Clinical College of Traditional Chinese Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, China.
Department of Integrated Chinese and Western Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, China.
Medicine (Baltimore). 2024 Jan 19;103(3):e36467. doi: 10.1097/MD.0000000000036467.
Osteosarcoma (OS) has a high recurrence rate, disability rate, mortality and metastasis, it brings great economic burden and psychological pressure to patients, and then seriously affects the quality of life of patients. At present, the treatment methods of OS mainly include radiotherapy, chemotherapy, surgical therapy and neoadjuvant chemotherapy combined with limb salvage surgery. These treatment methods can relieve the clinical symptoms of patients to a certain extent, and also effectively reduce the disability rate, mortality and recurrence rate of OS patients. However, because metastasis of tumor cells leads to new complications, and OS cells become resistant with prolonged drug intervention, which reduces the sensitivity of OS cells to drugs, these treatments still have some limitations. More and more studies have shown that traditional Chinese medicine (TCM) has the characteristics of "multiple targets and multiple pathways," and can play an important role in the development of OS through several key signaling pathways, including PI3K/AKT, Wnt/β-catenin, tyrosine kinase/transcription factor 3 (JAK/STAT3), Notch, transforming growth factor-β (TGF-β)/Smad, nuclear transcription factor-κB (NF-κB), mitogen-activated protein kinase (MAPK), nuclear factor E2-related factor 2 (Nrf2), Hippo/YAP, OPG/RANK/RANKL, Hedgehog and so on. In this paper, the signaling pathways of cross-interference between active ingredients of TCM and OS were reviewed, and the development status of novel OS treatment was analyzed. The active ingredients in TCM can provide therapeutic benefits to patients by targeting the activity of signaling pathways. In addition, potential strategies for targeted therapy of OS by using ferroptosis were discussed. We hope to provide a unique insight for the in-depth research and clinical application of TCM in the fields of OS growth, metastasis and chemotherapy resistance by understanding the signaling crosstalk between active ingredients in TCM and OS.
骨肉瘤（OS）具有高复发率、高致残率、高死亡率和易转移的特点，给患者带来了巨大的经济负担和心理压力，严重影响了患者的生活质量。目前，骨肉瘤的治疗方法主要包括放疗、化疗、手术治疗以及新辅助化疗联合保肢手术。这些治疗方法在一定程度上可以缓解患者的临床症状，也能有效降低骨肉瘤患者的致残率、死亡率和复发率。然而，由于肿瘤细胞的转移导致新的并发症产生，以及骨肉瘤细胞对药物的长期干预产生耐药性，降低了骨肉瘤细胞对药物的敏感性，这些治疗方法仍存在一定的局限性。越来越多的研究表明，中药（TCM）具有“多靶点、多途径”的特点，通过多条关键信号通路，如 PI3K/AKT、Wnt/β-catenin、酪氨酸激酶/转录因子 3（JAK/STAT3）、Notch、转化生长因子-β（TGF-β）/Smad、核转录因子-κB（NF-κB）、丝裂原活化蛋白激酶（MAPK）、核因子 E2 相关因子 2（Nrf2）、Hippo/YAP、OPG/RANK/RANKL、Hedgehog 等，在骨肉瘤的发生发展中发挥重要作用。本文综述了 TCM 活性成分与骨肉瘤相互作用的信号通路，并分析了新型骨肉瘤治疗方法的发展现状。TCM 中的活性成分可以通过靶向信号通路的活性为患者提供治疗益处。此外，还讨论了利用铁死亡靶向治疗骨肉瘤的潜在策略。通过了解 TCM 活性成分与骨肉瘤之间的信号串扰，希望为中药在骨肉瘤生长、转移和化疗耐药等领域的深入研究和临床应用提供独特的见解。
