自噬调节作为胶质母细胞瘤的一种治疗选择
Regulation of autophagy as a therapeutic option in glioblastoma.
作者信息
Manea Amanda J, Ray Swapan K
机构信息
Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC, 29209, USA.
出版信息
Apoptosis. 2021 Dec;26(11-12):574-599. doi: 10.1007/s10495-021-01691-z. Epub 2021 Oct 23.
Around three out of one hundred thousand people are diagnosed with glioblastoma multiforme, simply called glioblastoma, which is the most common primary brain tumor in adults. With a dismal prognosis of a little over a year, receiving a glioblastoma diagnosis is oftentimes fatal. A major advancement in its treatment was made almost two decades ago when the alkylating chemotherapeutic agent temozolomide (TMZ) was combined with radiotherapy (RT). Little progress has been made since then. Therapies that focus on the modulation of autophagy, a key process that regulates cellular homeostasis, have been developed to curb the progression of glioblastoma. The dual role of autophagy (cell survival or cell death) in glioblastoma has led to the development of autophagy inhibitors and promoters that either work as monotherapies or as part of a combination therapy to induce cell death, cellular senescence, and counteract the ability of glioblastoma stem cells (GSCs) for initiating tumor recurrence. The myriad of cellular pathways that act upon the modulation of autophagy have created contention between two groups: those who use autophagy inhibition versus those who use promotion of autophagy to control glioblastoma growth. We discuss rationale for using current major therapeutics, their molecular mechanisms for modulation of autophagy in glioblastoma and GSCs, their potentials for making strides in combating glioblastoma progression, and their possible shortcomings. These shortcomings may fuel the innovation of novel delivery systems and therapies involving TMZ in conjunction with another agent to pave the way towards a new gold standard of glioblastoma treatment.
每十万人口中约有三人被诊断患有多形性胶质母细胞瘤,简称为胶质母细胞瘤,它是成人中最常见的原发性脑肿瘤。胶质母细胞瘤的预后很差,存活时间略超过一年,因此被诊断出患有胶质母细胞瘤往往是致命的。近二十年前,当烷化剂化疗药物替莫唑胺(TMZ)与放射疗法(RT)联合使用时,其治疗取得了重大进展。从那时起进展甚微。人们已经开发出专注于调节自噬(一种调节细胞稳态的关键过程)的疗法,以遏制胶质母细胞瘤的进展。自噬在胶质母细胞瘤中的双重作用(细胞存活或细胞死亡)导致了自噬抑制剂和促进剂的开发,它们既可以作为单一疗法,也可以作为联合疗法的一部分来诱导细胞死亡、细胞衰老,并对抗胶质母细胞瘤干细胞(GSC)引发肿瘤复发的能力。作用于自噬调节的众多细胞途径在两组人之间引发了争论:一组是使用自噬抑制的人,另一组是使用促进自噬来控制胶质母细胞瘤生长的人。我们讨论了使用当前主要治疗方法的理论依据、它们在胶质母细胞瘤和GSC中调节自噬的分子机制、它们在对抗胶质母细胞瘤进展方面取得进展的潜力以及它们可能存在的缺点。这些缺点可能会推动新型给药系统和涉及TMZ与另一种药物联合使用的疗法的创新,为胶质母细胞瘤治疗的新金标准铺平道路。