cancer stem cell

肿瘤干细胞
  • 文章类型: Journal Article
    以前,我们确定AP-1转录因子FOSL1是维持HNSCC中癌症干细胞(CSC)所必需的,和AP-1抑制剂,T-5224,可以消除HNSCCCSCs。然而,它的效力相对较低,而且,T-5224是否通过靶向FOSL1根除CSC,以及FOSL1是否作为消除HNSCC中CSC的有效靶标,需要进一步验证。我们首先发现T-5224可以直接结合FOSL1。作为一个原则证明,使用T-5224作为弹头设计并合成了几种cereblon(CRBN)招募PROTACs,以更有效地靶向FOSL1。顶部化合物可以有效降解HNSCC中的FOSL1,从而有效消除CSC以抑制HNSCC肿瘤发生,与T-5224相比,效力提高了约30到100倍。总之,我们的研究进一步验证了FOSL1是消除HNSCC中CSC的有效靶标,并提示PROTACs可能为开发靶向FOSL1的新型分子提供了独特的分子工具.
    Previously, we identified that AP-1 transcription factor FOSL1 is required to maintain cancer stem cells (CSCs) in HNSCC, and an AP-1 inhibitor, T-5224, can eliminate HNSCC CSCs. However, its potency is relatively low, and furthermore, whether T-5224 eradicates CSCs through targeting FOSL1 and whether FOSL1 serves as an effective target for eliminating CSCs in HNSCC, require further validation. We first found that T-5224 can bind to FOSL1 directly. As a proof-of-principle, several cereblon (CRBN)-recruiting PROTACs were designed and synthesized using T-5224 as a warhead for more effective of targeting FOSL1. The top compound can potently degrade FOSL1 in HNSCC, thereby effectively eliminating CSCs to suppress HNSCC tumorigenesis, with around 30 to 100-fold improved potency over T-5224. In summary, our study further validates FOSL1 as an effective target for eliminating CSCs in HNSCC and suggests that PROTACs may provide a unique molecular tool for the development of novel molecules for targeting FOSL1.
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  • 文章类型: Journal Article
    在过去的20年里,越来越多的证据表明,免疫球蛋白(Ig)可以从非B细胞广泛产生,包括正常和恶性乳腺上皮细胞。在正常乳腺组织中,在妊娠和哺乳期乳腺上皮细胞中已发现IgG和IgA的表达,可以分泌到牛奶中,并可能参与新生儿免疫。另一方面,非B-IgG在乳腺癌细胞中高表达,与乳腺癌患者预后不良有关。重要的是,一组特定的IgG,在Asn162位点上具有独特的N-连接的聚糖,并且在新型聚糖(称为唾液酸化IgG(SIA-IgG))的末端具有异常的唾液酸化修饰,已在乳腺癌干/祖细胞中发现。SIA-IgG能显著促进迁移能力,侵入性,和转移,以及在体外和体内增强自我更新和致瘤性。这些发现表明,乳腺上皮细胞在生理和病理条件下可以产生具有不同生物学活性的Ig。哺乳期,这些Igs可能是牛奶Igs的主要来源,以保护新生儿免受病原体感染,在病理条件下,它们显示致癌活性,促进乳腺癌的发生和进展。
    Over the past 20 years, increasing evidence has demonstrated that immunoglobulins (Igs) can be widely generated from non B cells, including normal and malignant mammary epithelial cells. In normal breast tissue, the expression of IgG and IgA has been identified in epithelial cells of mammary glands during pregnancy and lactation, which can be secreted into milk, and might participate in neonatal immunity. On the other hand, non B-IgG is highly expressed in breast cancer cells, correlating with the poor prognosis of patients with breast cancer. Importantly, a specific group of IgG, bearing a unique N-linked glycan on the Asn162 site and aberrant sialylation modification at the end of the novel glycan (referred to as sialylated IgG (SIA-IgG)), has been found in breast cancer stem/progenitor-like cells. SIA-IgG can significantly promote the capacity of migration, invasiveness, and metastasis, as well as enhance self-renewal and tumorigenicity in vitro and in vivo. These findings suggest that breast epithelial cells can produce Igs with different biological activities under physiological and pathological conditions. During lactation, these Igs could be the main source of milk Igs to protect newborns from pathogenic infections, while under pathological conditions, they display oncogenic activity and promote the occurrence and progression of breast cancer.
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  • 文章类型: Journal Article
    癌团由一组异质细胞组成,其中一小部分构成癌症干细胞,因为它们分化程度较低,并且具有很高的发展癌症的能力。Versican是位于许多人体组织中的细胞外基质蛋白。通过RT-PCR检测,versican的mRNA已显示具有“剪接模式”,northern印迹分析,和cDNA测序。基于这些知识,本研究旨在揭示versican分子的剪接变体,它们被认为与DU-145人前列腺癌细胞系和从该细胞系分离的前列腺癌干细胞的发病机理有关。在这项研究中,已使用RWPE-1正常前列腺和DU-145人前列腺癌细胞系。根据它们的CD133+/CD44+分离前列腺癌干细胞和剩余的非前列腺癌干细胞组(大量群体)。在所有组中分离RNA,通过IlluminaNextSeq500测序系统完成剪接变体的序列分析。通过生物信息学评价对结果进行分析。由于分析了差异转录表达中versican基因的五种同工型,观察到仅在同种型Versican0和Versican1中发现了显着变化。在这项研究中,我们探索了这种分子的功能,我们认为这种分子在癌症进展中有效,并建议在完成体内实验后可以获得更有价值的结果。
    A cancer mass is composed of a heterogeneous group of cells, a small part of which constitutes the cancer stem cells since they are less differentiated and have a high capacity to develop cancer. Versican is an extracellular matrix protein located in many human tissues. The mRNA of versican has been shown to have \"splicing patterns\" as detected by RT-PCR, northern blot analysis, and cDNA sequencing. Based on this knowledge this study aims to reveal the splice variants of versican molecules, which are thought to be involved in the pathogenesis of the DU-145 human prostatic carcinoma cell line and prostatic cancer stem cells isolated from this cell line. In this study, RWPE-1 normal prostatic and DU-145 human prostate cancer cell lines have been used. Prostatic cancer stem cells and the remaining group of non-prostatic-cancer stem cells (bulk population) were isolated according to their CD133+/CD44+. RNA was isolated in all groups, and sequence analysis was accomplished for splicing variants by Illumina NextSeq 500 sequencing system. The results were analyzed by bioinformatic evaluation. As five isoforms of the versican gene in the differential transcript expression are analyzed, it was observed that a significant change was only found in the isoforms Versican 0 and Versican 1. In this study, we explored the function of this molecule which we think to be effective in cancer progression, and suggested that more valuable results can be obtained after the accomplishment of in vivo experiments.
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  • 文章类型: Journal Article
    microRNAs(miRNAs)和肿瘤干细胞(CSCs)的共调控在肿瘤发生过程中非常重要。已知miR-127-5p在乳腺癌中下调。在这项研究中,我们的目的是研究硼酸(BA),以其先前未研究的抗癌特性而闻名,会影响miR127-5p的表达和负责乳腺癌干细胞(BC-SC)转移的基因。通过免疫磁性细胞分离从人乳腺癌细胞(MCF-7)中分离BC-SC,并用流式细胞术和球体形成表征。通过MTT测定评估BC-SC的活力及其响应于硼酸(BA)的IC50值的测定。硼酸对细胞中的细胞活力表现出剂量和时间依赖性的抑制。MCF-7细胞和BC-SCs中硼酸的IC50剂量分别为45.69mM和41.27mM,分别。通过RT-qPCR分析阐明了BA对转移基因和miR127-5p表达的影响。而COL1A1(p<0.05)和VIM(p<0.01)的表达下调,miR-127-5p的表达,ZEB1(p<0.01),CDH1(p<0.05),ITGB1(p<0.05),ITGA5(p<0.05),LAMA5(p<0.01),和蜗牛(p<0.05),与RT-qPCR结果相比,在剂量处理的BC-SC中上调(p<0.001)。我们的发现表明硼酸可以诱导miR-127-5p表达。然而,不能说它提高了乳腺癌干细胞的转移特性。
    Coregulation of microRNAs (miRNAs) and cancer stem cells (CSCs) is very important in carcinogenesis. miR-127-5p is known to be downregulated in breast cancer. In this study, we aimed to investigate how boric acid (BA), known for its previously unstudied anti-cancer properties, would affect the expression of miR127-5p and genes responsible for breast cancer stem cells (BC-SCs) metastasis. BC-SCs were isolated from human breast cancer cells (MCF-7) by immunomagnetic cell separation and characterized with flow cytometry and sphere formation. The viability of BC-SCs and the determination of its IC50 value in response to boric acid (BA) were assessed via the MTT assay. Boric acid exhibited dose- and time-dependent inhibition of cell viability in cells. The IC50 doses of boric acid in MCF-7 cells and BC-SCs were 45.69 mM and 41.27 mM, respectively. The impact of BA on the expression of metastatic genes and miR127-5p was elucidated through RT-qPCR analysis. While the expression of the COL1A1 (p < 0.05) and VIM (p < 0.01) was downregulated, the expression of the miR-127-5p, ZEB1 (p < 0.01), CDH1 (p < 0.05), ITGB1 (p < 0.05), ITGA5 (p < 0.05), LAMA5 (p < 0.01), and SNAIL (p < 0.05), was up-regulated in dose-treated BC-SCs (p < 0.001) to the RT-qPCR results. Our findings suggest that boric acid could induce miR-127-5p expression. However, it cannot be said that it improves the metastasis properties of breast cancer stem cells.
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  • 文章类型: Journal Article
    胎盘特异性蛋白1(PLAC-1)是主要在胎盘和睾丸中表达的基因。有趣的是,它也被发现在许多实体瘤中表达,它与恶性细胞特征有关。然而,目前尚无关于PLAC-1与肿瘤干细胞(CSC)之间关系的证据报道.在目前的研究中,我们探讨了PLAC-1分子在源自人PC-3细胞系的前列腺癌干细胞(PCSCs)中的表达.使用称为球体形成测定的三维细胞培养技术实现PCSC的富集。为了确认PCSC的身份,我们检查了与干性和多能性相关的基因的表达,如SOX2,OCT4,Nanog,C-Myc,和KLF-4,以及干细胞分化分子,如CD44和CD133。使用实时PCR和流式细胞术在PCSC和原始肿瘤细胞(亲本细胞)中进行这些评估。随后,我们使用相同的技术在基因和蛋白质水平上评估了PLAC-1分子在富集细胞和亲本肿瘤细胞中的表达.来自PC-3细胞系的肿瘤细胞在非粘附培养基中形成具有CSC特征的球状体。SOX2,OCT4,Nanog,和C-Myc基因(p<0.01),并且分子CD44和CD133(p<0.05)在PCSCs中与亲本细胞相比显著升高。与亲本细胞相比,PCSC中PLAC-1分子的表达在基因(p<0.01)和蛋白质(p<0.001)水平均显示显著增加。总之,首次表明PLAC-1在源自人PC-3细胞系的PCSCs中上调。本研究可能提出PLAC-1作为靶向治疗的潜在靶点,这应该通过进一步的研究来证实。
    Placenta-specific protein 1 (PLAC-1) is a gene primarily expressed in the placenta and the testis. Interestingly, it is also found to be expressed in many solid tumors, and it is involved in malignant cell features. However, no evidence has been reported regarding the relationship between PLAC-1 and cancer stem cells (CSCs). In the current research, we explored the expression of the PLAC-1 molecule in prostate cancer stem cells (PCSCs) derived from the human PC-3 cell line. The enrichment of PCSCs was achieved using a three-dimensional cell culture technique known as the sphere-formation assay. To confirm the identity of PCSCs, we examined the expression of genes associated with stemness and pluripotency, such as SOX2, OCT4, Nanog, C-Myc, and KLF-4, as well as stem cell differentiation molecules like CD44 and CD133. These evaluations were conducted in both the PCSCs and the original tumor cells (parental cells) using real-time PCR and flow cytometry. Subsequently, we assessed the expression of the PLAC-1 molecule in both enriched cells and parental tumor cells at the gene and protein levels using the same techniques. The tumor cells from the PC-3 cell line formed spheroids with CSC characteristics in a non-adherent medium. The expression of SOX2, OCT4, Nanog, and C-Myc genes (p < 0.01), and the molecules CD44 and CD133 (p < 0.05) were significantly elevated in PCSCs compared to the parental cells. The expression of the PLAC-1 molecule in PCSCs showed a significant increase compared to the parental cells at both gene (p < 0.01) and protein (p < 0.001) levels. In conclusion, it was indicated for the first time that PLAC-1 is up-regulated in PCSCs derived from human PC-3 cell line. This study may propose PLAC-1 as a potential target in targeted therapies, which should be confirmed through further studies.
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  • 文章类型: Journal Article
    "骨肉瘤智囊团"医疗顾问委员会会议在圣莫尼卡举行,CA,2024年2月2-3日美国目标是制定预防骨肉瘤复发的战略方法。骨肉瘤代谢和骨肉瘤的基因组不稳定性,骨肉瘤的免疫治疗,CAR-T细胞疗法,DeltaRex-G肿瘤靶向基因治疗,重新利用的药物,替代药物,和个性化医疗进行了讨论。只有DeltaRex-G被投票。结论如下:在临床试验中没有证明干预能提高生存率。此外,共识(10/12赞成)是,未经免疫治疗的DeltaRex-G可施用长达一年.应进行DeltaRex-G的2/3期随机研究,以确定是否可以降低高危个体的复发率。此外,我们可以尝试使用毒性最小的药物的个性化方法,同时承认没有疗效数据作为依据.应在骨肉瘤小鼠模型中测试重新使用的药物和替代疗法。此外,未修饰的IL-2引发的γ-δ(NK)细胞疗法可用于预防复发。最后,建议快速发展CAR-T细胞疗法,需要一个致力于骨肉瘤研究的研究所。
    A \"Think Tank for Osteosarcoma\" medical advisory board meeting was held in Santa Monica, CA, USA on February 2-3, 2024. The goal was to develop a strategic approach to prevent recurrence of osteosarcoma. Osteosarcoma metabolism and the genomic instability of osteosarcoma, immunotherapy for osteosarcoma, CAR-T cell therapy, DeltaRex-G tumor-targeted gene therapy, repurposed drugs, alternative medicines, and personalized medicine were discussed. Only DeltaRex-G was voted on. The conclusions were the following: No intervention has been demonstrated to improve survival in a clinical trial. Additionally, the consensus (10/12 in favor) was that DeltaRex-G without immunotherapy may be administered for up to one year. Phase 2/3 randomized studies of DeltaRex-G should be performed to determine whether the incidence of recurrence could be reduced in high-risk individuals. Furthermore, a personalized approach using drugs with minimal toxicity could be attempted with the acknowledgement that there are no efficacy data to base this on. Repurposed drugs and alternative therapies should be tested in mouse models of osteosarcoma. Moreover, unmodified IL-2 primed Gamma Delta (NK) cell therapy may be used to prevent recurrence. Lastly, rapid development of CAR-T cell therapy is recommended, and an institute dedicated to the study of osteosarcoma is needed.
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  • 文章类型: Journal Article
    癌症干细胞(CSC)在很大程度上影响结直肠癌(CRC)的发展,转移,复发,和对治疗的抵抗力。布洛芬和热疗可有效治疗癌症。在这里,我们评估了热疗和布洛芬对分离的CRC-CSC的影响。
    这项实验研究于2020年9月至2022年1月在病理学系进行,医学院,ShirazUniversityofMedicalSciences,伊朗。使用非粘附培养系统从HT-29细胞中分离CSC。为了确认分离的CSC的干性,通过实时定量PCR(qRT-PCR)和流式细胞术检测,评估了干性基因和蛋白质标志物的表达。用热疗和布洛芬处理分离的CSC。通过MTT测定和锥虫蓝染色确定细胞活力。stemness的表达,扩散,通过qRT-PCR评估Wnt信号通路和凋亡基因。
    CSC在14天内分离。CD-133标记和OCT3/4,C-MYC的表达,分离的CSC中KLF4和NANOG基因高于HT-29细胞(P<0.05)。处理的CSC的细胞活力显著降低(P<0.05)。热疗降低OCT3/4、NANOG、PCNA,WNT1和CTNNB1基因的表达与P53、BAX、和KLF4基因(P<0.05)。布洛芬降低OCT3/4、BCL2、NANOG、PCNA,WNT1和CTNNB1基因的表达与P53、BAX、和KLF4基因在处理的CSC中(P<0.05)。
    热疗和布洛芬治疗表现出对结肠直肠CSC的抑制作用。然而,使用联合疗法仍有待测试。
    UNASSIGNED: Cancer stem cells (CSCs) substantially influence the development of colorectal cancer (CRC), metastasis, relapse, and resistance to therapy. Ibuprofen and hyperthermia can be effective in the treatment of cancer. Herein, we evaluated the effects of hyperthermia and ibuprofen on the isolated-CSCs of CRC.
    UNASSIGNED: This experimental study was conducted between Sep 2020 and Jan 2022 at the Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Iran. A non-adhesive culture system was used to isolate CSCs from HT-29 cells. To confirm the stemness nature of isolated-CSCs, the expression of stemness genes and protein markers was evaluated by quantitative Real-time PCR (qRT-PCR) and flow cytometry assay. The isolated-CSCs were treated with hyperthermia and ibuprofen. The cell viability was determined by MTT assay and trypan blue staining. The expression of stemness, proliferation, Wnt signaling pathway and apoptosis genes was assessed by qRT-PCR.
    UNASSIGNED: CSCs were isolated within 14 days. The expression of CD-133 marker and OCT3/4, C-MYC, KLF4, and NANOG genes in isolated-CSCs was higher than HT-29 cells (P<0.05). Cell viability of treated-CSCs were considerably reduced (P<0.05). Hperthermia reduced the expression of OCT3/4, NANOG, PCNA, WNT1 and CTNNB1 genes and increased the expression of P53, BAX, and KLF4 genes (P<0.05). Ibuprofen decreased the expression of OCT3/4, BCL2, NANOG, PCNA, WNT1, and CTNNB1 genes and increased the expression of P53, BAX, and KLF4 genes in treated-CSCs (P<0.05).
    UNASSIGNED: Hyperthermia and ibuprofen treatment demonstrate an inhibitory effect on colorectal CSCs. However, using combination therapy is remaining to be tested.
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  • 文章类型: Journal Article
    背景:长链非编码RNA(lncRNAs)与多种头颈部肿瘤相关,并在癌症中起重要作用。本研究探讨了Linc00662在下咽鳞状细胞癌(HSCC)中的分子机制。方法:采用实时定量逆转录聚合酶链反应(qRT-PCR)检测HSCC组织中基因的表达。使用CCK-8测定法测量肿瘤细胞的活力和增殖。使用流式细胞术和蛋白质印迹法测量HSCC细胞凋亡。使用球体形成测定来检查细胞干细胞性。建立异种移植肿瘤模型以研究Linc00662在体内的作用。结果:Linc00662在HSCC组织中的表达水平明显高于癌旁正常组织。Linc00662的表达与肿瘤分期无显著关系。发现具有高Linc00662表达的患者具有比具有低Linc00662表达的患者更短的总生存期。Linc00662过表达促进细胞活力并抑制细胞凋亡。使用在线数据库和双荧光素酶报告基因,miR-15b-5p被证实为Linc00662的潜在下游海绵。此外,Linc00662在HSCC细胞中与miR-15b-5p呈负相关。miR-15b-5p的耗尽可以在体内和体外逆转Linc00662的功能。此外,Linc00662促进肿瘤生长,它被miR-15b-5p模拟物废除。重要的是,肿瘤干细胞的干性由Linc00662/miR-15b-5p轴介导。结论:高Linc00662的HSCC患者预后差,高Linc00662通过靶向miR-15b-5p诱导肿瘤细胞干性。Linc00662可作为头颈部鳞状细胞癌的新型诊断和靶标志物。
    Background: Long non-coding RNAs (lncRNAs) are associated with multiple head and neck tumors and play important roles in cancer. This study explored the molecular mechanism of Linc00662 in hypopharyngeal squamous cell carcinoma (HSCC). Methods: Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect gene expression in HSCC tissues. The viability and proliferation of tumor cells were measured using CCK-8 assays. HSCC cell apoptosis was measured using flow cytometry and western blotting. Cell stemness was examined using the sphere formation assay. A xenograft tumor model was established to investigate the role of Linc00662 in vivo. Results: The expression level of Linc00662 in HSCC tissues was significantly higher than that in adjacent normal tissues. The expression of Linc00662 had no significant relationship with the tumor stage. Patients with high Linc00662 expression were found to have shorter overall survival than those with low Linc00662 expression. Linc00662 over-expression promoted cell viability and inhibited apoptosis. Using online databases and a dual luciferase reporter, miR-15b-5p was confirmed as a potential downstream sponge of Linc00662. Moreover, Linc00662 was negatively associated with miR-15b-5p in HSCC cells. Depletion of miR-15b-5p can reverse the function of Linc00662 in vivo and in vitro. Furthermore, Linc00662 promotes tumor growth, which was abolished by miR-15b-5p mimics. Importantly, the stemness of cancer stem cells was mediated by the Linc00662/miR-15b-5p axis. Conclusion: Patients with HSCC with high Linc00662 showed poor prognosis and high Linc00662 induced stemness of tumor cells by targeting miR-15b-5p. Linc00662 may serve as a novel diagnostic and target marker for head and neck squamous cell carcinoma.
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  • 文章类型: Journal Article
    头颈部鳞状细胞癌(HNSCC)是头颈部区域的主要恶性肿瘤,并且有有限的治疗选择。环状RNA(circularRNAs),一类相当大的非编码RNA分子,在人类疾病的发展和进展中发挥重要作用,采用各种机制,如microRNA海绵,与RNA结合蛋白相互作用,和翻译能力。越来越多的证据强调了HNSCC中许多circRNAs的差异表达,和许多失调的circRNAs强调了它们在恶性进展和治疗抗性中的关键参与。这篇综述旨在全面概述这些特点,生物发生,和circRNAs的机制,阐明它们在HNSCC中的功能意义。此外,我们深入研究了circRNAs的临床意义,考虑到它们作为生物标志物或诊断目标的潜力,预后,以及HNSCC中的治疗应用。讨论扩展到探索circRNAs临床翻译的未来挑战,强调需要进一步研究。
    Head and neck squamous cell carcinoma (HNSCC) represents the predominant malignancies in the head and neck region, and has limited therapeutic alternatives. Circular RNAs (circRNAs), a substantial category of non-coding RNA molecules, exert influential roles in human disease development and progression, employing various mechanisms such as microRNA sponging, interaction with RNA-binding proteins, and translational capabilities. Accumulating evidence highlights the differential expression of numerous circRNAs in HNSCC, and numerous dysregulated circRNAs underscore their crucial involvement in malignant advancement and resistance to treatment. This review aims to comprehensively outline the characteristics, biogenesis, and mechanisms of circRNAs, elucidating their functional significance in HNSCC. In addition, we delve into the clinical implications of circRNAs, considering their potential as biomarkers or targets for diagnosis, prognosis, and therapeutic applications in HNSCC. The discussion extends to exploring future challenges in the clinical translation of circRNAs, emphasizing the need for further research.
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  • 文章类型: Journal Article
    癌症干细胞(SC)理论提出,SCs群体作为基本肿瘤过程背后的驱动力,包括转移,复发,和对治疗的抵抗力。III期和高危II期结直肠癌(CRC)患者的护理标准包括手术和辅助化疗。氟嘧啶类药物及其与奥沙利铂的联合使用可提高治愈率,能够根除一小部分患者的隐匿性转移性SC。不可切除的转移性CRC的治疗基于化疗,VEGF和EGFR抗体,和酪氨酸激酶抑制剂。免疫疗法用于MSI-H肿瘤。目前使用的药物靶向分裂细胞,虽然通常能有效缩小肿瘤肿块,这些药物在很大程度上未能治愈转移性疾病。SCs的产生是由于干细胞/祖细胞的遗传和表观遗传改变或体细胞的去分化,其中不同的信号通路如Wnt/β-catenin,刺猬,缺口,TGF-β/SMAD,PI3K/Akt/mTOR,NF-κB,JAK/STAT,DNA损伤反应,河马YAP发挥了关键作用。抗肿瘤治疗可以通过消除SCs来改善,成为设计新型制剂的有吸引力的目标。这里,我们综述了以这些途径为重点的靶向治疗在CRC中的疗效评估的临床试验.
    The cancer stem cell (SC) theory proposes that a population of SCs serves as the driving force behind fundamental tumor processes, including metastasis, recurrence, and resistance to therapy. The standard of care for patients with stage III and high-risk stage II colorectal cancer (CRC) includes surgery and adjuvant chemotherapy. Fluoropyrimidines and their combination with oxaliplatin increased the cure rates, being able to eradicate the occult metastatic SC in a fraction of patients. The treatment for unresectable metastatic CRC is based on chemotherapy, antibodies to VEGF and EGFR, and tyrosine-kinase inhibitors. Immunotherapy is used in MSI-H tumors. Currently used drugs target dividing cells and, while often effective at debulking tumor mass, these agents have largely failed to cure metastatic disease. SCs are generated either due to genetic and epigenetic alterations in stem/progenitor cells or to the dedifferentiation of somatic cells where diverse signaling pathways such as Wnt/β-catenin, Hedgehog, Notch, TGF-β/SMAD, PI3K/Akt/mTOR, NF-κB, JAK/STAT, DNA damage response, and Hippo-YAP play a key role. Anti-neoplastic treatments could be improved by elimination of SCs, becoming an attractive target for the design of novel agents. Here, we present a review of clinical trials assessing the efficacy of targeted treatment focusing on these pathways in CRC.
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