Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China.
Adv Sci (Weinh). 2024 Jan;11(3):e2305662. doi: 10.1002/advs.202305662. Epub 2023 Nov 8.
Increasing numbers of studies have shown that tumor cells prefer fermentative glycolysis over oxidative phosphorylation to provide a vast amount of energy for fast proliferation even under oxygen-sufficient conditions. This metabolic alteration not only favors tumor cell progression and metastasis but also increases lactate accumulation in solid tumors. In addition to serving as a byproduct of glycolytic tumor cells, lactate also plays a central role in the construction of acidic and immunosuppressive tumor microenvironment, resulting in therapeutic tolerance. Recently, targeted drug delivery and inherent therapeutic properties of nanomaterials have attracted great attention, and research on modulating lactate metabolism based on nanomaterials to enhance antitumor therapy has exploded. In this review, the advanced tumor therapy strategies based on nanomaterials that interfere with lactate metabolism are discussed, including inhibiting lactate anabolism, promoting lactate catabolism, and disrupting the "lactate shuttle". Furthermore, recent advances in combining lactate metabolism modulation with other therapies, including chemotherapy, immunotherapy, photothermal therapy, and reactive oxygen species-related therapies, etc., which have achieved cooperatively enhanced therapeutic outcomes, are summarized. Finally, foreseeable challenges and prospective developments are also reviewed for the future development of this field.
越来越多的研究表明,肿瘤细胞即使在氧充足的条件下,也更喜欢通过发酵糖酵解而非氧化磷酸化来提供大量能量,以促进快速增殖。这种代谢改变不仅有利于肿瘤细胞的进展和转移,还会导致实体瘤中乳酸的积累增加。乳酸不仅作为糖酵解肿瘤细胞的副产物发挥作用,而且在构建酸性和免疫抑制性肿瘤微环境中发挥核心作用,导致治疗耐受。最近,靶向药物输送和纳米材料的固有治疗特性引起了极大关注,基于纳米材料调节乳酸代谢以增强抗肿瘤治疗的研究也如雨后春笋般涌现。本综述讨论了基于纳米材料干扰乳酸代谢的先进肿瘤治疗策略,包括抑制乳酸合成、促进乳酸分解和破坏“乳酸穿梭”。此外,还总结了最近在将乳酸代谢调节与其他治疗方法(包括化学疗法、免疫疗法、光热疗法和活性氧相关疗法等)相结合方面的进展,这些方法已取得协同增强的治疗效果。最后,还对该领域的未来发展进行了可预见的挑战和前瞻性展望。
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