CICS-UBI - Health Sciences Research Centre, Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506, Covilha, Portugal.
Curr Drug Targets. 2018;19(15):1801-1817. doi: 10.2174/1389450119666180115165447.
Several gene deviations can be responsible for triggering oncogenic processes. However, mutations in tumour suppressor genes are usually more associated to malignant diseases, with p53 being one of the most affected and studied element. p53 is implicated in a number of known cellular functions, including DNA damage repair, cell cycle arrest in G1/S and G2/M and apoptosis, being an interesting target for cancer treatment.
Considering these facts, the development of gene therapy approaches focused on p53 expression and regulation seems to be a promising strategy for cancer therapy.
Several studies have shown that transfection of cancer cells with wild-type p53 expressing plasmids could directly drive cells into apoptosis and/or growth arrest, suggesting that a gene therapy approach for cancer treatment can be based on the re-establishment of the normal p53 expression levels and function. Up until now, several clinical research studies using viral and non-viral vectors delivering p53 genes, isolated or combined with other therapeutic agents, have been accomplished and there are already in the market, therapies based on the use of this gene.
This review summarizes the different methods used to deliver and/or target the p53 as well as the main results of therapeutic effect obtained with the different strategies applied. Finally, the ongoing approaches are described, also focusing on the combinatorial therapeutics to show increased therapeutic potential of combining gene therapy vectors with chemo or radiotherapy.
有几种基因变异可能引发致癌过程。然而,肿瘤抑制基因的突变通常与恶性疾病的关系更为密切,其中 p53 是受影响和研究最多的元素之一。p53 参与了许多已知的细胞功能,包括 DNA 损伤修复、G1/S 和 G2/M 细胞周期阻滞和细胞凋亡,是癌症治疗的一个有趣靶点。
考虑到这些事实,针对 p53 表达和调控的基因治疗方法的发展似乎是癌症治疗的一种有前途的策略。
多项研究表明,将野生型 p53 表达质粒转染癌细胞可以直接诱导细胞凋亡和/或生长停滞,这表明癌症治疗的基因治疗方法可以基于重新建立正常的 p53 表达水平和功能。到目前为止,已经完成了使用病毒和非病毒载体传递 p53 基因的几项临床研究,这些基因单独或与其他治疗剂结合使用,并且已经有基于该基因使用的疗法上市。
本文综述了用于传递和/或靶向 p53 的不同方法,以及应用不同策略获得的治疗效果的主要结果。最后,还描述了正在进行的方法,重点关注联合治疗,以展示将基因治疗载体与化疗或放疗联合使用的增加的治疗潜力。