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表征胶质瘤中的细胞应激和GRP78以加强肿瘤治疗

Characterizing Cell Stress and GRP78 in Glioma to Enhance Tumor Treatment.

作者信息

Liu Kristie, Tsung Kathleen, Attenello Frank J

机构信息

Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.

Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.

出版信息

Front Oncol. 2020 Dec 11;10:608911. doi: 10.3389/fonc.2020.608911. eCollection 2020.

Abstract

Glioblastoma (GBM) is the most common primary brain tumor, carrying a very poor prognosis, with median overall survival at about 12 to 15 months despite surgical resection, chemotherapy with temozolomide (TMZ), and radiation therapy. GBM recurs in the vast majority of patients, with recurrent tumors commonly displaying increase in resistance to standard of care chemotherapy, TMZ, as well as radiotherapy. One of the most commonly cited mechanisms of chemotherapeutic and radio-resistance occurs the glucose-regulated protein 78 (GRP78), a well-studied mediator of the unfolded protein response (UPR), that has also demonstrated potential as a biomarker in GBM. Overexpression of GRP78 has been directly correlated with malignant tumor characteristics, including higher tumor grade, cellular proliferation, migration, invasion, poorer responses to TMZ and radiation therapy, and poorer patient outcomes. GRP78 expression is also higher in GBM tumor cells upon recurrence. Meanwhile, knockdown or suppression of GRP78 has been shown to sensitize cells to TMZ and radiation therapy. In light of these findings, various novel developing therapies are targeting GRP78 as monotherapies, combination therapies that enhance the effects of TMZ and radiation therapy, and as treatment delivery modalities. In this review, we delineate the mechanisms by which GRP78 has been noted to specifically modulate glioblastoma behavior and discuss current developing therapies involving GRP78 in GBM. While further research is necessary to translate these developing therapies into clinical settings, GRP78-based therapies hold promise in improving current standard-of-care GBM therapy and may ultimately lead to improved patient outcomes.

摘要

胶质母细胞瘤(GBM)是最常见的原发性脑肿瘤,预后极差,尽管进行了手术切除、替莫唑胺(TMZ)化疗和放射治疗,总体中位生存期约为12至15个月。绝大多数GBM患者会复发,复发性肿瘤通常对标准护理化疗药物TMZ以及放疗的耐药性增加。化疗和放疗耐药最常被提及的机制之一是葡萄糖调节蛋白78(GRP78),它是一种研究充分的未折叠蛋白反应(UPR)介质,也已证明有潜力作为GBM的生物标志物。GRP78的过表达与恶性肿瘤特征直接相关,包括更高的肿瘤分级、细胞增殖、迁移、侵袭、对TMZ和放疗的反应较差以及患者预后较差。GBM肿瘤细胞复发时GRP78表达也更高。同时,已证明敲低或抑制GRP78可使细胞对TMZ和放疗敏感。鉴于这些发现,各种新型开发疗法将GRP78作为单一疗法、增强TMZ和放疗效果的联合疗法以及治疗递送方式。在本综述中,我们阐述了GRP78被认为特异性调节胶质母细胞瘤行为的机制,并讨论了目前在GBM中涉及GRP78的开发疗法。虽然将这些开发疗法转化为临床应用还需要进一步研究,但基于GRP78的疗法有望改善当前GBM的标准护理疗法,并最终可能改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c3b/7759649/b44d88a6dabc/fonc-10-608911-g001.jpg

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