Multi-drug resistance (MDR)

多药耐药 (MDR)
  • 文章类型: Journal Article
    结直肠癌(CRC)涉及各种遗传改变,肝转移构成了重大的临床挑战。此外,CRC细胞大多表现出对传统治疗如化疗的抗性增加。研究更先进和有效的疗法以防止药物耐药性和转移并延长患者寿命至关重要。因此,预期小干扰RNA(siRNA)将是可以通过RNA干扰(RNAi)控制基因表达的特殊工具。在真核生物中,RNAi是一种破坏特定信使RNA(mRNA)分子的生物学机制,从而抑制基因表达。在CRC的管理中,这种治疗方法是一种潜在的治疗药物.然而,重要的是要承认siRNA治疗存在重大问题,如低血清稳定性和非特异性吸收到生物系统。因此,正在创建交付机制来解决这些问题。在目前的工作中,我们通过关注与转移相关的主要信号通路以及与多药耐药(MDR)过程相关的基因,探讨了siRNA治疗的潜在益处,并概述了治疗CRC的困难.
    Colorectal cancer (CRC) involves various genetic alterations, with liver metastasis posing a significant clinical challenge. Furthermore, CRC cells mostly show an increase in resistance to traditional treatments like chemotherapy. It is essential to investigate more advanced and effective therapies to prevent medication resistance and metastases and extend patient life. As a result, it is anticipated that small interfering RNAs (siRNAs) would be exceptional instruments that can control gene expression by RNA interference (RNAi). In eukaryotes, RNAi is a biological mechanism that destroys specific messenger RNA (mRNA) molecules, thereby inhibiting gene expression. In the management of CRC, this method of treatment represents a potential therapeutic agent. However, it is important to acknowledge that siRNA therapies have significant issues, such as low serum stability and nonspecific absorption into biological systems. Delivery mechanisms are thus being created to address these issues. In the current work, we address the potential benefits of siRNA therapy and outline the difficulties in treating CRCby focusing on the primary signaling pathways linked to metastasis as well as genes implicated in the multi-drug resistance (MDR) process.
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  • 文章类型: Journal Article
    汞(Hg)是危害牲畜的最有效的有毒重金属之一,人类,和生态健康。由于不受控制地暴露于未经处理的制革工业废水,汞等金属在自然界中正在增加,因此,成为全球关注的问题。因此,了解在这种严重条件下蓬勃发展的微生物区系及其特征变得非常重要。在这项研究的过程中,从加尔各答皮革工厂的制革废水中分离出两种耐汞细菌,印度,能够耐受2.211×10-3M(600µg/ml)汞。16SrDNA分析显示与弗氏柠檬酸杆菌具有很强的序列同源性,在本研究中被命名为BNC22A和BNC22C。此外,它们对镍(Ni)和铬(Cr)的耐受性分别为6.31×10-3M(1500µg/ml)和6.792×10-3M(2000µg/ml)。然而,两种分离物均对砷(As)和镉(Cd)敏感。此外,他们的抗生素敏感性谱揭示了对多种药物的耐药趋势。在医疗保健系统和农业中过度使用和滥用抗生素已被确定为抗生素功效下降的两个主要原因。尽管它们产生脂肪酶的能力使它们成为工业上有效的生物体,它们抵抗几种抗生素和有毒金属的能力使得这项研究非常相关。此外,它们消除重金属毒性的能力使它们成为生物修复的潜在候选者。最后,绿豆种子萌发试验表明,BNC22A和BNC22C对汞刺激的毒性具有显著的有利作用。
    Mercury (Hg) is one of the most potent toxic heavy metals that distresses livestock, humans, and ecological health. Owing to uncontrolled exposure to untreated tannery industrial effluents, metals such as Hg are increasing in nature and are, therefore, becoming a global concern. As a result, understanding the thriving microflora in that severe condition and their characteristics becomes immensely important. During the course of this study, two Hg-resistant bacteria were isolated from tannery wastewater effluents from leather factories in Kolkata, India, which were able to tolerate 2.211 × 10- 3 M (600 µg/ml) Hg. 16 S rDNA analysis revealed strong sequence homology with Citrobacter freundii, were named as BNC22A and BNC22C for this study. In addition they showed high tolerance to nickel (Ni) and Chromium (Cr) at 6.31 × 10- 3 M (1500 µg/ml) and 6.792 × 10- 3 M (2000 µg/ml) respectively. However, both the isolates were sensitive to arsenic (As) and cadmium (Cd). Furthermore, their antibiotic sensitivity profiles reveal a concerning trend towards resistance to multiple drugs. Overuse and misuse of antibiotics in healthcare systems and agriculture has been identified as two of the main reasons for the decline in efficacy of antibiotics. Though their ability to produce lipase makes them industrially potent organisms, their competence to resist several antibiotics and metals that are toxic makes this study immensely relevant. In addition, their ability to negate heavy metal toxicity makes them potential candidates for bioremediation. Finally, the green mung bean seed germination test showed a significant favourable effect of BNC22A and BNC22C against Hg-stimulated toxicity.
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  • 文章类型: Journal Article
    确定具有四环素和氨苄西林的银纳米颗粒(AgNPs)对多重耐药性(MDR)和广泛耐药性(XDR)伤寒沙门氏菌的抗菌活性。
    从9月开始进行横截面非概率目的性研究,2021年5月,2022年在微生物学系PNSShifa,卡拉奇医院.收集可疑伤寒患者的血液培养物,并在自动Bact/Alert系统中孵育。在血液和MacConkey上鉴定阳性培养物,并用API-10S处理,通过血清分型(O9抗血清)(SSI诊断沙门氏菌)确认。抗生素抗性通过Kirby-Bauer圆盘扩散(Sigma和Rich)进行。MDR和XDR分离物保存在脑心输液中,体积为2ml,在-70°C的螺旋盖瓶中。抗菌粉剂(氨苄西林和四环素(AlfaAesar)通过电称重天平(OHAUS)称重,服用1mg抗菌药物。抗生素系列浓度的吸收光谱(UV-Vis分光光度计(Mole-Que-)AgNP(10nm)(nanocomposix)+抗生素(1:1体积比)。银纳米颗粒与四环素和氨苄西林的缀合是通过FTIR(thermosscientificThermosScientificsNicolet50)完成的。
    在77个分离株中,对头孢曲松(XDR)耐药54例,对头孢曲松(MDR)敏感23例。所有分离株对阿奇霉素和美罗培南敏感。比较氨苄青霉素和Amp-AgNPsas和四环素与Tet-AgNPs的抑制区域。还进行最小抑制浓度以确定抗微生物活性。
    通过四环素与银纳米颗粒的组合即使在低浓度下也获得了对伤寒沙门氏菌分离株的显著协同抑制作用。
    UNASSIGNED: To determine the antimicrobial activity of silver nano-particles(AgNPs) with tetracycline and ampicillin against multi-drug resistance (MDR) and extensively-drug resistance (XDR) Salmonella typhi.
    UNASSIGNED: Cross sectional non-probability purposive study was conducted from September, 2021 to May, 2022 at Microbiology department PNS Shifa, Hospital Karachi. Blood cultures of patients suspicious of typhoid fever were collected and incubated in automated Bact/Alert system. Positive cultures were identified on blood and MacConkey and processed by API-10S, confirmed by serotyping (O9 antisera) (SSI Diagnostica\'s Salmonella). Antibiotic resistance was done by Kirby-Bauer disk diffusion (Sigma and Rich). MDR and XDR isolates were preserved in Brain Heart Infusion in a volume of 2ml in screw capped bottles at -70°C. Antimicrobial powders (ampicillin and tetracycline (Alfa Aesar) weighed by an electrical weighing balance (OHAUS) to take 1mg of antimicrobial drug. Absorbance spectra of serial concentrations of antibiotics (UV-Vis spectrophotometer (Mole-Qule-) AgNPs (10nm) (nanocomposix) + Antibiotic in (1:1 volume ratio). Conjugation of silver nanoparticles with tetracycline and ampicillin was done by FTIR (thermos scientificThermos ScientificNicolet 50).
    UNASSIGNED: Out of 77 isolates, 54 were resistant to ceftriaxone (XDR) and 23 sensitive to ceftriaxone (MDR). All isolates were susceptible to azithromycin and meropenem. Comparison of zone of inhibitions of ampicillin and Amp-AgNPsas and tetracycline with Tet-AgNPs was done. Minimal inhibitory concentration was also done to determine antimicrobial activity.
    UNASSIGNED: Significant synergistic inhibitory effects against Salmonella Typhi isolates were obtained by combination of tetracycline with silver nano-particles even at low concentration.
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  • 文章类型: Journal Article
    全球范围内,癌症相关死亡的主要原因之一是结肠癌。由于这种癌症具有巨大的转移潜力,有效的治疗是复杂的,有时是不可能的。尽管传统化疗的改进和靶向治疗的出现,克服多药耐药性(MDR)和副作用仍然是重大挑战。作为癌症中靶向基因沉默的治疗干预,RNA技术显示出希望,某些基于RNA的制剂目前正在进行临床研究。各种研究报道,基于RNA的纳米颗粒已经证明了靶向药物递送的巨大前景。基因治疗,和其他生物医学应用。然而,使用RNA作为治疗工具存在严重的局限性,主要与其稳定性低和细胞摄取差有关。纳米技术提供了一种灵活和定制的替代方案,因为在体内安全地递送裸RNA分子存在困难,比如它们的半衰期很短,化学稳定性低,和核酸酶降解的敏感性。除了保护RNA分子免受免疫系统攻击和酶分解,基于纳米颗粒的递送系统允许RNA在肿瘤部位积累。RNA和RNA相关纳米药物治疗结肠癌的潜力,以及克服与mRNA有关的任何困难的前景,在这项研究中进行了综述,随着当前mRNA治疗的进展以及纳米材料设计和递送策略的进步。
    Globally, one of the leading causes of cancer-related deaths is colon cancer. As this form of cancer has a tremendous potential to metastasize, effective treatment is complicated and sometimes impossible. Despite the improvement of conventional chemotherapy and the advent of targeted therapies, overcoming multi-drug resistance (MDR) and side effects remain significant challenges. As a therapeutic intervention for targeted gene silencing in cancer, RNA technology shows promise and certain RNA-based formulations are currently undergoing clinical studies. Various studies have reported that RNA-based nanoparticles have demonstrated substantial promise for targeted medication delivery, gene therapy, and other biomedical applications. However, using RNA as a therapeutic tool presents severe limitations, mainly related to its low stability and poor cellular uptake. Nanotechnology offers a flexible and tailored alternative due to the difficulties in delivering naked RNA molecules safely in vivo, such as their short half-lives, low chemical stability, and susceptibility to nuclease degradation. In addition to shielding RNA molecules from immune system attacks and enzymatic breakdown, the nanoparticle-based delivery systems allow RNA accumulation at the tumor site. The potential of RNA and RNA-associated nanomedicines for the treatment of colon cancer, as well as the prospects for overcoming any difficulties related to mRNA, are reviewed in this study, along with the current progress of mRNA therapeutics and advancements in designing nanomaterials and delivery strategies.
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  • 文章类型: Journal Article
    大肠杆菌是人类胃肠道中的共生细菌;然而,它可能是致病性的,并导致肠内和肠外部位的严重感染。尿致病性大肠杆菌占尿路感染的80-90%,可导致尿败血症和脓毒性休克。因此,多药耐药的尿路致病性大肠杆菌对全球医疗系统构成相当大的风险。噬菌体疗法被证明是对非处方药抗生素的乐观解决方案,这有助于解决全球多药耐药细菌的问题。本研究旨在分离一种新型噬菌体,可用于治疗多药耐药大肠杆菌介导的尿路感染。从患有尿路感染的患者收集27个大肠杆菌分离物以评估噬菌体vB_Ec_ZCEC14的抗菌功效。针对大肠杆菌菌株(EC/4)遇到噬菌体动力学,除了评估噬菌体在不同温度下的稳定性,pH值,和紫外线暴露期。全基因组测序和形态学分析进行进一步的噬菌体鉴定,表明噬菌体vB_Ec_ZCEC14属于Straboviridae家族。噬菌体vB_Ec_ZCEC14在80℃下表现出耐热性,在pH3和pH12之间的pH稳定性,以及对紫外线暴露45分钟的耐久性。噬菌体-宿主相互作用结果表明,噬菌体vB_Ec_ZCEC14在较低浓度(MOI0.1)下具有强而稳定的抗菌作用。研究结果强烈表明,噬菌体vB_Ec_ZCEC14作为治疗抗生素抗性尿路致病性大肠杆菌的潜在治疗替代品具有重要的前景。
    Escherichia coli is a commensal bacterial species in the human gastrointestinal tract; however, it could be pathogenic and cause severe infections in intra and extra-intestinal sites. Uropathogenic E. coli accounts for 80-90% of urinary tract infections that can result in urosepsis and septic shock. Consequently, multidrug-resistant uropathogenic E. coli poses a considerable risk to the healthcare system worldwide. Phage therapy is demonstrated as an optimistic solution to over-the-counter antibiotics that contribute to the global issue of multidrug-resistant bacteria. This study aims to isolate a novel phage that could be implemented to cure urinary tract infections mediated by multidrug-resistant E. coli. Twenty-seven E. coli isolates were collected from patients with urinary tract infections to assess the antibacterial efficacy of phage vB_Ec_ZCEC14. Phage kinetics were encountered against the E. coli strain (EC/4), in addition to evaluating phage stability under various temperatures, pH values, and UV exposure periods. Full genome sequencing and morphological analysis were conducted for further phage characterization, which revealed that phage vB_Ec_ZCEC14 belongs to the family Straboviridae. Phage vB_Ec_ZCEC14 showed thermal tolerance at 80 ℃, pH stability between pH 3 and pH 12, and endurance to UV exposure for 45 min. The phage-host interaction results revealed that phage vB_Ec_ZCEC14 has strong and steady antibacterial action at lower concentrations (MOI 0.1). The study findings strongly indicate that phage vB_Ec_ZCEC14 holds significant promise as a potential therapeutic alternative for treatment of antibiotic-resistant uropathogenic E. coli.
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  • 文章类型: Journal Article
    背景:伤寒是由伤寒沙门氏菌引起的人类致命疾病。伤寒杆菌感染需要立即抗生素治疗,它们的广泛使用导致了多药耐药(MDR)病原体。噬菌体的使用正成为治疗这些耐药细菌的新方法。该研究涉及针对伤寒沙门氏菌的噬菌体分离和确定噬菌体-抗生素协同作用。
    目的:分离针对伤寒沙门氏菌的噬菌体,伤寒的病原体,并研究它们与抗生素联合使用时的潜在协同作用。
    方法:横断面研究。
    方法:Widal试验为阳性;取20份腹泻粪便样本,为了确认伤寒沙门氏菌,进行了不同的生化试验.圆盘扩散技术用于确定抗菌素耐药性,双琼脂覆盖法用于从污水中分离针对伤寒沙门氏菌的噬菌体。为了测试抗生素-噬菌体的协同作用,通过噬菌体和不同的抗生素浓度处理伤寒沙门氏菌。
    结果:11个样本在SS-琼脂上呈黑色菌落,伤寒沙门氏菌呈阳性。这些是过氧化氢酶和MR在TSI上呈碱性阳性。在琼脂覆盖后观察到清晰的斑块。分离的噬菌体在各种pH和温度水平下是稳定的。在琼脂平板上观察到协同作用。当噬菌体与细菌草坪培养物和环丙沙星圆盘结合使用时,该区域扩大了。在滴定板中,细菌生长抑制具有0.03的显着p值,噬菌体-环丙沙星组合比单独的噬菌体和抗生素更有效。
    结论:该研究强调了分离的噬菌体与抗生素的协同作用,它们不仅对伤寒沙门氏菌感染有效,而且还降低了抗生素耐药性。
    BACKGROUND: Typhoid fever is a fatal disease in humans that is caused by Salmonella typhi. S. typhi infections need immediate antibiotic therapy, and their extensive use has led to multidrug-resistant (MDR) pathogens. The use of bacteriophages is becoming a new way to treat these resistant bacteria. This research was directed to bacteriophage isolation against S. typhi and to determine phage-antibiotic synergism.
    OBJECTIVE: To isolate bacteriophages targeting S. typhi, the causative agent of typhoid fever, and investigate their potential synergistic effects when combined with antibiotics.
    METHODS: A cross-sectional study.
    METHODS: The Widal test was positive; twenty diarrheal stool samples were taken, and for confirmation of S. typhi, different biochemical tests were performed. The disc-diffusion technique was used to determine antimicrobial resistance, and the double agar overlay method was used for bacteriophage isolation from sewage water against S. typhi. To test antibiotic-phage synergism, the S. typhi bacteria was treated by phages together with varying antibiotic concentrations.
    RESULTS: Eleven samples were positive for S. typhi with black colonies on SS-agar. These were catalase and MR positive with alkali butt on TSI. Clear plaques were observed after the agar overlay. Isolated phages were stable at various pH and temperature levels. Synergism was observed on agar plate. The zone was enlarged when phages were combined with bacterial lawn culture and ciprofloxacin disk. Bacterial growth inhibition had a significant p-value of 0.03 in titration plates, with the phage-ciprofloxacin combination being more effective than the phage and antibiotic alone.
    CONCLUSIONS: The study highlights the synergistic effects of isolated bacteriophages with antibiotics, which are not only effective against S. typhi infection but also decrease antibiotic resistance.
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  • 文章类型: Journal Article
    结核病(TB)是全球十大传染病之一。它被归类为导致全球数百万人死亡的主要杀手疾病。尽管有标准化的治疗方案,不坚持治疗增加了多药耐药(MDR)和广泛耐药(XDR)结核病的发展。另一个挑战是通过常规治疗靶向肺泡中TB储库的死亡。随着有效抗结核药物的稀缺,结核病耐药性可能会成为结核病的未来抑制作用。向纳米靶向药物递送系统的范式改变主要是由于缺乏有效的治疗和MDR的TB感染复发发作增加。纳米技术的新兴领域提供了一个令人钦佩的机会,通过准确的诊断和有效的治疗来对抗MDR和XDR。通过肺部途径靶向肺部的新策略可以克服MDR的新发生率并增强患者的依从性。因此,这篇综述强调了纳米技术对肺部药物递送的重要性和最新研究,纳米技术发展的需要,纳米医学的有益方面,纳米载体的安全问题,和临床研究。
    Tuberculosis (TB) is among the top 10 infectious diseases worldwide. It is categorized among the leading killer diseases that are the reason for the death of millions of people globally. Although a standardized treatment regimen is available, non-adherence to treatment has increased multi-drug resistance (MDR) and extensive drug-resistant (XDR) TB development. Another challenge is targeting the death of TB reservoirs in the alveoli via conventional treatment. TB Drug resistance may emerge as a futuristic restraint of TB with the scarcity of effective Anti-tubercular drugs. The paradigm change towards nano-targeted drug delivery systems is mostly due to the absence of effective therapy and increased TB infection recurrent episodes with MDR. The emerging field of nanotechnology gave an admirable opportunity to combat MDR and XDR via accurate diagnosis with effective treatment. The new strategies targeting the lung via the pulmonary route may overcome the new incidence of MDR and enhance patient compliance. Therefore, this review highlights the importance and recent research on pulmonary drug delivery with nanotechnology along with prevalence, the need for the development of nanotechnology, beneficial aspects of nanomedicine, safety concerns of nanocarriers, and clinical studies.
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  • 文章类型: Journal Article
    尽管在个性化抗癌方法方面做出了广泛的努力和持续的进展,对于一些肿瘤,化疗仍然是一线或唯一的治疗方法,这些肿瘤可能由于ATP结合盒转运蛋白的过表达等原因而及时对化疗药物产生抗性。使用三阴性乳腺癌(MDA-MB-231;TNBC)和非小细胞肺癌(A549;NSCLC)的临床相关耐药模型,我们测试了I-CBP112-CBP/EP300溴结构域抑制剂通过降低ABC基因转录来克服耐药性的功效。I-CBP112在所有耐药品系中显著降低ABCB1、ABCC1、ABCC2、ABCC3、ABCC5和ABCG2,以及TNBC中的ABCC10和紫杉醇耐药的NSCLC中的ABCC4,从而增加2D和3D培养物中的细胞内药物积累和细胞毒性。这仅是由ABC抑制剂如Tariquidar(ABCB1-P-糖蛋白和ABCG2)和MK-571(ABCC)的联合作用产生的。而ABCB1/ABCG2或ABCC蛋白的单一抑制并不影响药物积累,因此意味着需要同时缺乏大多数药物泵的活性以增强药物保留。I-CBP112不能同时直接抑制ABCB1、ABCG2和ABCC亚家族成员的活性。重要的是,I-CBP112处理的癌细胞将人巨噬细胞极化为促炎表型。此外,I-CBP112对原代细胞系保持无毒,它也没有增强抗癌药物对血液免疫细胞的毒性。ADMET特性的计算机模拟分析证实了I-CBP112的所需药代动力学特征。结果表明,CBP/p300抑制剂是耐药癌症表型化疗的有前途的辅助药物,能够降低ABC转运蛋白表达。
    Despite extensive efforts and ongoing progress in personalized anticancer approaches, chemotherapy remains the first line or the only treatment for some tumors that may develop resistance to chemotherapeutics in time due to inter alia overexpression of ATP-binding cassette transporters. Using clinically-relevant resistant models of triple negative breast cancer (MDA-MB-231; TNBC) as well as non-small cell lung cancer (A549; NSCLC), we tested the efficacy of I-CBP112 - CBP/EP300 bromodomain inhibitor to overcome drug resistance by declining ABC gene transcription. I-CBP112 significantly reduced ABCB1, ABCC1, ABCC2, ABCC3, ABCC5 and ABCG2 in all resistant lines, as well as ABCC10 in TNBC and ABCC4 in paclitaxel-resistant NSCLC, thereby increasing intracellular drug accumulation and cytotoxicity in 2D and 3D cultures. This was phenocopied only by the joint effect of ABC inhibitors such as tariquidar (ABCB1 - P-glycoprotein and ABCG2) and MK-571 (ABCC), whereas single inhibition of ABCB1/ABCG2 or ABCC proteins did not affect drug accumulation, thereby implying the need of simultaneous deficiency in activity of majority of drug pumps for enhanced drug retention. I-CBP112 failed to directly inhibit activity of ABCB1, ABCG2 and ABCC subfamily members at the same time. Importantly, I-CBP112 treated cancer cells polarized human macrophages into proinflammatory phenotypes. Moreover, I-CBP112 remained non-toxic to primary cell lines, nor did it enhance anticancer drug toxicity to blood-immune cells. In silico assay of ADMET properties confirmed the desired pharmacokinetic features of I-CBP112. The results suggest that the CBP/p300 inhibitor is a promising co-adjuvant to chemotherapy in drug-resistant cancer phenotypes, capable of decreasing ABC transporter expression.
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  • 文章类型: Journal Article
    结外NK/T细胞淋巴瘤(ENKTCL)是一种罕见且高度侵袭性的恶性肿瘤,在全球范围内具有显着的种族和地理差异。除了以前的“鼻型”初始描述之外,这些淋巴瘤主要起源于结外,通常会导致血管损伤和组织破坏,虽然没有完全理解,EB病毒(EBV)在其发病机制中具有重要作用。初始评估必须包括对没有坏死的代表性和有活力的肿瘤区域进行血液病理学检查,以进行适当的免疫组织化学研究。包括EBV编码的小RNA(EBER)原位杂交(ISH)。用18-氟代脱氧葡萄糖(18F-FDG-PET/CT)进行正电子发射断层扫描对准确分期至关重要,大多数患者在诊断时会有局部疾病(IE/IIE)。除了其他T细胞恶性肿瘤,即使是局部病例,最好的治疗方法是联合治疗(化疗加放疗)和非蒽环类药物治疗.对于晚期疾病,含有l-天冬酰胺酶的方案显示出提高的存活率,但复发和难治性病例的结局很差.如今,即使对致病途径有了更好的了解,前期治疗完全基于化疗和放疗,与治疗相关的死亡率也不低。针对信号通路和免疫疗法的未来策略正在发展,但是我们需要以先发制人的方式更好地识别那些结果不佳的患者。鉴于这种疾病的稀有性,迫切需要国际合作,临床试验是改变未来的方式。
    Extranodal NK-/T-cell lymphoma (ENKTCL) is a rare and highly aggressive malignancy with significant racial and geographic variations worldwide. In addition to the formerly \"nasal-type\" initial description, these lymphomas are predominantly extranodal in origin and typically cause vascular damage and tissue destruction, and although not fully understood, Epstein-Barr virus (EBV) has an important role in its pathogenesis. Initial assessment must include a hematopathology review of representative and viable tumor areas without necrosis for adequate immunohistochemistry studies, including EBV-encoded small RNA (EBER) in situ hybridization (ISH). Positron emission tomography with 18-fluorodeoxyglucose (18F-FDG-PET/CT) for accurate staging is essential, and most patients will have localized disease (IE/IIE) at diagnosis. Apart from other T-cell malignancies, the best treatment even for localized cases is combined modality therapy (chemotherapy plus radiotherapy) with non-anthracycline-based regimens. For advanced-stage disease, l-asparaginase-containing regimens have shown improved survival, but relapsed and refractory cases have very poor outcomes. Nowadays, even with a better understanding of pathogenic pathways, up-front therapy is completely based on chemotherapy and radiotherapy, and treatment-related mortality is not low. Future strategies targeting signaling pathways and immunotherapy are evolving, but we need to better identify those patients with dismal outcomes in a pre-emptive way. Given the rarity of the disease, international collaborations are urgently needed, and clinical trials are the way to change the future.
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  • 文章类型: Journal Article
    女性中最常见的癌症之一是乳腺癌。尽管乳腺癌的治疗取得了巨大的飞跃,该疾病仍然是妇女死亡的主要原因之一,也是主要的公共卫生挑战。化学疗法的治疗功效受到化学抗性和毒性的阻碍。基于纳米的脂质药物递送系统提供受控的药物释放,纳米尺寸,和特定地点的定位。乳腺癌治疗包括手术,化疗,和放射治疗。尽管如此,由于癌症干细胞转移和化疗耐药,目前尚无单一的治疗方法有效。因此,为了靶向乳腺癌干细胞,使用纳米载体系统是必要的。这篇文章讨论了乳腺癌的治疗选择,包括化疗等现代治疗程序,等。,以及一些创新的治疗选择,突出了负载有化疗药物如纳米乳剂(NE)的脂质纳米载体的作用,固体-脂质纳米粒(SLN),纳米结构脂质载体(NLCs),和脂质体,他们的研究表明,它们可以限制癌细胞的生长,降低复发风险,以及尽量减少化疗后的转移。本文还探讨了FDA批准的基于脂质的纳米载体,市售配方,和正在考虑进一步研究的基于配体的制剂。
    One of the most common cancers that occur in females is breast cancer. Despite the significant leaps and bounds that have been made in treatment of breast cancer, the disease remains one of the leading causes of death among women and a major public health challenge. The therapeutic efficacy of chemotherapeutics is hindered by chemoresistance and toxicity. Nano-based lipid drug delivery systems offer controlled drug release, nanometric size and site-specific targeting. Breast cancer treatment includes surgery, chemotherapy and radiotherapy. Despite this, no single method of treatment for the condition is currently effective due to cancer stem cell metastasis and chemo-resistance. Therefore, the employment of nanocarrier systems is necessary in order to target breast cancer stem cells. This article addresses breast cancer treatment options, including modern treatment procedures such as chemotherapy, etc. and some innovative therapeutic options highlighting the role of lipidic nanocarriers loaded with chemotherapeutic drugs such as nanoemulsion, solid-lipid nanoparticles, nanostructured lipid carriers and liposomes, and their investigations have demonstrated that they can limit cancer cell growth, reduce the risk of recurrence, as well as minimise post-chemotherapy metastasis. This article also explores FDA-approved lipid-based nanocarriers, commercially available formulations, and ligand-based formulations that are being considered for further research.
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