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肿瘤细胞内氧化还原状态与耐药性——偶然发现还是因果关系?

Tumor intracellular redox status and drug resistance--serendipity or a causal relationship?

作者信息

Pervaiz Shazib, Clement Marie-Veronique

机构信息

NUS Graduate School for Integrative Sciences and Engineering, Faculty of Medicine, National University of Singapore, Singapore 117597.

出版信息

Curr Pharm Des. 2004;10(16):1969-77. doi: 10.2174/1381612043384411.


DOI:10.2174/1381612043384411
PMID:15180532
Abstract

Reducing tumor load by therapeutic induction of cell death in the transformed phenotype is the desirable goal of most chemotherapeutic regimens. Despite the tremendous strides made in our understanding of mechanisms that endow tumor cells with the ability to evade execution signals, development of chemo-resistance is still a major obstacle in the successful management of the disease. A host of factors have been implicated in the acquisition of the resistant phenotype, such as activation of drug efflux pumps, overexpression of proteins that inhibit cell death, absence of critical members of the death circuitry, and selective loss of cell cycle checkpoints. Consequently, it is now well established that the process of carcinogenesis is not only a result of an increase in cells' proliferative capacity, but a product of increased proliferation and defective or diminished cell death signaling. To that end, one of the critical determinants of cellular response to exogenous stimuli is the cellular redox status. Intracellular generation of reactive oxygen species (ROS) is tightly regulated by the intrinsic anti-oxidant defense systems. Despite the conventional dogma that ROS are harmful to the cell, experimental evidence over the last decade or so bear witness to the fact that ROS also play an important role as signaling molecules in diverse physiological processes. Indeed, low levels of intracellular ROS have been linked to cellular proliferation and cell cycle progression, which provides an explanation for the pro-oxidant state invariably associated with the transformed phenotype. Coupled to that are recent observations implicating pro-oxidant intracellular milieu in tumor cells' resistance to cell death signals delivered through the cell surface receptor or upon exposure to chemotherapeutic drugs. These studies provide convincing evidence to support a direct or indirect role for intracellular superoxide anion in creating an intracellular milieu non-permissive for cell death execution. Thus a novel approach to enhancing tumor cell sensitivity to chemotherapy-induced cell death would be to favourably tailor the cytosolic milieu to allow efficient apoptotic execution. Here we present a brief discussion on the role of ROS in cell growth and differentiation, and more specifically address the issue of chemo-resistance from the standpoint of cellular redox status.

摘要

通过治疗性诱导转化表型中的细胞死亡来降低肿瘤负荷是大多数化疗方案的理想目标。尽管我们在理解赋予肿瘤细胞逃避死亡信号能力的机制方面取得了巨大进展,但化疗耐药性的发展仍然是成功治疗该疾病的主要障碍。许多因素与耐药表型的获得有关,如药物外排泵的激活、抑制细胞死亡的蛋白质的过度表达、死亡信号通路关键成员的缺失以及细胞周期检查点的选择性丧失。因此,现在已经明确,致癌过程不仅是细胞增殖能力增加的结果,而且是增殖增加以及细胞死亡信号传导缺陷或减弱的产物。为此,细胞对外源刺激反应的关键决定因素之一是细胞氧化还原状态。细胞内活性氧(ROS)的产生受到内在抗氧化防御系统的严格调控。尽管传统观念认为ROS对细胞有害,但过去十年左右的实验证据证明,ROS在多种生理过程中作为信号分子也发挥着重要作用。事实上,细胞内低水平的ROS与细胞增殖和细胞周期进程有关,这为与转化表型始终相关的促氧化状态提供了解释。与此相关的是最近的观察结果,表明促氧化的细胞内环境与肿瘤细胞对通过细胞表面受体传递的细胞死亡信号或暴露于化疗药物时的耐药性有关。这些研究提供了令人信服的证据,支持细胞内超氧阴离子在创造不允许细胞死亡执行的细胞内环境中起直接或间接作用。因此,增强肿瘤细胞对化疗诱导的细胞死亡敏感性的一种新方法是有利地调整胞质环境以允许有效的凋亡执行。在这里,我们简要讨论ROS在细胞生长和分化中的作用,并更具体地从细胞氧化还原状态的角度探讨化疗耐药性问题。

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