多发性骨髓瘤病理机制中脂质和氨基酸代谢与免疫检查点分子关系的研究进展  

Relationship between metabolism of lipid and amino acid with immune checkpoint molecules in the pathogenesis of multiple myeloma

作　　者：宋佳殷 黄仲夏[1] Song Jiayin;Huang Zhongxia(Department of Hematology,Multiple Myeloma Medical Center of Beijing,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院石景山院区血液科,北京

出　　处：《国际移植与血液净化杂志》2024年第1期6-8,共3页International Journal of Transplantation and Hemopurification

摘　　要：多发性骨髓瘤(multiple myeloma,MM)简称骨髓瘤,是一种易发生于老年人的恶性浆细胞肿瘤,几乎所有的MM患者均由意义未明的单克隆免疫球蛋白血症(MGUS)/冒烟型骨髓瘤(SMM)发展而来。随着病情演变和进展,患者逐渐出现高钙血症、肾损害、贫血和骨损害等CRAB症状。虽然靶向新药(如硼替佐米、来那度胺和达雷妥尤单抗)的应用改善了MM患者的生存,但MM仍不可治愈。MM是一高度依赖骨髓微环境的疾病,探索MM疾病过程中肿瘤微环境的变化愈发重要。在MM病情演变和发病过程中,代谢重编程除了在维持MM细胞自身的生长和增殖中起重要作用,同时通过释放信号分子和分泌代谢产物调节免疫,代谢重编程和免疫逃逸是肿瘤微环境中的两个重要的方面。本文对MM疾病过程中脂质、氨基酸类代谢物及T/NK免疫细胞和一些免疫检查点分子变化进行综述,以进一步探索其在MM病理过程中的地位,为MM治疗提供新思路。Multiple myeloma(MM)is a malignant plasma cell tumor that is prone to occur in the elderly.Almost all MM patients develop from monoclonal immunoglobulinemia of unknown significance(MGUS)/smoldering MM(SMM).As the disease evolves and progresses,patients gradually develop CRAB symptoms such as hypercalcemia,kidney damage,anemia,and bone damage from asymptomatic to asymptomatic.Although the application of targeted new drugs such as bortezomib,lenalidomide and daratumumab has improved the survival of patients with MM,it is still an incurable disease.MM is a highly dependent disease on the bone marrow microenvironment(TME),and exploring the changes in TME during the pathological process of MM is becoming increasingly important.In the evolution and progression of MM,metabolic reprogramming plays an important role in maintaining the growth and proliferation of MM cells themselves,and immune escape and immune reprogramming are also indispensable in this pathological process.This article reviews the changes in lipids,amino acid metabolites,T/NK immune cells,and some immune checkpoint molecules during the complex TME process in MM patients,in order to further explore their role in the pathogenesis and provide new ideas for future targeted therapy for.MM.

关 键 词：多发性骨髓瘤 意义未明的单克隆免疫球蛋白血症 机制 脂质代谢 氨基酸代谢 免疫检测点分子 

分 类 号：R733.3[医药卫生—肿瘤]