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。     

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。     

原发性肝癌的多药耐药

肝癌多药耐药的产生是多基因、多因素、多途径、多步骤综合作用的复杂过程,因此研究引起肝癌多药耐药的相关因素、作用机制及逆转MDR,提高肝癌化疗效果成为目前肝癌研究的热点,但不同的肝癌耐药细胞株有不同的多药耐药基因表型,如何针对不同的基因表型来逆转肝癌的多药耐药,是临床治疗肝癌需要面对的一个问题.     

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。     

ABC转运蛋白研究的新进展

ABC转运蛋白主要包括P-糖蛋白、多药耐药相关蛋白和乳腺癌耐药蛋白,它们属于同一家族,具有保守的功能结构域和多样化的生物学功能。ABC转运蛋白部分成员的过表达与肿瘤细胞的多药耐药性（MDR）密切相关,是导致化疗失败的主要原因。随着对MDR机制认识的深入,针对多药耐药蛋白的特异结构域已设计出多种形式的MDR逆转药物。近年来发现,ABC转运蛋白广泛存在于多种正常的组织和器官,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作用。因此,通过转植ABC转运蛋白基因有可能降低经济鱼类、虾等水产品中有毒污染物的积累。     

异源物代谢核受体PXR与肿瘤多药耐药相关性的研究进展

肿瘤的多药耐药性是临床化疗中迫切需要解决的问题.孕烷X受体(pregnane X receptor,PXR)为配体活化的转录因子,其下游靶基因均为主司异源性药物/毒物生物转化功能的I相、II相代谢酶及III相转运蛋白,可对药物代谢动力学过程产生重要的影响,故有可能成为逆转肿瘤多药耐药的新的药物作用靶点.本文总结了PXR在肿瘤多药耐药中的作用及机制、新型PXR配体类药物研发等方面的研究进展.     

介导多药耐药的ABC转运蛋白超家族与MTX耐药性的关系研究

细胞耐药性的产生是导致肿瘤化疗失败的重要因素, 尤其是多药耐药是目前研究的一个重点。ABC转运蛋白超家族成员介导药物的外排, 与多药耐药密切相关。为了解该家族成员与MTX耐药的相关性, 进一步探讨MTX的耐药机制, 应用SuperArray基因芯片对MTX耐药前后编码ABC转运蛋白超家族成员的mdr1、mrp1、mrp2、mrp3、mrp5、mrp6和abcg2 7个基因进行检测, 并对MRP1和MRP5蛋白表达进行了验证。结果显示, 与MTX耐药性相关的ABC转运蛋白超家族成员主要为多药耐药相关蛋白, 其中mrp1和mrp5呈现高表达, 并且, 在MTX抗性细胞中, MRP5在mRNA及蛋白水平的表达均明显增强, 提示其在MTX耐药机制中起重要作用, 可能为潜在的药物作用靶点。     

新辅助化疗对骨肉瘤多药耐药相关蛋白表达的影响

目的:探讨不同新辅助化疗方案对多药耐药相关蛋白在骨肉瘤组织中表达的影响。方法:采用RP-PCR技术以及免疫组化技术检测48例骨肉瘤患者在不同新辅助化疗方案实施前后多药耐药相关蛋白在mRNA以及蛋白水平的表达变化。结果:在同一新辅助化疗方案实施前后以及不同新辅助化疗方案之间,肿瘤组织的多药耐药蛋白的mRNA及蛋白表达均无显著性差异。结论:不同新辅助化疗方案的实施对骨肉瘤多药耐药蛋白表达的影响有限,其多药耐药性可能主要决定于肿瘤本身,检测多药耐药蛋白的表达有利于制定个体化化疗方案。     

多药耐药基因产物在宫颈癌中的研究进展

化疗多药耐药是影响宫颈癌化疗疗效的重要因素.目前关于多药耐药(multidmgresistance,MDR)产生机制的研究报道很多,主要包括以下几个方面:(1)典型性多药耐药:如多药耐药基因1(multidrug resistance gene 1,MDRI)及其编码的蛋白P糖蛋白(P-glycoprotein,P-gp)、多药耐药相关蛋白(multidrug resistance-associated protein,MRP)和肺耐药蛋白(lung resistance-related protein,LRP)基因及其编码的蛋白的过度表达;(2)谷胱苷肤-S-转移酶-π的表达;(3)非典型性多药耐药:由拓扑异构酶Ⅱ(Topo Ⅱ)介导的耐药机制;(4)细胞凋亡抑制(例如:突变型P53和癌基因Her-2/neu/C-erbB-2表达增加)等.这些因素之问还可以相互影响、共同作用,造成宫颈癌对多种抗肿瘤药物的耐药[2].本文就多药耐药基因产物在宫颈癌中的研究进展进行综述.     

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。     

Drug resistance‐related microRNAs in osteosarcoma: Translating basic evidence into therapeutic strategies

Although the application of multiple chemotherapy brought revolutionary changes to improve overall survival of osteosarcoma patients, the existence of multidrug resistance (MDR) has become a great challenge for successful osteosarcoma treatment in recent decades. Substantial studies have revealed various underlying mechanisms of MDR in cancers. As for osteosarcoma, evidence has highlighted that microRNAs (miRNAs) can mediate in the processes of DNA damage response, apoptosis avoidance, autophagy induction, activation of cancer stem cells, and signal transduction. Besides, these drug resistance‐related miRNAs showed much promise for serving as candidates for predictive biomarkers of poor outcomes and shorter survival time, and therapeutic targets to reverse drug resistance and overcome treatment refractoriness. This review aims to demonstrate the potential molecular mechanisms of miRNAs‐regulated drug resistance in osteosarcoma, and provide insight in translating basic evidence into therapeutic strategies.     

Doxorubicin and chloroquine coencapsulated liposomes: preparation and improved cytotoxicity on human breast cancer cells

Doxorubicin, as a widely used chemotherapeutic, always causes multidrug resistance in human cancer cells. To circumvent drug resistance, we developed a novel formulation where doxorubicin hydrochloride (DOX) and chloroquine phosphate (CQ) were simultaneously loaded into liposomes by a pH-gradient method where CQ played the role of a chemical sensitizer. The various factors were investigated to optimize the formulation and manufacturing conditions of DOX and CQ coencapsulated liposomes (DCL). The resultant DCLs achieved the high encapsulation efficiency of both drugs over 90%. Further, DCLs significantly displayed resistance reversal action on a doxorubicin-resistant human breast cancer cell line (MCF-7/ADR) through the cooperation of CQ with DOX. The reversal fold of DCL with the DOX/CQ/soybean phosphatidylcholine weight ratio of 0.5:1:50 was 5.7, compared to free DOX. These results demonstrate that DCL is a promising formulation for the treatment of DOX-resistant breast cancer.     

Synthesis and evaluation of furoxan-based nitric oxide-releasing derivatives of tetrahydroisoquinoline as anticancer and multidrug resistance reversal agents

Multidrug resistance in tumor cells poses a major obstacle to efficient chemotherapy. Several types of agents have been recognized as multidrug resistance inhibitors, among which the tetrahydroisoquinolines is the most studied. In current study 16 furoxan-based nitric oxide-releasing derivatives of tetrahydroisoquinoline were synthesized. Their cytotoxic activities and effects in reversing multidrug resistance have been evaluated. The results revealed that these compounds had moderate cytotoxic effects. Compounds 7a-f, 7h, and 7l showed higher cytotoxicities than the rest, but lower than adriamycin on K562 cell line. Compounds 7d, 7f, and 7l exhibited potent MDR reversal activities on K562/A02 cell line. The accumulation assay indicated that compounds 7d, 7f, and 7l significantly increased the intracellular accumulation of rhodamine123 in K562/A02 cells. Furthermore, these three compounds produced high concentrations of NO in K562/A02 cells. Potentially, the high concentrations of NO produced by NO donor moieties will lead to an increased cytotoxicity to K562/A02 cells. Our results suggested that compounds 7d, 7f, and 7l had anticancer effects, as well as multidrug resistance reversal effects.     

Codelivery of survivin inhibitor and chemotherapeutics by tumor-derived microparticles to reverse multidrug resistance in osteosarcoma

Reportedly, the elevated expression of survivin has been observed in several tumor types, strictly involved in tumor development. In the present study, we detected elevated survivin expression in tumor tissues derived from patients with chemoresistant osteosarcoma when compared with those from chemosensitive patients. Importantly, knockdown of survivin in osteosarcoma cells significantly suppressed cell proliferation and chemoresistance both in vitro and in vivo. Simultaneously, chemotherapy mediates the upregulation of survivin in osteosarcoma cells through a survivin-based selective killing effect, resulting in the development of multidrug resistance. The utilization of tumor-derived microparticles to coencapsulate the survivin inhibitor YM155 and chemotherapeutic agents could effectively reverse multidrug resistance, leading to improved anticancer effects, as well as reduced systemic toxicity. In summary, the expression of survivin contributes to resistance toward osteosarcoma drugs, whereas employing survivin inhibiting combination therapy, based on a microparticle codelivery system, could efficiently reverse resistance and avoid potential systemic toxicity.     

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.     

胃癌多药耐药相关microRNA的筛选和鉴定

目的:研究胃癌多药耐药相关microRNA并对其进行鉴定、靶基因预测和预测靶基因的生物信息学分析。方法:运用microRNA芯片对胃癌多药耐药细胞SGC7901/ADR和其亲本细胞SGC7901进行microRNA表达谱分析;采用实时定量PCR的方法对差异表达的miRNA进行验证;再运用生物信息学方法对差异表达的miRNA进行靶基因预测;再对预测的靶基因进行GO和KEGG通路分析。结果:与SGC7901相比SGC7901/ADR表达上调超过2倍的miRNA有6个,表达下调超过2倍的有11个。实时定量PCR对共同差异表达的microRNA进行验证显示与芯片结果的一致性。对这17个差异表达的miRNA进行靶基因预测,再对预测得到的靶基因进行GO和KEGG通路分析显示预测的靶基因参与了肿瘤相关通路、MAPK通路、Focal Adhesion通路等。结论:我们初步筛选得到了胃癌多药耐药相关miRNA并对其进行了生物信息学分析,为进一步地探索miRNA在胃癌多药耐药中的作用及其分子机制奠定了基础。     

洛贝林逆转肿瘤细胞多药耐药机制新进展

洛贝林,是从半边莲的品种中提取的一种哌啶生物碱。近期发现洛贝林可以逆转肿瘤细胞的多药耐药,可能作为新型、低毒、有效的耐药逆转剂。研究其作用机理、体内实验等将有助于探讨其临床实用性。