辐射诱导血管损伤的生物标志物。
Biomarkers of radiation-induced vascular injury.
机构信息
Departments of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
出版信息
Cancer Rep (Hoboken). 2019 Apr;2(2):e1152. doi: 10.1002/cnr2.1152. Epub 2018 Dec 3.
OBJECTIVE
Cancer survivorship has thrown the spotlight on the incidence of nonmalignant chronic diseases in cancer patients. Endothelial injury is increasingly recognized as a consequence of cancer treatment, particularly after radiation therapy (RT). This review is to provide a current understanding on the pathophysiological mechanisms and predictive biomarkers of radiation-induced vascular injury.
RECENT FINDINGS
Radiation directly impacts vasculature by causing endothelial apoptosis and senescence, and alterations in normal homeostasis. This altered milieu at the endothelial surface may contribute to a systemic chronic inflammatory state that is superimposed upon the cascade of normal senescence processes leading to acceleration of age-related disorders, atherosclerosis, and chronic fibrosis. Vasculature imaging, blood-based or cell-component biomarkers, and signatures of genomics, proteomics, metabolomics, and radiomics are potential tools for detection of vascular damage after irradiation.
CONCLUSIONS
Development of a valid prediction model by combining an array of imaging tools, blood-based biomarkers, coupled with novel predictors like exosomes and metabolic degradation products can serve to identify RT-induced vascular injury early for subsequent introduction of newer therapeutic approaches to counter radiation morbidity.
目的
癌症生存研究使人们关注癌症患者中非恶性慢性疾病的发病率。血管内皮损伤越来越被认为是癌症治疗的后果，特别是放射治疗（RT）之后。本综述旨在提供对放射诱导的血管损伤的病理生理机制和预测生物标志物的最新认识。
最近的发现
放射直接通过引起内皮细胞凋亡和衰老以及正常稳态的改变来影响血管。内皮表面这种改变的环境可能导致全身性慢性炎症状态，这种状态叠加在正常衰老过程的级联反应之上，导致与年龄相关的疾病、动脉粥样硬化和慢性纤维化的加速。血管成像、基于血液的或细胞成分的生物标志物以及基因组学、蛋白质组学、代谢组学和放射组学的特征是检测照射后血管损伤的潜在工具。
结论
通过结合一系列成像工具、基于血液的生物标志物以及新型预测因子（如外泌体和代谢降解产物）来开发有效的预测模型，可以早期识别 RT 诱导的血管损伤，随后引入新的治疗方法来对抗辐射引起的疾病。
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