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BTB 的通透性。circ_DENND4C 的敲低可以显著增强                         new practice updates[J]. Crit Rev Oncol Hematol,2021,
        miR-577 对下游靶基因 Cldn-5、Ocln 和 ZO-1 的降解,促                 168:103535.
        进阿霉素跨越 BTB,最终导致胶质瘤细胞凋亡 。cir-                       [ 3 ]  YASASWI P S,SHETTY K,YADAV K S. Temozolomide
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        cRNA_001160也被认为是GDMEC生长的重要调节剂,                          nano enabled medicine:promises made by the nanocarriers
        可以增强阿霉素耐药性,其潜在机制是可通过海绵吸附                                in glioblastoma therapy[J]. J Control Release,2021,336:
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        miR-195-5p 来上调红细胞特异性转化基因变异体 1
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       (erythroblast transformation specific variant 1,ETV1)的
                                                                lecular and cellular complexity of glioma. focus on tu-
        表达,过表达的 ETV1 可以与紧密连接相关蛋白的启动
                                                                mour microenvironment and the use of molecular and ima-
        子结合,从而提高紧密连接相关蛋白的表达,最终阻断
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        阿霉素向胶质瘤细胞的递送,抑制阿霉素诱导的细胞凋
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        亡 。此外,circRNA_104075在胶质瘤对苦参碱耐药中                    [ 5 ]  SUN W,ZHOU H D,HAN X T,et al. Circular RNA:a
        的作用也已被证实:其可以通过激活 Wnt/β-连环蛋白                             novel type of biomarker for glioma:review[J]. Mol Med
       (β-catenin)和 PI3K/Akt 信号通路来诱导胶质瘤细胞发                      Rep,2021,24(2):602.
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        生自噬,以此减弱苦参碱的细胞毒性 。circRNA 调控                       [ 6 ]  PENG D Z,LUO L,ZHANG X Y,et al. CircRNA:an
        胶质瘤细胞对阿霉素和苦参碱的耐药机制见表 2,其调                               emerging star in the progression of glioma[J]. Biomed
        节机制可为胶质瘤化疗耐药提供新的策略。                                     Pharmacother,2022,151:113150.
        表2 circRNA调控胶质瘤细胞对阿霉素和苦参碱耐药                        [ 7 ]  SALAMI R,SALAMI M,MAFI A,et al. Circular RNAs
             的具体机制                                              and glioblastoma multiforme:focus on molecular mecha-

        circRNA种类  胶质瘤中表达情况  靶基因及信号通路       药物    参考文献          nisms[J]. Cell Commun Signal,2022,20(1):13.
        circ_USP1  上调        miR-194-5p/FLI1  阿霉素  [34]    [ 8 ]  KHUNWEERAPHONG N,KUCHLER K. Multidrug re-
        circ_DENND4C  上调     miR-577/Cldn、Ocln、ZO-1  阿霉素  [35]  sistance in mammals and fungi:from MDR to PDR:a
        circ_001160  上调      miR-195-5p/ETV1  阿霉素  [36]         rocky road from atomic structures to transport mecha-
        circ_104075  上调      Wnt/β-catenin、PI3K/Akt  苦参碱  [37]
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        4 总结与展望                                            [ 9 ]  BARTOLINI D,TORQUATO P,PIRODDI M,et al. Tar-
            circRNA 在胶质瘤化疗耐药中起关键调控作用,通                          geting glutathione S-transferase P and its interactome with
        过使用特异性 siRNA 或特定过表达载体来靶向纠正耐                             selenium compounds in cancer therapy[J]. Biochim Bio-
        药形成过程中内源性circRNA的失调 ,可能是逆转胶质                            phys Acta Gen Subj,2019,1863(1):130-143.
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        瘤耐药的一种有效策略。miRNA 类药物的开发是近年                         [10]  WIESE M,STEFAN S M. The A-B-C of small-molecule
        来特别活跃的研究领域,目前已有数百项涉及 miRNA                              ABC transport protein modulators:from inhibition to acti-
        类药物的临床试验正在进行之中。例如,Cobomarsen是                           vation:a case study of multidrug resistance-associated pro-
        一种基于锁核酸修饰的 anti-miR-155,其以患者体内的                         tein 1(ABCC 1 )[J]. Med Res Rev,2019,39(6):2031-2081.
        致癌性 miR-155 为靶点来调节细胞的增殖和分化,目前                      [11]  MARINHO M A G,DA SILVA MARQUES M,LETTNIN
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        于circRNA是新兴的研究靶点,相关的机制研究仍有待
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        进一步探索,迄今为止,还未见有关于 circRNA 药物进
                                                                91-104.
        入临床前试验的报道。但是,circRNA 独特的结构和功
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        能使其作为胶质瘤耐药治疗的潜在靶点仍值得我们深
                                                                zation of the blood-brain barrier integrity and the brain
        入探索。总之,circRNA 已被证明可以直接调控胶质瘤
                                                                transport of SN-38 in an orthotopic xenograft rat model of
        的耐药性,在监测和克服胶质瘤耐药方面有着巨大潜
                                                                diffuse intrinsic pontine glioma[J]. Pharmaceutics,2020,
        力。当前还有许多与耐药性密切相关的 circRNA 仍然                            12(5):399.
        未知,仍迫切需要我们进行更深入的科学研究和临床试                           [13]  ZHANG X M,KATSAKHYAN L,LIVOLSI V A,et al.
        验,以进一步开发其临床价值。                                          TP53 mutation and extraneural metastasis of glioblasto-
        参考文献                                                    ma:insights from an institutional experience and compre-
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        中国药房    2022年第33卷第15期                                             China Pharmacy 2022 Vol. 33 No. 15  ·1919 ·
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