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表皮生长因子与表皮生长因子受体:皮肤创伤治疗与癌症治疗中的阴阳关系

Epidermal Growth Factor and Epidermal Growth Factor Receptor: The Yin and Yang in the Treatment of Cutaneous Wounds and Cancer.

作者信息

Bodnar Richard J

机构信息

Department of Pathology, University of Pittsburgh , Pittsburgh, Pennsylvania. ; Pittsburgh Veterans Affairs Healthcare System , Pittsburgh, Pennsylvania.

出版信息

Adv Wound Care (New Rochelle). 2013 Feb;2(1):24-29. doi: 10.1089/wound.2011.0326.

Abstract

SIGNIFICANCE

Epidermal growth factor (EGF) and EGF receptor (EGFR) play an essential role in wound healing through stimulating epidermal and dermal regeneration. The development of new therapies for enhancing wound healing has included the use of EGF. In addition, EGFR inhibitors (EGFRis) have become a therapeutic option for the treatment of cancer. Thus, therapies targeting EGF/EGFR are useful for the treatment of both cutaneous wounds and cancer.

RECENT ADVANCES

Identification of EGFR as a regulator of normal and pathological cell function has allowed for the development of EGFRis for the treatment of cancer and topical administration of EGF to enhance wound healing.

CRITICAL ISSUES

The use of EGFRi has emerged as an option for metastatic cancers. These drugs induce dermatological toxicity, a papulopustular rash that is pruritic and painful; chronic use may negatively impact wound healing. Currently, there is no standard therapy to alleviate the side effects caused by EGFRi administration except to reduce or eliminate EGFRi usage. Therefore, side effects from these drugs should be taken into consideration on patients prone to develop chronic wounds and with cutaneous injuries.

FUTURE DIRECTIONS

There is a need for adjunctive treatment to eliminate dermatological toxicity from EGFRi use. The development of new downstream targets of EGFR may be a rational strategy to reduce potential cutaneous side effects and provide a better strategy for the treatment of cancer. Until then, the topical use of EGF could be used to ameliorate dermatological lesions caused by EGFRi.

摘要

意义

表皮生长因子(EGF)和表皮生长因子受体(EGFR)通过刺激表皮和真皮再生在伤口愈合中发挥重要作用。增强伤口愈合的新疗法的开发包括使用EGF。此外,EGFR抑制剂(EGFRis)已成为癌症治疗的一种选择。因此,靶向EGF/EGFR的疗法对皮肤伤口和癌症的治疗均有用。

最新进展

将EGFR鉴定为正常和病理细胞功能的调节因子,使得开发用于治疗癌症的EGFRis以及局部施用EGF以促进伤口愈合成为可能。

关键问题

EGFRi已成为转移性癌症的一种治疗选择。这些药物会引起皮肤毒性,即一种瘙痒且疼痛的丘疹脓疱性皮疹;长期使用可能会对伤口愈合产生负面影响。目前,除了减少或停用EGFRi外,没有标准疗法来减轻EGFRi给药引起的副作用。因此,对于容易形成慢性伤口和有皮肤损伤的患者,应考虑这些药物的副作用。

未来方向

需要辅助治疗来消除使用EGFRi引起的皮肤毒性。开发EGFR的新下游靶点可能是减少潜在皮肤副作用并提供更好癌症治疗策略的合理策略。在此之前,局部使用EGF可用于改善由EGFRi引起的皮肤病变。

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