组蛋白去乙酰化酶抑制剂及其衍生的多靶点抑制剂在胃肠道肿瘤中的研究进展
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丁杰, Email: dingjieboy@126.com

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国家自然科学基金资助项目(81360366,81302169);贵州省社会发展攻关资助项目( 黔科合SZ字[2014]3023号);贵州省优秀青年科技人才培养对象基金资助项目(黔科合平台人才[2017]5602);贵州省高层次创新型人才培养对象资助项目(GZSYQCC[2014]001);贵州省科技计划基金资助项目(黔科合基础[2019]1198号;黔科合基础[2020]1Z064);贵州省高层次留学人才创新创业基金资助项目(留学人才择优资助合同(2018)04号);贵州省社会发展攻关资助项目 (黔科合LH字[2014]7012号)。


Research progress of histone deacetylase inhibitors and their deriving multitarget inhibitors in gastrointestinal cancer
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    摘要:

    胃癌的新发病例排在恶性肿瘤的第5位,而结直肠癌是世界第三大常见的恶性肿瘤和第四大癌症死亡原因。组蛋白乙酰化的动态平衡由组蛋白乙酰转移酶(HAT)和组蛋白去乙酰化酶(HDAC)两个酶家族共同维持。HDAC能将赖氨酸上的乙酰基去除,从而抑制基因转录,但HDAC异常高表达可诱导正常细胞发生癌变,并参与其发展、增殖、侵袭和转移。靶向抑制HDAC已被证实具有抗肿瘤的效应,组蛋白去乙酰化酶抑制剂(HDACi)能抑制HDAC的表达及活性,并通过影响细胞活性氧水平、阻滞细胞周期、促进损伤DNA修复、抗血管新生、影响细胞信号通路、诱导自噬凋亡及增加细胞对放化疗药物的敏感性发挥强效的抗瘤作用,在胃癌及结直肠癌中HDAC则表达增高,HDACi在胃肠道肿瘤的研究中也呈现出良好的成效,由于I、II和IV类HDAC的催化核心发挥功能均依赖于Zn2+,故多数HDACi均含有Zn2+鳌合基团,异羟肟酸类抑制剂中的SAHA、TSA小剂量单独给药时已具有良好的抗肿瘤的成效,但后期临床研究发现,SAHA由于活性低,在治疗胃癌及结直肠癌的临床试验疗效并不佳,TSA的活性有所提高,但对HDAC选择性仍低,苯甲酰胺类HDACi在选择性上得以改善,但也无法只针对于特定亚型的HDAC,后期的环肽类及新报道的HDACi在HDAC的选择性上逐渐增加,但也仅限在动物及细胞实验阶段,并且上述的HDACi除与Zn2+结合之外还能与其他金属酶结合,从而缺乏绝对的特异性,故大多数的HDACi在很小的剂量下就已引发了副作用,由于肿瘤的发生、发展涉及多环节、多因素,单一靶标常常不能有效杀灭癌细胞,并易产生耐药性,联合多靶标比单一靶标具有更强的抑癌效用,甚至能减轻药物耐药性的产生,但有时联合用药时会因药物间相互影响而带来不良反应,为了避免药物间相互影响,研究者基于药效基团拼接理念,将HDACi活性基团与其他不同作用靶点药物的活性基团进行合理拼接设计合成新的具有多靶点抑制剂,研究证实,多靶点抑制剂既能避免药物间的相互作用,还能提高药物作用,现依次介绍HDACi及HDACi相关的多重抑制剂在胃肠道肿瘤的研究进展。

    Abstract:

    New cases of gastric cancer rank fifth in malignant tumors, while colorectal cancer is the third most common malignant tumor and the fourth most common cause of cancer death in the world. The dynamic balance of histone acetylation is jointly maintained by histone acetyltransferase (HAT) and histone deacetylase, (HDAC) enzyme families. HDAC can remove acetyl groups from lysine, thus inhibiting gene transcription. However, abnormally high expression of HDAC can induce normal cells to turn cancerous and participate in its development, proliferation, invasion and metastasis. Targeted inhibition of HDAC has been proved to have anti-tumor effect. Histone deacetylase inhibitors (HDACi) can inhibit the expression and activity of HDAC. Moreover, HDAC plays a potent anti-tumor role by influencing the level of cell reactive oxygen species, blocking cell cycle, promoting repair of damaged DNA, resisting angiogenesis, influencing cell signal pathways, inducing autophagy apoptosis and increasing the sensitivity of cells to chemoradiotherapy drugs. HDAC expression is increased in gastric cancer and colorectal cancer, and HDACi also shows good results in the study of gastrointestinal tumors. Since the catalytic core functions of class I, II and IV HDAC all depend on Zn2+, most HDACi contain Zn2+ chelating groups. SAHA and TSA in hydroxamic acid inhibitors have good anti-tumor effects when administered alone in small doses. However, later clinical studies found that SAHA has poor clinical efficacy in treating gastric cancer and colorectal cancer due to its low activity. The activity of TSA has been improved, but its selectivity to HDAC is still low, benzamide HDACi is improved in selectivity, but it cannot be only targeted at specific subtypes of HDAC. The selectivity of late cyclic peptides and newly reported HDACi is gradually increased, but it is only limited to animal and cell experimental stages, and the above-mentioned HDACi can combine with other metalloenzymes in addition to Zn2+, thus lacking absolute specificity. Therefore, most HDACi has caused side effects at a very small dose. As the occurrence and development of tumors involve multiple steps and factors, a single target often cannot effectively kill cancer cells and is prone to drug resistance. Combination of multiple targets has stronger anti-cancer effect than a single target, and can even reduce the occurrence of drug resistance. However, sometimes adverse reactions caused by drug interaction may occur when drugs are used in combination. In order to avoid drug interaction, based on the concept of pharmacophore splicing, researchers designed and synthesized a new multitarget inhibitor by reasonably splicing HDACi active groups and active groups of other drugs with different action targets. Studies have proved that multi-target inhibitors not only avoid drug interactions, but also improve drug effects. This paper introduces in turn the research progress of HDACi and HDACi-related multi-inhibitors in gastrointestinal tumors.

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李显, 丁杰, 夏宇, 岑祥莹, 吴明, 张林, 樊斐, 曾家兴, 糜睿.组蛋白去乙酰化酶抑制剂及其衍生的多靶点抑制剂在胃肠道肿瘤中的研究进展[J].中国普通外科杂志,2020,29(10):1251-1260.
DOI:10.7659/j. issn.1005-6947.2020.10.012

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  • 收稿日期:2020-02-15
  • 最后修改日期:2020-09-21
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  • 在线发布日期: 2020-10-25