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神经胶质瘤,尤其是恶性胶质瘤,是最致命的原发性脑肿瘤之一。目前有效治疗神经胶质瘤仍然面临巨大挑战[1]。虽然可以通过手术完全切除肿瘤改进患者的生存率,但是神经外科医师从健康的神经组织中准确定位和识别肿瘤组织非常困难[2]。此外,由于胶质瘤具有特殊的快速渗透式增长方式和高侵袭性,导致其对放化疗不敏感[1, 3]。因此,迫切需要找到一种有效的方法来治疗这种恶性疾病。近年来,蝎子毒素如氯毒素(chlorotoxin,CTX)及其类似物东亚钳蝎氯毒素(Buthus martensii Karsch chlorotoxin,BmK CT)已被越来越多地应用于胶质瘤的靶向显像和治疗研究中[4-5]。
CTX又称TM-601,来源于以色列蝎,是一个由36个氨基酸组成、含4对二硫键的短链神经毒素多肽[6],可与神经胶质瘤细胞膜上特异性表达的氯离子通道和上调表达的基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)结合,从而抑制其生长和迁移[7-9]。此外,有研究表明,CTX还能抑制新生血管的生成,起到抗肿瘤生长的作用[10]。如今,CTX已经通过临床前期安全性试验,进入Ⅰ/Ⅱ期临床试验[11]。
目前,国内购买CTX困难且价格昂贵,许多学者对从东亚钳蝎中提纯、筛选出的CTX类似物展开研究,其中,BmK CT是东亚钳蝎中第1个纯化出来的CTX类似物。之前,国内学者许均华等[12]对CTX的结构、功能及药理研究作了比较有价值的综述,本文首次重点介绍BmK CT的来源、化学结构、作用机制以及其在胶质瘤靶向显像与治疗中的应用研究进展,并且总结其优势及其在未来研究中的挑战。
东亚钳蝎氯毒素在胶质瘤靶向显像与治疗中的研究进展
Development of research in targeting image and therapy of gliomas using Buthus martensii Karsch chlorotoxin
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摘要: 神经胶质瘤是颅内最常见的肿瘤,尤其是恶性胶质瘤,具有高复发率和致死率的特点。因其侵袭性生长,目前采取的手术联合放化疗的综合治疗方案疗效欠佳。如何靶向显像和治疗胶质瘤成为研究的重点。近年来,大量研究表明,作为氯毒素的类似物,东亚钳蝎氯毒素能特异性地结合神经胶质瘤细胞表达的氯离子通道和基质金属蛋白酶2,从而抑制胶质瘤细胞的侵润生长和迁移。以东亚钳蝎氯毒素为配体的生物结合物在胶质瘤靶向显像和治疗中的研究越来越多。笔者将全面介绍东亚钳蝎氯毒素的来源、化学结构、作用机制及其在胶质瘤靶向显像与治疗中的应用研究进展,并总结其优势及在未来研究中所面临的挑战。Abstract: Gliomas, especially malignant gliomas, are the most common primary brain tumors associated with high recurrence rate and significant mortality. The combination of surgery and radio- chemotherapy is the best treatment for them nowadays. However, due to their biological characteristics of invasive growth, they do not respond well to traditional therapy. How to target the tumor in situ, and inhibit tumor cell proliferation and invasion is the key for study. In recent years, many studies have demonstrated that Buthus martensii Karsch chlorotoxin(BmK CT), an important chlorotoxin-like peptide, specifically inhibited glioma cells growth and metastasis as a blocker of the chloride ion channel and matrix metallopro-teinase-2(MMP-2). The bioconjugates of BmK CT with other molecules have played an increasing role in targeted imaging and treatment of gliomas. In this review, its source, chemical structure and mechanisms will be provided. Besides, advantages and challenges in the use of BmK CT as a specific agent for imaging and theranostic applications in gliomas will be addressed.
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Key words:
- Glioma /
- Buthus martensii Karsch chlorotoxin /
- Chlorotoxin /
- Targeted imaging /
- Targeted therapy
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