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酪氨酸激酶抑制剂作为缺血性中风和其他神经系统疾病的新疗法:能否带来更好的治疗结果?

Tyrosine Kinase Inhibitor as a new Therapy for Ischemic Stroke and other Neurologic Diseases: is there any Hope for a Better Outcome?

作者信息

Gągało Iwona, Rusiecka Izabela, Kocić Ivan

机构信息

Department of Pharmacology, Medical University of Gdansk, Debowa 23, 80-204, Gdansk, Poland.

出版信息

Curr Neuropharmacol. 2015;13(6):836-44. doi: 10.2174/1570159x13666150518235504.

Abstract

The relevance of tyrosine kinase inhibitors (TKIs) in the treatment of malignancies has been already defined. Aberrant activation of tyrosine kinase signaling pathways has been causally linked not only to cancers but also to other non-oncological diseases. This review concentrates on the novel plausible usage of this group of drugs in neurological disorders, such as ischemic brain stroke, subarachnoid hemorrhage, Alzheimer's disease, multiple sclerosis. The drugs considered here are representatives of both receptor and non-receptor TKIs. Among them imatinib and masitinib have the broadest spectrum of therapeutic usage. Both drugs are effective in ischemic brain stroke and multiple sclerosis, but only imatinib produces a therapeutic effect in subarachnoid hemorrhage. Masitinib and dasatinib reduce the symptoms of Alzheimer's disease. In the case of multiple sclerosis several TKIs are useful, including apart from imatinib and masitinib, also sunitinib, sorafenib, lestaurtinib. Furthermore, the possible molecular targets for the drugs are described in connection with the underlying pathophysiological mechanisms in the diseases in question. The most frequent target for the TKIs is PDGFR which plays a pivotal role particularly in ischemic brain stroke and subarachnoid hemorrhage. The collected data indicates that TKIs are very promising candidates for new therapeutic interventions in neurological diseases.

摘要

酪氨酸激酶抑制剂(TKIs)在恶性肿瘤治疗中的相关性已得到明确。酪氨酸激酶信号通路的异常激活不仅与癌症有因果关系,还与其他非肿瘤性疾病有关。本综述聚焦于这类药物在神经系统疾病中的新潜在用途,如缺血性脑卒、蛛网膜下腔出血、阿尔茨海默病、多发性硬化症。这里所考虑的药物包括受体型和非受体型TKIs的代表。其中,伊马替尼和马西替尼的治疗用途最为广泛。这两种药物对缺血性脑卒和多发性硬化症均有效,但只有伊马替尼对蛛网膜下腔出血有治疗作用。马西替尼和达沙替尼可减轻阿尔茨海默病的症状。对于多发性硬化症,几种TKIs都有用,除了伊马替尼和马西替尼外,还有舒尼替尼、索拉非尼、来他替尼。此外,还结合相关疾病的潜在病理生理机制描述了这些药物可能的分子靶点。TKIs最常见的靶点是血小板衍生生长因子受体(PDGFR),其在缺血性脑卒和蛛网膜下腔出血中尤其起关键作用。收集到的数据表明,TKIs是神经系统疾病新治疗干预措施中非常有前景的候选药物。

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