自噬在恶性血液病防治过程中的研究进展

Research progress of autophagy in the prevention and treatment of malignant hematologic diseases

自噬在恶性血液病前期能清除细胞内的异常物质和细胞器,在后期有助于恶性细胞获得各种物质和能量,促进肿瘤细胞生长增殖,具有双向作用。临床中放化疗、去甲基化及靶向治疗均能激活自噬,诱导肿瘤细胞发生Ⅱ型程序性细胞死亡,清除恶性细胞,但其产生的大量物质有助于残留的肿瘤细胞存活,导致机体产生耐药性。目前发现联合自噬抑制剂能有效提升恶性血液病的治疗效果,特别是对于复发难治性患者。临床治疗中,如何针对本病各阶段自噬情况,有效调节自噬水平、清除肿瘤细胞、抑制疾病进展,是恶性血液病防治的关键。

Autophagy can remove abnormal substances and organelles in cells in the early stage of malignant hematopathy,and help malignant cells to obtain various substances and energy in the later stage,and promote the growth and proliferation of tumor cells,which has a two-way effect.In clinical practice,chemoradiotherapy,demethylation,and targeted therapy can all activate autophagy,induce typeⅡprogrammed cell death of tumor cells and clear malignant cells,but a large amount of substances produced can help the survival of residual tumor cells and lead to drug resistance.It has been found that the combination of autophagy inhibitors can effectively improve the therapeutic effect of malignant hematologic diseases,especially for patients with relapsed and refractory diseases.In clinical treatment,how to effectively regulate the level of autophagy,remove tumor cells,and inhibit the progression of the disease are the key to the prevention and treatment of malignant hematologic diseases.