex virus-thymidine kinase-expressing adenoviral mutants that transcomplement each other within tumor cells, hereby improving transgene delivery and efficacy by viral replication in situ. Transcomplementation of vectors increased the fraction of transduced of tumor cells. This increase was accompanied by greater tumor volume reduction compared to non-transcomplementing approaches. Survival time improved with non-replicating vectors plus GCV compared to controls. However, transcomplementation/replication of vectors led to a further significant increment in anti-tumor activity and survival time (p < 0.02). In treated animals, we observed a high number of apoptotic nuclei both adjacent to and distant from injection sites and sites of viral oncolysis. Ultrastructural analyses exhibited nuclear inclusion bodies characteristic of virus production in situ, and provided further evidence that this therapy induced apoptotic cell death within tumor cells. We conclude that the efficacy of suicide gene therapy is significantly amplified by viral replication and, in combination with GCV, significantly reduces tumor burden and increases survival time.     

基于腺相关病毒的多手段联合肿瘤治疗策略

腺相关病毒(adeno-associated virus,AAV)本身具有抗肿瘤活性,以其为基础构建的重组腺相关病毒(rAAV)作为肿瘤基因治疗载体已应用于临床试验研究。与其他的药物一样,单一的AAV基因药物,可能无法对肿瘤这一多基因、多步骤的复杂疾病发挥有效的治疗作用。国内外实验研究发现,多种化疗药物和放疗手段,不但可以提高rAAV载体的基因表达效率,也能促进AAV病毒本身的复制;反过来,AAV可以提高肿瘤细胞对放化疗的敏感性。联合AAV与其他的肿瘤治疗策略将有助于优化肿瘤治疗效果。     

EGR-1启动子在肿瘤基因治疗中的应用

EGR-1的启动子为早期生长反应因子-1基因上游约-550-0bp的一顺式作用元件。其活性受控于一些诱导剂,如电离辐射,联合EGR-1的启动子与治疗基因（如TNF-α、自杀基因）,用辐射能在肿瘤局部从时,空调控治疗基因的表达,使其产物局限于肿瘤局部,并发挥放疗的杀肿瘤效应,而放疗与转基因产物又有协同作用。放射治疗与基因治疗的配伍为肿瘤的治疗提供了新思路。     

Tumor microenvironment as the “regulator” and “target” for gene therapy

In this review, we focus on strategies for designing functional nano gene carriers, as well as choosing therapeutic genes targeting the tumor microenvironment. Gene mutations have a great impact on the occurrence of cancer. Thus, gene therapy plays a major role in cancer therapy and has the potential to cure cancer. Well‐designed gene therapy largely relies on effective gene carriers, which can be divided into viral carriers and non‐viral carriers. A gene carrier delivers functional genes to their intracellular target and avoids nucleic acids being degraded by nucleases in the serum. Most conventional cancer gene therapies only target cancer cells and do not appear to be sufficintly efficient to pass clinical trials. Accumulating evidence has shown that extending the therapeutic strategies to the tumor microenvironment, rather than the tumor cell itself, can allow more options for achieving robust anti‐cancer efficiency. In addition, unusual features between tumor microenvironment and normal tissues, such as a lower pH, higher glutathione and reactive oxygen species concentrations, and overexpression of some enzymes, facilitate the design of smart stimuli‐responsive gene carriers regulated by the tumor microenvironment. These carriers interact with nucleic acids and then form stable nanoparticles under physiological conditions. By regulation of the tumor microenvironment, stimuli‐responsive gene carriers are able to change their properties and achieve high gene delivery efficiency. Considering the tumor microenvironment as the “regulator” and “target” when designing gene carriers and choosing therapeutic genes shows significant benefit with respect to improving the accuracy and efficiency of cancer gene therapy.