Antineoplastic drug

抗肿瘤药物
  • 文章类型: Journal Article
    一种新颖而强大的电化学传感工具,用于测定粘滞剂(VIS),一种抗癌药物,通过整合分子印迹聚合物(MIP)的选择性识别能力和金属有机骨架(MOF)的灵敏度增强能力来开发。在这一步之前,使用裸玻碳电极(GCE)研究了VIS的电化学行为。据观察,在0.5MH2SO4溶液作为电解质,VIS具有约1.3V的氧化峰,并且氧化机制是扩散控制的。使用裸GCE测定标准溶液中的VIS在2.5μM至100μM的浓度范围内显示出线性响应,检测限(LOD)为0.75μM。由于裸露的GCE无法实现足够的灵敏度和选择性,在研究的下一步中开发了MIP传感器。为此,首先用合成的Co-MOF通过滴铸对GCE表面进行改性。随后,以2-丙烯酰胺基-2-甲基丙磺酸(AMPS)为单体,VIS为模板,通过热聚合方法合成了MIP网络。MOF是理想的电极材料,因为它们具有可控和多样的形态和可修饰的表面性质。这些特征使得能够开发具有更均匀的结合位点和对靶分子的高亲和力的MIP。集成MOF可以帮助传感器的性能与期望的稳定性和再现性。电化学分析表明,通过掺入MOF分子,可以观察到输出信号的增强,这与MOF的灵敏度增强作用是一致的,其通过提供更多的锚定位点用于将聚合物纹理附着到电极表面。这MOF-MIP传感器表现出令人印象深刻的线性动态范围从0.1到1.0pM的VIS,检测限在低皮摩尔范围内。此外,MOF-MIP传感器提供高精度,测定VIS的选择性和精密度,从血清样品的复合培养基中没有观察到干扰。此外,在这项研究中,分析绿色度量(AGREE),分析绿色准备(AGREEprep)和蓝色适用性等级指数(BAGI)用于计算绿色轮廓得分。
    A novel and robust electrochemical sensing tool for the determination of vismodegib (VIS), an anticancer drug, has been developed by integrating the selective recognition capabilities of molecularly imprinted polymer (MIP) and the sensitivity enhancement capability of metal-organic framework (MOF). Prior to this step, the electrochemical behavior of VIS was investigated using a bare glassy carbon electrode (GCE). It was observed that in 0.5 M H2SO4 solution as electrolyte, VIS has an oxidation peak around 1.3 V and the oxidation mechanism is diffusion controlled. The determination of VIS in a standard solution using a bare GCE showed a linear response in the concentration range from 2.5 μM to 100 μM, with a limit of detection (LOD) of 0.75 μM. Since sufficient sensitivity and selectivity could not be achieved with bare GCE, a MIP sensor was developed in the next step of the study. For this purpose, the GCE surface was first modified by drop casting with as-synthesized Co-MOF. Subsequently, a MIP network was synthesized via a thermal polymerization approach using 2-acrylamido-2-methylpropanesulfonic acid (AMPS) as monomer and VIS as template. MOFs are ideal electrode materials due to their controllable and diverse morphologies and modifiable surface properties. These characteristics enable the development of MIPs with more homogeneous binding sites and high affinity for target molecules. Integrating MOFs could help the performance of sensors with the desired stability and reproducibility. Electrochemical analysis revealed an observable enhancement of the output signal by the incorporation of MOF molecules, which is consistent with the sensitivity-enhancing role of MOF by providing more anchoring sites for the attachment of the polymer texture to the electrode surface. This MOF-MIP sensor exhibited impressive linear dynamic ranges ranging from 0.1 to 1.0 pM for VIS, with detection limits in the low picomolar range. In addition, the MOF-MIP sensor offers high accuracy, selectivity and precision for the determination of VIS, with no interference observed from complex media of serum samples. Additionally, in this study, Analytical GREEnness metric (AGREE), Analytical GREEnness preparation (AGREEprep) and Blue Applicability Grade Index (BAGI) were used to calculate the green profile score.
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  • 文章类型: Journal Article
    阿克拉霉素(aclacinomycinA)是蒽环类抗肿瘤抗生素之一,具有多方面的抗肿瘤活性机制。作为第二代药物,与阿霉素或柔红霉素等标准蒽环类药物相比,它具有多种优势,这可能将其定位为抗肿瘤治疗中的潜在重磅药物。阿克拉霉素的主要作用机制包括抑制两种类型的拓扑异构酶,抑制肿瘤侵袭过程,产生活性氧,抑制胰凝乳蛋白酶样活性,对顺铂降解的影响,和抑制血管生成。因此,阿克拉比星似乎是抗肿瘤治疗的理想候选者。然而,尽管最初对其临床应用感兴趣,到目前为止,仅进行了数量有限的高质量试验.阿克拉比星主要被评估为急性骨髓性和淋巴母细胞性白血病的诱导疗法。研究表明,阿克拉霉素可能与其他抗癌药物联合治疗具有重要的前景,尽管需要进一步的研究来证实其潜力。本文对阿克拉霉素的多种作用机制进行了深入的探索,其药代动力学,潜在毒性,以及对其进行研究的临床试验。
    Aclarubicin (aclacinomycin A) is one of the anthracycline antineoplastic antibiotics with a multifaceted mechanism of antitumor activity. As a second-generation drug, it offers several advantages compared to standard anthracycline drugs such as doxorubicin or daunorubicin, which could position it as a potential blockbuster drug in antitumor therapy. Key mechanisms of action for aclarubicin include the inhibition of both types of topoisomerases, suppression of tumor invasion processes, generation of reactive oxygen species, inhibition of chymotrypsin-like activity, influence on cisplatin degradation, and inhibition of angiogenesis. Therefore, aclarubicin appears to be an ideal candidate for antitumor therapy. However, despite initial interest in its clinical applications, only a limited number of high-quality trials have been conducted thus far. Aclarubicin has primarily been evaluated as an induction therapy in acute myeloid and lymphoblastic leukemia. Studies have indicated that aclarubicin may hold significant promise for combination therapies with other anticancer drugs, although further research is needed to confirm its potential. This paper provides an in-depth exploration of aclarubicin\'s diverse mechanisms of action, its pharmacokinetics, potential toxicity, and the clinical trials in which it has been investigated.
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  • 文章类型: Journal Article
    化疗是一种常见而有效的癌症治疗方法,但这些药物也与影响患者健康的显著副作用有关。一种令人衰弱的副作用是粘膜炎,以炎症为特征,溃疡,并改变了胃肠道(GI)粘膜衬里的生理功能。了解化疗引起的肠粘膜炎(CIM)的机制对于制定有效的预防措施和支持治疗至关重要。化学疗法不仅靶向癌细胞而且还在胃肠道中快速分裂的细胞。这些药物破坏内质网(ER)稳态,导致ER应激和激活各种肠上皮细胞类型的未折叠蛋白反应(UPR)。UPR触发信号通路,加剧组织炎症和损伤,影响肠上皮细胞的分化和命运,并损害肠粘膜屏障的完整性。这些因素显著促进粘膜炎的发展和进展。在这次审查中,我们旨在深入概述ER应激在粘膜炎中的作用及其对胃肠道功能的影响.这将提供对潜在机制的宝贵见解,并强调可能改善癌症患者治疗结果和生活质量的潜在治疗干预措施。
    Chemotherapy is a common and effective treatment for cancer, but these drugs are also associated with significant side effects affecting patients\' well-being. One such debilitating side effect is mucositis, characterized by inflammation, ulcerations, and altered physiological functions of the gastrointestinal (GI) tract\'s mucosal lining. Understanding the mechanisms of chemotherapy-induced intestinal mucositis (CIM) is crucial for developing effective preventive measures and supportive care. Chemotherapeutics not only target cancer cells but also rapidly dividing cells in the GI tract. These drugs disrupt endoplasmic reticulum (ER) homeostasis, leading to ER-stress and activation of the unfolded protein response (UPR) in various intestinal epithelial cell types. The UPR triggers signaling pathways that exacerbate tissue inflammation and damage, influence the differentiation and fate of intestinal epithelial cells, and compromise the integrity of the intestinal mucosal barrier. These factors contribute significantly to mucositis development and progression. In this review, we aim to give an in-depth overview of the role of ER-stress in mucositis and its impact on GI function. This will provide valuable insights into the underlying mechanisms and highlighting potential therapeutic interventions that could improve treatment-outcomes and the quality of life of cancer patients.
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  • 文章类型: Journal Article
    由于严重的副作用,廉价的发展,简单而灵敏的氨甲蝶呤(ATP,抗肿瘤药物)非常重要,但仍然是一个挑战。在这项工作中,用简单的自聚合方法制备了由碳纳米碗(CNB)和β-环糊精(β-CD)(CNB-CD)组成的低成本纳米杂化物,并将其用作电极材料,开发了一种新型的ATP电化学传感器。扫描/透射电子显微镜,傅里叶变换红外光谱,利用照相图像和电化学技术来表征所制备的CNB和CNB-CD材料的形貌和结构。在CNB(突出的电性能和表面积)和β-CD(优越的分子识别和溶解能力)的配位优势的基础上,CNB-CD纳米杂化修饰电极对ATP表现出优异的传感性能,并获得0.002μM的低检测限以及0.005-12.0μM的较大线性度。此外,准备好的传感器提供了理想的可重复性,稳定性,选择性和实际应用性能,确认该建议可能在ATP的测定中具有重要的应用。
    Resulted from the severe side effects, the development of inexpensive, simple and sensitive method for amethopterin (ATP, an antineoplastic drug) is very important but it still remains a challenge. In this work, low cost nanohybrid composed of carbon nanobowl (CNB) and β-cyclodextrins (β-CD) (CNB-CD) was prepared with a simple autopolymerization way and applied as electrode material to develop a novel electrochemical sensor of ATP. Scanning-/transmission-electron microscopy, Fourier transform infrared spectrum, photographic image and electrochemical technologies were utilized to characterize morphologies and structure of the as-prepared CNB and CNB-CD materials. On the basic of the coordination advantages from CNB (prominent electrical property and surface area) and β-CD (superior molecule-recognition and solubility capabilities), the CNB-CD nanohybrid modified electrode exhibits superior sensing performances toward ATP, and a low detection limit of 0.002 μM coupled with larger linearity of 0.005-12.0 μM are obtained. In addition, the as-prepared sensor offers desirable repeatability, stability, selectivity and practical application property, confirming that this proposal may have important applications in the determination of ATP.
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  • 文章类型: Journal Article
    目的:肺纤维化(PF)是一种严重的,进行性疾病,这可能是由于接触某些药物引起的。
    方法:我们查询了2000年至2022年的美国FDA不良事件报告系统(FAERS),使用搜索词“肺纤维化”和“特发性肺纤维化”,并排除了18岁以下患者的报告,以及性别或年龄不详的患者。报告按通用药物名称排序,计数,并使用基于指数函数的最佳拟合趋势线随时间绘制。
    结果:从2000年到2022年,FAERS报告了24095935起不良药物事件,其中17520(0.07%)被报告为PF。在排除包含年龄不详患者的报告后(5255,30%),性别(122,0.7%),年龄在18岁以下(155,0.9%),我们的研究包括11988例报告.研究样本的平均年龄为66.5±13.1岁,6248例(52.1%)为男性。按年份绘制11988份报告,显示出一条指数最佳拟合线(R2=0.88),随着时间的推移具有正斜率。与PF相关的前五个药物类别是疾病改善抗风湿药(DMARDs,39.4%),抗肿瘤药(26.4%),心血管药物(12.6%),皮质类固醇(4.6%),和免疫抑制剂(4.0%)。
    结论:FAERS数据库的23年分析显示PF不良事件报告呈指数增长。发现怀疑患有DMARDs和抗肿瘤剂的PF报告每年显着增加。我们的研究强调了重要的趋势,应用于指导与潜在重要药物相关的PF研究。
    OBJECTIVE: Pulmonary fibrosis (PF) is a severe, progressive disease, which may be caused by exposure to certain medications.
    METHODS: We queried the U.S. FDA Adverse Event Reporting System (FAERS) from 2000 to 2022, using the search terms \"pulmonary fibrosis\" and \"idiopathic pulmonary fibrosis\" and excluded reports with patients under the age of 18 years, and patients with unknown sex or age. Reports were sorted by generic drug names, counted, and plotted over time using a best-fit trendline based on an exponential function.
    RESULTS: From 2000 to 2022, there were 24 095 935 adverse drug events reported in FAERS, of which 17 520 (0.07%) were reported as PF. After excluding reports containing patients with unknown age (5255, 30%), sex (122, 0.7%), and age below 18 years old (155, 0.9%), our study included 11 988 reports. The mean age of the study sample was 66.5 ± 13.1 years, and 6248 patients (52.1%) were male. Plotting the 11 988 reports by year revealed an exponential best fit line (R2 = 0.88) with a positive slope over time. The top five drug classes associated with PF were disease modifying antirheumatic drugs (DMARDs, 39.4%), antineoplastic agents (26.4%), cardiovascular agents (12.6%), corticosteroids (4.6%), and immunosuppressive agents (4.0%).
    CONCLUSIONS: A 23-year analysis of the FAERS database revealed exponentially increasing adverse event reports of PF. Significant annual increases in reporting of PF suspected with DMARDs and antineoplastic agents were identified. Our study highlights important trends, which should be used to guide PF research related to drugs of potential importance.
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  • 文章类型: Observational Study
    抗肿瘤药物(AD)对医疗保健专业人员的内部污染仍然是当前的职业健康问题,特别是因为这些化合物被归类为NIOSH处理的危险。为了改善预防措施,在医疗机构的护理人员中进行了一项与这种内部污染相关的因素研究.这项研究是对来自法国两家医院的护士进行的横断面观察研究的元数据的统计分析。在先前的研究中评估了每个护士的内部污染,并通过在至少一个尿液样品中是否检测到至少一个研究的AD来定义。为每个参与者收集三个尿液样本和一份自我问卷。五个AD的分析(环磷酰胺,异环磷酰胺,5-氟尿嘧啶的代谢产物,甲氨蝶呤,阿霉素)通过液相色谱与串联质谱联用进行。通过将来自自我问卷的数据与内部污染数据相结合,使用多变量逐步下降回归模型来确定与内部污染相关的因素。共有74名护士参加了这项研究,其中68名护士参加了这项工作:39名护士和29名护士没有可检测到的内部AD污染。可以确定内部污染的两个保护因素:高“手套佩戴评分”(OR:0.957;95CI:0.93-0.98;p<0.01)和高“处理AD和/或照顾AD治疗患者的总年数”(OR:0.797;95CI:0.67-0.91;p<0.01)。此外,确定了导致内部污染的三个因素,即“对暴露于广告的任务感到充分了解”(OR:9.585;95CI:2.23-57.05;p<0.01),“处理装有用于管理所研究AD的设备的垃圾箱”(OR:8.04;95CI:1.87-46.08;p<0.01)和“为接受研究AD之一治疗的患者更换床单和/或铺床”(OR:10.479;95CI:1.43-133.30;p<0.05)。因此,当(1)在医疗保健服务中实施预防措施和(2)培训和告知暴露的工作人员时,应考虑直接或间接处理AD时使用手套以及某些任务的污染性质。需要进一步的研究来确认这些结果并将其扩展到其他专业类别。
    Internal contamination of healthcare professionals by antineoplastic drugs (ADs) remains a current occupational health issue, particularly because these compounds are classified as dangerous to handle by the NIOSH. In order to improve preventive actions, a study of the factors associated with this internal contamination was conducted among nursing staff in health care institutions. This study is a statistical analysis of metadata from a cross-sectional observational study conducted among nurses in two French hospitals. The internal contamination of each nurse was assessed in a previous study and was defined by whether or not at least one studied AD was detected in at least one urine sample. Three urine samples and a self-questionnaire were collected for each participant. Analysis of five ADs (cyclophosphamide, ifosfamide, metabolite of 5-fluorouracil, methotrexate, doxorubicin) were performed by liquid chromatography coupled to tandem mass spectrometry. A multivariate stepwise descending regression model was used to determine factors associated with internal contamination by coupling data from a self-questionnaire with internal contamination data. A total of 74 nurses participated to the study and 68 were included for this work: 39 nurses with and 29 without detectable internal ADs contamination. Two protective factors of internal contamination could be identified: a high \"glove wearing score\" (OR: 0.957; 95%CI: 0.93-0.98; p < 0.01) and a high \"total number of years handling ADs and/or caring for patients treated with ADs\" (OR: 0.797; 95%CI: 0.67-0.91; p < 0.01). In addition, three factors contributing to internal contamination were identified, namely \"feeling sufficiently informed about tasks exposing to ADs\" (OR: 9.585; 95%CI: 2.23-57.05; p < 0.01), \"disposal of a waste bin containing equipment used for administration of the ADs studied\" (OR: 8.04; 95%CI: 1.87-46.08; p < 0.01) and \"changing sheets and/or making bed of a patient treated by one of the ADs studied\" (OR: 10.479; 95%CI: 1.43-133.30; p < 0.05). Thus, the use of gloves when handling ADs directly or indirectly and the contaminating nature of certain tasks should be taken into account when (1) implementing preventive actions in health care services and (2) training and informing exposed staff. Further studies would be desirable to confirm these results and extend them to other professional categories.
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  • 文章类型: Journal Article
    使无机抗肿瘤药物顺铂在溶液中与二肽半胱氨酸甘氨酸(CysGly)反应,被选为谷胱甘肽的功能模型,并使用电喷雾电离质谱(ESI-MS)分析反应产物。选定的复合物,即,主要取代产物顺式-[PtCl(NH3)2(CysGly)]+和螯合物顺式-[PtCl(NH3)(CysGly)]+,进行红外多光子解离(IRMPD)光谱检查,以获得其振动特征。将实验红外离子光谱与计算出的不同似然异构族的红外吸收进行了比较,发现CysGly通过单价络合物中的去质子化硫醇基团优先结合铂(II),顺式-[PtCl(NH3)2(CysGly)]+,在S中进化,N-结合的螯合物结构通过半胱氨酸残基的SH和NH2官能团顺式-[PtCl(NH3)(CysGly)]+。此外,我们的发现表明,铂反应不影响CysGly肽键,保持其反式配置。这些结果为Pt(II)-复合物与谷胱甘肽的反应性提供了额外的见解,谷胱甘肽与细胞顺铂抗性有关。
    The inorganic antineoplastic drug cisplatin was made to react in solution with the dipeptide cysteinylglycine (CysGly), chosen as a functional model of glutathione, and the reaction products were analyzed using electrospray ionization mass spectrometry (ESI-MS). Selected complexes, i.e., the primary substitution product cis-[PtCl(NH3)2(CysGly)]+ and the chelate cis-[PtCl(NH3)(CysGly)]+, were submitted to IR multiple photon dissociation (IRMPD) spectroscopy obtaining their vibrational features. The experimental IR ion spectra were compared with the calculated IR absorptions of different plausible isomeric families, finding CysGly to bind preferentially platinum(II) via its deprotonated thiolic group in the monovalent complex, cis-[PtCl(NH3)2(CysGly)]+, and to evolve in the S,N-bound chelate structure cis-[PtCl(NH3)(CysGly)]+ through the SH and NH2 functionality of the cysteine residue. Moreover, our findings indicate that the platination reaction does not affect the CysGly peptide bond, which remains in its trans configuration. These results provide additional insights into the reactivity of Pt(II)-complexes with glutathione which is involved in cellular cisplatin resistance.
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  • 文章类型: Journal Article
    自1979年以来,已经证明了护理人员对抗肿瘤剂的职业暴露。自1990年代初以来,来自几个国家的大量研究表明,抗肿瘤药物污染了护理设施。因为它更容易取样,大多数工人的污染测量是在尿液样本中进行的。伊立替康的分布和消除半衰期表明,血液可以被认为比尿液更好地用于对医护人员的潜在污染进行生物监测。我们在这里描述了同时定量伊立替康的UHPLC-MS/MS方法的开发和验证,和它的两种主要代谢产物,APC和SN-38在血浆和红细胞(RBC)中处于超痕量水平。这种方法已应用于从法国综合癌症中心的几个医疗保健服务机构收集的血液样本。结果表明,该方法足够灵敏,可以识别非常低浓度的伊立替康和SN-38对医护人员的污染。此外,结果表明,红细胞的分析是非常有趣的,并补充血清。
    The occupational exposure of caregivers to antineoplastic agents has been demonstrated since 1979. Since the early 1990s, numerous studies from several countries have demonstrated the contamination of care facilities by antineoplastic drugs. As it is easier to sample, most contamination measurements in workers are carried out in urine sample. The distribution and elimination half-lives of irinotecan suggest that blood can be considered as better than urine for the biomonitoring of a potential contamination of healthcare workers. We describe here the development and the validation of a UHPLC-MS/MS method to simultaneously quantify irinotecan, and two of its main metabolites, APC and SN-38, at ultra-trace levels in plasma and red blood cells (RBC). This method has been applied to blood samples collected from several healthcare services in a French comprehensive cancer center. The results demonstrate that the method is sensitive enough to identify a contamination of healthcare workers by irinotecan and SN-38 at very low concentrations. Moreover, the results show that analysis of RBC is of great interest and complementary to that of serum.
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  • 文章类型: Journal Article
    目的:确定在不饱和脂肪栓塞的急性期血脑屏障(BBB)是否打开以增强药物输送。
    方法:我们注入了油酸,亚油酸,和亚麻酸乳剂通过大鼠的右颈总动脉,然后是锥虫蓝,用于肉眼和镧,用于电子显微镜(EM)检查。还给予阿霉素和替莫唑胺,然后在30分钟时对大鼠实施安乐死,1h,分析台盼蓝色调以半定量测量BBB开口。使用解吸电喷雾电离质谱(DESI-MS)成像来评估药物递送。
    结果:在油酸组中,乳液输注后30分钟在每组中观察到的台盼蓝染色在1小时时增加,在2小时后降低。亚油酸和亚麻酸基团随时间显示弱染色。色相和台盼蓝分析结果确证。EM显示紧密连接开口,而DESI-MS成像显示所有三组同侧半球的阿霉素和替莫唑胺信号强度均增加.
    结论:我们证明了油酸,亚油酸,亚麻酸乳液打开了血脑屏障,促进药物输送到大脑。色相分析和DESI-MS成像适用于分析脑组织中的多柔比星和替莫唑胺浓度。
    To determine whether the blood-brain barrier (BBB) opens to enhance drug delivery during the acute stage of unsaturated fat embolism.
    We infused oleic, linoleic, and linolenic acid emulsions through the right common carotid artery of rats, followed by trypan blue for gross and lanthanum for electron microscopic (EM) examination. Doxorubicin and temozolomide were also administered, and then the rats were euthanized at 30 min, 1 h, and 2 h. Trypan blue hue was analyzed to semiquantitatively measure BBB opening. Desorption electrospray ionization-mass spectrometry (DESI-MS) imaging was used to evaluate drug delivery.
    Trypan blue staining observed in each group 30 min after emulsion infusion increased at 1 h and decreased after 2 h in the oleic acid group. The linoleic and linolenic acid groups showed weak staining over time. The hue and trypan blue analysis results were corroborative. EM showed tight junction opening, whereas DESI-MS imaging showed increased doxorubicin and temozolomide signal intensities in ipsilateral hemispheres of all three groups.
    We demonstrated that oleic, linoleic, and linolenic acid emulsions opened the BBB, promoting drug delivery to the brain. Hue analysis and DESI-MS imaging are appropriate for analysis of doxorubicin and temozolomide concentrations in brain tissue.
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  • 文章类型: Systematic Review
    随着癌症病例的增加,抗肿瘤剂的使用有望增加。这将伴随着职业暴露的增加,这会对工人造成不必要的健康影响。我们的目的是概述职业性暴露于抗肿瘤剂后的遗传毒性和表观遗传效应,并评估浓度-效应关系。在四个数据库中搜索了研究职业性暴露于抗肿瘤剂的基因毒性和/或表观遗传影响的论文。在检索到的245份论文中,62人被包括在这次审查中。在这篇系统的文献综述中,我们证实,医护人员接触抗肿瘤药物可导致基因毒性损害.然而,我们观察到除医护人员以外的工作人员缺乏暴露以及遗传毒性和表观遗传效应的数据.此外,目前关于抗肿瘤药物暴露引起的潜在表观遗传效应以及关于体内抗肿瘤药物浓度与职业性接触抗肿瘤药物后的遗传毒性和表观遗传效应之间的联系的知识存在差距。为未来的研究提供了第一步。
    With increasing numbers of cancer cases, the use of antineoplastic agents is expected to rise. This will be accompanied by an increase in occupational exposure, which can cause unwanted health effects in workers. Our aim was to give an overview of genotoxic and epigenetic effects after occupational exposure to antineoplastic agents and to assess the concentration-effect relation. Four databases were searched for papers investigating genotoxic and/or epigenetic effects of occupational exposure to antineoplastic agents. Out of the 245 retrieved papers, 62 were included in this review. In this systematic literature review, we confirmed that exposure of healthcare workers to antineoplastic agents can lead to genotoxic damage. However, we observed a lack of data on exposure as well as genotoxic and epigenetic effects in workers other than healthcare workers. Furthermore, gaps in the current knowledge regarding the potential epigenetic effects caused by antineoplastic drug exposure and regarding the link between internal antineoplastic drug concentration and genotoxic and epigenetic effects after occupational exposure to antineoplastic agents were identified, offering a first step for future research.
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