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精准治疗中2个相互依存的元素:精准医学和纳米医药
引用本文:张付雷,李威.精准治疗中2个相互依存的元素:精准医学和纳米医药[J].第二军医大学学报,2017,38(6):689-698.
作者姓名:张付雷  李威
作者单位:第二军医大学国际合作肿瘤研究所,上海,200433
基金项目:国家自然科学基金(31470964, 81171450). Supported by National Natural Science Foundation of China (31470964, 81171450).
摘    要:以基因组测序、生物信息和大数据库为基础,寻找到个体疾病原因、治疗靶点和精确分类的精准医学(precision medicine)为肿瘤治疗带来了新的希望,但真正的精准治疗(precision therapy)还包括如何将所筛药物精准递送并按剂量适时释放到治疗靶点,这也是临床上实现抗肿瘤精准治疗时面临的系列问题,具体包括如何突破体内生物屏障将药物安全递送到病灶、如何增加药物的瘤内富集、如何促进靶细胞的内吞,以及如何将药物精准递送到细胞内的作用靶点等.基于纳米技术的纳米医药(nanomedicine)能有效解决这些问题:通过精细设计和纳米载体裁剪,实现将治疗药物分子精确高效地递送到靶器官、靶组织、靶细胞和靶细胞器,并在病灶部位的刺激下按需控制药物剂量.精准医学和纳米医药的结合能够实现真正意义上的精准治疗,即从肿瘤分子分型、药物筛选、药物精准投递、控制释放到治疗.因此,基于精准医学对疾病进行精准诊断和药物靶点筛选,其可被形象地称为肿瘤精准治疗的“先遣部队和侦察兵”;而通过纳米医药可实现将筛选的抗肿瘤药物精确递送和释放到治疗靶点,可将其比喻为肿瘤精准治疗的“精准战略轰炸”,精准医学和纳米医药是精准治疗中2个相互依存且必不可少的元素.

关 键 词:肿瘤  精准治疗  精准医学  纳米药物  靶向递送
收稿时间:2017/5/15 0:00:00
修稿时间:2017/5/26 0:00:00

Precision medicine and nanomedicine: two essential and interdependent elements in precision therapy
ZHANG Fu-lei and LI Wei.Precision medicine and nanomedicine: two essential and interdependent elements in precision therapy[J].Academic Journal of Second Military Medical University,2017,38(6):689-698.
Authors:ZHANG Fu-lei and LI Wei
Institution:International#$NBSJoint#$NBSCancer#$NBSInstitute,#$NBSThe Second Military Medical University,International#$NBSJoint#$NBSCancer#$NBSInstitute,#$NBSThe Second Military Medical University
Abstract:The precise medicine has shown new hope for cancer treatment because it can provide clear individual disease causes, precise therapeutic targets and accurate classification based on the genome sequencing, bioinformatics, and large databases. However, the effective precise therapy should also include how to delivery and drug release with controlled dosage at the precise therapeutic targets. This is the issue appeared in clinical precise therapy, that is, how to achieve precise delivery and regulated the dosage ofscreened drugs, which includes how to overcome the biological barrier, how to deliver the drugs to tumor, how to enhance intratumoral accumulation, promote endocytosis of target cells, and accurate delivery of drugs to a series of intracellular therapeutic targets. Nanomedicine, which is defined by using nanotechnology to traditional medicine, can effectively solve the problems as mentioned above. Through the finely design and nanocarrier''s tailoring, it will be easy toaccuratedelivery the screened drug molecules toprecisetargetedtumor, to precisetargeted organs, to precise targeted tissues, to precise targeted cells and to preciseintracellulartargeted organelles, and precisely regulate the drug release to a desirable dosage. Consequently, the traditional precise medicine refers to accurate diagnosis and accurate delivery and release of drug, which is the so called "scouts and advance troops" of precision treatment of cancer. On the other hand, the nanomedicine is mainly focus on the acute drug delivery and controlled release at the targeted tumor site, which could be called as the "accurate strategic bombing". Both the precise medicine and the nanomedicine is an essential and interdependent part in precise therapy.
Keywords:Cancer therapy  Nanomedicine  Precision medicine  Targeted therapy
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