与光动力疗法相关的纳米医学用于胶质母细胞瘤治疗。
Nanomedicine associated with photodynamic therapy for glioblastoma treatment.
作者信息
de Paula Leonardo B, Primo Fernando L, Tedesco Antonio C
机构信息
Department of Chemistry, Center of Nanotechnology and Tissue Engineering - Photobiology and Photomedicine Research Group, Faculty of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, 14040-901, São Paulo, Brazil.
School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, 14801-903, São Paulo, Brazil.
出版信息
Biophys Rev. 2017 Oct;9(5):761-773. doi: 10.1007/s12551-017-0293-3. Epub 2017 Aug 19.
Glioblastoma, also known as glioblastoma multiforme (GBM), is the most recurrent and malignant astrocytic glioma found in adults. Biologically, GBMs are highly aggressive tumors that often show diffuse infiltration of the brain parenchyma, making complete surgical resection difficult. GBM is not curable with surgery alone because tumor cells typically invade the surrounding brain, rendering complete resection unsafe. Consequently, present-day therapy for malignant glioma remains a great challenge. The location of the invasive tumor cells presents several barriers to therapeutic delivery. The blood-brain barrier regulates the trafficking of molecules to and from the brain. While high-grade brain tumors contain some "leakiness" in their neovasculature, the mechanisms of GBM onset and progression remain largely unknown. Recent advances in the understanding of the signaling pathways that underlie GBM pathogenesis have led to the development of new therapeutic approaches targeting multiple oncogenic signaling aberrations associated with the GBM. Among these, drug delivery nanosystems have been produced to target therapeutic agents and improve their biodistribution and therapeutic index in the tumor. These systems mainly include polymer or lipid-based carriers such as liposomes, metal nanoparticles, polymeric nanospheres and nanocapsules, micelles, dendrimers, nanocrystals, and nanogold. Photodynamic therapy (PDT) is a promising treatment for a variety of oncological diseases. PDT is an efficient, simple, and versatile method that is based on a combination of a photosensitive drug and light (generally laser-diode or laser); these factors are separately relatively harmless but when used together in the presence of oxygen molecules, free radicals are produced that initiate a sequence of biological events, including phototoxicity, vascular damage, and immune responses. Photodynamic pathways activate a cascade of activities, including apoptotic and necrotic cell death in both the tumor and the neovasculature, leading to a permanent lesion and destruction of GBM cells that remain in the healthy tissue. Glioblastoma tumors differ at the molecular level. For example, gene amplification epidermal growth factor receptor and its receptor are more highly expressed in primary GBM than in secondary GBM. Despite these distinguishing features, both types of tumors (primary and secondary) arise as a result dysregulation of numerous intracellular signaling pathways and have standard features, such as increased cell proliferation, survival and resistance to apoptosis, and loss of adhesion and migration, and may show a high degree of invasiveness. PDT may promote significant tumor regression and extend the lifetime of patients who experience glioma progression.
胶质母细胞瘤,也称为多形性胶质母细胞瘤(GBM),是成人中最常见且恶性程度最高的星形胶质细胞瘤。从生物学角度来看,GBM是极具侵袭性的肿瘤,常常表现为脑实质的弥漫性浸润,这使得完整的手术切除变得困难。仅通过手术无法治愈GBM,因为肿瘤细胞通常会侵入周围脑组织,使得完整切除不安全。因此,目前针对恶性胶质瘤的治疗仍然是一个巨大的挑战。侵袭性肿瘤细胞的位置给治疗带来了诸多障碍。血脑屏障调节着分子进出大脑的运输。虽然高级别脑肿瘤的新生血管存在一些“渗漏”,但GBM的发病和进展机制在很大程度上仍然未知。对GBM发病机制所涉及的信号通路的最新认识进展,促使了针对与GBM相关的多种致癌信号异常的新治疗方法的开发。其中,已经制备了药物递送纳米系统来靶向治疗剂,并改善其在肿瘤中的生物分布和治疗指数。这些系统主要包括基于聚合物或脂质的载体,如脂质体、金属纳米颗粒、聚合物纳米球和纳米胶囊、胶束、树枝状大分子、纳米晶体和纳米金。光动力疗法(PDT)是一种针对多种肿瘤疾病的有前景的治疗方法。PDT是一种高效、简单且通用的方法,它基于光敏药物和光(通常是激光二极管或激光)的组合;这些因素单独使用时相对无害,但在氧分子存在的情况下一起使用时,会产生自由基,引发一系列生物事件,包括光毒性、血管损伤和免疫反应。光动力途径激活一系列活动,包括肿瘤和新生血管中的凋亡和坏死性细胞死亡,导致GBM细胞在健康组织中形成永久性损伤并被破坏。胶质母细胞瘤肿瘤在分子水平上存在差异。例如,基因扩增的表皮生长因子受体及其受体在原发性GBM中比在继发性GBM中表达更高。尽管有这些区别特征,但两种类型的肿瘤(原发性和继发性)都是由于众多细胞内信号通路失调而产生的,并且具有一些标准特征,如细胞增殖增加、存活和对凋亡的抵抗、黏附丧失和迁移,并且可能表现出高度的侵袭性。PDT可能促进显著的肿瘤消退,并延长经历胶质瘤进展的患者的生存期。