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转运体介导的酪氨酸激酶抑制剂细胞分布作为慢性髓性白血病潜在的耐药机制

Transporter-Mediated Cellular Distribution of Tyrosine Kinase Inhibitors as a Potential Resistance Mechanism in Chronic Myeloid Leukemia.

作者信息

Verhagen Noor E, Koenderink Jan B, Blijlevens Nicole M A, Janssen Jeroen J W M, Russel Frans G M

机构信息

Division of Pharmacology and Toxicology, Department of Pharmacy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.

Department of Haematology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.

出版信息

Pharmaceutics. 2023 Oct 26;15(11):2535. doi: 10.3390/pharmaceutics15112535.

Abstract

Chronic myeloid leukemia (CML) is a hematologic neoplasm characterized by the expression of the BCR::ABL1 oncoprotein, a constitutively active tyrosine kinase, resulting in uncontrolled growth and proliferation of cells in the myeloid lineage. Targeted therapy using tyrosine kinase inhibitors (TKIs) such as imatinib, nilotinib, dasatinib, bosutinib, ponatinib and asciminib has drastically improved the life expectancy of CML patients. However, treatment resistance occurs in 10-20% of CML patients, which is a multifactorial problem that is only partially clarified by the presence of TKI inactivating mutations. It may also be a consequence of a reduction in cytosolic TKI concentrations in the target cells due to transporter-mediated cellular distribution. This review focuses on drug-transporting proteins in stem cells and progenitor cells involved in the distribution of TKIs approved for the treatment of CML. Special attention will be given to ATP-binding cassette transporters expressed in lysosomes, which may facilitate the extracytosolic sequestration of these compounds.

摘要

慢性髓性白血病(CML)是一种血液肿瘤,其特征是表达BCR::ABL1癌蛋白,这是一种组成型活性酪氨酸激酶,导致髓系细胞不受控制地生长和增殖。使用酪氨酸激酶抑制剂(TKIs)如伊马替尼、尼洛替尼、达沙替尼、博舒替尼、普纳替尼和阿塞西尼布进行靶向治疗,显著提高了CML患者的预期寿命。然而,10%-20%的CML患者会出现治疗耐药性,这是一个多因素问题,TKI失活突变的存在只能部分解释该问题。这也可能是由于转运蛋白介导的细胞分布导致靶细胞中胞质TKI浓度降低的结果。本综述重点关注参与CML治疗的TKIs分布的干细胞和祖细胞中的药物转运蛋白。将特别关注溶酶体中表达的ATP结合盒转运蛋白,其可能促进这些化合物的胞外隔离。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0711/10675650/0f8189712c2b/pharmaceutics-15-02535-g001.jpg

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