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胶质瘤是成人最常见的原发性脑肿瘤之一,占恶性脑肿瘤的70%以上,具有恶性程度高、侵袭性强、治疗效果及预后差等特点,临床主要治疗手段为手术切除、放化疗或两者联合治疗[1]。然而,血脑屏障(BBB)的选择通透性以及肿瘤细胞的多药耐药(MDR)特点给胶质瘤的治疗带来了挑战[2]。
BBB指的是位于中枢神经系统的一种无孔微血管结构,主要由血管内皮细胞以及位于内皮细胞层囊腔表面的壁细胞组成[3]。BBB的主要功能是维护大脑内环境的稳态,严格管控物质进出大脑,保障大脑功能的正常运行。然而,这种保护作用限制了很多药物进入脑内,使得一些治疗脑部疾病的药物难以在病灶部位达到有效药物浓度,成为药物治疗脑部疾病的重要制约因素[3-4]。
冰片属芳香开窍类中药,又名2-茨醇,属于小分子脂溶性双环单萜类物质,其主要有效成分为龙脑。在《中国药典》2020版中,收录的冰片有两种:一种通过人工合成而得,名为冰片,又名合成龙脑;另一种为经樟科植物樟[Cinnamomum cam phora(L.)Presl]的新鲜枝、叶提取加工而得的天然冰片,又名右旋龙脑[5]。现代药理学研究表明冰片具有促进药物透过各种体内外屏障,抗菌、保护心脑血管、镇痛抗炎以及防止血栓等多种药理作用[6-7]。近年来,许多研究表明冰片与抗胶质瘤的化疗药物联合应用,可以明显提高化疗药物的生物利用度和治疗疗效,本文就近年来冰片对胶质瘤化疗的辅助治疗临床前研究作一综述,以期为胶质瘤的临床治疗提供新的思路。
Advances in preclinical studies on borneol as an adjuvant for glioma
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摘要: 胶质瘤是一种常见的原发性恶性脑肿瘤,目前临床主要治疗手段为手术切除联合放化疗,但由于血脑屏障的选择通透性和肿瘤细胞的多药耐药性特点,使得治疗效果并不理想。近年来,研究发现冰片具有开放血脑屏障以及促进化疗药物渗透的作用,冰片与化疗药物联用或共载,化疗药物能更多地靶向胶质瘤组织,增加疗效。本文就近年来冰片与化疗药物联合应用的临床前研究进行综述,以期为胶质瘤的治疗提供有益参考。Abstract: Glioma is a common primary malignant brain tumor. At present, the main clinical treatment is surgical resection combined with radiotherapy and chemotherapy. Due to the selective permeability of the blood-brain barrier and the characteristics of multi-drug resistance of tumor cells, the therapeutic effect is not ideal. In recent years, studies have found that borneol could open the blood-brain barrier and promote the infiltration of chemotherapy drugs. When borneol is combined with or co-carried with chemotherapy drugs, chemotherapy drugs could target more glioma tissues and increase efficacy. The preclinical studies on the combination of borneol and chemotherapy drugs in recent years were reviewed in this article, in order to provide useful reference for the treatment of glioma.
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Key words:
- glioma /
- borneol /
- chemotherapy /
- blood-brain barrier
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