Brown Thomas J, James Victoria
Biodiscovery Institute, School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK.
Cancers (Basel). 2021 May 18;13(10):2435. doi: 10.3390/cancers13102435.
Cancer stem cells (CSCs) have increasingly been shown to be a crucial element of heterogenous tumors. Although a relatively small component of the population, they increase the resistance to treatment and the likelihood of recurrence. In recent years, it has been shown, across multiple cancer types (e.g., colorectal, breast and prostate), that reciprocal communication between cancer and the microenvironment exists, which is, in part, facilitated by extracellular vesicles (EVs). However, the mechanisms of this method of communication and its influence on CSC populations is less well-understood. Therefore, the aim of this systematic review is to determine the evidence that supports the role of EVs in the manipulation of the tumor microenvironment to promote the survival of CSCs. Embase and PubMed were used to identify all studies on the topic, which were screened using PRISMA guidelines, resulting in the inclusion of 16 studies. These 16 studies reported on the EV content, pathways altered by EVs and therapeutic targeting of CSC through EV-mediated changes to the microenvironment. In conclusion, these studies demonstrated the role of EV-facilitated communication in maintaining CSCs via manipulation of the tumor microenvironment, demonstrating the potential of creating therapeutics to target CSCs. However, further works are needed to fully understand the targetable mechanisms upon which future therapeutics can be based.
癌症干细胞（CSCs）越来越被证明是异质性肿瘤的关键组成部分。尽管在肿瘤细胞群体中所占比例相对较小，但它们会增加肿瘤对治疗的抗性以及复发的可能性。近年来，在多种癌症类型（如结直肠癌、乳腺癌和前列腺癌）中都已表明，癌症与微环境之间存在相互作用，而细胞外囊泡（EVs）在一定程度上促进了这种相互作用。然而，这种通讯方式的机制及其对癌症干细胞群体的影响仍不太清楚。因此，本系统综述的目的是确定支持细胞外囊泡在操纵肿瘤微环境以促进癌症干细胞存活中所起作用的证据。使用Embase和PubMed数据库来识别关于该主题的所有研究，并根据PRISMA指南进行筛选，最终纳入了16项研究。这16项研究报告了细胞外囊泡的内容、由细胞外囊泡改变的信号通路以及通过细胞外囊泡介导的微环境变化对癌症干细胞进行治疗靶向。总之，这些研究证明了细胞外囊泡介导的通讯在通过操纵肿瘤微环境来维持癌症干细胞方面的作用，表明了开发针对癌症干细胞的治疗方法的潜力。然而，还需要进一步的研究来全面了解未来治疗方法所基于的可靶向机制。
