| 摘要: |
| 多发性骨髓瘤是一种多进程疾病,不同疾病进程对化疗和放疗的敏感性不同,敏感性减低可造成疾病复发或成为难治性多发性骨髓瘤。骨髓瘤细胞的生长、凋亡的抑制及耐药性依赖于参与免疫调节的细胞因子和血管生成的生长因子,如IL-6、VEGF等。沙利度胺既具有抗血管生成作用,又具有免疫调节功能,是治疗多发性骨髓瘤的有效药物之一,但长期服用沙利度胺可引起深静脉血栓等严重并发症,使与沙利度胺结构相似但比其更安全、高效的免疫调节类药物(immunomodulatory drugs, IMiDs)的探讨成为热点。IMiDs具有抗新生血管形成作用,同时可共刺激T细胞亚群,诱导细胞因子产生并提升NK细胞数量与功能,通过增强抗体依赖细胞介导的细胞毒性杀伤肿瘤细胞。本文简述IMiDs治疗多发性骨髓瘤的机制及其初步临床试验结果。 |
| 关键词: 免疫调节 血管生成 沙利度胺类似物 多发性骨髓瘤 |
| DOI：10.3724/SP.J.1008.2010.00 |
| 投稿时间：2010-03-11修订日期：2010-07-10 |
| 基金项目: |
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| Anti-angiogenesis and immunomodulation effect of immunomodulatory drugs in patients with multiple myeloma |
| HOU Jian1*,HUO Jun1, LIN Tian-bao2 |
| (Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;1. Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;2. Department of Ultrasound, Hangzhou Sanatorium of PLA Nanjing Military Area Command, Hangzhou 310007, Zhejiang, China) |
| Abstract: |
| Multiple myeloma is a multi-step disease, and different steps have different sensitivities to chemotherapy and radiotherapy.Low sensitivity can result in recurrent and refractory multiple myeloma.The growth of myeloma cells, apoptosis inhibition and drug resistance depend on the participation of immunomodulatory cytokines and vascular endothelial growth factors, such as IL-6 and VEGF.Thalidomide, an effective drug for multiple myeloma, has both anti-angiogenesis effect and immunoregulatory function; but long term use of thalidomide can result in complications such as deep venous thrombosis.Immunomodulatory drugs (IMiDs)are more effective thalidomide analogues and they have become a focus of study.IMiDs have anti-angiogenesis effect; they can co-stimulate T cell subgroup, induce cytokine production, and increase the quality and quantity of NK cells, exerting cytotoxic effect against tumor cells via antibody dependent manner.This article reviews the mechanism of IMiDs in treatment of multiple myeloma and the preliminary result of the clinical trails. |
| Key words: immunomodulatory angiogenesis thalidomide analogues multiple myeloma |
