EGFR/TGFα and TGFβ/CTGF Signaling in Neuroendocrine Neoplasia: Theoretical Therapeutic Targets.

EGFR/TGFα and TGFβ/CTGF Signaling in Neuroendocrine Neoplasia: Theoretical Therapeutic Targets.
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神经内分泌肿瘤中的EGFR/TGFα和TGFβ/CTGF信号传导:理论治疗靶标。

DOI:
10.1159/000334891
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发表时间:
2013
期刊:
影响因子:
4.1
通讯作者:
Modlin IM
Modlin IM
中科院分区:
医学2区
文献类型:
--
作者:
Kidd M;Schimmack S;Lawrence B;Alaimo D;Modlin IM

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神经内分泌肿瘤(NEN)是一个异质性恶性肿瘤家族,其增殖部分依赖于微环境和肿瘤本身分泌的生长因子。在 NEN 实验模型中表现出重要性的生长因子包括 EGF、TGFα、TGFβ 和 CTGF。 EGF 和 TGFα 与 EGFR 结合,刺激完整的 RAS/RAF/MAPK 通路,导致与细胞增殖、侵袭和转移相关的基因转录。理论上,TGFα 刺激可以在 MAPK 通路的多个点被抑制,但成功仅限于 NEN 模型,并且在临床环境中并不明显。 TGFβ1 刺激 TGFβRI 和 II,通过 SMAD 介导的生长抑制剂 P21 (WAF1/CIP1) 激活来抑制神经内分泌细胞生长。尽管一些 NEN 被 TGFβ1 抑制,但在胃和小肠 NEN 的实验模型中却发现了反常的生长。因此,由于 TGFβ1 分泌的增殖调节方向的不确定性,NEN 中 TGFβ1 的治疗靶向变得复杂。 CTGF 表达与包括 NEN 在内的多种癌症中更恶性的临床表型相关。 CTGF 促进胃和小肠 NEN 模型的生长,并且是由肠嗜铬细胞来源的 NEN 引起的局部和远处纤维化的介体。 CTGF 抑制剂是可用的,但尚未在 NEN 中尝试其抗增殖作用。总之,生长因子对于 NEN 增殖至关重要,尽管针对这些蛋白质的干预措施在实验模型中是有效的,但临床疗效有限。
Neuroendocrine neoplasms (NENs) are a heterogeneous family of malignancies whose proliferation is partially dependent on growth factors secreted by the microenvironment and the tumor itself. Growth factors of demonstrated importance in experimental models of NENs include EGF, TGFα, TGFβ and CTGF. EGF and TGFα bind to EGFR to stimulate an intact RAS/RAF/MAPK pathway, leading to transcription of genes associated with cell proliferation, invasion and metastasis. Theoretically, TGFα stimulation can be inhibited at several points of the MAPK pathway, but success is limited to NEN models and is not evident in the clinical setting. TGFβ1 stimulates TGFβRI and II resulting neuroendocrine cell growth inhibition through SMAD-mediated activation of the growth inhibitor P21(WAF1/CIP1). Although some NENs are inhibited by TGFβ1, paradoxical growth is seen in experimental models of gastric and small intestinal NENs. Therapeutic targeting of TGFβ1 in NENs is therefore complicated by uncertainty regarding the direction of proliferative regulation accorded by TGFβ1 secretion. CTGF expression is associated with more malignant clinical phenotypes in a variety of cancers including NENs. CTGF promotes growth in gastric and small intestinal NEN models, and is implicated as a mediator of local and distant fibrosis caused by NENs of enterochromaffin cell origin. CTGF inhibitors are available but untried in NENs for their anti-proliferative effect. In summary, growth factors are essential to NEN proliferation, and although intervention targeting these proteins is effective in experimental models, limited clinical efficacy has been identified.
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