摘要
卵巢癌的早期症状不典型并且缺乏有效的筛查方法,多数患者确诊时已是晚期,严重危害当代妇女健康。肿瘤减灭术后以铂类药物为主的化疗是晚期卵巢癌和复发性卵巢癌患者的首选,但几乎所有的复发性卵巢癌患者最终都会发展为铂耐药。因此寻找天然、安全、有效的化疗增敏剂已成为卵巢癌研究中迫切而又重要的课题。随着中药在癌症治疗中的应用日益广泛,人们对中药单体的研究也日渐深入,中药单体干预卵巢癌顺铂(DDP)耐药的机制也愈发清晰。基于中药单体研究现状,通过查阅多个中英文数据库中中药单体相关实验研究,发现中药单体在多方面参与了逆转卵巢癌DDP耐药,其机制可以概括为以下6个方面:增加胞内药物浓度、逆转凋亡受阻、逆转胞内信号通路异常、增加DNA损伤和抑制DNA修复、调控胞内自噬、抑制上皮间质转化(EMT)。中药单体从多靶点减轻了卵巢癌DDP耐药,增加了DDP对卵巢癌体外细胞和体内移植瘤的毒性作用,因此中药单体有望成为卵巢癌DDP化疗的天然增敏剂。然而中药单体目前的研究还存在实验类型单一、机制尚不完全明确、不良反应不明等不足,从实验室到临床,中药单体增敏DDP化疗的应用未来还需要多靶点、多水平的实验研究及大规模的临床研究的验证。
Because the early symptoms of ovarian cancer are not typical and there is a lack of effective screening methods,most patients are diagnosed at an advanced stage,which seriously endangers the health of modern women.Platinum-based chemotherapy after tumor reduction is the first choice for patients with advanced and recurrent ovarian cancer,but almost all patients with recurrent ovarian cancer will eventually develop platinum resistance.Therefore,the search for natural,safe,and effective chemotherapeutic sensitizers has become an urgent and important topic in the study of ovarian cancer.With the increasingly extensive application of traditional Chinese medicine(TCM)in the treatment of cancer,the research on Chinese herbal monomers is also deepening,and the mechanisms of Chinese herbal monomers in intervening in cisplatin(DDP)-induced resistance of ovarian cancer is becoming increasingly clearer.Based on the research status of Chinese herbal monomers available in many Chinese and English databases,it was found that Chinese herbal monomers were involved in the reversal of DDP-induced resistance of ovarian cancer via many routes,mainly through increasing the intracellular drug concentration,reversing the blocked apoptosis,correcting the abnormal intracellular signaling pathway,enhancing DNA damage and inhibiting DNA repair,regulating intracellular autophagy,and suppressing epithelial mesenchymal transition(EMT).Chinese herbal monomers weaken the resistance of ovarian cancer to DDP from multiple targets and enhance the toxicity of DDP to ovarian cancer cells in vitro and transplanted tumors in vivo.Therefore,Chinese herbal monomers are expected to become natural sensitizers for ovarian cancer chemotherapy with DDP.However,the current studies on Chinese herbal monomers are still confined to the single experimental type,and their action mechanisms and toxic and side effects remain to be further clarified.The application of Chinese herbal monomers for sensitizing DDP chemotherapy still needs to be verified by multi-target,multi-level experimental studies and large-scale clinical studies in the future.
作者
申芳
徐佳越
刘芳媛
韩凤娟
SHEN Fang;XU Jia-yue;LIU Fang-yuan;HAN Feng-juan(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第3期226-233,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(82074484)。
关键词
卵巢癌
中药单体
顺铂
化疗耐药
研究进展
ovarian cancer
Chinese herbal monomers
cisplatin(DDP)
chemotherapy resistance
research progress
