针对癌症干细胞的光热治疗策略及研究进展  

Photothermal therapy strategies and research advances targeting cancer stem cells

作　　者：刘影 冯仕为 沈诗洋 莫然[1] LIU Ying;FENG Shiwei;SHEN Shiyang;MO Ran(State Key Laboratory of Natural Medicines,China Pharmaceutical University,Nanjing 211198,China;Zhongshan Institute for Drug Discovery,Zhongshan 528400,China;Pharmaceutical Preparation Research Center,Shanghai Institute of Materia Medica,Chinese Academy of Sciences,Shanghai 201203,China)

机构地区：[1]中国药科大学多靶标天然药物全国重点实验室,江苏南京211198 [2]中科中山药物创新研究院,广东中山528400 [3]中国科学院上海药物研究所,上海201203

出　　处：《广东药科大学学报》2025年第2期149-157,共9页Journal of Guangdong Pharmaceutical University

基　　金：国家自然科学基金项目(82273876,82104090);江苏省自然科学基金项目(BK20240012,BK20210425)。

摘　　要：肿瘤光热治疗(photothermal therapy,PTT)通过近红外(near infrared,NIR)光激发光热剂产生热效应,局部升温诱导癌细胞死亡,具有精准、无创以及高效等优势。然而,癌症干细胞(cancer stem cells,CSCs)能介导肿瘤产生对PTT的耐受。CSCs多分布于光穿透受限且光热剂难以到达的肿瘤深层区域,无法被NIR充分消融;CSCs高表达热损伤修复因子,使其耐热性显著高于普通癌细胞;CSCs依赖无氧糖酵解供能,可持续适应PTT产生的热应激。本文综述了近年来针对CSCs的PTT研究进展,重点探讨通过纳米药物递送系统增强光热效应与靶向效率的技术手段,并结合抑制热损伤修复、调控干性通路、诱导分化、引发氧化应激以及调节肿瘤微环境等克服CSCs对PTT耐受性的策略,展望了肿瘤PTT在未来的发展方向及转化应用面临的挑战。Tumor photothermal therapy(PTT)employs near-infrared light to activate photothermal agents,generating localized heat to induce cancer cell death.It offers significant advantages in precision,noninvasiveness,and high efficiency.However,cancer stem cells(CSCs)mediate tumor resistance to PTT.CSCs are often located in deep tumor regions where light penetration is limited and photothermal agents are less accessible,making them difficult to ablate with NIR.Additionally,CSCs exhibit high expression of heat damage repair factors,granting them significantly greater heat resistance than regular cancer cells.Moreover,CSCs rely on anaerobic glycolysis for energy,enabling persistent adaptation to PTT-induced thermal stress.This review summarizes recent advances in PTT targeting CSCs,focusing on technological approaches to enhance photothermal effects and targeting efficiency through nanodelivery systems.It also explores strategies to overcome CSC resistance to PTT,including inhibition of heat damage repair,regulation of stemness pathways,induction of differentiation,oxidative stress generation,and tumor microenvironment modulation,to overcome PTT resistance.Furthermore,this review critically discusses future directions for PTT-based CSC elimination and identifies challenges in clinical translation,offering insights into bridging the gap between preclinical research and therapeutic applications.

关 键 词：肿瘤光热治疗 癌症干细胞 纳米药物递送系统 治疗耐受 联合治疗 

分 类 号：R730.5[医药卫生—肿瘤]