血脑屏障上的药物转运体P-糖蛋白

血脑屏障(Blood-brain Barrier,简称BBB)是维护脑内环境稳态的重要功能单位,它不仅可以阻止血液中的有害物质进入脑组织,而且能够清除脑内的有毒代谢产物。BBB上表达的转运系统在积极转运营养物质入脑和选择性外排药物的两个方面均发挥了重要作用。其中P-糖蛋白由于自身结构功能的特异性和作用底物的广泛性而备受关注。本文主要论述了BBB上P-糖蛋白的特性、表达、转运底物及其体内外研究的进展情况。P-糖蛋白作为BBB的重要组成部分在中枢神经系统治疗药物的摄取、分布和排泄中发挥了越来越重要的作用。因此,对P-糖蛋白的研究将有助于阐明药物脑部转运机制,为增加药物的BBB通透性、提高脑内靶点药物浓度提供新的研究思路。     

血脑屏障通过P-糖蛋白将药物“挤出”

完整的血脑屏障可保护大脑免受多种潜在毒性化合物的侵害,从而维持脑内稳态。屏障功能依赖于脑毛细血管内皮细胞之间的紧密连接以及位于内皮细胞顶膜上高表达的外排转运蛋白(如P-糖蛋白)。以往研究发现,P-糖蛋白不仅作为“药泵”将药物运到细胞外,还可介导化疗药物(如阿霉素)在肿瘤细胞中被溶酶体所捕获和封闭,从而使细胞产生耐药性。但是,P-糖蛋白在脑毛细血管内皮细胞中是否也有类似作用尚不清楚。     

P-糖蛋白在多药耐药的K562细胞转运苯妥英纳与卡马西平中的作用

研究证实,多药转运体与难治性癫痫耐药机制密切相关,P-糖蛋白在其中起重要作用．主要研究P-糖蛋白拮抗剂维拉帕米对P-糖蛋白过表达的K562细胞耐药性及细胞内苯妥英纳与卡马西平浓度的影响．首先建立了P-糖蛋白高表达的K562/Dox(阿霉素诱导)耐药细胞株,比较耐药细胞株和P-糖蛋白表达阴性的K562细胞株对苯妥英纳和卡马西平的耐药性,并观察给予维拉帕米后,耐药细胞内抗癫痫药物的浓度变化．结果发现,苯妥英纳和卡马西平对K562/Dox细胞株的半数抑制浓度(IC₅₀)明显高于K562细胞株,加入维拉帕米后,苯妥英纳和卡马西平对K562/Dox 细胞的IC₅₀明显下降,逆转倍数分别为2.5和1.5．进一步研究发现,K562/Dox细胞内苯妥英纳和卡马西平的浓度均显著少于其药敏K562细胞,仅分别为正常K562细胞的23.6%和32.2%．当加入维拉帕米后,K562/Dox细胞内抗癫痫药物浓度明显升高(P < 0.05)．由此证明,高表达的P-糖蛋白参与了细胞的药物转运,在难治性癫痫的耐药机制中扮演重要角色．     

七叶皂苷对P-糖蛋白功能的影响

目的:探讨七叶皂苷时P-糖蛋白功能的影响.方法:构建稳定表达P-糖蛋白的LLC-PK1细胞系,以real-time RT-PCR和Western Blotting分析P-糖蛋白基因mRNA和蛋白表达,共聚焦显微镜观察P-糖蛋白细胞定位,流式细胞术检测细胞内罗丹明123荧光强度.结果:(1)P-糖蛋白在LLC-PK1细胞中稳定高表达;(2)转染细胞中P-糖蛋白定位在细胞膜上;(3)七叶皂苷抑制P-糖蛋白功能.细胞内罗丹明123荧光强度增加123%,但其抑制效果是维拉帕米的30%.结论:七叶皂苷抑制P-糖蛋白功能,但其抑制效果弱于维拉帕米.     

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。     

卵巢肿瘤中P-糖蛋白、谷胱甘肽S转移酶-π的表达及临床意义

目的研究P-糖蛋白(P-gp)、谷胱甘肽S转移酶π(GST-π)在卵巢肿瘤中的表达及其临床意义。方法采用S-P免疫组化方法,检测57例卵巢恶性肿瘤、8例正常卵巢与4例良性肿瘤中P-gp、GST-π的表达。结果P-gp在卵巢恶性肿瘤与正常卵巢及良性肿瘤中的表达有显著性差异,P-gp表达与恶性肿瘤分期、分级无关,而与组织学类型及化疗有关。GST-π的表达在卵巢恶性肿瘤与正常卵巢及良性肿瘤中的表达有显著性差异,与化疗有关,而与组织学类型、分期、分级无关。结论卵巢恶性肿瘤中存在着原发耐药,P-gp及GST-π的表达与化疗耐药高度相关。     

P-糖蛋白的研究进展

P-糖蛋白是一类能量依赖性的转运蛋白,能将许多结构不同的化合物逆向转运出细胞.P-糖蛋白的过表达与肿瘤细胞的多药耐药性(Multidrug Resistance,MDR)密切相关,是导致肿瘤化疗失败的主要原因.随着对MDR机制认识的深入,已针对P-糖蛋白的结构设计出多种形式的MDR逆转药物.近年研究发现,P-糖蛋白广泛存在于正常的组织和器官,参与药物和内、外源毒素的吸收、分布和排泄,行使解毒和防御保护的功能.因此,通过转植P-糖蛋白基因可有效地降低经济鱼类、虾等水产品和经济作物中有毒污染物的积累,对保护人类健康将有着积极意义.     

P-糖蛋白线粒体转位与线粒体DNA缺失肿瘤细胞多药耐药产生的关系

线粒体DNA缺失细胞(ρ~0细胞)拮抗化疗药物诱导的凋亡,但其确切机制尚不明确。本研究探讨P-gp线粒体转位与人肝癌细胞(SK-Hepl)mtDNA缺失细胞(ρ~0SK-Hep1)多药耐药产生的关系。以SK-Hep1、ρ~0SK-Hep1和转线粒体细胞SK-Hep1Cyb为研究对象,CCK-8方法检测细胞对药物敏感性;AnnexinV/PI双染法及DAPI染色法检测细胞凋亡;Westernblot检测P-gp表达;激光共聚焦显微镜结合免疫荧光检测P-gP细胞内分布。结果显示,SK-Hep1、ρ~0SK-Hep1和SK-Hep1Cyb细胞对多柔比星(DOX)的IC_(50)分别为0.62±0.02μg/ml、4.93±0.17μg/ml和0.57±0.02μg/ml。SK-Hep1、ρ~0SK-Hep1和SK-Hep1Cyb细胞凋亡率分别为1 1.25%±1.36%、4.75%±0.98%和14.50%±1.57%,ρ~0SK-Hep1对细胞凋亡有明显抗性。Western blot检测发现ρ~0细胞内P-gP、Bax、Bcl-2表达增加,Bcl-2/Bax比值增加。免疫荧光共定位显示,ρ~0细胞线粒体内P-gP...     

多药耐药基因1 C3435T 多态性与癫痫耐药的关联性研究

目的:探讨我国癫痫患者P-糖蛋白基因多态性(C3435T)与抗癫痫药物反应性的关联性.方法:采用PCR-RFLP(聚合酶链反应-限制性片段长度多态性分析)的方法对156例癫痫患者外周血进行分型.其中,耐药组癫痫患者85例,有效组癫痫患者71例.结果:耐药组癫痫患者CC基因型21例,占24.70%;有效组癫痫患者CC基因型19例,占26.76%.两组比较无显著差异性.结论:本研究未发现P-gpC3435T基因型与癫痫耐药的关联性.     

多药耐药基因1C3435T多态性与癫痫耐药的关联性研究

目的：探讨我国癫痫患者P-糖蛋白基因多态性（C3435T）与抗癫痫药物反应性的关联性。方法：采用PCR--RFLP（聚合酶链反应--限制性片段长度多态性分析）的方法对156例癫痫患者外周血进行分型。其中,耐药组癫痫患者85例,有效组癫痫患者71例。结果：耐药组癫痫患者CC基因型21例,占24.70%;有效组癫痫患者CC基因型19例,占26.76%。两组比较无显著差异性。结论：本研究未发现P-gp C3435T基因型与癫痫耐药的关联性。     

基于微流控芯片的体外血脑屏障模型构建

目的:利用微流控芯片技术构建易调控、接近在体微环境的体外血脑屏障模型。方法:微流控芯片体外模型采用上下双培养池结构,由多聚碳酸酯膜分隔,两套流路系统控制流体。细胞采用原代分离纯化的大鼠脑血管内皮细胞和星形胶质细胞,免疫荧光技术进行鉴定,分别按次序注入微流控芯片上下培养池,按1μl/min的流速进行灌注培养,构建体外血脑屏障模型,并对此模型进行鉴定和评价。结果:原代分离纯化得到两种细胞,免疫荧光法鉴定细胞纯度达95%以上。共培养3天紧密连接开始形成,5天达到峰值,超微结构观察显示内皮细胞之间形成紧密连接,且荧光素钠渗透实验和TEER值测量表明屏障形成良好。结论:成功构建微流控芯片体外血脑屏障模型,可成为一个新的平台应用于药物筛选、神经系统基础等多项研究中。     

CNS Drug Design Based on Principles of Blood-Brain Barrier Transport

Abstract: Lipid-soluble small molecules with a molecular mass under a 400–600-Da threshold are transported readily through the blood-brain barrier in vivo owing to lipid-mediated transport. However, other small molecules lacking these particular molecular properties, antisense drugs, and peptide-based pharmaceuticals generally undergo negligible transport through the blood-brain barrier in pharmacologically significant amounts. Therefore, if present day CNS drug discovery programs are to avoid termination caused by negligible blood-brain barrier transport, it is important to merge CNS drug discovery and CNS drug delivery as early as possible in the overall CNS drug development process. Strategies for special formulation that enable drug transport through the blood-brain barrier arise from knowledge of the molecular and cellular biology of blood-brain barrier transport processes.     

1840 MHz射频辐射对大鼠血脑屏障通透性的影响

目的:探讨环境射频辐射暴露对雄性SD大鼠血脑屏障通透性的影响。方法:36只成年雄性SD大鼠随机分为暴露组和假暴露组,对暴露组大鼠进行频率为1840 MHz、比吸收率(SAR值)为2 W/kg、每日1 h、连续7 d的全身辐照。硝酸镧示踪透射电镜法和白蛋白免疫组化法观察暴露后大鼠脑皮质血脑屏障超微结构和通透性,免疫印迹法检测血脑屏障紧密连接相关蛋白ZO-1表达水平。结果:透射电镜结果显示,假暴露组镧颗粒仅出现在大鼠脑微血管管腔内;而在暴露组,除微血管管腔外,在局部脑皮质微血管内皮基底膜处和周围脑实质间亦可见镧颗粒沉积。免疫组化染色显示,假暴露组大鼠脑皮质微血管周围未见白蛋白渗出,而暴露组大鼠脑皮质微血管周围有明显白蛋白沉积。上述结果提示,射频辐射暴露可能增加血脑屏障通透性。免疫印迹结果显示,与假暴露组相比,暴露组大鼠脑皮质ZO-1蛋白表达水平明显降低(P0.001),差异具有统计学意义。结论:1840 MHz射频辐射可诱导血脑屏障发生一定程度地开放,紧密连接相关蛋白ZO-1表达水平的改变可能参与该过程。     

Inhibition of human P-glycoprotein transport and substrate binding using a galantamine dimer

The human multidrug resistance transporter P-glycoprotein (P-gp) prevents the entry of compounds into the brain by an active efflux mechanism at the blood-brain barrier (BBB). Treatment of neurodegenerative diseases, therefore, has become a challenge and the development of new reversible inhibitors of P-gp is pertinent to overcome this problem. We report the design and synthesis of a crosslinked agent based on the Alzheimer’s disease treatment galantamine (Gal-2) that inhibits P-gp-mediated efflux from cultured cells. Gal-2 was found to inhibit the efflux of the fluorescent P-gp substrate rhodamine 123 in cancer cells that over-express P-gp with an IC₅₀ value of approximately 0.6 μM. In addition, Gal-2 was found to inhibit the efflux of therapeutic substrates of P-gp, such as doxorubicin, daunomycin and verapamil with IC₅₀ values ranging from 0.3 to 1.6 μM. Through competition experiments, it was determined that Gal-2 modulates P-gp mediated efflux by competing for the substrate binding sites. These findings support a potential role of agents, such as Gal-2, as inhibitors of P-gp at the BBB to augment treatment of neurodegenerative diseases.     

Mechanism of thioflavin T accumulation inside cells overexpressing P-glycoprotein or multidrug resistance-associated protein: role of lipophilicity and positive charge

Alzheimer's disease is characterized by the presence of amyloid deposition. Thioflavin T (ThT) has been one of the molecules of choice to attempt the detection of these amyloid deposits. However, it has been reported that ThT was unable to cross blood-brain barrier (BBB). Our aim was to understand the mechanism according to which it has been said that ThT is not able to cross the BBB. For this purpose we have used cellular models overexpressing P-glycoprotein (P-gp) or multidrug resistance-associated protein (MRP1), two proteins overexpressed in BBB. Our results show that: (i) ThT is able to cross membranes and to penetrate inside the cells; (ii) ThT is a P-gp substrate; (iii) ThT is poor MRP1 substrate. In conclusion, our results suggest that two factors could be involved in the low accumulation of ThT in the brain: ThT is a P-gp substrate and its lipophilicity is low.     

脂筏、紧密连接和血脑屏障的关系

血脑屏障破坏是缺血性脑卒中急性期发生脑水肿及神经元毒性损害的核心病理过程之一,目前尚无特效保护方法。血脑屏障通透性调节的中心环节是内皮细胞的紧密连接,而紧密连接结构蛋白表达水平和位置分布的变化与脑微血管通透性的改变及脑水肿的程度密切相关。脂筏是高流动性的细胞膜脂质双层内富含胆固醇的特殊脂质和蛋白质的动态微区,它参与细胞蛋白转运。血脑屏障上有大量的脂筏存在,紧密连接结构蛋白分布于脂筏中,其功能受胆固醇调节,且脂筏上紧密结合的脂质有利于蛋白质的寡聚化。因此,基于脂筏调节血脑屏障紧密连接可能为脑保护研究提供新的药物靶点。     

Evaluation of Diagnostic Value of Mediastinum for Differentiation of Drug Sensitive,Multi and Extensively Drug Resistant Tuberculosis Using Chest X-Rays

Background and ObjectiveThe rise of Drug Resistant Tuberculosis (DR TB), particularly Multi DR (MDR), and Extensively DR (XDR) has reduced the rate of control of the disease. Computer aided diagnosis using Chest X-rays (CXRs) can help in mass screening and timely diagnosis of DR TB, which is essential to administer proper treatment regimens. In CXRs, lungs and mediastinum are two significant regions which contain the information about the likelihood of DR TB. The objective of this work is to analyze the shape characteristics of lungs and mediastinum to improve the diagnostics accuracy for differentiation of Drug Sensitive (DS), MDR and XDR TB using computer aided diagnostics system.MethodsThe CXR images of DS and DR TB patients are obtained from a public database. The lung fields are segmented from the CXRs using Reaction Diffusion Level Set Evolution. Mediastinum is segmented from the delineated lung masks using Chan Vese model. The shape features from each lung and mediastinum masks are extracted and analysed. The discriminative power of individual and combination of both lung and mediastinum features are evaluated using machine learning techniques for classification of DS vs MDR, MDR vs XDR and DS vs XDR TB images. The performances of classifiers are compared using standard metrics.ResultsThe proposed segmentation methods are able to delineate lungs and mediastinum from the CXR images. The extracted lung and mediastinum features are found to be statistically significant (p < 0.05) for differentiation of DS and DR TB conditions. Using the combination of both lung and mediastinum features, Multi-Layer Perceptron classifier achieves maximum F-measure of 82.4%, 81.0% and 87.0% for differentiation of DS vs MDR, MDR vs XDR and DS vs XDR, respectively.ConclusionAnalysis of mediastinum along with the lungs in chest X-rays could improve the diagnostic performance for differentiation of drug sensitive and resistant TB conditions. The proposed methodology is able to differentiate DS, MDR and XDR TB, and found to be clinically relevant. Hence, this work is useful for computer-based early detection of DS and DR TB conditions.     

Drug Transfer Across the Blood-Brain Barrier: Correlation Between In Vitro and In Vivo Models

To assess the drug transport across the blood-brain barrier (BBB), we compared the maximal brain extraction values at time 0 [E(0) values] obtained using either in vitro or in vivo methods. The in vitro BBB model consisted of a coculture of brain capillary endothelial cells growing on one side of a filter and astrocytes on the other. The in vivo model used intracarotid injection in anesthetized rats. Eleven compounds were tested. They were selected because they exhibit quantitatively different brain extraction rates: very low for inulin and sucrose, low for oxicam-related nonsteroidal antiinflammatory drugs and diclofenac, and high for propranolol and diazepam. As these compounds are apparently transferred by a passive diffusion mechanism, two others, glucose and leucine, were added that cross the BBB by a known carrier-mediated process. The in vivo and in vitro E(0) values showed a strong correlation as indicated by the Spearman's correlation coefficient (r = 0.88, p less than 0.01). The relative ease with which such cocultures can be produced in large quantities could facilitate the screening of new centrally acting drugs.     

肠屏障功能障碍与胃癌恶液质关系的临床研究

目的:观察胃癌恶液质患者血浆内毒素(LPS)水平、血浆D-乳酸(D-LAC)水平、血浆二胺氧化酶(DAO)水平及肿瘤坏死因子α(TNF-α)水平,初步探讨肠屏障功能障碍与胃癌恶液质的关系。方法:选取2014年3月至2014年12月我院普外科预行手术治疗的胃癌恶液质患者30例,年龄及性别匹配的胃癌非恶液质患者50例,健康对照者80例,采用偶氮显色鲎试验法定量测定外周血LPS水平,改良分光光度法测定外周血D-LAC水平,ELISA法测定血浆DAO水平及TNF-α水平,并记录各组身高、体质量、总蛋白、白蛋白及血红蛋白等指标。结果:胃癌恶液质组血浆LPS水平、D-LAC水平、血浆DAO水平及TNF-α水平显著高于胃癌非恶液质组[LPS:(0.33±0.09)EU/m Lvs(0.17±0.03)EU/m L,P0.05;D-LAC:(1.82±0.10)mg/L vs(1.47±0.07)mg/L,P0.05;DAO:(4.38±0.65)μg/Lvs(2.71±0.52)μg/L,P0.05;TNF-α:(0.51±0.13)μg/L vs(0.30±0.16)μg/L,P0.05];对照组血浆LPS水平、D-LAC水平、血浆DAO水平及TNF-α水平显著低于非恶液质组[LPS:(0.07±0.03)EU/m L vs(0.17±0.03)EU/m L,P0.05;D-LAC:(0.81±0.74)mg/L vs(1.47±0.07)mg/L,P0.05;DAO:(1.84±0.15)μg/L vs(2.71±0.52)μg/L,P0.05;TNF-α:(0.11±0.12)μg/L vs(0.30±0.16)μg/L,P0.05]。胃癌恶液质组(r=0.94,P0.01)、非恶液质组(r=0.93,P0.01)及对照组(r=0.91,P0.01)血浆LPS水平均与TNF-α呈显著正相关。结论:胃癌恶液质患者的肠黏膜通透性增加,可发生内毒素易位,其血浆LPS水平与TNF-α水平呈显著正相关。