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从对组蛋白去乙酰化酶抑制剂作用机制的深入理解到恶性淋巴瘤和浆细胞骨髓瘤治疗的进展

From a Better Understanding of the Mechanisms of Action of Histone Deacetylases Inhibitors to the Progress of the Treatment of Malignant Lymphomas and Plasma Cell Myeloma.

作者信息

Mihaila Romeo G

机构信息

"Lucian Blaga" University of Sibiu, Faculty of Medicine, Spitalul Clinic Judetean de Urgenta Sibiu, str Lucian Blaga, nr 2A, Sibiu, 550169 Sibiu, Romania.

出版信息

Recent Pat Anticancer Drug Discov. 2017 Nov 20;12(4):283-295. doi: 10.2174/1574892812666170920110054.

DOI:10.2174/1574892812666170920110054
PMID:28933264
Abstract

BACKGROUND

Notable progress has been made in chemo- and immunotherapy of B-cell lymphomas, but less in the treatment of T-cell lymphomas.

OBJECTIVE

Histone deacetylases inhibitors are a potentially useful therapeutic mean, as an epigenetic dysregulation is present in lymphomas, and especially in T-cell types. We aimed to study the progress made in this area.

METHOD

A mini-review was achieved using the articles published in PubMed in the last two years and the new patents made in this field.

RESULTS

Histone deacetylases inhibitors are involved in the derepression of tumor suppressor genes through a histone deacetylase-mediated transcriptional process. Their inhibition is followed by cell cycle arrest, cell differentiation, apoptosis, sometimes autophagy, and a reversal of the transformed phenotype. They can also remove the resistance to chemo- or immunotherapy through different pathways. Some of them, as romidepsin, may decrease the protein level of multi-drug resistance associated protein 1, followed by a decrease in cellular drug export activity for DNA alkylating agents. Some compounds are approved for relapsed/refractory T-cell lymphomas or multiple myeloma treatment. The recent patents and the clinical trials with a histone deacetylases inhibitor administred in a synergistic drug combination with a demethylating, immunomodulatory, or anticancer agent as well as the discovery of more selective histone deacetylases inhibitors, with fewer side effects, could be a way to increase the treatment efficacy.

CONCLUSION

New and more effective histone deacetylases inhibitors given alone or in drug combination are a solution for an improved response to the treatment of patients with relapsed/refractory lymphoproliferative disorders.

摘要

背景

B细胞淋巴瘤的化疗和免疫治疗已取得显著进展,但T细胞淋巴瘤的治疗进展较少。

目的

组蛋白去乙酰化酶抑制剂是一种潜在有用的治疗手段,因为淋巴瘤尤其是T细胞类型存在表观遗传失调。我们旨在研究该领域取得的进展。

方法

通过检索过去两年在PubMed上发表的文章以及该领域的新专利进行小型综述。

结果

组蛋白去乙酰化酶抑制剂通过组蛋白去乙酰化酶介导的转录过程参与肿瘤抑制基因的去抑制。其抑制作用随后导致细胞周期停滞、细胞分化、凋亡,有时还会引发自噬,并逆转转化表型。它们还可以通过不同途径消除对化疗或免疫治疗的耐药性。其中一些药物,如罗米地辛,可能会降低多药耐药相关蛋白1的水平,进而降低细胞对DNA烷化剂的药物输出活性。一些化合物已被批准用于复发/难治性T细胞淋巴瘤或多发性骨髓瘤的治疗。最近的专利以及将组蛋白去乙酰化酶抑制剂与去甲基化、免疫调节或抗癌药物联合使用的临床试验,以及发现副作用更少的更具选择性的组蛋白去乙酰化酶抑制剂,可能是提高治疗效果的一种方法。

结论

单独使用或联合用药的新型更有效的组蛋白去乙酰化酶抑制剂是改善复发/难治性淋巴增殖性疾病患者治疗反应的一种解决方案。

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