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全身化疗与局部递送干细胞的S-TRAIL联合用于切除的脑肿瘤治疗。

Combination of systemic chemotherapy with local stem cell delivered S-TRAIL in resected brain tumors.

作者信息

Redjal Navid, Zhu Yanni, Shah Khalid

机构信息

Molecular Neurotherapy and Imaging Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Stem Cells. 2015 Jan;33(1):101-10. doi: 10.1002/stem.1834.

Abstract

Despite advances in standard therapies, the survival of glioblastoma multiforme (GBM) patients has not improved. Limitations to successful translation of new therapies include poor delivery of systemic therapies and use of simplified preclinical models which fail to reflect the clinical complexity of GBMs. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis specifically in tumor cells and we have tested its efficacy by on-site delivery via engineered stem cells (SC) in mouse models of GBM that mimic the clinical scenario of tumor aggressiveness and resection. However, about half of tumor lines are resistant to TRAIL and overcoming TRAIL-resistance in GBM by combining therapeutic agents that are currently in clinical trials with SC-TRAIL and understanding the molecular dynamics of these combination therapies are critical to the broad use of TRAIL as a therapeutic agent in clinics. In this study, we screened clinically relevant chemotherapeutic agents for their ability to sensitize resistant GBM cell lines to TRAIL induced apoptosis. We show that low dose cisplatin increases surface receptor expression of death receptor 4/5 post G2 cycle arrest and sensitizes GBM cells to TRAIL induced apoptosis. In vivo, using an intracranial resection model of resistant primary human-derived GBM and real-time optical imaging, we show that a low dose of cisplatin in combination with synthetic extracellular matrix encapsulated SC-TRAIL significantly decreases tumor regrowth and increases survival in mice bearing GBM. This study has the potential to help expedite effective translation of local stem cell-based delivery of TRAIL into the clinical setting to target a broad spectrum of GBMs.

摘要

尽管标准疗法取得了进展,但多形性胶质母细胞瘤(GBM)患者的生存率并未提高。新疗法成功转化的局限性包括全身疗法的递送不佳以及使用简化的临床前模型,这些模型无法反映GBM的临床复杂性。肿瘤坏死因子相关凋亡诱导配体(TRAIL)特异性地诱导肿瘤细胞凋亡,我们已通过工程干细胞(SC)在GBM小鼠模型中进行现场递送测试其疗效,该模型模拟了肿瘤侵袭和切除的临床情况。然而,约一半的肿瘤细胞系对TRAIL耐药,通过将目前正在临床试验的治疗药物与SC-TRAIL联合使用来克服GBM中的TRAIL耐药性,并了解这些联合疗法的分子动力学,对于TRAIL作为治疗药物在临床上的广泛应用至关重要。在本研究中,我们筛选了具有临床相关性的化疗药物,以了解它们使耐药GBM细胞系对TRAIL诱导的凋亡敏感的能力。我们发现低剂量顺铂在G2期细胞周期停滞后增加死亡受体4/5的表面受体表达,并使GBM细胞对TRAIL诱导的凋亡敏感。在体内,使用耐药原发性人源GBM的颅内切除模型和实时光学成像,我们发现低剂量顺铂与合成细胞外基质包裹的SC-TRAIL联合使用可显著降低肿瘤再生,并提高携带GBM小鼠的生存率。这项研究有可能有助于加快基于局部干细胞递送TRAIL的有效转化,使其进入临床环境,以靶向广泛的GBM。

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