Alsabbagh Rama, Ahmed Munazza, Alqudah Mohammad A Y, Hamoudi Rifat, Harati Rania
Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates.
Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
Cancers (Basel). 2023 Apr 12;15(8):2258. doi: 10.3390/cancers15082258.
Brain metastasis is an incurable end-stage of systemic cancer associated with poor prognosis, and its incidence is increasing. Brain metastasis occurs through a multi-step cascade where cancer cells spread from the primary tumor site to the brain. The extravasation of tumor cells through the blood-brain barrier (BBB) is a critical step in brain metastasis. During extravasation, circulating cancer cells roll along the brain endothelium (BE), adhere to it, then induce alterations in the endothelial barrier to transmigrate through the BBB and enter the brain. Rolling and adhesion are generally mediated by selectins and adhesion molecules induced by inflammatory mediators, while alterations in the endothelial barrier are mediated by proteolytic enzymes, including matrix metalloproteinase, and the transmigration step mediated by factors, including chemokines. However, the molecular mechanisms mediating extravasation are not yet fully understood. A better understanding of these mechanisms is essential as it may serve as the basis for the development of therapeutic strategies for the prevention or treatment of brain metastases. In this review, we summarize the molecular events that occur during the extravasation of cancer cells through the blood-brain barrier in three types of cancer most likely to develop brain metastasis: breast cancer, melanoma, and lung cancer. Common molecular mechanisms driving extravasation in these different tumors are discussed.
脑转移是系统性癌症的一种无法治愈的终末期,预后较差,且其发病率正在上升。脑转移通过一个多步骤级联过程发生,癌细胞从原发肿瘤部位扩散至脑部。肿瘤细胞通过血脑屏障(BBB)外渗是脑转移中的关键步骤。在外渗过程中,循环中的癌细胞沿着脑内皮细胞(BE)滚动,与之黏附,然后诱导内皮屏障发生改变,从而穿过血脑屏障进入脑部。滚动和黏附通常由选择素以及炎症介质诱导的黏附分子介导,而内皮屏障的改变则由蛋白水解酶(包括基质金属蛋白酶)介导,迁移步骤由包括趋化因子在内的多种因子介导。然而,介导外渗的分子机制尚未完全明确。更好地理解这些机制至关重要,因为这可能为开发预防或治疗脑转移的治疗策略奠定基础。在本综述中,我们总结了最有可能发生脑转移的三种癌症(乳腺癌、黑色素瘤和肺癌)中癌细胞通过血脑屏障外渗过程中发生的分子事件。讨论了驱动这些不同肿瘤外渗的常见分子机制。