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Tumor microenvironment and epithelial mesenchymal transition as targets to overcome tumor multidrug resistance.
Erin, Nuray; Grahovac, Jelena; Brozovic, Anamaria; Efferth, Thomas.
Afiliación
  • Erin N; Department of Medical Pharmacology, Immunopharmacology and Immunooncology Unit, School of Medicine, Akdeniz University, Turkey. Electronic address: nerin@akdeniz.edu.tr.
  • Grahovac J; Laboratory for Experimental Pharmacology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
  • Brozovic A; Division of Molecular Biology, Ruder Boskovic Institute, Zagreb, Croatia.
  • Efferth T; Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany.
Drug Resist Updat ; 53: 100715, 2020 12.
Article en En | MEDLINE | ID: mdl-32679188
It is well established that multifactorial drug resistance hinders successful cancer treatment. Tumor cell interactions with the tumor microenvironment (TME) are crucial in epithelial-mesenchymal transition (EMT) and multidrug resistance (MDR). TME-induced factors secreted by cancer cells and cancer-associated fibroblasts (CAFs) create an inflammatory microenvironment by recruiting immune cells. CD11b+/Gr-1+ myeloid-derived suppressor cells (MDSCs) and inflammatory tumor associated macrophages (TAMs) are main immune cell types which further enhance chronic inflammation. Chronic inflammation nurtures tumor-initiating/cancer stem-like cells (CSCs), induces both EMT and MDR leading to tumor relapses. Pro-thrombotic microenvironment created by inflammatory cytokines and chemokines from TAMs, MDSCs and CAFs is also involved in EMT and MDR. MDSCs are the most common mediators of immunosuppression and are also involved in resistance to targeted therapies, e.g. BRAF inhibitors and oncolytic viruses-based therapies. Expansion of both cancer and stroma cells causes hypoxia by hypoxia-inducible transcription factors (e.g. HIF-1α) resulting in drug resistance. TME factors induce the expression of transcriptional EMT factors, MDR and metabolic adaptation of cancer cells. Promoters of several ATP-binding cassette (ABC) transporter genes contain binding sites for canonical EMT transcription factors, e.g. ZEB, TWIST and SNAIL. Changes in glycolysis, oxidative phosphorylation and autophagy during EMT also promote MDR. Conclusively, EMT signaling simultaneously increases MDR. Owing to the multifactorial nature of MDR, targeting one mechanism seems to be non-sufficient to overcome resistance. Targeting inflammatory processes by immune modulatory compounds such as mTOR inhibitors, demethylating agents, low-dosed histone deacetylase inhibitors may decrease MDR. Targeting EMT and metabolic adaptation by small molecular inhibitors might also reverse MDR. In this review, we summarize evidence for TME components as causative factors of EMT and anticancer drug resistance.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/farmacología; Resistencia a Múltiples Medicamentos/efectos de los fármacos; Resistencia a Antineoplásicos/efectos de los fármacos; Neoplasias/tratamiento farmacológico; Animales; Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico; Fibroblastos Asociados al Cáncer/efectos de los fármacos; Fibroblastos Asociados al Cáncer/inmunología; Fibroblastos Asociados al Cáncer/metabolismo; Línea Celular Tumoral; Desmetilación del ADN/efectos de los fármacos; Modelos Animales de Enfermedad; Resistencia a Múltiples Medicamentos/inmunología; Resistencia a Antineoplásicos/inmunología; Transición Epitelial-Mesenquimal/efectos de los fármacos; Transición Epitelial-Mesenquimal/inmunología; Regulación Neoplásica de la Expresión Génica/efectos de los fármacos; Inhibidores de Histona Desacetilasas/farmacología; Inhibidores de Histona Desacetilasas/uso terapéutico; Humanos; Subunidad alfa del Factor 1 Inducible por Hipoxia/antagonistas & inhibidores; Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo; Mediadores de Inflamación/antagonistas & inhibidores; Mediadores de Inflamación/metabolismo; Neoplasias/inmunología; Neoplasias/patología; Serina-Treonina Quinasas TOR/antagonistas & inhibidores; Serina-Treonina Quinasas TOR/metabolismo; Microambiente Tumoral/efectos de los fármacos; Microambiente Tumoral/inmunología; Macrófagos Asociados a Tumores/efectos de los fármacos; Macrófagos Asociados a Tumores/inmunología; Macrófagos Asociados a Tumores/metabolismo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Resistencia a Múltiples Medicamentos / Resistencia a Antineoplásicos / Neoplasias Tipo de estudio: Prognostic_studies Límite: Animals / Humans Idioma: En Revista: Drug Resist Updat Asunto de la revista: ANTINEOPLASICOS Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Resistencia a Múltiples Medicamentos / Resistencia a Antineoplásicos / Neoplasias Tipo de estudio: Prognostic_studies Límite: Animals / Humans Idioma: En Revista: Drug Resist Updat Asunto de la revista: ANTINEOPLASICOS Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido