Beta blockers, norepinephrine, and cancer: an epidemiological viewpoint.
Beta blockers, norepinephrine, and cancer: an epidemiological viewpoint.
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DOI：
10.2147/clep.s33695
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发表时间：
2012
影响因子：
3.9
通讯作者：
Fitzgerald PJ
中科院分区：
文献类型：
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作者：
Fitzgerald PJ
越来越多的证据表明，神经递质去甲肾上腺素（NE）及其姐妹分子肾上腺素（EPI）（肾上腺素）影响某些类型的癌症。最近的几项流行病学研究表明，长期使用β受体阻滞剂（拮抗NE/EPI受体）可降低乳腺癌和恶性黑色素瘤的复发、进展或死亡率。临床前研究表明，用药物操纵NE和EPI的水平或受体会影响实验诱导的癌症。心理压力可能在某些癌症病例中起病因作用（已在流行病学上显示），这可能部分由交感神经系统释放的NE和EPI介导，作为身体“战斗或逃跑”反应的一部分。一个不太被理解的现象是NE/EPI的遗传音调可能在癌症中起作用。NE和EPI可能通过与已经参与异常细胞复制的分子途径（如P38/MAPK途径）相互作用或通过氧化应激影响癌症。除β受体阻滞剂外，基于NE/EPI的药物也可以预防或治疗各种类型的癌症，抑制交感神经系统的胆碱酯酶抑制剂也可以，这可以通过流行病学测试。
There is growing evidence that the neurotransmitter norepinephrine (NE) and its sister molecule epinephrine (EPI) (adrenaline) affect some types of cancer. Several recent epidemiological studies have shown that chronic use of beta blocking drugs (which antagonize NE/EPI receptors) results in lower recurrence, progression, or mortality of breast cancer and malignant melanoma. Preclinical studies have shown that manipulation of the levels or receptors of NE and EPI with drugs affects experimentally induced cancers. Psychological stress may play an etiological role in some cases of cancer (which has been shown epidemiologically), and this could be partly mediated by NE and EPI released by the sympathetic nervous system as part of the body’s “fight or flight” response. A less well-appreciated phenomenon is that the genetic tone of NE/EPI may play a role in cancer. NE and EPI may affect cancer by interacting with molecular pathways already implicated in abnormal cellular replication, such as the P38/MAPK pathway, or via oxidative stress. NE/EPI-based drugs other than beta blockers also may prevent or treat various types of cancer, as may cholinesterase inhibitors that inhibit the sympathetic nervous system, which could be tested epidemiologically.