Drug repositioning of disulfiram induces endometrioid epithelial ovarian cancer cell death via the both apoptosis and cuproptosis pathways

Various therapeutic strategies have been developed to overcome ovarian cancer.However,the prognoses resulting from these strategies are still unclear.In the present work,we screened 54 small molecule compounds approved by the FDA to identify novel agents that could inhibit the viability of human epithelial ovarian cancer cells.Among these,we identified disulfiram(DSF),an old alcohol-abuse drug,as a potential inducer of cell death in ovarian cancer.Mechanistically,DSF treatment significantly reduced the expression of the anti-apoptosis marker Bcell lymphoma/leukemia-2(Bcl-2)and increase the expression of the apoptotic molecules Bcl2 associated X(Bax)and cleaved caspase-3 to promote human epithelial ovarian cancer cell apoptosis.Furthermore,DSF is a newly identified effective copper ionophore,thus the combination of DSF and copper was used to reduce ovarian cancer viability than DSF single treatment.Combination treatment with DSF and copper also led to the reduced expression of ferredoxin 1 and loss of Fe-S cluster proteins(biomarkers of cuproptosis).In vivo,DSF and copper gluconate significantly decreased the tumor volume and increased the survival rate in a murine ovarian cancer xenograft model.Thus,the role of DSF revealed its potential for used as a viable therapeutic agent for the ovarian cancer.

Disulfiram联合Cu对耐药白血病细胞的作用及与JNK通路的关系

目的研究disulfiram(DS)联合Cu(DS/Cu)对耐药白血病细胞株HL60/ADM的逆转耐药作用及与JNK通路的关系。方法MTT法检测DS/Cu对HL60/ADM细胞的增殖抑制作用;选取DS/Cu对HL-60/ADM无明显杀伤作用的IC20值作为逆转浓度,MTT法检测IC20浓度DS/Cu联合不同浓度ADM处理24h后的IC50值;流式细胞仪检测阿霉素、DS/Cu单药及DS/Cu与阿霉素联合处理HL-60/ADM24h凋亡细胞比例的变化;Westernblotting检测c-jun表达的变化。结果DS/Cu对HL60/ADM细胞具有显著的增殖抑制作用,处理24hIC50为(1.11±0.025)μmol/L。HL-60/ADM细胞经IC20浓度(0.63μmol/L)DS/Cu处理24h后,ADM的IC50值从(7.69±1.87)降到(0.48±0.021)μg/mL,逆转倍数为15.95倍(P=0.003)。0.63μmol/L的DS/Cu、1.25μg/mL的阿霉素单药及上述浓度的DS/Cu联合阿霉素作用HL60/ADM细胞24h后,联合组凋亡细胞比例较DS/Cu或阿霉素单药组均显著增多(P<0.05)。Westernblotting显示阿霉素联合DS/Cu作用24h后c-jun表达水平显著增加。结论DS/Cu在体外对HL60/ADM细胞具有杀伤作用,IC20浓度的DS/Cu能够有效逆转HL60/ADM细胞的耐药,活化JNK通路是其机制之一。

Disulfiram及联合Cu对急性淋巴细胞白血病Molt4细胞增殖、凋亡及MDR1基因表达的影响

目的为进一步了解Disulfiram(DS)及DS联合Cu(DS/Cu)对急性淋巴细胞白血病Molt4细胞增殖、凋亡及多药耐药1(MDR1)基因水平表达的影响。方法用MTT法检测不同浓度(0.125、0.250、0.500、1.000、2.000、4.000μmol/mL)DS和DS/Cu对Molt4细胞的增殖抑制作用;用Annexin-ⅴ-FITC/PI流式细胞术检测不同浓度DS和DS/Cu作用Molt4细胞24h后凋亡细胞比例;实时荧光定量PCR检测不同浓度DS和DS/Cu对Molt4细胞MDR1基因表达水平的影响。结果不同浓度的DS对Molt4细胞有一定的抑制增殖作用,且呈剂量依赖性,IC50为(1.370±0.263)μmol/mL。DS/Cu联合后对Molt4细胞增殖抑制作用显著增强,IC50降为(0.560±0.443)μmol/mL,DS/Cu对Molt4细胞的抑制作用显著高于DS单药(P=0.005)。DS单药及DS/Cu对Molt4细胞均有诱导凋亡的作用,但DS/Cu对诱导Molt4细胞凋亡的比例显著高于DS单药(P=0.01)。DS单药对Molt4细胞MDR1基因表达水平无明显影响,而DS/Cu能显著降低Molt4细胞MDR1基因表达水平(P<0.001)。结论 DS对Molt4细胞有一定的抑制增殖、诱导凋亡作用,但对Molt4细胞MDR1表达水平无明显影响。DS/Cu不仅对Molt4细胞抑制增殖、诱导凋亡作用显著增强,还可显著下调Molt4细胞MDR1基因表达水平。

Disulfiram thermosensitive in-situ gel based on solid dispersion for cataract

To improve the corneal permeability and water-solubility of disulfiram(DSF), which is an ocular drug for cataract, P188 was selected as a matrix to prepare solid dispersion of DSF(DSF SD) by hot melt method. The DSF SD was characterized by DSC, XRD, and IR, and the results suggested that DSF was amorphous in DSF SD. The DSF SD was added to borate buffer solution(BBS) contained 20% poloxamer P407 and 1.2% poloxamer P188 to form in-situ gel. In vitro and in vivo experiments revealed that DSF SD combined with in-situ gel(DSF SD/in-situ gel) increased the residence time and the amount of DSF penetrated through the corneal. The pharmacodynamics studies exhibited DSF SD/in-situ gel delayed the development of selenium-induced cataract at some content. These results investigated that DSF SD/in-situ gel as a drug delivery system can improve DSF ocular permeability.

Adverse hepatic reactions associated with calcium carbimide and disulfiram therapy: Is there still a role for these drugs?

Disulfiram and calcium carbimide are two alcohol deterrants widely used in alcoholism treatment, however, there exist great concerns over their safety. Reports on hepatotoxicity, mainly related to disulfiram therapy, have been published. The hepatotoxic potential of calcium carbimide is less well characterized. Here, we describe four cases of liver damage related to this therapeutic group that were submitted to a Registry of hepatotoxicity and point out the limitations that we face when prescribing these compounds. A reassessment of the role of these compounds in the management of alcohol dependence is clearly needed.

Disulfiram in the management of alcohol dependence: A comprehensive clinical review

Disulfiram remains a viable option as a treatment for alcohol dependence and has been shown in recent studies to be successful in treating patients with alcohol dependence in a manner that is superior to both naltrexone and acamprosate. It is also useful in dual diagnosis patients and those with co-morbid cocaine and alcohol dependence. Although disulfiram’s mechanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anticraving effects as well. Recent reviews exhort to the importance of supervised disulfiram therapy in highlighting many of the potential and unique benefits of disulfiram. The present article will review the major clinical trials of disulfiram spanning nearly 60 years. It also discusses the usage of disulfiram across diverse populations along with monitoring for compliance and various adverse effects that may be encountered. The paper also reviews certain studies on long acting disulfiram therapy, recent comparative trials of disulfiram and its use in alcohol dependence. The review concludes with the role of disulfiram in the present day and long-term pharmacotherapy of alcohol dependence along with future research needs in this area.

Disulfiram’s Antineoplastic Effects on Ovarian Cancer

Objective: Aldehyde dehydrogenase (ALDH) enzymatic activity identifies ovarian cancer stem-like cells. We investigated the antineoplastic activity of the ALDH inhibitor Disulfiram on bulk ovarian cancer cells and CD133+/ALDH+ cancer stem-like cells. Study Design: Ovarian cancer cell lines, human ovarian surface epithelial cells, and mesenchymal stem cells were treated with increasing concentrations of Disulfiram and/or Cisplatin in vitro. Treated cells were assessed for viability or FACS-analyzed for either percentage of ovarian cancer stem-like cells or induction of apoptosis. Disulfiram’s impact on cancer stem-like cells was tested in vitro using tumor sphere formation assays and in vivo using tumor initiation assays with in vitro-treated A2780 cells in NSG mice. Finally, Disulfiram’s in vivo activity was assessed versus CD133+/ALDH+ cell-initiated tumor xenografts. Results: Disulfiram demonstrated antineoplastic activity against multiple ovarian cancer cell lines. While Disulfiram had limited in vitro toxicity against human ovarian surface epithelial cells or mesenchymal stem cells (IC50 of ~15 μM and >30 μM, respectively), its antineoplastic activity against cell lines was comparable to Cisplatin (IC50 ~1.5 μM). Disulfiram-mediated cell death was due, at least in part, to induction of apoptosis. Disulfiram activity was additive with chemotherapy. Disulfiram demonstrated selective depletion of CD44+ cells but not the CD133+ cancer stem-like cells. Disulfiram had no therapeutic impact on tumor initiation studies or in vivo therapy of whole cell line or stem cell-initiated tumor xenografts. Conclusions: In biologically relevant concentrations, Disulfiram has clear antineoplastic activity against ovarian cancer cells in vitro. Disulfiram selectively depleted CD44+ but not CD133+ ovarian cancer stem-like cells in vitro. However, Disulfiram had no significant activity in vivo. Thus, improved and more selective ALDH inhibitors may be required to target ovarian cancer stem cells.

Toxicological Evaluation of Disulfiram, Copper Gluconate and Disulfiram/Copper Gluconate Combination on Renal Function in Rodents

This research work investigated and compared the chronic renal toxicological profile of disulfiram, copper gluconate and disulfiram/copper gluconate combination, in a 90-day time- and dose-dependent study in rodents. 88 rats weighing an average of 280 g divided into eleven groups consisting of 8 rats each were used for this experiment. The control groups received normal saline as placebo and 99.5% dimethyl sulfoxide (DMSO) (solvent control). Three oral doses (low, medium and high) of disulfiram (18.65 mg/kg, 37.3 mg/kg and 74.6 mg/kg), copper gluconate (3.75 mg/kg, 7.5 mg/kg and 15 mg/kg) and both drugs in combination were administered daily with those of the combination given 12 hours apart. Blood samples were collected via cardiac puncture in heparinised bottles and centrifuged, and the serum was decanted on 30, 45, 60 and 90 days for analysis. Renal function parameters—electrolytes (Na+, K+), urea and creatinine were evaluated. Results showed significant (p < 0.05) dose- and time-dependent increase in electrolyte level (Na+, K+), blood urea and creatinine respectively. The results are all pointers to the development of renal failure. It therefore appears that the DSF/CG combination is nephrotoxic and this effect is dose-dependent and synergistic.

Effect of Disulfiram/Copper Gluconate Combination on Haematological Indices in Rodents

The chronic toxicological profile of disulfiram/copper gluconate (DSF/CG) combination was investigated in a 90 day time and dose dependent study. A total of 148 rats weighing 260 - 300 g were used for this study;60 for the pilot study and 88 for the chronic toxicity test. 88 rats divided into eleven groups consisting of 8 rats each were used for the main experiment. Groups 1 and 2 served as control groups and received normal saline as placebo and 99.5% dimethyl sulfoxide (DMSO) (Solvent control), respectively. Drugs were administered orally via a 1 ml syringe. Animals were given three doses (1/5th, 1/10th and 1/20th) of the calculated LD50 of 373 mg/kg and 75 mg/kg for disulfiram and copper gluconate respectively. Dosing was done daily with that of the combination given 12 hours apart. Blood samples were obtained via cardiac puncture on days 30, 45, 60 and 90 for analysis. Haematological parameters showed a significant (p < 0.05) dose- and time-dependent decrease in the packed cell volume, red blood cell count, white blood cell count and platelet count respectively. The results indicate bone marrow depression evidenced by anemia, leucopenia and thrombocytopenia in the experimental animals. The DSF/CG combination appears to exhibit a synergistic dose-dependent haematotoxicity.

Disulfiram (Antabuse) Neurotoxicity: Implications of Painful Small Fiber Sensory Polyneuropathy for Lyme Disease and Addiction

This article describes the prototypical clinical presentation, electrodiagnostic and neuropathological findings and treatment of a patient with painful peripheral neuropathy due to disulfiram toxicity. Although a review of the literature fails to reveal cases of painful peripheral neuropathy due to disulfiram toxicity, there has been heightened publicity of its risk in the treatment of persistent symptoms of Lyme disease following a standard of care course of antibiotics known as post-treatment Lyme disease syndrome. This article reviews the etiopathogenesis and diagnosis of predominant small fiber neuropathy resulting from disulfiram neurotoxicity, and offers recommendations for its use in Lyme disease and alcoholism.

The role of interleukin-18 in glioblastoma pathology implies therapeutic potential of two old drugs-disulfiram and ritonavir

Based on reporting in the last several years,an impressive but dismal list of cytotoxic chemotherapies that fail to prolong the median overall survival of patients with glioblastoma has prompted the development of treatment protocols designed to interfere with growth-facilitating signaling systems by using non-cytotoxic,non-oncology drugs.Recent recognition of the pro-mobility stimulus,interleukin-18,as a driver of centrifugal glioblastoma cell migration allows potential treatment adjuncts with disulfiram and ritonavir.Disulfiram and ritonavir are well-tolerated,non-cytotoxic,non-oncology chemotherapeutic drugs that are marketed for the treatment of alcoholism and human immunodeficiency virus(HIV) infection,respectively.Both drugs exhibit an interleukin-18—inhibiting function.Given the favorable tolerability profile of disulfiram and ritonavir,the unlikely drug-drug interaction with temozolomide,and the poor prognosis of glioblastoma,trials of addition of disulfiram and ritonavir to current standard initial treatment of glioblastoma would be warranted.

Repurposing disulfiram with CuET nanocrystals:Enhancing anti-pyroptotic effect through NLRP3 inflammasome inhibition for treating inflammatory bowel diseases

Drug repurposing offers a valuable strategy for identifying new therapeutic applications for existing drugs.Recently,disulfiram(DSF),a drug primarily used for alcohol addiction treatment,has emerged as a potential treatment for inflammatory diseases by inhibiting pyroptosis,a form of programmed cell death.The therapeutic activity of DSF can be further enhanced by the presence of Cu^(2+),although the underlying mechanism of this enhancement remains unclear.In this study,we investigated the mechanistic basis of Cu^(2+)-induced enhancement and discovered that it is attributed to the formation of a novel copper ethylthiocarbamate(CuET)complex.CuET exhibited significantly stronger anti-pyroptotic activity compared to DSF and employed a distinct mechanism of action.However,despite its potent activity,CuET suffered from poor solubility and limited permeability,as revealed by our druggability studies.To overcome these intrinsic limitations,we developed a scalable method to prepare CuET nanocrystals(CuET NCs)using a metal coordination-driven self-assembly approach.Pharmacokinetic studies demonstrated that CuET NCs exhibited a 6-fold improvement in bioavailability.Notably,CuET NCs exhibited high biodistribution in the intestine,suggesting their potential application for the treatment of inflammatory bowel diseases(IBDs).To evaluate their therapeutic efficacy in vivo,we employed a murine model of DSS-induced colitis and observed that CuET NCs effectively attenuated inflammation and ameliorated colitis symptoms.Our findings highlight the discovery of CuET as a potent anti-pyroptotic agent,and the development of CuET NCs represents a novel approach to enhance the druggability of CuET.

Disulfiram ameliorates STING/MITA-dependent inflammation and autoimmunity by targeting RNF115

STING(also known as MITA)is an adaptor protein that mediates cytoplasmic DNA-triggered signaling,and aberrant activation of STING/MITA by cytosolic self-DNA or gain-of-function mutations causes severe inflammation.Here,we show that STING-mediated inflammation and autoimmunity are promoted by RNF115 and alleviated by the RNF115 inhibitor disulfiram(DSF).Knockout of RNF115 or treatment with DSF significantly inhibit systemic inflammation and autoimmune lethality and restore immune cell development in Trex1^(–/–)mice and STING^(N153S/WT) bone marrow chimeric mice.In addition,knockdown or pharmacological inhibition of RNF115 substantially downregulate the expression of IFN-α,IFN-γand proinflammatory cytokines in PBMCs from patients with systemic lupus erythematosus(SLE)who exhibit high concentrations of dsDNA in peripheral blood.Mechanistically,knockout or inhibition of RNF115 impair the oligomerization and Golgi localization of STING in various types of cells transfected with cGAMP and in organs and cells from Trex1^(–/–)mice.Interestingly,knockout of RNF115 inhibits the activation and Golgi localization of STINGN153S as well as the expression of proinflammatory cytokines in myeloid cells but not in endothelial cells or fibroblasts.Taken together,these findings highlight the RNF115-mediated cell type-specific regulation of STING and STINGN153S and provide potential targeted intervention strategies for STING-related autoimmune diseases.

Disulfiram:A novel repurposed drug for cancer therapy

Cancer is a major global health issue.Effective therapeutic strategies can prolong patients’survival and reduce the costs of treatment.Drug repurposing,which identifies new therapeutic uses for approved drugs,is a promising approach with the advantages of reducing research costs,shortening development time,and increasing efficiency and safety.Disulfiram(DSF),a Food and Drug Administration(FDA)-approved drug used to treat chronic alcoholism,has a great potential as an anticancer drug by targeting diverse human malignancies.Several studies show the antitumor effects of DSF,particularly the combination of DSF and copper(DSF/Cu),on a wide range of cancers such as glioblastoma(GBM),breast cancer,liver cancer,pancreatic cancer,and melanoma.In this review,we summarize the antitumor mechanisms of DSF/Cu,including induction of intracellular reactive oxygen species(ROS)and various cell death signaling pathways,and inhibition of proteasome activity,as well as inhibition of nuclear factor-kappa B(NF-κB)signaling.Furthermore,we highlight the ability of DSF/Cu to target cancer stem cells(CSCs),which provides a new approach to prevent tumor recurrence and metastasis.Strikingly,DSF/Cu inhibits several molecular targets associated with drug resistance,and therefore it is becoming a novel option to increase the sensitivity of chemo-resistant and radio-resistant patients.Studies of DSF/Cu may shed light on its improved application to clinical tumor treatment.

Disulfiram enhances the antitumor activity of cisplatin by inhibiting the Fanconi anemia repair pathway

A series of chemotherapeutic drugs that induce DNA damage,such as cisplatin(DDP),are standard clinical treatments for ovarian cancer,testicular cancer,and other diseases that lack effective targeted drug therapy.Drug resistance is one of the main factors limiting their application.Sensitizers can overcome the drug resistance of tumor cells,thereby enhancing the antitumor activity of chemotherapeutic drugs.In this study,we aimed to identify marketable drugs that could be potential chemotherapy sensitizers and explore the underlying mechanisms.We found that the alcohol withdrawal drug disulfiram(DSF)could significantly enhance the antitumor activity of DDP.JC-1 staining,propidium iodide(PI)staining,and western blotting confirmed that the combination of DSF and DDP could enhance the apoptosis of tumor cells.Subsequent RNA sequencing combined with Gene Set Enrichment Analysis(GSEA)pathway enrichment analysis and cell biology studies such as immunofluorescence suggested an underlying mechanism:DSF makes cells more vulnerable to DNA damage by inhibiting the Fanconi anemia(FA)repair pathway,exerting a sensitizing effect to DNA damaging agents including platinum chemotherapy drugs.Thus,our study illustrated the potential mechanism of action of DSF in enhancing the antitumor effect of DDP.This might provide an effective and safe solution for combating DDP resistance in clinical treatment.

Chemical screening links disulfiram with cardiac protection after ischemic injury

Ischemia-reperfusion injury occurs after reperfusion treatment for patients suffering myocardial infarction,however the underlying mechanisms are incompletely understood and effective pharmacological interventions are limited.Here,we report the identification and characterization of the FDA-approved drug disulfiram(DSF)as a cardioprotective compound.By applying high-throughput chemical screening,we found that DSF decreased H_(2)O_(2)-induced cardiomyocyte death by inhibiting Gasdermin D,but not ALDH1,in cardiomyocytes.Oral gavage of DSF decreased myocardial infarct size and improved heart function after myocardial ischemia-reperfusion injury in rats.Therefore,this work reveals DSF as a potential therapeutic compound for the treatment of ischemic heart disease.

双硫仑联合紫杉醇对食管癌细胞增殖、侵袭能力的抑制作用及其机制

目的探讨双硫仑联合紫杉醇对食管癌细胞增殖、侵袭能力的抑制作用并分析其机制。方法以不同浓度双硫仑(0、10、20、40μmol/L)分别作用于食管癌细胞株TE-1和TE-10,CCK-8法测算细胞活力,筛选得到双硫仑最佳作用浓度为20μmol/L。将TE-1、TE-10食管癌细胞分别分为对照组(不加药物正常培养)、双硫仑组(20μmol/L双硫仑)、紫杉醇组(0.5μmol/L紫杉醇)、双硫仑+紫杉醇组(20μmol/L双硫仑+0.5μmol/L紫杉醇)。采用MTT法观察细胞增殖能力,流式细胞术观察细胞凋亡率,Transwell实验观察细胞侵袭能力,RT-qPCR法检测细胞α微管蛋白mRNA,Western blotting法检测细胞α微管蛋白、Bcl-2蛋白。结果TE-1及TE-10细胞增殖率对照组>双硫仑组>紫杉醇组>双硫仑+紫杉醇组,TE-1及TE-10细胞凋亡率对照组<双硫仑组<紫杉醇组<双硫仑+紫杉醇组(P均<0.05),TE-1及TE-10细胞穿膜细胞数对照组>双硫仑组>紫杉醇组>双硫仑+紫杉醇组(P均<0.05)。TE-1细胞α微管蛋白mRNA表达对照组>双硫仑组>紫杉醇组>双硫仑+紫杉醇组,TE-10细胞α微管蛋白mRNA表达对照组>双硫仑组>紫杉醇组、双硫仑+紫杉醇组;TE-1及TE-10细胞α微管蛋白、Bcl-2蛋白表达对照组>双硫仑组>紫杉醇组>双硫仑+紫杉醇组(P均<0.05)。结论双硫仑联合紫杉醇可增强对食管癌细胞增殖、侵袭能力的抑制作用,其机制可能与降低细胞中微管蛋白表达、促进细胞凋亡有关。

7种常见易发生不良反应真菌的毒性分析及安全应用

目的综述见手青类、胶陀螺、黑木耳、鹅膏菌类、橘黄裸伞、毛头鬼伞、卷边桩菇7种常见易发生不良反应条件性真菌研究现状,对其毒性成分进行分析,提出相应的安全应用建议,为资源开发及可持续应用提供参考。方法通过查阅国内外文献及相关书籍,对7种常见易发生不良反应真菌的研究现状、功效作用、毒性成分、不良反应等进行总结。结果7种常见易发生不良反应真菌所含的毒性成分种类复杂,包括多肽、生物碱、氨基酸、低聚异戊二烯类等化合物,可能会引起神经毒性、光敏毒性、胃肠道刺激、双硫仑样反应、溶血性中毒等不良反应,需引起重视。同时,这些真菌富含多种生物活性成分,具有显著药理活性,部分毒性成分又具开发成抗炎、镇痛、抗抑郁等药的潜力,值得更深入研究及合理开发应用。结论易发生不良反应真菌亦是重要的药用真菌资源,极具开发价值,目前许多易发生不良反应真菌研究重点多偏重药理作用和毒理作用,其毒力因子及其中毒机制尚未明确,需进一步深入研究,为其开发应用提供参考。

毛头鬼伞的本草考证及不良反应研究进展

目的探究药用真菌毛头鬼伞的用药历史与现代研究进展,为毛头鬼伞进一步研究应用提供参考。方法查阅古代本草专著,对毛头鬼伞的名称、产地、形态、药性、功效进行考证,并结合现代文献研究进行深入探索。结果毛头鬼伞用药历史悠久,其古代名称为鬼盖、地盖、鬼屋等,现代称毛头鬼伞、鸡腿菇。性平、味甘,归胃、心经,主治小儿寒热惊痫证、疔疮肿毒、恶疮、蜈蚣蛇蝎伤。现代药理学研究表明毛头鬼伞具有抗氧化、抗癌、保护肝脏、抗炎、抗糖尿病、抗菌、抗病毒和抗线虫活性等药理作用。通过系统查阅古今文献发现,毛头鬼伞可能引起双硫仑样反应、胃肠炎型中毒、特应性皮炎患者的皮肤反应、富集重金属等不良反应。结论通过对毛头鬼伞的本草考证及不良反应进行总结,可为毛头鬼伞的安全利用提供依据。

双硫仑联合铜在肿瘤耐药治疗中的应用及机制研究进展

目前肿瘤耐药性不断发展成为癌症治疗面临的主要问题。金属元素的应用越来越广泛,尤其是近年来铜死亡的发现,让我们重新聚焦铜在肿瘤治疗上的应用。而铜离子载体与铜联合使用可以提高细胞内Cu水平并发挥抗癌活性。其中双硫仑(disulfiram,DSF)成本低,高效且安全,是一种有效的铜离子载体,已被证明可以促进癌细胞死亡,包括铜死亡。DSF可以与二价铜离子螯合,产生二乙基二硫代氨基甲酸铜(Cu[DDC]2)复合物,用来抗肿瘤,还可以调节肿瘤多药耐药性(multidrug resistance,MDR)。近期双硫仑联合铜在国外展开了丰富的临床试验,并验证了其疗效及安全性。该文就双硫仑联合铜抗肿瘤耐药的应用及机制研究进展进行探讨,为肿瘤耐药的干预提供借鉴。