谁在化疗后刺激了肿瘤复发?

时间:2015年8月14日
来源:生物通

编辑推荐:

八月十二日,在美国癌症研究学会出版的著名期刊《Cancer Research》发表的一项研究报道称,给患者施用一种可阻止部分免疫系统加大力度的药物,可能阻止一些患者的癌症复发。

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生物通报道:八月十二日,在美国癌症研究学会出版的著名期刊《Cancer Research》发表的一项研究报道称,给患者施用一种可阻止部分免疫系统加大力度的药物,可能阻止一些患者的癌症复发。延伸阅读:Cell Rep:癌症致命复发的关键蛋白

在英国癌症研究所的资助下,来自英国谢菲尔德大学的科学家发现,化疗的肿瘤杀伤作用,可能致使治疗肿瘤中一群伤口愈合的白血细胞聚集在血管周围。这些细胞——称为M2巨噬细胞,可修复组织损伤并构建新的血管,这个过程,有时有助于治疗后的肿瘤复发。

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但是,用一种阻止这些修复细胞起作用的药物,来治疗小鼠,研究人员显著降低了化疗后肿瘤复发的速度。

这项研究的首席科学家、谢菲尔德大学肿瘤系的Claire Lewis教授说:“科学家们已经知道,当免疫系统对组织损伤作出反应时,人体驱动自身愈合的力量,有时会适得其反。我们的研究表明,用化疗法治疗肿瘤,可以刺激这部分的免疫系统,然后,这有助于肿瘤再生长。

“但是,将化疗药物与关闭这部分人体修复系统的药物相结合,减缓了化疗后肿瘤的生长。这对不能手术、因此需要化疗的患者,可能是特别重要的,可帮助他们尽可能地延长生存期。”

这还需要患者的临床试验,来确认这些早期研究结果,以探讨这种药物——由于其他原因(如骨髓移植)已经用于患者,是否可能在化疗后对癌症患者有帮助。

英国癌症研究所的科学通讯员Dr Áine McCarthy说:“化疗是一种基础的癌症治疗方法,已经拯救了成千上万人的生命,但有时肿瘤会复发,从而减少了病人的生存机会。我们不明白为什么肿瘤会复发,但是这项研究深入阐释了免疫系统在使肿瘤再次生长中的作用,重要的是,确定了一种药物,如果同时结合化疗使用,可以阻止这种情况的发生。

“但这是在小鼠体内进行的早期研究,还需要更多的研究来确定,阻断M2巨噬细胞是否也能减慢肿瘤的再生长。”

(生物通:王英)

生物通推荐原文摘要:
Perivascular M2 Macrophages Stimulate Tumor Relapse after Chemotherapy
Abstract: Tumor relapse after chemotherapy-induced regression is a major clinical problem, because it often involves inoperable metastatic disease. Tumor-associated macrophages (TAM) are known to limit the cytotoxic effects of chemotherapy in preclinical models of cancer. Here, we report that an alternatively activated (M2) subpopulation of TAMs (MRC1+TIE2HiCXCR4Hi) accumulate around blood vessels in tumors after chemotherapy, where they promote tumor revascularization and relapse, in part, via VEGF-A release. A similar perivascular, M2-related TAM subset was present in human breast carcinomas and bone metastases after chemotherapy. Although a small proportion of M2 TAMs were also present in hypoxic tumor areas, when we genetically ablated their ability to respond to hypoxia via hypoxia-inducible factors 1 and 2, tumor relapse was unaffected. TAMs were the predominant cells expressing immunoreactive CXCR4 in chemotherapy-treated mouse tumors, with the highest levels expressed by MRC1+ TAMs clustering around the tumor vasculature. Furthermore, the primary CXCR4 ligand, CXCL12, was upregulated in these perivascular sites after chemotherapy, where it was selectively chemotactic for MRC1+ TAMs. Interestingly, HMOX-1, a marker of oxidative stress, was also upregulated in perivascular areas after chemotherapy. This enzyme generates carbon monoxide from the breakdown of heme, a gas known to upregulate CXCL12. Finally, pharmacologic blockade of CXCR4 selectively reduced M2-related TAMs after chemotherapy, especially those in direct contact with blood vessels, thereby reducing tumor revascularization and regrowth. Our studies rationalize a strategy to leverage chemotherapeutic efficacy by selectively targeting this perivascular, relapse-promoting M2-related TAM cell population.

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