Modulation of sodium iodide symporter in thyroid cancer.

Modulation of sodium iodide symporter in thyroid cancer.
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DOI:
10.1007/s12672-014-0203-0
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发表时间:
2014-12
期刊:
影响因子:
3
通讯作者:
Jhiang SM
Jhiang SM
中科院分区:
医学2区
文献类型:
--
作者:
Lakshmanan A;Scarberry D;Shen DH;Jhiang SM

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放射性碘(RAI)是甲状腺癌的关键治疗手段。甲状腺癌患者RAI摄取缺失与患者的生存呈负相关。在这篇综述中,我们重点介绍了在提供足够剂量的I-131来根除转移性病变而不增加不良副作用风险方面遇到的挑战。钠碘同向转运体(NIS)介导碘内流,促甲状腺激素可选择性增强NIS在甲状腺细胞中的表达和功能。我们总结了我们目前对正常和癌症甲状腺细胞中NIS调节的了解,并建议在其他疾病的临床试验中评估的几种试剂可以用于恢复或进一步增加甲状腺癌中RAI的积聚。一旦在临床前小鼠模型和临床试验中得到验证,这些试剂,主要是小分子抑制剂,可以很容易地转化为临床实践。我们综述了现有的甲状腺癌基因工程小鼠模型,包括肿瘤的发展和进展以及甲状腺功能。这些小鼠不仅将为甲状腺肿瘤中RAI摄取丧失的机制提供重要的见解,而且还将作为临床前动物模型来评估候选试剂选择性增加甲状腺癌RAI摄取的有效性。综上所述,我们预计在不久的将来,RAI在甲状腺癌临床治疗中的最佳使用还没有到来。
Radioactive iodine (RAI) is a key therapeutic modality for thyroid cancer. Loss of RAI uptake in thyroid cancer inversely correlates with patient’s survival. In this review, we focus on the challenges encountered in delivering sufficient doses of I-131 to eradicate metastatic lesions without increasing the risk of unwanted side effects. Sodium iodide symporter (NIS) mediates iodide influx, and NIS expression and function can be selectively enhanced in thyroid cells by thyroid-stimulating hormone. We summarize our current knowledge of NIS modulation in normal and cancer thyroid cells, and we propose that several reagents evaluated in clinical trials for other diseases can be used to restore or further increase RAI accumulation in thyroid cancer. Once validated in preclinical mouse models and clinical trials, these reagents, mostly small-molecule inhibitors, can be readily translated into clinical practice. We review available genetically engineered mouse models of thyroid cancer in terms of their tumor development and progression as well as their thyroid function. These mice will not only provide important insights into the mechanisms underlying the loss of RAI uptake in thyroid tumors but will also serve as preclinical animal models to evaluate the efficacy of candidate reagents to selectively increase RAI uptake in thyroid cancers. Taken together, we anticipate that the optimal use of RAI in the clinical management of thyroid cancer is yet to come in the near future.
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