Centro de Hematologia de São Paulo, São Paulo, SP, Brazil.
Núcleo Avançado de Pesquisa em Oncologia, Hospital Santa Marcelina, Faculdade Santa Marcelina, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2022 Mar 7;20:eRB5954. doi: 10.31744/einstein_journal/2022RB5954. eCollection 2022.
Despite advances in understanding of carcinogenesis and of treatment of acute myeloid leukemia, this neoplasm still has a lethality of at least 30%. The search for biomarkers that can predict the response to treatment in the early stages of the disease is still necessary. In recent years, a new form of cellular communication between tumor and non-neoplastic cells has been discovered: the exchange of information through extracellular vesicles. These are small vesicles released by membrane-coated cells that carry proteins, lipids, messenger RNAs, microRNA and DNA, which can be internalized and promote biological changes in target cells. Exosomes are qualified as a type of extracellular vesicle and, in tumors, carry immunoinhibitory signals that promote the escape of immune control. Recent studies have showed their involvement in communication with the cells of the tumor microenvironment and with chemoresistance in several tumors. To date, there is no information about immunoregulatory microRNAs transported by exosomes and their correlation with clinical evolution during chemotherapy for acute myeloid leukemia. Knowledge about immunomodulatory microRNAs obtained by leukemic cells and transported by exosomes can direct us towards the design of new diagnostic and treatment tools in this type of leukemia.
尽管人们对致癌作用和急性髓细胞白血病的治疗有了深入的了解，但这种肿瘤的致死率仍至少为 30%。因此，仍需要寻找能够在疾病早期预测治疗反应的生物标志物。近年来，人们发现了肿瘤和非肿瘤细胞之间一种新的细胞间通讯形式：通过细胞外囊泡进行信息交换。这些是由膜包被的细胞释放的小囊泡，携带蛋白质、脂质、信使 RNA、microRNA 和 DNA，可以被内化并促进靶细胞的生物学变化。外泌体被认为是一种细胞外囊泡，在肿瘤中携带免疫抑制信号，促进免疫逃逸。最近的研究表明，它们参与了与肿瘤微环境细胞的通讯，并与几种肿瘤的化疗耐药性有关。迄今为止，关于急性髓细胞白血病化疗过程中外泌体携带的免疫调节 microRNA 及其与临床演变的相关性尚无信息。了解白血病细胞获得并通过外泌体转运的免疫调节 microRNA，有助于我们设计这种白血病的新型诊断和治疗工具。
