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[聚(ADP-核糖)聚合酶抑制剂——理论基础与临床应用]

[PARP inhibitors--theoretical basis and clinical application].

作者信息

Dębska Sylwia, Kubicka Joanna, Czyżykowski Rafał, Habib Maja, Potemski Piotr

机构信息

Klinika Chemioterapii Nowotworów Katedry Onkologii UM w Łodzi, Szpital Specjalistyczny im. M. Kopernika w Łodzi.

出版信息

Postepy Hig Med Dosw (Online). 2012 May 30;66:311-21. doi: 10.5604/17322693.999033.

Abstract

Poly-ADP-ribose polymerases (PARP) are involved in a number of processes that are vital for every living cell. Once activated by the presence of DNA damage they trigger poly-ADP-ribosylation of various proteins which are crucial for DNA repair, preserving of genom integrity, regulation of transcription, proliferation and apoptosis. PARP1, which is the best known enzyme of PARP protein family, plays a role in single-strand breaks (SSB) repair. Decrease of its activity results in accumulation of single strand DNA breaks (SSB) which leads as a consequence to double-strand breaks (DSBs). This disorder is particularly harmful to cells with deficiency of BRCA1/2 protein which is involved in repair of DNA double-strand breaks. This phenomenon is an example of "synthetic lethality" concept and contributes to research on application of PARP inhibitors in treatment of cancers associated with BRCA1/2 protein defect (breast or ovarian cancer). Noticed synergism between PARP inhibitors and genotoxic chemotherapy or radiotherapy determined another direction of research on application of these medicaments. After promising results of phase I and II trials with most commonly investigated PARP inhibitors--iniparib and olaparib--which recruited patients with triple negative breast cancer and ovarian cancer, further studies started. This paper presents theoretical basis of PARP inhibitors action as well as critical review of most important clinical trials of these medicaments.

摘要

聚-ADP-核糖聚合酶(PARP)参与许多对每个活细胞都至关重要的过程。一旦因DNA损伤的存在而被激活,它们就会触发各种蛋白质的聚-ADP-核糖基化,这些蛋白质对于DNA修复、基因组完整性的维持、转录调控、细胞增殖和凋亡至关重要。PARP1是PARP蛋白家族中最知名的酶,在单链断裂(SSB)修复中发挥作用。其活性降低会导致单链DNA断裂(SSB)积累,进而导致双链断裂(DSB)。这种紊乱对缺乏参与DNA双链断裂修复的BRCA1/2蛋白的细胞特别有害。这种现象是“合成致死”概念的一个例子,并有助于PARP抑制剂在治疗与BRCA1/2蛋白缺陷相关的癌症(乳腺癌或卵巢癌)中的应用研究。PARP抑制剂与基因毒性化疗或放疗之间已发现的协同作用确定了这些药物应用研究的另一个方向。在对最常研究的PARP抑制剂——依尼帕尼和奥拉帕尼——进行的I期和II期试验取得了有前景的结果,这些试验招募了三阴性乳腺癌和卵巢癌患者后,进一步的研究开始了。本文介绍了PARP抑制剂作用的理论基础以及对这些药物最重要临床试验的批判性综述。

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