基因逆转肿瘤多药耐药的研究进展

化疗在恶性肿瘤的综合治疗中占有非常重要的地位,而耐药性是严重影响肿瘤病人化疗效果及生存的主要原因之一,其中多药耐药(multi-drug resistance,MDR)最具临床意义。多药耐药是指肿瘤细胞对某一化疗药物产生耐药性后,对其他化学结构及机理不同的化疗药物也产生交叉耐药性。研究表明MDR是一个多阶段发展、多因素参与的复杂事件。逆转肿瘤多药耐药是目前肿瘤化疗的研究热点之一。近年随着基础科学研究的不断深入,基因逆转肿瘤多药耐药的研究已从分子水平上,定点、多位点阻断多药耐药基因的表达,已取得一些显著的进展。本文对肿瘤多药耐药机制以及逆转肿瘤多药耐药性的相关基因做一简要综述。     

核酸适配体介导的肿瘤免疫治疗研究进展

肿瘤免疫治疗是一种新的肿瘤治疗方式,在临床治疗中具有重要意义和应用前景,主要包括过继性细胞免疫治疗、肿瘤疫苗和抗体肿瘤免疫治疗。抗体在肿瘤免疫治疗中应用广泛,但其价格昂贵,质量易受不同批次的影响且存在免疫原性。核酸适配体(aptamer)是一类能与靶标高特异性高亲和力结合的短的单链寡核苷酸,素有“化学抗体”之称。核酸适配体易合成且成本低,质量稳定且免疫原性低,基于这些优势近年来也被开发用于肿瘤免疫治疗。本文综述了核酸适配体在肿瘤免疫治疗中的进展,主要包括核酸适配体通过靶向免疫检查点、共刺激受体、细胞因子、递送小干扰RNA (small interfering RNA,siRNA),间接调控肿瘤免疫进程,以及将核酸适配体修饰于细胞膜上直接介导免疫细胞靶向杀伤等。核酸适配体以多种方式在肿瘤免疫治疗中发挥作用,有潜力被开发用于临床治疗。     

骨肉瘤化疗多药耐药的分子机制及其逆转

目的：总结国内外对骨肉瘤化疗多药耐药的分子机制及相应逆转措施的研究进展;方法：应用PubMed及CNKI期刊全文数据库检索系统,以＂骨肉瘤、化疗多药耐药、机制、逆转＂等为关键词,检索2000-2011年的相关文献。纳入标准：1）骨肉瘤耐药相关的蛋白质、酶类及相关基因;2）各因素发挥作用的机制;3）相关的逆转措施。结果：骨肉瘤多药耐药是当今骨肉瘤化疗治疗的一大难题,多药耐药性即肿瘤细胞对一种抗肿瘤药物产生耐药性的同时,对其他结构和作用机制不同的多种药物产生交叉耐药性。其作用的发生是多种因素共同作用的结果。结论：与骨肉瘤化疗多药耐药相关的主要有P-糖蛋白,多药耐药相关蛋白,肺耐药蛋白,谷胱甘肽,拓扑异构酶,蛋白激酶C以及DNA损伤修复和细胞凋亡抑制等相关机制。而逆转措施主要通过抑制剂和基因疗法。     

以P-糖蛋白为靶点的肿瘤多药耐药逆转剂

肿瘤的多药耐药性(multidrug resistance,MDR)是导致化疗失败的主要原因,因此寻找高效低毒的MDR逆转剂已成为肿瘤药物开发领域的热点。P-糖蛋白是引起多药耐药性产生的重要因素之一,也是目前肿瘤多药耐药逆转剂最重要的药物靶点。本文介绍了P-糖蛋白的结构、功能和作用机制,以及以P-糖蛋白为靶标的肿瘤多药耐药逆转剂的开发现状。     

综述与专论: 适配体功能化外泌体在肿瘤靶向治疗中的应用

传统的肿瘤治疗方法因缺乏足够的靶向性而会产生严重的毒副作用。外泌体（exosome）是一种天然的纳米囊泡,参与细胞间的信息传递,并且作为药物递送载体具有出色的性能优势,包括低免疫原性、低毒性和能够穿越天然屏障等特点。然而以外泌体为载体的药物递送系统的靶向能力仍有不足。适配体（aptamer）是一类化学合成的单链核酸分子,具有分子质量小、易于修饰和免疫原性低等特点,可作为亲和性配体与靶向分子特异性结合。通过在外泌体表面修饰适配体,药物可以被精确递送到肿瘤细胞发生部位,从而实现对肿瘤的靶向治疗,提高肿瘤治疗效果,减少毒副作用。本篇综述将重点讨论适配体功能化外泌体药物靶向递送系统在各种肿瘤治疗方面的应用,并对其未来的挑战和机遇进行阐述。     

基于核酸适配体的DNA纳米结构在肿瘤研究中的应用进展

DNA纳米结构具有强大的分子载带量、良好的稳定性、可编辑性和生物相容性等特点,是纳米材料领域的研究热点。核酸适配体是一段短的寡核苷酸序列(RNA或ss DNA),能够折叠成特定的三维结构与靶标高特异性、高亲和力的结合。将核酸适配体的分子识别特性和DNA纳米结构相结合,可将靶向识别、生物成像及药物递送等特点集于一体,在生命科学研究领域,尤其是肿瘤领域,有着良好的应用前景。本文介绍了DNA纳米结构和核酸适配体的特点与优势,对近年来核酸适配体-DNA纳米结构在肿瘤标志物检测、靶向成像以及药物靶向递送的研究进展进行了综述,并对其发展前景进行了展望,期待核酸适配体-DNA纳米结构能为肿瘤的靶向诊疗提供新的策略。     

应用双向热循环消减SELEX技术筛选胃癌血清核酸适配体

胃癌是发病率及死亡率均较高的消化道恶性肿瘤之一,严重威胁人类的生命健康。血清肿瘤标志物的检测对提高早期胃癌的检出率,改善胃癌的治疗有重要的意义。核酸适配体以其灵敏度高、靶向性强等优势显示出了较强的临床适用性。本研究以双向热循环消减指数富集式配基系统进化(systematic evolution of ligands by exponential enrichment,SELEX)技术为支持,纳米（琼脂）磁珠材料为载体,胃癌血清及正常人血清为筛选靶标,结合高通量测序技术建立了快速高效的核酸适配体筛选方法。经过19轮双向筛选,获得高重复率的胃癌血清特异性核酸适配体序列10条及正常人血清特异性核酸适配体序列8条。将这些序列分别混合并制成检测试剂A、B,结合实时荧光定量PCR（quantitative real-time PCR,qPCR）技术,对100份临床血清样本进行特异性验证。通过比较分析,建立了快速高效的胃癌血清检测技术。结果显示,核酸适配体G AP1与N AP1的二级结构类似于抗体的“Y”型,且呈茎环状。检测试剂A、B对胃癌及正常人血清的检出率分别为92%和88%。表明本技术可以较准确地筛选得到高特异性和强亲和力的核酸适配体,体现了核酸适配体作为新型肿瘤标志物在临床检测及治疗的应用潜力。     

肿瘤多药耐药:机制及逆转剂

肿瘤细胞多药耐药性(multidrug resistance,MDR)的产生是临床上导致肿瘤化疗失败的主要原因之一,因此寻找高效低毒的MDR逆转剂已成为肿瘤药物开发领域的热点。MDR的作用机制主要包括P-糖蛋白、多药耐药相关蛋白、乳腺癌耐药蛋白、肺耐药相关蛋白等等。多药耐药逆转剂包括钙离子通道阻滞剂、维拉帕米及其衍生物等等。本文主要介绍了MDR的作用机制以及肿瘤多药耐药逆转剂的研究进展。     

两株毛筒腔菌属真菌逆转人乳腺癌细胞多药耐药性

高水平的多药耐药性（multidrug resistance,MDR）基因在肿瘤细胞中过量表达是肿瘤细胞耐药的内在原因,是导致肿瘤化疗失败的主要原素。寻求一种抑制MDR活性的抑制剂是提升抗肿瘤药物药效的重要途径。本研究采用低浓度持续诱导方法建立人乳腺癌细胞（MCF-7）耐药细胞系,结果显示,阿霉素（ADM）、紫杉醇和顺铂对MCF-7耐药细胞系有交叉耐药性,耐药指数（resistance index,RI）分别为5.11、3.55和1.79。菌株对肿瘤细胞的逆转活性筛选表明,红棕毛筒腔菌Tubeufia rubra PF02-2和河池毛筒腔菌T. hechiensis XSL05具有逆转肿瘤细胞多药耐药性为敏感性的活性,逆转倍数（reversion fold,RF）分别为3.79和1.07。结果表明,T. rubra和T. hechiensis具有开发为MDR逆转剂的潜能。     

分子模拟指导核酸适配体文库设计

核酸适配体是利用配体指数富集的系统进化技术（SELEX）从随机文库中筛选获得一段有功能的单链寡核苷酸。但因筛选过程中的文库选择、洗涤次数、分离效率、缓冲液离子含量和pH值等多种因素的影响,迄今所报道的亲和力与特异性都很高的核酸适配体为数不多。初始文库是核酸适配体筛选的源头,作为SELEX技术的根本,其设计是否合理直接影响到筛选的成败和效率。分子模拟能以核酸适配体文库为主体,计算机为主要工具,发展多种结构模拟与分析工具,辅助核酸适配体文库的合理设计。本文综述了现阶段利用分子模拟进行核酸适配体初始文库设计的相关方法,希望能为从源头上提高核酸适配体筛选的成功率提供线索。     

P-糖蛋白对结肠癌多药耐药的影响

结肠癌是常见的消化道恶性肿瘤。对术后患者以及无法采用手术治疗的患者,临床多采用化疗、放疗等综合性治疗方法。随着大量化疗药物在临床的广泛使用,结肠癌多药耐药性成为化疗失败的最主要原因。研究表明,P-糖蛋白(P-glycoprotein, P-gp)作为ATP结合盒(ABC)转运蛋白超家族成员之一,与多种肿瘤的多药耐药相关,其介导的多药耐药已经成为目前研究的热点。本文旨在通过对P-糖蛋白的结构、耐药机制以及逆转P-糖蛋白介导的结肠癌多药耐药新发现进行阐述,引导读者对P-糖蛋白在结肠癌多药耐药中的作用有更深入的了解。     

Cell-derived microvesicles and antitumoral multidrug resistance

Antitumoral chemotherapeutic treatments are often impaired by innate or acquired multidrug resistance (MDR). After four decades of MDR research, having underlined its complexity, new knowledge about the mechanisms of tumor resistance to antineoplastic drugs is a prerequisite for improving chemotherapy. Following our observations with a non-pathogenic eukaryotic microorganism, Dictyostelium discoideum, I suggest that MDR in tumor cells might be the consequence of a detoxification mechanism, mediated by cell-derived microvesicles. Recently published observations with tumoral human cells support this hypothesis. First, these cell-derived vesicles might impair chemotherapeutic efficiency of many structurally-different antineoplastic agents by preventing them to reach their intracellular target, followed by their expulsion outside the tumor cells, as observed for Dictyostelium cells. Secondly, besides their newly recognized function of intercellular communication, the cell-derived vesicles might also act as intercellular transporters of multidrug resistance proteins. Experiments are suggested for checking the hypothesis of cell-derived vesicles mediating multidrug resistance.     

基于溶酶体靶点的抗肿瘤细胞多药耐药性

随着恶性肿瘤的发病率逐年上升,化疗的应用范围也日益广泛,但肿瘤细胞的多药耐药性(multi-drug resistance,MDR)严重影响了化疗的效果。随着对MDR机制的深入了解,各细胞器对肿瘤细胞MDR的影响方面的研究也越来越得到人们的重视。本文综述了溶酶体与肿瘤细胞MDR的关系,并对以溶酶体为靶点的肿瘤多药耐药治疗的应用前景进行展望。     

Modulation of Multidrug Resistance in Cancer Cells by Liposome Encapsulated Doxorubicin

Abstract

A major problem in the chemotherapy of solid tumors and hematologic malignancies is the intrinsic as well as acquired cross resistance to multiple chemotherapeutic agents. Recently, this type of multidrug resistance has been related to a gene, MDR1, and its gene product, p-glycoprotein, which functions as the efflux pump, prevents accumulation of drugs and alters their cytotoxicity. Many drug-resistant human tumors express the MDR1 gene and MDR1 RNA levels are elevated in many cancers that have not responded to chemotherapy. The same persistent observation has been made in recurrent tumors who have responded initially to chemotherapy.

Doxorubicin is one of the most important anticancer agent having significant single agent activity in a variety of cancer types and is now the cornerstone of some widely used combination regimens. Despite the clinical effectiveness of the drug, doxorubicin resistance that arises in malignant cells following repeated courses of treatment is the major problem in the clinical management of neoplastic diseases. Recently, extensive studies have demonstrated that liposome encapsulated doxorubicin effectively modulates the multidrug resistance phenotype in cancer cells by altering the function of p-glycoprotein. This modulation of MDR phenotype by liposomes has been demonstrated in vitro in human breast cancer cells, ovarian cancer cells, human promyelocytic leukemia cells and in human colon cancer cells and in vivo in transgenic mice transfected with a functional MDR1 gene. It appears liposomes can play an effective role as a new modality of treatment for human cancers which have become refractory to chemotherapy. An exciting area of research which soon will emerge will exploit the different binding sites on p-glycoprotein by using combination of liposomes with other pharmacological modulators of MDR to impart maximal overcoming of multidrug resistance in cancer patients.     

Mechanisms and strategies to overcome multiple drug resistance in cancer

One of the major problems in chemotherapy is multidrug resistance (MDR) against anticancer drugs. ATP-binding cassette (ABC) transporters are a family of proteins that mediate MDR via ATP-dependent drug efflux pumps. Many MDR inhibitors have been identified, but none of them have been proven clinically useful without side effects. Efforts continue to discover not toxic MDR inhibitors which lack pharmacokinetic interactions with anticancer drugs. Novel approaches have also been designed to inhibit or circumvent MDR. In this review, the structure and function of ABC transporters and development of MDR inhibitors are described briefly including various approaches to suppress MDR mechanisms.     

缺氧诱导因子-1 α（HIF-1α）与卵巢癌多药耐药的关系

卵巢癌是常见的妇科恶性肿瘤,其死亡率居妇科肿瘤之首。化疗是其重要的治疗手段,而随之产生的肿瘤细胞多药耐药成为治疗失败的主要原因。低氧是所有实体肿瘤的特征,缺氧诱导因子-1α(HIF-1α)是介导细胞低氧反应最关键的核转录因子,对卵巢癌多药耐药的形成起到多方面的作用,本文就近年来以HIF-1α为靶点研究卵巢癌耐药的研究进展作一综述。     

Multiple drug resistance of tumor cells: manifestations, genetic basis, clinical aspects

Data are reviewed concerning the results of study of multidrug-resistant (MDR) tumor cells. MDR often develops in the course of chemotherapy or in vitro selection of tumor cells by vincristine, adriamycin, actinomycin D, colchicine, etc. MDR cells are resistant to all these drugs though their targets and mechanisms of toxic action are quite different. Resistance is due to the decreased accumulation by MDR cells of these compounds. The genetic basis for MDR is amplification of a large genomic region that contains a number of genes coding for products and functions that are under extensive study. Specific karyotype and amplified DNA alterations occur during the development of MDR imitating the processes of appearance and variability of multigene families. The obtained data demonstrate the ways of overcoming of tumor multidrug resistance in clinic.     

Hsa-miR-34a-5p reverses multidrug resistance in gastric cancer cells by targeting the 3′-UTR of SIRT1 and inhibiting its expression

Multidrug resistance (MDR) is a major obstacle to chemotherapy, which leads to ineffective chemotherapy, an important treatment strategy for gastric cancer (GC). The abnormality of microRNAs (miRNAs) is critical to the occurrence and progression of MDR in various tumors. In this study, hsa-miR-34a-5p was found to be decreased in multidrug resistant GC cells SGC-7901/5-Fluorouracil (SGC-7901/5-Fu) compared to the parental SGC-7901 cells. Overexpression of hsa-miR-34a-5p in SGC-7901/5-Fu cells promoted apoptosis and decreased migration and invasiveness after chemotherapy. In addition, overexpression of hsa-miR-34a-5p suppressed the growth of drug-resistant tumor in vivo. The mechanism of the effects of hsa-miR-34a-5p could include the regulation of the expression of Sirtuin 1 (SIRT1), P-glycoprotein (P-gp) or Multidrug resistance-related protein 1 (MRP1) through direct binding to the 3′-untranslated region (UTR) of SIRT1. Functional gain-and-loss experiments indicated that hsa-miR-34a-5p enhances the chemotherapy sensitivity of MDR GC cells by inhibiting SIRT1, P-gp and MRP1. In conclusion, hsa-miR-34a-5p can reverse the MDR of GC cells by inhibiting the expression of SIRT1, P-gp or MRP1.     

The reversion effect of the RNAi-silencing mdr1 gene on multidrug resistance of the leukemia cell HT9

Overexpression of P-glycoprotein (P-gp), the mdr1 gene product, confers multidrug resistance (MDR) to tumor cells and often limits the efficacy of chemotherapy. This study evaluated RNAi for specific silencing of the mdr1 gene and reversion of multidrug resistance. Three different short hairpin RNAs (shRNAs) were designed and constructed in a pSilencer 3.1-H1 neo plasmid. The shRNA recombinant plasmids were transfected into HT9 leukemia cells. The RNAi effect was evaluated by real-time PCR, Western blotting and cell cytotoxicity assay. In the cell, shRNAs can specifically down-regulate the expression of mdr1, mRNA and P-gp. Resistance against harringtonine, doxorubicin and curcumin was decreased. The study indicated that shRNA recombinant plasmids could modulate MDR in vitro.