Метаболическая модуляция биологического действия ионизирующего излучения и химиопрепаратов (обзор)

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Аннотация

В обзоре представлены общие сведения о микроокружении опухолевых клеток, его роли в развитии и прогрессировании злокачественного процесса и влиянии на результаты противоопухолевой терапии. Анализ показал, что разработка методов воздействия на ключевые метаболические мишени опухолевых клеток и их микроокружение является перспективным направлением в экспериментальной и клинической онкологии. Рассмотрены некоторые подходы для индукции метаболической модуляции: ингибиторы клеточных насосов, гипергликемия и гипертермия. Терапевтическое действие первых двух вариантов индукции основано на модуляции кислотно-щелочного равновесия (рН) опухоли. Биологический эффект гипертермии более широк и непосредственно зависит от выраженности и направленности температурно-экспозиционного режима нагревания. В конечном итоге такие изменения приводят к повышению повреждающего действия ионизирующей радиации и лекарственных препаратов на опухоль. Несмотря на то, что состав микроокружения неоднороден и варьирует в зависимости от вида опухоли, некоторые специфические клетки и медиаторы присутствуют во всех её типах. Поэтому разработанные методы лечения могут быть универсальными для большинства локализаций опухолей.

Проведённый анализ литературы позволяет считать, что имеются объективные экспериментальные и клинические данные для использования метаболических модуляторов в противоопухолевой терапии.

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Оразахмет Керимбаевич Курпешев

Сибирский научно-исследовательский институт гипертермии

Автор, ответственный за переписку.
Email: kurpeshev-ok@yandex.ru
ORCID iD: 0000-0003-3219-1596
SPIN-код: 2467-6046

д-р мед. наук

Россия, Искитим

Виктор Владимирович Пасов

Медицинский радиологический научный центр им. А.Ф. Цыба — филиал Национального медицинского исследовательского центра радиологии

Email: pasov@mrrc.obninsk.ru
ORCID iD: 0000-0003-0387-1648
SPIN-код: 8778-2401

д-р мед. наук

Россия, Обнинск

Анатолий Игоревич Пилипенко

Научно-производственное предприятие «Исток» им. А.И. Шокина

Email: aipilipenko@istokmw.ru
Россия, Фрязино

Глеб Алексеевич Уласов

Научно-производственное предприятие «Исток» им. А.И. Шокина

Email: gaulasov@istokmw.ru
Россия, Фрязино

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2. Рис. 1. Схематическое изображение взаимосвязи сосудистой сети опухоли и её микроокружения. Слева — рост опухолевых клеток вокруг капилляра и градиенты кислорода и питательных веществ по мере удаления от сосуда. Справа — блок-схема, показывающая роль различных факторов микроокружения опухоли на её развитие.

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