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。     

沉默MDR1基因逆转SGC7901/ADM细胞对紫杉醇的耐药性

本研究利用短发夹sh RNA(short hairpin RNA)沉默SGC7901/ADM细胞MDR1基因,从而逆转SGC7901/ADM细胞对紫杉醇的耐药性。根据MDR1基因序列设计并合成编码sh RNA的DNA模板,构建3种靶向MDR1基因重组干扰载体,稳定转染SGC7901/ADM细胞,q RT-PCR检测MDR1 m RNA表达水平,Western blotting检测MDR1蛋白表达水平,MTT法检测细胞对紫杉醇的敏感性。结果表明,成功构建了靶向MDR1基因的3种重组表达载体,分别转染SGC7901/ADM细胞后均能不同程度沉默MDR1基因的表达,其中p2.1-3对MDR1沉默效果最好,m RNA和蛋白的沉默效率分别为78.5%和45%。紫杉醇对细胞的IC50值由(3.147±0.494)μmol/L降至(0.714±0.059)μmol/L,逆转率达到(78.22±1.906)%。结果表明,靶向MDR1的干扰表达载体能够抑制MDR1基因的表达,从而逆转SGC7901/ADM细胞对紫杉醇的耐药性。     

沉默MDR1基因表达逆转肺癌A549/DDP细胞对顺铂的耐药性

本研究以A549/DDP细胞为实验对象,利用shRNA(short hairpin RNA)沉默MDR1基因,逆转人肺癌A549/DDP细胞对顺铂的耐药性。构建3种靶向MDR1基因重组干扰载体,稳定转染A549/DDP细胞,qRT-PCR检测MDR1 mRNA表达水平,Western blotting检测MDR1蛋白表达水平,MTT法检测细胞对顺铂的敏感性。结果显示成功构建了3种靶向MDR1的重组表达载体p2.1-1、p2.1-2和p2.1-3。3种干扰表达载体均能有效沉默A549/DDP细胞MDR1基因表达,其中p2.1-3对MDR1沉默效果最好,对mRNA和蛋白的沉默效率分别为51.47%和53.24%。转染p2.1-3的细胞对顺铂的IC50由(72.08±7.00)μmol/L降至(31.89±3.39)μmol/L,逆转率达到(67.60±5.70)%。这些结果表明靶向MDR1的重组干扰载体均能够有效抑制MDR1表达,其中p2.1-3干扰效果最佳并且能逆转A549/DDP细胞对顺铂的耐药性。     

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。     

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。     

肿瘤多药耐药与自噬、DNA修复和肿瘤干细胞相关的分子机制研究进展

肿瘤多药耐药(multi-drug resistance,MDR)所导致的化疗失败,依旧是肿瘤治疗中存在的难点。虽然针对MDR,已经成功开发了三代靶向三磷酸腺苷结合盒转运体(ATP binding cassette transporter,ABC)的抑制剂,也有MDR调节剂和化学增敏剂,多功能纳米载体和RNA干扰等方法可有效逆转MDR,但是由于肿瘤多药耐药机制的复杂性,MDR依然是肿瘤治疗中面临的难题。将从目前研究比较集中的ABC转运体异常表达; DNA损伤修复的改变和细胞凋亡的异常;自噬诱导与耐药及肿瘤干细胞与耐药等四方面入手,针对目前MDR机制的研究进展做一综述,旨在为MDR的研究提供思路和方法。     

HepG2/mdr1稳定细胞系的建立及特性研究

将已构建好的含有人多药耐药（multidrug resistance, MDR）全长基因的真核表达质粒pCI-neo-mdr1,应用脂质体导入人肝癌HepG2细胞,应用G418筛选出人肝癌多药耐药细胞株HepG2/mdr1。通过对HepG2/mdr1细胞形态学的观察和生物学特性的研究,成功地建立了高效、稳定的HepG2/mdr1细胞系;为深入研究肝癌的MDR及其逆转提供了理想的细胞模型,并为探索建立肝癌MDR细胞株提供新的方法和思路,同时为研究肝癌细胞胰岛素抵抗与MDR的关系提供了模型细胞。 将已构建好的含有人多药耐药（multidrug resistance, MDR）全长基因的真核表达质粒pCI-neo-mdr1,应用脂质体导入人肝癌HepG2细胞,应用G418筛选出人肝癌多药耐药细胞株HepG2/mdr1。通过对HepG2/mdr1细胞形态学的观察和生物学特性的研究,成功地建立了高效、稳定的HepG2/mdr1细胞系;为深入研究肝癌的MDR及其逆转提供了理想的细胞模型,并为探索建立肝癌MDR细胞株提供新的方法和思路,同时为研究肝癌细胞胰岛素抵抗与MDR的关系提供了模型细胞。     

HepG2/mdrl稳定细胞系的建立及特性研究

将已构建好的含有人多药耐药(muhidrug resistance,MDR)全长基因的真核表达质粒pCI-neo-mdrl,应用脂质体导入人肝癌HepG2细胞,应用C418筛选出人肝癌多药耐药细胞株HepG2/mdrl.通过对HepG2/mdrl细胞形态学的观察和生物学特性的研究,成功地建立了高效、稳定的HepG2/mdrl细胞系;为深入研究肝癌的MDR及其逆转提供了理想的细胞模型,并为探索建立肝癌MDR细胞株提供新的方法和思路,同时为研究肝癌细胞胰岛素抵抗与MDR的关系提供了模型细胞.     

shRNA抑制c-fos表达对P-gp介导的乳腺癌多药耐药的影响

多药耐药(multidrug resistance,MDR)是导致化疗失败的重要原因,多药耐药基因(multidrug resistance gene,mdr1)产物P-糖蛋白(P-glycoprotein,P-gp)过表达是最主要的耐药机制。原癌基因c-fos在肿瘤MDR中的作用渐受重视。主要选用人乳腺癌敏感株MCF-7和阿霉素(adriamycin,ADR)筛选的、mdr1/P-gp高表达的耐药株MCF-7/ADR,探讨c-fos在P-gp介导的乳腺癌MDR中的作用。相对于MCF-7,c-fos在MCF-7/ADR高表达。采用shRNA法下调c-fos表达后,MCF-7/ADR对ADR的敏感性大大增强,且mdr1/P-gp表达减少、P-gp外排功能降低。c-fos表达下调可逆转对P-gp介导的乳腺癌MDR的实验结果,为c-fos成为逆转肿瘤耐药诊断和治疗的新靶标,对实现耐药乳腺癌的分子靶向治疗提供了理论基础。     

质膜蛋白与肿瘤多药耐药现象

多药耐药(MDR)是影响肿瘤化疗效果的主要障碍,是由于在耐药细胞质膜上的一系列蛋白是使细胞免受有害因素的攻击。通过30年的研究．证实了肿瘤细胞逃逸化疗药物攻击的许多途径．很显然,多药耐药已经成为肿瘤阻碍各种化疗药物有效治疗的途径。因此．评价肿瘤多药耐药机制及其耐药程度,探讨新的逆转肿瘤多药耐药方法有助于提高化疗效果。本文就MDR中质膜蛋白的分子结构和表型、耐药机制及其逆转方法的研究进展进行综述。     

Designed P-glycoprotein inhibitors with triazol-tetrahydroisoquinoline-core increase doxorubicin-induced mortality in multidrug resistant K562/A02 cells

Multidrug resistance (MDR) refers to the cross-resistance of cancer cells to one drug, accompanied by other drugs with different mechanisms and structures, which is one of the main obstacles of clinical chemotherapy. Overexpression of P-glycoprotein (P-gp) was an extensively studied cause of MDR. Therefore, inhibiting P-gp have become an important strategy to reverse MDR. In this study, two series of triazole-tetrahydroisoquinoline-core P-gp inhibitors were designed and synthesized. Among them, compound I-5 had a remarkable reversal activity of MDR activity and the preliminary mechanism study was also carried out. All the results proved that compound I-5 was considered as a promising P-gp-mediated MDR reversal candidate.     

Structure-activity relationships of some taxoids as multidrug resistance modulator

1,7-Deoxy-4-deacetylbaccatin III (12) and its five analogues 6-9, 13, and their oxetane ring opened derivatives 14, 16, and 17, which were synthesized from taxinine, showed significant activity as MDR reversal agent by the assay of the calcein accumulation toward MDR human ovarian cancer 2780AD cells. The most effective compound 12 in this assay is actually efficient for the recovery of cytotoxic activity of paclitaxel (taxol), adriamycin (ADM), and vincristine (VCR) toward MDR 2780AD cells at the same level toward parental 2780 cells. This activity of 12 is very interesting because baccatin III (4) has no such MDR reversal activity but has cytotoxic activity. The essential functional groups inducing such a difference in biological activity between 4 and 12 are 4alpha-acetoxyl for 4 and 4alpha-hydroxyl for 12. In seven compounds possessing MDR reversal activity, compound 12 is the most desirable compound for anti-MDR cancer reversal agent, because it has the highest accumulation ability of anticancer agent in MDR cancer cells and weak cytotoxic activity. Compounds 8 and 13 showed significant cytotoxic activity toward HepG2 and VA-13, respectively, as well as MDR reversal activity. They are expected to become lead compounds for new types of anticancer agent or anti-MDR cancer agent.     

Novel approaches to reversing anti-cancer drug resistance using gene-specific therapeutics.

One of the underlying mechanisms of multidrug resistance (MDR) is cellular overproduction of P-glycoprotein (P-gp), which acts as an efflux pump for various anti-cancer drugs. P-gp is encoded by a group of related genes termed MDR; only MDR1 is known to confer the drug resistance, and its overexpression in cancer cells has been a therapeutic target to circumvent the resistance. To overcome P-gp-mediated drug resistance, we have developed six anti-MDR1 hammerhead ribozymes and delivered them to P-gp-overproducing human leukemia cell line by a retroviral vector containing RNA polymerase III promoter. These ribozyme-transduced cells became vincristine-sensitive, concomitant with the decreases in MDR1 expression, P-gp amount and efflux pump function. Among the ribozymes tested, the anti-MDR1 ribozyme against the translation-initiation site exhibited the highest efficacy. The retrovirus-mediated transfer of this most potent anti-MDR1 ribozyme into a human lymphoma cell line, which was made resistant by infection of pHaMDR1/A retroviral vector and thus possessed a low degree of MDR due to P-gp expression relevant to clinical MDR, resulted in a complete reversal of MDR phenotype. In addition to retrovirus-mediated transfer of ribozymes, we evaluated the efficacy of cationic liposome-mediated transfer of ribozyme. Treatment of a P-gp-producing human breast cancer cell line with the liposome-ribozyme complex resulted in reversal of resistance, concomitant with the decreases in both MDR1 expression and P-gp amount. Confocal microscopic imaging of the cells after treatment with liposome/FITC-dextran showed cytoplasmic fluorescence that was abolished by cytochalasin B, indicating a high endocytotic activity in these cells. The endocytotic activity was well correlated with the success of cationic liposome-mediated transfer of MDR1 ribozyme. These distinct approaches using either retrovirus- or liposome-mediated transfer of anti-MDR1 ribozyme may be selectively applicable to the treatment of MDR cells with different properties such as endocytotic activity as a specific means to reverse resistance.     

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。     

Genes of multidrug resistance in haematological malignancies

Since the early 1970s, multiple drug resistance has been known to exist in cancer cells and is thought to be attributable to a membrane-bound, energy-dependent pump protein (P-glycoprotein [P-gp]) capable of extruding various related and unrelated chemotherapeutic drugs. The development of refractory disease in haematological malignancies is frequently associated with the expression of one or several multidrug resistance (MDR) genes. MDR1, multidrug resistance-associated protein (MRP) and lung-resistance protein (LRP) have been identified as important adverse prognostic factors. Recently it has become possible to reverse clinical MDR by blocking P-gp-mediated drug efflux. The potential relevance of these reversal agents of MDR as well as the potential new approaches to treat the refractory disease are discussed in this article. In addition, an array of different molecules and mechanisms by which resistant cells can escape the cytotoxic effect of anticancer drugs has now been identified. These molecules and mechanisms include apoptosis-related proteins and drug inactivation enzymes. Resistance to chemotherapy is believed to cause treatment failure in more than 50% patients. Clearly, if drug resistance could be overcome, the impact on survival would be highly significant. This review focuses on molecular mechanism of drug resistance in haematological malignancies with emphasis on molecules involved in MDR. In addition, it brings the survey of methods involved in determination of MDR, in particular P-gp/MDR1, MRP and LRP.     

Synthesis of curcumin mimics with multidrug resistance reversal activities

In order to discover novel multidrug resistance (MDR) reversal agents for efficient cancer chemotherapy, the unsymmetrical curcumin mimics with various amide moieties (6-19) were synthesized and evaluated their MDR reversal activities in MDR cell line KBV20C. Among the tested compounds, 13, 16, and 17 showed potent MDR reversal activities by inhibiting drug efflux function of P-glycoprotein in KB20C cells, and almost recovered the cytotoxicity of vincristine and paclitaxel against KBV20C cell to the degree of potency against drug sensitive KB cells.     

Modulation of human mammary cell sensitivity to paclitaxel by new quinoline sulfonamides.

Sulfonamide derivatives of chloroquine and primaquine were synthesised and evaluated against both paclitaxel-sensitive and paclitaxel-resistant mammarian cancer cell lines. All derivatives exhibited at least 96% MDR reversal activity when co-administered with paclitaxel at 5 microM. The best compound, a chloroquine derivative, exhibited 99% MDR reversal activity when co-administered with paclitaxel at 1 microM. Molecular modelling studies reveal that these derivatives share a common pharmacophore with taxane MDR reversal agents.     

三种中药制剂Ams-11、Fw-13、Tul-17逆转肿瘤细胞多药耐药性的研究

为寻找能有效逆转肿瘤细胞多药耐药性的药物,通过体外细胞实验对Ams-11、Fw-13、Tul-17三种中药制剂逆转肿瘤细胞多药耐药性的作用进行了分析。并用流式细胞仪测定了Tul-17处理细胞后药物累积程度的变化及细胞P糖蛋白表达情况。为进一步研究体外细胞实验筛选出的多药耐药逆转剂在体内的药效学,将其中Fw13用于人白血病K562/ADR裸鼠移植瘤逆转试验。结果:在无细胞毒性的剂量范围内,该三种中药制剂均能明显增强多药耐药细胞对抗癌药物的敏感性,而且其逆转作用呈剂量依赖关系。Tu-17处理后,K562耐药细胞表达的P糖蛋白较对照降低1.5倍,对罗丹明123的累积量是对照的2.5倍。用Fw13治疗人白血病K562/ADR裸鼠移植瘤,可将硫酸长春新碱(VCR)对K562/ADR的抑瘤率从19.79%提高到86.59%,与单独VCR治疗疗效有显著性差异(P<0.05)。结果表明,这三种中药制剂可望成为肿瘤多药耐药逆转剂,在肿瘤化疗中发挥作用。     

Design,synthesis and biological evaluation of novel tetrahydroisoquinoline derivatives as P-glycoprotein-mediated multidrug resistance inhibitors

Multidrug resistance (MDR) is one of the main obstacles of clinical chemotherapy. A great deal of research shows that the occurrence of drug resistance in various malignant tumors is closely related to the expression of P-glycoprotein (P-gp) on the surface of the cell membrane. In this paper, based on the structure-activity relationship of phenylethyl tetrahydroisoquinoline, we choose tariquidar as the lead compound for the design and synthesis of 17 novel tetrahydroisoquinoline P-gp inhibitors. Additionally, in vitro and in vivo cytotoxicity assays and reversed MDR activity assays were evaluated. Among them, compound 3 had a good reversal of MDR activity and the reversal mechanism study of it was carried out. All of these results demonstrated that compound 3 was considered to be a promising P-gp-mediated MDR reversal candidate.