背景:癌症是导致死亡的主要原因,癌细胞由于长期暴露于补充化疗治疗而产生耐药性的易感性被称为多药耐药癌细胞(MDRC),这是恶性肿瘤治疗的一个重要障碍。由于补充药物失去了效力,近年来,开发潜在的替代和新颖的治疗方法已被提升为重中之重。在这种情况下,来自植物和动物来源的生物活性蛋白凝集素显示出具有巨大治疗潜力的抗癌药物的宝贵来源。
目的:本手稿的主要目的是启发基于证据的(从1986年到2022年)使用凝集素替代治疗方法的可能分子机制,而不是用于癌症治疗的补充药物。
方法:已适当遵循PRISMA规则,并系统地综合了定性和定量数据。文章是基于临床和临床前报告发表的凝集素,研究了深入的细胞机制,逆转药物综合肿瘤学,作为纳米携带的靶向递送。1986年至2022年对文章进行了系统筛选,并根据电子数据库搜索进行了筛选,Medline(PubMed),谷歌学者,WebofScience,百科全书,Scopus,和ClinicalTrials.gov数据库。
结果:搜索发现了来自38个不同国家的4,212种出版物,其中170篇参考文章被用于我们的分析,在16种联合疗法及其作用方式中,包括剂量和作用机制的27项临床试验研究。纳入了属于28个不同家庭的30种凝集素的报告。根据一些临床和临床前报告,对凝集素的逆转机制和针对MDRC的替代疗法进行了严格的筛选,凝集素可以抑制过表达的基因,如P-53,EGFR,还有P-GP,MRP,和ABC转运蛋白与药物的细胞内运输有关。因为,药物外排机制导致MDRC,在这种现象中,凝集素在逆转外排机制中起关键作用。很少有临床前报道提到,凝集素与补充药物结合显示出协同作用,并且作为纳米药物载体有助于递送到靶向部位。
结论:我们已经讨论了使用凝集素的替代疗法,并深入了解了对抗MDRC癌症的逆转耐药机制,增强功效,减少毒性和不良事件,并确保有针对性的交付,并对其在癌症诊断和预后方面的应用进行了讨论。然而,在药物开发和临床试验中需要进一步的研究,这可能有助于阐述MDRC癌症的逆转机制和开启新的治疗模式.
BACKGROUND: Cancer is characterized as the leading cause of death, and the susceptibility of cancer cells to develop resistance due to long-term exposure to complementary chemotherapeutic treatment is referred to as multidrug resistance cancer cells (MDRC), which is a significant obstacle in the treatment of malignancies. Since complementary medicine lost its effectiveness, the development of potential alternative and novel therapeutic approaches has been elevated to a top priority in recent years. In this context, a bioactive protein lectin from plant and animal sources exhibits an invaluable source of anticancer agents with vast therapeutic potential.
OBJECTIVE: This manuscript\'s primary purpose is to enlighten the evidence-based (from 1986 to 2022) possible molecular mechanism of alternative treatment approaches using lectins over the complementary medicines used for cancer treatment.
METHODS: The PRISMA rules have been followed properly and qualitative and quantitative data are synthesized systematically. Articles were identified based on Clinical and preclinical reports published on lectin that investigated the in-depth cellular mechanisms, of reverse drug integrative oncology, as a nano-carried targeted delivery. Articles were systematically screened from 1986 to 2022 and selected based on electronic database searches, Medline (PubMed), Google Scholar, Web of Science, Encyclopaedias, Scopus, and ClinicalTrials.gov database.
RESULTS: The search turned up 4,212 publications from 38 different nations, of which 170 reference articles were used in our analysis, in 16 combination therapy and their mode of action, and 27 clinical trial studies including dosage and mechanism of action were included. Reports from the 30 lectins belonging to 28 different families have been included. The reversal mechanism of lectin and alternative therapy against MDRC is critically screened and according to a few clinical and preclinical reports, lectin can suppress the overexpressing genes like P-53, EGFR, and P-gp, MRP, and ABC transporter proteins associated with intracellular transportation of drugs. Since, the drug efflux mechanism leads to MDRC, in this phenomenon, lectin plays a key role in reversing the efflux mechanism. Few preclinical reports have mentioned that lectin shows synergism in combination with complementary medicine and as a nano drug carrier helps to deliver to the targeted site.
CONCLUSIONS: We have discussed the alternative therapy using lectin and an in-depth insight into the reversal drug resistance mechanisms to combat MDRC cancer, enhance the efficacy, reduce toxicity and adverse events, and ensure targeted delivery, and their application in the field of cancer diagnosis and prognosis has been discussed. However, further investigation is necessary in drug development and clinical trials which could be helpful to elaborate the reversal mechanism and unlock newer treatment modalities in MDRC cancer.