免疫调节剂治疗多发性骨髓瘤的抗血管生成及免疫调节作用机制  

Anti-angiogenesis and immunomodulation effect of immunomodulatory drugs in patients with multiple myeloma

作　　者：火俊[1] 林天宝[2] 侯健[1] 

机构地区：[1]第二军医大学长征医院血液科,上海200003 [2]南京军区杭州疗养院特诊科,杭州310007

出　　处：《第二军医大学学报》2010年第9期1023-1025,共3页Academic Journal of Second Military Medical University

摘　　要：多发性骨髓瘤是一种多进程疾病,不同疾病进程对化疗和放疗的敏感性不同,敏感性减低可造成疾病复发或成为难治性多发性骨髓瘤。骨髓瘤细胞的生长、凋亡的抑制及耐药性依赖于参与免疫调节的细胞因子和血管生成的生长因子,如IL-6、VEGF等。沙利度胺既具有抗血管生成作用,又具有免疫调节功能,是治疗多发性骨髓瘤的有效药物之一,但长期服用沙利度胺可引起深静脉血栓等严重并发症,使与沙利度胺结构相似但比其更安全、高效的免疫调节类药物(immunomodulato-ry drugs,IMiDs)的探讨成为热点。IMiDs具有抗新生血管形成作用,同时可共刺激T细胞亚群,诱导细胞因子产生并提升NK细胞数量与功能,通过增强抗体依赖细胞介导的细胞毒性杀伤肿瘤细胞。本文简述IMiDs治疗多发性骨髓瘤的机制及其初步临床试验结果。Multiple myeloma is a multi-step disease, and different steps have different sensitivities to chemotherapy and radiotherapy.Low sensitivity can result in recurrent and refractory multiple myeloma.The growth of myeloma cells, apoptosis inhibition and drug resistance depend on the participation of immunomodulatory cytokines and vascular endothelial growth factors, such as IL-6 and VEGF.Thalidomide, an effective drug for multiple myeloma, has both anti-angiogenesis effect and immunoregulatory function; but long term use of thalidomide can result in complications such as deep venous thrombosis.Immunomodulatory drugs （IMiDs）are more effective thalidomide analogues and they have become a focus of study.IMiDs have anti-angiogenesis effect; they can co-stimulate T cell subgroup, induce cytokine production, and increase the quality and quantity of NK cells, exerting cytotoxic effect against tumor cells via antibody dependent manner.This article reviews the mechanism of IMiDs in treatment of multiple myeloma and the preliminary result of the clinical trails.

关 键 词：免疫调节 血管生成 沙利度胺类似物 多发性骨髓瘤 

分 类 号：R733.3[医药卫生—肿瘤] R979.19[医药卫生—临床医学]