用于肿瘤治疗的PI3K/mTOR双重抑制剂的研究进展

磷脂酰肌醇3-激酶（PBK）是细胞内重要的信号转导分子,在细胞存活、增殖和分化过程中起重要调节作用。且是磷脂酰肌醇3-激酶／蛋白激酶B／雷帕霉素靶蛋白信号转导通路的关键节点蛋白,与细胞周期、血管形成、肿瘤发生和侵袭的关系密切,现已证实PBKs是潜力巨大的药物治疗靶点,针对该通路的抑制剂近年来成为研究热点,抗肿瘤治疗前景看好。     

PI3K/mTOR双重抑制剂的研究进展

磷脂酰肌醇3-激酶/哺乳动物雷帕霉素靶蛋白(phosphoinosmde-3-kinase/the mammalian target of rapamycin,PI3K/mTOR)双重抑制剂已经成为抗肿瘤药物研发的热点之一。本文介绍芳基脲类和3-吡啶基杂环类等PI3K/mTOR双重抑制剂的化学结构,根据其结构特点及其与PI3Kγ共结晶模式,剖析了两类抑制剂药效团的基本结构。     

选择性PI3K抑制剂的研究进展

磷脂酰肌醇3-激酶（PI3K）是细胞内重要的信号转导分子,在细胞存活、增殖和分化过程中起重要调节作用。PI3K是PI3K/AKT/mT0R信号转导通路中的关键节点蛋白,调控着重要的生命活动。现已证实磷脂酰肌醇3-激酶（PI3Ks）是潜力巨大的药物治疗靶点,特别是PI3Kα现己成为抗肿瘤治疗的重要靶点之一。目前己有多种针对PI3Ks的抑制剂进入临床研究。然而现有抑制剂的化学类型不多且选择性不高、临床应用受局限。因此积极研究和开发结构新颖的PI3K选择性抑制剂对于疾病的靶向治疗具有重要意义。本文将对选择性PI3K抑制剂在抗肿瘤方面的研究进展作一综述。     

PI3K/Akt信号通路与肝纤维化

PI3K/Akt信号通路为细胞内重要信号传导通路之一,在促进细胞增殖、抑制凋亡的过程中发挥重要作用。PI3K/Akt信号通路与肝纤维化的发生、发展密切相关。通过干预PI3K/Akt信号通路,研究肝纤维化的发病机制和药物治疗是有意义的途径。该文就PI3K/Akt信号通路的构成、转导途径及其在肝纤维化中的作用作一综述。     

Targeting PI3K/AKT signaling for treatment of idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrotic interstitial pneumonia with unknown causes. The incidence rate increases year by year and the prognosis is poor without cure. Recently, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB/AKT) signaling pathway can be considered as a master regulator for IPF. The contribution of the PI3K/AKT in fibrotic processes is increasingly prominent, with PI3K/AKT inhibitors currently under clinical evaluation in IPF. Therefore, PI3K/AKT represents a critical signaling node during fibrogenesis with potential implications for the development of novel anti-fibrotic strategies. This review epitomizes the progress that is being made in understanding the complex interpretation of the cause of IPF, and demonstrates that PI3K/AKT can directly participate to the greatest extent in the formation of IPF or cooperate with other pathways to promote the development of fibrosis. We further summarize promising PI3K/AKT inhibitors with IPF treatment benefits, including inhibitors in clinical trials and pre-clinical studies and natural products, and discuss how these inhibitors mitigate fibrotic progression to explore possible potential agents, which will help to develop effective treatment strategies for IPF in the near future.     

Discovery of a Novel Series of Thienopyrimidine as Highly Potent and Selective PI3K Inhibitors

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Pirfenidone for the treatment of idiopathic pulmonary fibrosis

Although multidrug therapy is required in order to achieve good blood pressure control in many hypertensives, there are no studies directly comparing fixed-dose combinations as initial therapy. The Avoiding Cardiovascular events through COMbination therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial compares regimens of benazepril plus amlodipine versus benazepril plus hydrochlorothiazide, force-titrated to 40/10 and 40/25mg, respectively. A total of 12,600 high-risk hypertensives have been randomised and will be followed for 3 – 5years, during which cardiovascular events will be monitored. The investigators hypothesise that the benazepril plus amlodipine regimen will decrease cardiovascular events by 15% compared with benazepril plus hydrochlorothiazide. Recruitment began in 2003, and the trial is expected to end in 2008. The ACCOMPLISH trial shares important limitations with many other recent trials that will make it difficult to apply the results in clinical practice. These include the focus on high-risk hypertensive patients, in whom significant reductions in relative risk will translate into meaningful reductions in absolute risk: in lower-risk hypertensives with a low absolute risk, similar relative risk reductions may not be of great impact on the population disease burden. In ACCOMPLISH, as in most industry-sponsored clinical trials, the main goal appears to be market-driven: doses of drugs tested are not those available for clinical practice. The question asked, whether the combination of benazepril with either diuretic or dihydropyridine calcium channel blocker is more efficacious, is not a clinically compelling one. Finally, the univariate subgroup analyses proposed are unlikely to lead to an understanding of whether either combination has specific advantages for patients encountered clinically, most of whom have multiple risk factors. Thus, it appears that ACCOMPLISH, as with many recent pharmacological trials, will not greatly impact the treatment of hypertension.     

Targeting the endothelin pathway in the idiopathic pulmonary fibrosis: the role of bosentan

Background: Idiopathic pulmonary fibrosis (IPF) is a rapidly lethal disease characterized by anarchic, progressive fibrosis. Pulmonary fibrosis is the result of interactions between many effector cells and cytokines and better understanding of this can help with identification of novel therapeutic targets. Objective: To evaluate the role of the endothelin-1 (ET-1) pathway in IPF pathogenesis and the effects of therapeutic targeting with bosentan, an ET-1 antagonist. Methods: Data on ET-1's pathogenic involvement in IPF and the preclinical and clinical data on bosentan in this context are discussed and analyzed. A parallel overview of existing and upcoming therapies for IPF is presented. Conclusions: Bosentan is a promising antifibrotic therapy for IPF and clinical data on its long-term efficacy support its use.     

成纤维细胞在特发性肺纤维化发病机制及治疗中的研究进展

目前治疗特发性肺纤维化(IPF)的主要药物为糖皮质激素和免疫抑制剂,但其疗效尚未获得明确的临床证据.IPF中的主要效应细胞为成纤维细胞,干扰成纤维细胞的增殖对抑制IPF的进展有重要的临床意义.本文重点论述IPF的诊断标准并综述成纤维细胞在IPF发病机制及治疗中的研究进展.     

Nintedanib for the treatment of idiopathic pulmonary fibrosis

Introduction: Idiopathic Pulmonary Fibrosis (IPF) is an interstitial lung disease characterized by the progressive loss of pulmonary function, ultimately leading to respiratory failure and death. Two novel compounds, nintedanib and pirfenidone, have shown efficacy in reducing the rate of decline of lung function in IPF patients. The multiple tyrosine kinase inhibitor nintedanib has extensively being studied as a potential angiogenesis inhibitor in clinical against various neoplastic disorders. Afterwards, this compound was successfully tested in IPF.

Areas covered: Herein, the authors review the working mechanisms of nintedanib, its pharmacological profile, and its efficacy and safety for patients with IPF.

Expert opinion: Nintedanib has shown to be safe and effective in patients with IPF, with a favorable long-term safety profile. There is a lack of comparative trials of pirfenidone and nintedanib, and the choice of treatment is left to the physicians’ judgement. Future directions of nintedanib use are represented by the treatment of progressive fibrosing interstitial lung disease other than IPF, IPF with advanced functional impairment, and lung fibrosis secondary to connective tissue diseases. A promising safety profile for the combinational use of nintedanib and pirfenidone in IPF has also recently emerged.     

补肺活血胶囊对肺纤维化模型小鼠的治疗作用及对PI3K/Akt信号通路的影响

目的 探索补肺活血胶囊治疗特发性肺纤维化的作用及其机制。方法 将60只C57BL/6J雄性小鼠分为对照组、模型组、吡非尼酮组及补肺活血胶囊高、低剂量组,每组各12只。除对照组外,其余各组小鼠气管滴注博来霉素建立肺纤维化模型。造模后第1天开始干预治疗,补肺活血胶囊低、高剂量组分别ig 315、630 mg/(kg∙d)的补肺活血胶囊溶液,吡非尼酮组ig吡非尼酮200 mg/(kg∙d),对照组、模型组ig等剂量生理盐水。连续给药28 d后取材,收集小鼠的肺组织,分别运用苏木精–伊红染色（HE）和马松（Masson）法观察小鼠的肺组织病理学变化,酶联免疫吸附法（ELISA）检测肺组织羟脯氨酸（HYP）含量,实时荧光定量（qRT-PCR）法检测肺组织Ⅰ型胶原蛋白（COL-I）、纤连蛋白1（Fn1）、α-平滑肌肌动蛋白（α-SMA）mRNA相对表达水平,免疫组化法检测肺组织磷酸化的磷脂酰肌醇-3-激酶（p-PI3K）和磷酸化的蛋白激酶B（p-Akt）蛋白的表达水平。结果 与对照组比较,模型组小鼠肺组织结构明显被破坏、炎症细胞渗出及胶原纤维沉积增多,肺组织中HYP含量明显升高,COL-I、Fn1、α-SMA mRNA相对表达量均明显升高,p-PI3K和p-Akt蛋白的表达量显著升高（P＜0.01）;与模型组相比,补肺活血胶囊高剂量组、吡非尼酮组小鼠肺组织结构改善明显、炎症细胞渗出以及胶原纤维沉积明显减少,肺组织中HYP含量明显降低,COL-Ⅰ、Fn1、α-SMA mRNA相对表达量均明显降低,p-PI3K和p-Akt蛋白的表达量显著降低（P＜0.01）。结论 补肺活血胶囊具有抗纤维化的作用,可能与PI3K/Akt信号通路有关。     

Novel 1,5-naphthyridine PI3Kδ inhibitors,an evaluation of WO2011075628

A small series of aryl(1-arylamino)ethyl,1,5-naphthyridine derivatives that selectively inhibit PI3Kδ was prepared. The compounds are claimed to be useful in the treatment of cancer, inflammatory and autoimmune diseases. The compounds represent further variations around a structural motif explored in a number of previous applications by the applicant.     

甘草次酸对胃癌细胞SGC7901增殖、凋亡及PI3K-Akt-mTOR通路的影响

目的 探究甘草次酸对胃癌SGC7901细胞增殖、凋亡及PI3K-Akt-mTOR通路的影响。方法 体外培养胃癌SGC7901细胞,分为对照组和甘草次酸低、中、高浓度（12.5、25.0、50.0 μmol/L）组,药物处理24、48、72 h后,CCK-8法检测细胞增殖情况;药物处理48 h后,流式细胞仪检测细胞周期分布及细胞凋亡情况;Western blotting检测凋亡相关蛋白Bcl-2、Bax、cleaved Caspase-3以及PI3K-Akt-mTOR信号通路中磷酸化PI3K、Akt、mTOR蛋白表达水平。结果 甘草次酸低、中、高浓度组胃癌SGC7901细胞增殖受到明显抑制,并呈时间和剂量相关性（P<0.05）。与对照组比较,甘草次酸低、中、高浓度组胃癌SGC7901细胞G₀/G₁期细胞比例显著降低（P<0.05）,G₂/M期细胞比例及凋亡率显著升高（P<0.05）,Bax、cleaved Caspase-3蛋白表达水平显著升高（P<0.05）,Bcl-2、p-PI3K、p-Akt、p-mTOR蛋白表达水平显著降低（P<0.05）。结论 甘草次酸可抑制胃癌SGC7901细胞增殖,促进其凋亡,其机制可能与抑制PI3K-Akt-mTOR信号通路激活有关。     

Effect of Inhibiting Histone Deacetylase with Short-Chain Carboxylic Acids and Their Hydroxamic Acid Analogs on Vertebrate Development and Neuronal Chromatin

Carboxylic acids with known central nervous system and histone deacetylase (HDAC) inhibitory activities were converted to hydroxamic acids and tested using a suite of in vitro biochemical assays with recombinant HDAC isoforms, cell based assays in human cervical carcinoma Hela cells and primary cultures from mouse forebrain, and a whole animal (Xenopus laevis) developmental assay. Relative to the parent carboxylic acids, two of these analogs exhibited enhanced potency, and one analog showed altered HDAC isoform selectivity and in vivo activity in the Xenopus assay. We discuss potential uses of these novel hydroxamic acids in studies aimed at determining the utility of HDAC inhibitors as memory enhancers and mood stabilizers.     

Evaluation of WO2012037204 and WO2012037226: Exelixis' selective PI3Kδ inhibitors; the basis of a US$251 million deal

Two applications each claim compounds described as selective PI3Kδ inhibitors. The first claims 2-amino-3-substituted-8-methylquinoline derivatives. The second, more substantial, application claims a broad range of cyclic amine derivatives of 6-aminopurines. These are the first patent applications from Exelixis relating to its PI3Kδ inhibitor program despite its disclosure of the biological profile of its lead inhibitor XL-499 in late 2010.     

Novel inhibitors of the PI3K family

PI3K is an important node regulating the signaling of several essential biological processes. PI3K catalyzes the phosphorylation in position 3 of the inositol ring of phosphatidyl-inositide producing important lipid second messengers. The products of PI3K activity recruit PDK1 and AKT Ser/Thr kinases to the plasma membrane where they get activated transducing a potent proliferative and anti-apoptotic signal to the cell. PI3K is activated by growth factors, insulin and GPCR activation. Furthermore, PI3K can be activated by direct binding to oncogenic Ras proteins. PI3K is commonly altered in human cancers by point activating mutations or by amplification. Furthermore, other proteins of the route are also altered in human tumors (such as phosphatase and tensin homolog in chromosome 10 or human EGF receptor 2) providing constitutive activation of PI3K. The evidence indicates that the PI3K pathway is a potential target for cancer chemotherapy. Indeed, many companies and academic laboratories have initiated a variety of approaches to inhibit the PI3K pathway at different points. In this work, we review the targeting of PI3K protein for therapeutical intervention.     

新型PI3K抑制剂邻苯二甲酰亚胺及其衍生物的设计合成与抗肿瘤活性

目的设计合成新的磷脂酰肌醇3-激酶抑制剂,并测定其体外活性。方法通过结构替换、分子对接技术设计一系列邻苯二甲酰亚胺类化合物。以4-溴邻苯二甲酸酐为原料经胺解反应得到N-芳基-4-溴邻苯二甲酰亚胺Ⅰ1～Ⅰ8;Ⅰ1～Ⅰ8再与3-(4-氟苯磺酰胺基)苯硼酸经Suzuki偶联得到N-芳基-4-(3-对氟苯磺酰胺苯基)邻苯二甲酰亚胺Ⅲ1～Ⅲ8;以阿霉素为阳性对照,采用MTT法进行体外活性测定。结果与结论合成了16个未见文献报道的邻苯二甲酰亚胺类化合物,目标化合物的结构经1H-NMR、MS谱确证;体外活性实验结果显示,N-芳基-4-(3-对氟苯磺酰胺苯基)邻苯二甲酰亚胺衍生物具有潜在的抑制肿瘤生长作用,其中,化合物Ⅲ1对A549、MCF-7肿瘤细胞表现出显著的抑制活性,具有进一步研究的价值。