基于一氧化氮联合光热疗法用于肿瘤治疗的研究进展

Advance on nitric oxide combined photothermal therapy for tumor treatment

光热疗法(photothermal therapy,PTT)具有不良反应小、治疗特异性好等优点,在医学研究中得到广泛关注。深入研究发现,采用单一PTT进行肿瘤治疗时,往往需要很高温度才能实现肿瘤的完全消融,这种高温会对机体带来明显的热损伤和炎症反应,影响治疗效果。近年来,高浓度的一氧化氮(nitric oxide,NO)对肿瘤有较强的抑制作用,并且可增加肿瘤细胞对温度和药物的敏感性,提高治疗效果。然而作为NO供体的化合物往往存在生物相容性差、非靶向递送等问题,限制了该方法的医学应用。综上所述,将NO供体与纳米光热制剂(photothermal agents,PTAs)有机地结合,有望克服单一治疗方法的缺点,实现“1+1>2”的抗肿瘤效果。鉴于NO联合PTT用于肿瘤治疗研究的快速发展,本综述首先对不同种类NO供体的抗肿瘤机制进行介绍;之后重点对基于NO联合PTT的治疗策略进行探讨;最后着重讨论基于这种联合治疗策略在癌症临床治疗中的应用前景和面临的挑战。

Photothermal therapy(PTT)has attracted significant attention due to minimal side effects and high treatment specificity.However,it often requires very high temperature to achieve complete tumor ablation under a single PTT.Such high temperature brings obvious thermal damage and inflammatory response to the body,affecting the therapeutic effect.In recent years,nitric oxide(NO)has been used to significantly inhibit tumor growth and enhance the sensitivity of tumor cells of temperature and drugs,thus enhancing the therapeutic effect.However,compounds as NO donors often have some disadvantages such as poor biocompatibility and untargeted delivery,etc.,therefore,this medical application based on NO therapy is limited.In conclusion,the organic combination of NO donors and photothermal agents(PTAs)is expected to overcome the shortcomings of single therapy and achieve the antitumor effect of"1+1>2".In view of the rapid development of NO combining with PTT in tumor therapy,this review firstly introduces the antitumor mechanisms of different types of NO donors.Then the treatment strategy based on NO combined with PTT is discussed.Finally,the prospects and challenges of this combination therapy strategy in the clinical treatment of cancer are discussed.