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。     

反义RNA在基因治疗中的应用

由于反义RNA作为封闭基因表达的有效手段具有特异性强、安全性高、操作简单、靶基因范围广等特点,已被广泛应用于基因治疗肿瘤和病毒相关疾病的研究,反义RNA治疗肿瘤可以通过抑制癌基因的表达、封闭融合癌基因、抑制肿瘤细胞的耐药性、调节细胞因子的表达量等途径;反义RNA治疗病毒相关疾病多集中在艾滋病上,其手段主要是反义封闭TAR。反义RNA作为基因治疗的新途径具有良好的前景,但在设计上和应用上还存在一些急待解决的问题。     

采用sPD-1协同4-1BBL进行肿瘤免疫基因治疗的研究

目的 探讨采用sPD-1协同4-1 BBL进行肿瘤免疫基因治疗的效果及相关的免疫学机制.方法 以不同剂量的H22肝癌细胞接种于BALB/c小鼠右后腿肌肉内,建立小鼠肿瘤模型;采用可溶性PD-1 （sPD-1）和4-1 BBL真核表达质粒体内转染进行基因治疗;观察接种不同剂量肿瘤细胞、不同治疗时间小鼠的成瘤率及肿瘤治疗效果;RT-PCR检测肿瘤微环境中免疫调控相关基因的表达;组织切片检测肿瘤细胞浸润肌肉组织的组织学变化;流式细胞仪检测脾脏细胞毒性T细胞（CTLs）的杀瘤效率.结果 转染4-1 BBL/sPD-1基因治疗后,接种低剂量（1 × 104个/ml） H22肿瘤细胞的小鼠肿瘤生长完全受到抑制;接种高剂量（1×105个/ml） H22肿瘤细胞的小鼠肿瘤也受到显著抑制.通过延长基因治疗,荷瘤小鼠的成瘤率随着治疗时间的延长逐渐递减,至8周时成瘤率为0;基因治疗不仅促进IFN-γ和IL-2基因表达上调,而且也使TGF-p、IL-10的表达下调;瘤组织中CD8＋ T淋巴细胞数量增多和脾淋巴细胞的杀瘤效率显著增加.结论 利用体内存在的少量肿瘤可作为抗原刺激淋巴细胞的激活;基因治疗适用于对手术、化疗、放疗后体内残存的少量肿瘤细胞的清除;当体内存在大量肿瘤细胞时,适当延长基因治疗时间可获得较好的治疗效果.     

当前肿瘤基因治疗中存在的主要问题及其解决途径

本文概述了当前肿瘤基因治疗研究中存在的一些主要问题,如绝大多数治疗方案中目的基因只有一个,肿瘤基因治疗缺乏靶向性,基因转移载体的效率、安全性及容量等问题。讨论了解决这些问题的主要途径,即肿瘤多基因联合治疗、直接体内途径基因治疗与靶向基因治疗、基因转移载体的改造。     

选择性复制型腺病毒介导的自杀基因HSV -tk 在 肿瘤基因治疗中的应用

自杀基因治疗是肿瘤基因治疗的手段之一,治疗效果与自杀基因能否被高效、选择性的导入肿瘤细胞有关。肿瘤选择性复制型腺病毒（conditionally replication adenovirus,CRADs）可以特异性的在肿瘤细胞中复制,在复制的同时所携带的治疗基因也大量表达。由CRAds介导的自杀基因,实现了对肿瘤的病毒治疗和基因治疗的结合,提高了治疗效率和使用复制型腺病毒的安全性。     

腺病毒携带IL-12增强抗原致敏树突细胞在肝癌基因治疗中的研究

目的:近年来通过应用白介素-12治疗肿瘤取得良好效果,因此对国内外应用腺病毒携带IL-12增强抗原致敏树突细胞在肝癌基因治疗中的研究进展进行总结,以探索更为可行治疗方法。方法:运用Pubmed、Elsevier Sciencedirect、CNKI及万方全文数据库检索系统,以腺病毒,IL-12,肝癌,树突细胞为关键词,检索2008-01至2012-11月发表的文献。纳入标准:1)IL-12的生物学特性,在抗肿瘤过程中的免疫作用,2)应用腺病毒携带IL-12对抗肝癌治疗研究,3)肿瘤抗原致敏树突细胞对肿瘤的影响。根据纳入标准分析文献26篇。结果:通过腺病毒携带IL-12可以增强肿瘤抗原致敏树突细胞的免疫应答。并通过诱导肿瘤细胞的凋亡,减少新生血管的生成而对肿瘤产生直接抑制,有效抑制肝癌的生长和转移。结论:本文通过对IL-12的生物学特征、抗肿瘤通路、作用机制及在腺病毒介导下肿瘤抗原致敏树突细胞研究进展的概述,为腺病毒携带IL-12作为肝癌的基因治疗进一步提供理论依据和探索,期待在将来应用IL-12为基础的基因治疗一定会为包括肝癌在内的肿瘤治疗提供新的途径。     

反义核酸在肿瘤研究中的应用

反义核酸研究已活跃于肿瘤研究及基因治疗领域,反义核酸通过碱基配对待异性地抑制基因表达,因此为研究肿瘤中癌基因和生长因子的功能及癌基因突变检测提供了更为有效的手段,并为肿瘤的基因治疗提供了可能途径.文章综述了反义核酸在基因治疗中所面临的问题及部分解决办法.     

基于痘苗病毒载体的恶性肿瘤基因治疗研究进展

基因治疗一直是肿瘤生物治疗的重要策略,而以溶瘤痘苗病毒为载体的肿瘤治疗近年来受到较多关注。该文总结了目前用于恶性肿瘤治疗的痘苗病毒和基于痘苗病毒载体的基因治疗研究进展及其在各个领域的成果。     

当前肿瘤基因治疗中存在的主要问题及其解决途径

本文概述了当前肿瘤基因治疗研究中存在的一些主要问题,如绝大多数治疗方案中目的基因只有一个,肿瘤基因治疗缺乏靶向性,基因转移载体的效率、安全性及容量等问题。讨论了解决这些问题的主要途径,即肿瘤多基因联合治疗、直接体内途径治疗与靶向基因治疗、基因转移载体的改造。     

RNA干扰在肿瘤基因治疗中的应用策略

运用RNA干扰（RNAi）技术可以通过以下策略进行肿瘤的靶向治疗：抑制癌基因、生长因子及其受体的过表达,从而抑制细胞生长;干扰细胞周期蛋白及其相关基因的表达,从而抑制细胞增殖;抵抗致癌病毒的入侵;抑制抗凋亡基因的表达;上调和恢复抑癌基因的功能;抑制肿瘤发生过程中的关键酶;抑制与肿瘤转移有关的血管生成;靶向端粒酶;靶向耐药基因。尽管目前RNAi已经较为广泛地应用于基因功能研究和肿瘤疾病的基因治疗研究中,但其在应用过程中还有许多亟待解决的问题。我们就RNAi及其在肿瘤疾病基因治疗中的应用策略和存在的问题做一综述。     

Prostate cancer gene therapy-what have we learned and where are we going?

With recent advances in genetic engineering, tumor biology, and immunology, gene therapy has been recognized as a promising new treatment option for various cancers, including prostate cancer. Several clinical trials of prostate cancer gene therapy, using therapeutic genes which include suicide genes, immunomodulatory genes, tumor suppressor genes, and anti-oncogenes, are under way and preliminary reports have emerged. Although gene therapy for prostate cancer is still at an early stage and requires additional technological breakthroughs, new insights obtained from recent clinical trials indicate a promising potential for prostate cancer gene therapy. In this report, general concepts, current progress, and future prospects in prostate cancer gene therapy are summarized.     

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.     

A new strategy for cancer therapy based on a predictive indicator.

Tumor-associated genes have been analyzed at the molecular level in recent years, and using the analyses of these genes as a predictive indicator for cancer therapy has attracted attention. Among such genes, the actions of a tumor suppressor gene p53 are focused on the cancer therapy, and it is suggested that p53 genotypes can be used as a predictive indicator for radiotherapy, thermotherapy and chemotherapy. Transfection of wtp53 to p53-null cells increased radiation- or thermo-sensitivity and stimulated apoptosis induced by these therapies. Although therapy-induced apoptosis is suppressed in mp53 cells, apoptosis can be stimulated by glycerol treatment as a chemical chaperone. Therefore, a new strategy of combining p53-targeted gene therapy or chemical chaperone therapies is expected to improve the outcome and efficiency of cancer therapy in the future.     

Butyrate as a model for "gene-regulating chemoprevention and chemotherapy."

Recent progress in molecular genetics has facilitated understanding of the mechanisms of carcinogenesis. However, there is not yet any effective therapy or prevention for cancer based on the molecular mechanisms of carcinogenesis. So-called "gene therapy" for cancer is expected to become a new method of treatment, but there are still several serious problems with gene therapy. As a matter of fact, it seems impossible to adopt gene therapy for prevention. We therefore tried to develop a different method of cancer prevention or therapy based on the molecular mechanisms of carcinogenesis. For instance, the tumor-suppressor gene p53 is mutated in about 50% of human malignancies. It is known that p53 stimulates the promoter activities of p21/WAF1, gadd45 and bax genes, resulting in cell cycle arrest, DNA repair and apoptosis, respectively. Therefore, chemical compounds that can stimulate these genes should compensate for the function of p53. As a model of this, we found that histone deacetylase inhibitors such as butyrate or trichostatin A dramatically stimulate the p21/WAF1 gene promoter through the Spl sites, resulting in cell cycle arrest. Interestingly, another group has recently reported that phenylbutyrate, which is also known as a histone deacetylase inhibitor, is very effective for leukemia patients. We therefore consider methods of up-regulating p21/WAF, gadd45 or bax genes should be useful for cancer therapy and termed this method "Gene-regulating chemotherapy". Theoretically, the chemicals up-regulating such genes should be also useful for chemoprevention, and we also termed it as "Gene-regulating chemoprevention". In conclusion, we propose that "Gene-regulating chemotherapy or chemoprevention" may be a promising new method for cancer therapy or prevention and histone deacetylase inhibitor is a good candidate for this method.     

Cancer immunogene therapy: A review

Although immunotherapy has long held out promise as a specific, potent approach to cancer therapy, clinical applications have been unrewarding to date. However, advances in gene transfer technology and basic immunology have opened new avenues to stimulate antitumor immune responses including immunogene therapy. Many different approaches to immunogene therapy have been identified. These include transferring genes encoding proinflammatory proteins to tumor cells, suppressing immunosuppressive gene expression, and transferring proinflammatory genes and/or tumor antigen genes to professional antigen-presenting cells. In some cases, genes are transferred to tumor or antigen-presenting cells in situ. In others, gene transfer is performed ex vivo as part of preparing an anticancer vaccine. We discuss the underlying approach, relative success, and clinical application of various cancer immunogene therapy strategies, paying particular attention to immunogene therapy vaccines. Large numbers of preclinical studies have been reported, but only scattered clinical trial results have appeared in the literature. Although very successful preclinically, the ideal cancer immunogene therapy approach remains to be determined and will likely vary with tumor type. Clinical impact may be improved in the future as treatment protocols are refined.     

Targeting gene-virotherapy for cancer

Gene therapy and viral therapy for cancer have therapeutic effects, but there has been no significant breakthrough in these two forms of therapy. Therefore, a new strategy called “targeting gene-virotherapy”, which combines the advantages of gene therapy and viral therapy, has been formulated. This new therapy has stronger antitumor effects than either gene therapy or viral therapy. A tumor-specific replicative adenovirus vector ZD55 （E1B55KD deleted Adv.） was constructed and various single therapeutic genes were inserted into ZD55 to form ZD55-gene. These are the targeting gene-virotherapy genes. But experiments showed that a single gene was not effective in eliminating the tumor mass, and therefore two genes were separately inserted into ZD55. This strategy is called “targeting dual gene-virotherapy” （with PCT patent）. Better results were obtained with this strategy, and all the xenograft tumor masses were completely eliminated in all mice when two suitable genes producing a synergetic or compensative effect were chosen. Twenty-six papers on these strategies have been published by researchers in our laboratory. Furthermore, an adenoviral vector with two targeting promoters harboring two antitumor genes has been constructed for cancer therapy. Promising results have been obtained with this adenoviral vector and another patent has been applied for. This antitumor strategy can be used to kill tumor cells completely with minimum damage to normal cells.     

基因的单核苷酸多态性与乳腺癌关系的研究进展

乳腺癌是女性发病率最高的恶性肿瘤,具有家族聚集性,其发生发展是一个复杂的过程,涉及多种不同基因的相互作用和相互调控。随着基因技术和分子生物技术的飞速发展,许多基因被揭示在乳腺癌的发生发展中起关键作用,如BRCA、FGFR、ATM、ZNF365、Pokemon基因等。基于流行病学研究,这些易感基因可被分为高外显率易感基因和低外显率易感基因,其多态性对乳腺癌具有重要的影响。对乳腺癌易感基因的研究有助于阐明乳腺癌的发生机制、发展过程,对其早期诊断、预后判断和良恶性鉴别也有着重要的意义,可为乳腺癌的临床生物基因靶向治疗提供新的靶点和理论基础。本文主要对这些基因的单核苷酸多态性与乳腺癌关系的研究进展进行了综述。     

构建多顺反子表达载体的有效工具——FMDV 2A

近年来肿瘤多基因治疗倍受关注,然而目前缺少一种有效的构建多顺子的工具。传统的构建多顺反子的工具,如IRES等,由于存在结构大,上下游基因表达差异显著等缺陷,严重限制了其应用。FMDV2A,因其具有结构小、剪切效率高等优点为多基因治疗带来了新的希望。主要介绍了FMDV2A的特性、"剪切"活力及其在构建多顺反子载体中的应用。     

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.     

Prospects for gene therapy in human prostate cancer

Prostate cancer is the most common neoplasm in men and a significant cause of mortality in affected patients. Despite significant advances, current methods of treatment are effective only in the absence of metastatic disease. Gene therapy offers a renewed hope of using the differential characteristics of normal and malignant tissue in constructing treatment strategies. Several clinical trials in prostate cancer gene therapy are currently under way, using immunomodulatory genes, anti-oncogenes, tumor suppressor genes and suicide genes. A continued understanding of the etiological mechanisms involved in the establishment and progression of prostate cancer, along with advances in gene therapy technology, should make gene therapy for prostate cancer therapeutically valuable in the future.