脉冲电场在医学中的基础研究及电穿孔的临床应用

脉冲电场利用方波直流脉冲发生器改变细胞膜的通透性,并在细胞膜上形成纳米级细孔,其被称为电穿孔是一种新型微创技术,分为可逆电穿孔(reversible electroporation)及不可逆电穿孔(irreversible electroporation)。在过去的四十年,电穿孔大量的实验研究及其自身的优点及先进性,使电穿孔相关的技术已被允许应用与临床。目前临床和实验中应用电穿孔的化疗药物已有十余种,通过电穿孔进行基因转染及DNA疫苗的研发已取得巨大成功。尤其近几年发展的非热能的不可逆电穿孔对实体肿瘤的消融作用,为肿瘤治疗提供新的思路,因其比其他局部治疗方法:具有治疗时间短,减少间接热损伤,对毗邻主要血管的肿瘤组织有消融能力等优点引起了对不可逆电穿孔巨大的临床研究兴趣。本文就电穿孔的基本理论,电化学治疗,基因电转染及不可逆电穿孔的临床应用进行探讨。

Basic Studies of Electric Pulse in Medicine and the Role of ReversibleElectroporation in Tumor Ablation

The permeability of cell membranes was altered to form nanoscale defects or pores, which was termedelectroporation. It is an innovative minimally invasive technique, including reversible electroporation (RE) and irreversibleelectroporation(IRE). During the past four decades, advances in fundamental and experimental electroporation research have allowed forthe translation of electroporation-based technologies to the clinic. Currently there are more than ten kinds of chemotherapeutic drugs hadbeen applied to clinic and experiments, Gene electrotransfer and electroporation-mediated DNA vaccination have attained a hugesuccess. As a nonthermal therapy in resent years, IRE offers several potential benefits over other focal therapies, i.e. short treatmentdelivery time, reduced collateral thermal injury, and the ability to treat tumors adjacent to major blood vessels. These advantages havestimulated widespread interest in basic through clinical studies of IRE. In this review, the basic studies and current applications ofelectroporation and the role of irreversible electroporation in tumor ablation were summarised.