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光动力和声动力疗法治疗骨肿瘤的最新进展及病理机制(综述)。

Recent advances and pathological mechanisms in photodynamic and sonodynamic therapy in the treatment of bone tumors (Review).

机构信息

Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China.

Department of Orthopedics, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China.

出版信息

Oncol Rep. 2023 Nov;50(5). doi: 10.3892/or.2023.8635. Epub 2023 Sep 29.


DOI:10.3892/or.2023.8635
PMID:37772391
Abstract

Given the recent advances that have been made with photodynamic therapy (PDT) combined with sonodynamic therapy (SDT) (PDT/SDT; also known as SPDT), the application of this combination therapy in the clinic has provided another major breakthrough in the medical field, especially with regard to the treatment of deep tumors. Concerning its application in the treatment of bone tumors, numerous pathological mechanisms have been taken advantage of to overcome the barrier of tissue hypoxia, and SPDT is expected to achieve radical effects, with high penetration depth and low aggressiveness. In the present review, it is comprehensively shown how, according to the histoanatomy of bone tumors, PDT and SDT target cells in a coordinated manner, affecting such processes as necrotizing apoptosis, pyroptosis, autophagy and ferroptosis on the macroscopic level, and crucially, thrombosis at the vascular level, which leads to the triggering of immunogenic cell death in local and distant locations. Additionally, PDT and SDT have been shown to have roles in: i) degrading the extracellular matrix; ii) influencing the receptor activator of nuclear factor‑κB (RANK)/RANK ligand signaling pathway; iii) disrupting the equilibrium between glutathione peroxidase 4 and reactive oxygen species (ROS); and iv) destroying the microscopic structure of the bone tumor. Upon PDT/SDT stimulation, several mechanisms act in concert to ensure that the targeted bone tumor is eliminated. Furthermore, widely distributed ROS have been revealed to promote osteoclast formation and osteogenic mineralization through the regulation of macrophages, processes that greatly improve the effects of postoperative repair. Finally, the developmental prospects of bone tumor engineering in the future are discussed in the present review.

摘要

鉴于光动力疗法(PDT)与声动力疗法(SDT)相结合(PDT/SDT;也称为 SPDT)的最新进展,这种联合治疗在临床上的应用为医学领域提供了另一个重大突破,特别是在治疗深部肿瘤方面。在其在骨肿瘤治疗中的应用方面,利用了许多病理机制来克服组织缺氧的障碍,并且 SPDT 有望实现根治效果,具有高穿透深度和低侵袭性。在本综述中,全面展示了 PDT 和 SDT 如何根据骨肿瘤的组织解剖学,协调地靶向细胞,在宏观水平上影响坏死性凋亡、细胞焦亡、自噬和铁死亡等过程,并且在血管水平上至关重要的是导致局部和远处部位触发免疫原性细胞死亡。此外,PDT 和 SDT 在以下方面发挥作用:i)降解细胞外基质;ii)影响核因子 κB 受体激活剂(RANK)/RANK 配体信号通路;iii)破坏谷胱甘肽过氧化物酶 4 和活性氧(ROS)之间的平衡;iv)破坏骨肿瘤的微观结构。在 PDT/SDT 刺激下,几种机制协同作用,以确保消除靶向骨肿瘤。此外,广泛分布的 ROS 通过调节巨噬细胞促进破骨细胞形成和成骨矿化,大大提高了术后修复效果。最后,本文讨论了未来骨肿瘤工程的发展前景。

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Recent advances and pathological mechanisms in photodynamic and sonodynamic therapy in the treatment of bone tumors (Review).

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