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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。
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