Rossi Francesca, Di Paola Alessandra, Pota Elvira, Argenziano Maura, Di Pinto Daniela, Marrapodi Maria Maddalena, Di Leva Caterina, Di Martino Martina, Tortora Chiara
Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 4, 80138 Napoli, Italy.
Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via S. Maria di Costantinopoli 16, 80138 Napoli, Italy.
Cancers (Basel). 2021 Sep 30;13(19):4933. doi: 10.3390/cancers13194933.
Anti-cancer treatments improve survival in children with cancer. A total of 80% of children treated for childhood cancer achieve 5-year survival, becoming long-term survivors. However, they undergo several chronic late effects related to treatments. In childhood cancer survivors a chronic low-grade inflammation, known as inflamm-aging, is responsible for frailty, a condition characterized by vital organ failure and by premature aging processes. Inflamm-aging is closely related to chemotherapy and radiotherapy, which induce inflammation, accumulation of senescent cells, DNA mutations, and the production of reactive oxygen species. All these conditions are responsible for the onset of secondary diseases, such as osteoporosis, cardiovascular diseases, obesity, and infertility. Considering that the pathobiology of frailty among childhood cancer survivors is still unknown, investigations are needed to better understand frailty's biological and molecular processes and to identify inflamm-aging key biomarkers in order to facilitate the screening of comorbidities and to clarify whether treatments, normally used to modulate inflamm-aging, may be beneficial. This review offers an overview of the possible biological mechanisms involved in the development of inflamm-aging, focusing our attention on immune system alteration, oxidative stress, cellular senescence, and therapeutic strategies.
抗癌治疗可提高儿童癌症患者的生存率。接受儿童癌症治疗的儿童中，共有80%实现了5年生存，成为长期幸存者。然而，他们会经历与治疗相关的几种慢性晚期效应。在儿童癌症幸存者中，一种称为炎症衰老的慢性低度炎症是导致虚弱的原因，虚弱是一种以重要器官功能衰竭和过早衰老过程为特征的状况。炎症衰老与化疗和放疗密切相关，化疗和放疗会引发炎症、衰老细胞的积累、DNA突变以及活性氧的产生。所有这些情况都会导致继发性疾病的发生，如骨质疏松症、心血管疾病、肥胖症和不孕症。鉴于儿童癌症幸存者中虚弱的病理生物学仍然未知，需要进行研究以更好地了解虚弱的生物学和分子过程，并确定炎症衰老的关键生物标志物，以便于筛查合并症，并阐明通常用于调节炎症衰老的治疗方法是否有益。本综述概述了炎症衰老发展过程中可能涉及的生物学机制，重点关注免疫系统改变、氧化应激、细胞衰老和治疗策略。
