非甾体类雄激素受体的靶向药物研究进展

雄激素受体在前列腺癌的发生和发展中作用明确。临床上用于治疗前列腺癌的药物为雄激素受体配体结合域的竞争性抑制剂。然而,这类药物的疗效因患者表现出现抵抗而受到限制,导致疾病发展为去势抵抗性前列腺癌。近年来靶向雄激素受体N-端结合域或DNA结合域的药物被报道,这些药物能够克服当前药物治疗的缺点,目前正在临床研究中。对不同靶向的非甾体类雄激素受体的研究进展进行综述。     

雄激素受体抑制剂的研究进展

雄激素受体与前列腺癌的发生、发展密切相关,是配体依赖的转录因子,其与雄激素结合后发生构象转化形成二聚体而活化,并进入细胞核中与相应的 DNA 反应元件结合,促进靶基因的转录,进而促进细胞的增殖。在前列腺癌组织中,雄激素受体的增殖或突变能使其对血清中较低含量的雄激素敏感,是前列腺癌恶化的主要原因。设计合成对野生型及突变型雄激素受体具有较好抑制活性的药物是治疗前列腺癌的首要策略。该文综述了雄激素受体的结构、功能及其抑制剂的研究进展,期望为新型抗前列腺癌药物的设计研究提供参考。     

用于治疗前列腺癌的雄激素受体拮抗剂

前列腺癌是男性泌尿生殖系统常见的恶性肿瘤,雄激素受体与前列腺细胞发育和前列腺癌发生密切相关,有可能成为治疗前列腺癌的重要靶点。对前列腺癌进行去势治疗后却常见发生更为凶险的去势抵抗性前列腺癌,因此,寻找对去势抵抗性前列腺癌有效的雄激素受体拮抗剂是当今研究热点。综述雄激素受体拮抗剂的作用机制及研究进展。     

非甾体类雄激素受体拮抗剂的研究进展

研究发现,雄激素受体与前列腺癌的发生存在密切关系。雄激素拮抗疗法成为临床治疗早期前列腺癌的有效手段,近20年来已有多个药物上市(如氟他胺、羟基氟他胺和比卡鲁胺等),但这些经典的药物在治疗中易产生抗雄激素撤除综合症等问题,因此其应用受到限制。目前,新近研发的非甾体类雄激素受体拮抗剂(如RD162、MDV3100和BMS-641988)活性更强,正进行临床试验,并有望解决过去雄激素受体拮抗剂存在的问题。查阅国内外相关文献,对已上市药物、当前临床研究的药物以及近年发现的小分子雄激素受体抑制剂的研究进展进行综述。     

抗前列腺癌雄激素受体拮抗剂研究进展及市场分析

前列腺癌是男性常见肿瘤。雄激素受体（androgen receptor,AR）是雄激素与前列腺癌细胞结合、发挥激素生物活性、促进前列腺癌组织生长的必要物质。目前AR拮抗剂是前列腺癌主要治疗药物,恩扎卢胺等第2代AR拮抗剂已获批上市,市场关注度高。综述抗前列腺癌AR拮抗剂研究进展,并对市场销售情况进行分析。     

雄激素受体降解剂的研究进展

由于雄激素受体配体结合域的点突变、表达剪切变异体等诸多因素,使得现有的前列腺癌治疗手段相继无效,因此亟需新的策略用于前列腺癌的治疗。近年来靶向蛋白降解技术取得巨大进展,其中雄激素受体降解剂通过促进雄激素受体的降解来阻断雄激素受体信号通路,有望解决临床前列腺癌患者出现耐药的问题。该综述围绕靶向雄激素受体的蛋白降解靶向嵌合体(PROTAC)技术和小分子降解剂,分别从作用机制和代表性化合物两方面概述了该领域的研究进展。相较于PROTAC分子固有的成药性缺陷,小分子雄激素受体降解剂更具优势,现正成为治疗前列腺癌的主要研究方向。     

放疗对前列腺癌患者细胞雄激素受体的影响

目的 观察放疗对前列腺癌细胞雄激素受体的影响.方法 培养人前列腺癌细胞株LNCap及CWR22R,每个细胞株各分为两组,即放疗组及非放疗组,培养第3天,每组3个培养皿分别加入75%乙醇1nm（EtoH组,作为阴性对照）,比较放疗本身对细胞株ARmRA的影响）;加入DHT（二氢睾酮）1 nm及10 nm,DHT分别相当去势及正常睾酮水平.培养至第5天,放疗组进行放射治疗,剂量为2.7 Gy/min,持续3 min,放疗后24 h收集细胞;非放疗组不作放射治疗,RT-PCR方法比较每个细胞株组雄激素受体（AR）,PSA表达的改变,并重复试验3次.结果 放射治疗前后,EtoH组的ARmRNA,PSAmRNA差异无统计学意义,DHT1组ARmRNA,PSAmRNA显著下降（P〈0.01）,而DHT10组ARmRNA表达则显著上升（P〈0.01）,PSAmRNA轻度升高（P〉0.05）.结论在睾酮达去势水平的前列腺癌细胞,放疗有效;而在正常睾酮水平的前列腺癌细胞,放疗效果不佳.AR下降可作为放疗有效性的较灵敏指标.     

非雄激素竞争型雄激素受体拮抗剂设计策略

雄激素受体(androgen receptor,AR)是前列腺癌治疗中最为重要的药物靶点,但抗雄激素药物在使用过程中产生的耐药性问题给前列腺癌患者的治疗带来了巨大挑战.本文回顾了雄激素受体的结构功能及传统治疗位点产生药物抗性的原因,并总结非雄激素竞争型的雄激素受体拮抗剂设计策略,为发展新型抗前列腺癌药物提供依据.     

靶向核受体的抗前列腺癌小分子药物研发新进展

作为全球男性第二大常见癌症,前列腺癌严重威胁着人类健康。在前列腺癌发病过程中,雄激素受体（androgen receptor,AR）起着关键作用,糖皮质激素受体（glucocorticoid receptor,GR）也参与调节部分AR通路下游基因,因此,阻断AR和GR信号通路是前列腺癌治疗的重要策略。综述从核受体AR和GR的结构特征和生物学功能出发,从药物化学角度系统介绍了近5年来靶向核受体的抗前列腺癌药物研发新进展,包括雄激素竞争性AR拮抗剂、雄激素非竞争性AR拮抗剂、AR降解剂、GR拮抗剂和AR/GR双重拮抗剂等,为去势抵抗性前列腺癌的治疗提供新思路。     

HN Saponin F通过雄激素受体抑制雄激素依赖的前列腺癌细胞LNCaP增殖

目的研究HN Saponin F的类雄激素活性,探讨其对雄激素依赖性前列腺癌细胞LNCa P增殖的调控作用及作用机制。方法细胞免疫荧光法检测HN Saponin F对LNCa P细胞中本底水平和双氧睾酮DHT刺激时雄激素受体AR的细胞核转位的影响;MTT法检测HN Saponin F对本底水平和DHT诱导的LNCa P细胞增殖的影响;转染AR的特异si RNA进一步检测HN Saponin F调节LNCa P细胞增殖的机制。结果与DHT类似,HN Saponin F剂量依赖性地促进LNCa P细胞中AR从细胞质转位到细胞核;与DHT联用后,HN Saponin F还可抑制DHT诱导的AR核转位。DHT可以明显促进LNCa P细胞增殖,HN Saponin F可以剂量依赖性地抑制LNCa P细胞的增殖,且可以抑制DHT诱导的LNCa P细胞增殖。AR的特异si RNA抑制AR的表达后,LNCa P细胞本底和DHT诱导的增殖水平被明显抑制,但HN Saponin F失去了进一步抑制LNCa P细胞增殖的作用。结论 HN Saponin F通过AR拮抗雄激素活性,抑制雄激素依赖的前列腺癌细胞增殖,提示HN Saponin F可以作为潜在的AR拮抗剂,用于雄激素依赖性前列腺癌药物的开发。     

去势抵抗前列腺癌中的非激素信号通路作用机制及其相关药物研究进展

前列腺癌是男性泌尿生殖系统常见的恶性肿瘤之一,近十年来我国前列腺癌的发病率呈明显上升的趋势。目前,以雄激素阻断为主的内分泌治疗是除根治手术和放疗或化疗之外临床上比较主流的前列腺癌治疗方案,虽然在治疗前期能获得良好的临床收益,但近九成的患者仍会进入去势抵抗阶段,且其中又有近九成的患者会发生骨转移,患者的生活质量随着疾病进程急剧降低。有研究表明在形成去势抵抗的过程中,除雄激素信号通路外还涉及了多种其他分子信号的变化,包括经典的致癌信号通路和免疫炎症致癌信号通路等。了解这些独立于雄激素信号通路的其他信号通路在去势抵抗形成中的作用机制,将有助于了解雄激素阻断治疗在去势抵抗中的脱靶效应以及引入新的治疗靶点和治疗策略,推动去势抵抗摆脱临床"无药可用"的困境。     

Phase I and II therapies targeting the androgen receptor for the treatment of castration resistant prostate cancer

Introduction: Prostate cancer is the most common cancer in elderly males. Regardless of the initial hormonal treatment in metastatic disease, a significant proportion of patients develop castration resistant prostate cancer (CRPC). A better understanding of the molecular mechanisms behind castration resistance has led to the approval of oral medications such as abiraterone acetate and enzalutamide. Relevant research is accelerated with numerous agents being tested for the management of CRPC.

Areas covered: The authors present Phase I and II studies targeting the androgen receptor for the treatment of CRPC. Three groups of agents are identified according to the mechanism of action. These include the CYP-17 modulators (Orteronel, Galeterone, VT-464 and CFG-920), novel antiandrogens (Apatorsen, ARN-509, ODM-201, EZN-4176, AZD-3514) and bipolar androgen therapy.

Expert opinion: Further understanding of the mechanisms leading to castration resistance in prostate cancer can reveal potential targets for the development of novel anti-cancer agents. Except for the development of novel antiandrogens and CYP-17 modulators, bipolar androgen therapy is an interesting therapeutic approach. The combinations of the novel agents tested in Phase I and II studies with established agents is another field of interest. The real challenge is to distinguish a novel anti-cancer agent with acceptable tolerability and the best outcome.     

miR-34a通过调控雄激素受体基因抑制前列腺癌细胞系LNCaP增殖

目的:探究miR-34a对雄激素受体(AR)基因的调控作用及对前列腺癌(PCa)LNCaP细胞增殖、凋亡的影响。方法:收集2016年10月至2019年9月本院泌尿外科行前列腺穿刺活检确诊为PCa患者组织标本36例,另取同期行手术治疗切除的良性前列腺增生(BPH)组织标本41例。体外培养LNCaP细胞,分别转染miR-34a mimics(mimics组),miR-34a mimic NC(NC组),设正常生长细胞为空白对照组(BC组),另在mimics组基础上转染AR过表达(AR过表达组)载体及其对照(AR对照组),采用CCK-8试剂盒检测细胞活性,Annexin V-FITC/PI双染色流式细胞凋亡检测试剂盒检测细胞凋亡率,实时定量PCR(RT-qPCR)检测miR-34a及AR mRNA表达水平,免疫印迹法检测AR蛋白、细胞周期蛋白D1(cyclinD1)及原癌基因产物(c-Mcy)、细胞凋亡相关蛋白(Bcl-2、Bax、capase-3)的表达水平。结果:与BPH组织比较,PCa组织中miR-34a表达水平显著降低(P<0.05),AR mRNA及蛋白表达水平均显著增加(P<0.05);与BC、NC组比较,mimics组LNCap细胞miR-34a表达水平、细胞凋亡率、Bax蛋白表达水平显著增加(P<0.05),AR、Cyclin D1、Bcl-2、Bax蛋白表达水平显著降低(P<0.05),同一时间LNCap细胞活力均显著降低(P<0.05);双荧光素酶实验结果显示,miR-34a与AR可能存在一定的调控关系,过表达AR基因可逆转miR-34a mimics对LNCaP细胞增殖抑制,促进凋亡作用。结论:miR-34a可能通过调控AR抑制前列腺癌LNCaP细胞增殖,促进其凋亡。     

Discovery and biological characterization of a novel series of androgen receptor modulators

BACKGROUND AND PURPOSE: Selective androgen receptor modulators are of great value in the treatment of prostate cancer. The purpose of this study was to provide a preliminary characterization of a new class of non-steroidal androgen receptor modulators discovered in a high-throughput screening campaign. EXPERIMENTAL APPROACH: Competitive receptor binding, luciferase-based reporter methods, cell proliferation and in vivo assays were employed to evaluate an initial set of compounds from chemistry efforts. KEY RESULTS: Forty-nine analogues from the chemistry efforts showed high affinity binding to androgen receptors, agonist and/or antagonist activities in both CV-1 and MDA-MB-453 transfection assays. A proliferation assay in LNCaP cells also exhibited this profile. A representative of these non-steroidal compounds (compound 21) was devoid of activity at other nuclear receptors (oestrogen, progesterone, glucocorticoid and mineralocorticoid receptors) in the CV-1 co-transfection assay. At the same time, in an immature castrated rat model, it behaved as an androgen receptor antagonist against the growth of prostate, seminal vesicles and levator ani induced by exogenous androgen. Separation of compound 21 into its enantiomers showed that nearly all the androgen receptor modulating activity and binding resided in the dextrorotatory compound (23) while the laevorotatory isomer (22) possessed weak or little effect depending on the cell type studied. CONCLUSIONS AND IMPLICATIONS: These non-steroidal compounds may represent a new class of androgen receptor modulators for the treatment of not only prostate cancer but other clinical conditions where androgens and androgen receptors are involved in the pathological processes.     

Sesquiterpenoids from myrrh inhibit androgen receptor expression and function in human prostate cancer cells

Aim:

To examine whether two naturally occurring sesquiterpenoids (ST1 and ST2) with anti-proliferative activity in prostate cancer cells inhibit androgen receptor (AR) signaling.

Methods:

Human prostate cancer cell lines LNCaP and PC3 were used. The expression of AR, AR translocation into the nucleus, and expression levels of AR coactivators ARA70 and steroid receptor coactivator-1 (SRC-1) in LNCaP cells were examined using real-time PCR and Western blot. Changes in prostate-specific antigen (PSA) protein levels, PSA promoter activity, and androgen response element (ARE)-mediated reporter gene activity were examined using enzyme-linked immunoabsorbent assay (ELISA) and transient transfection assays. Co-immunoprecipitation was performed to analyze the interaction between AR and the AR coactivators in ST1- and ST2-treated cells.

Results:

In LNCaP cells, ST1 and ST2 (40 μmol/L) led to a significant decrease in the expression of AR as well as a reduction of AR translocation into the nucleus, but had no effect on AR protein translation. ST1 and ST2 treatment also resulted in a significant decrease in the level of PSA protein secreted into the medium and was able to suppress PSA promoter-dependent and ARE-dependent luciferase activity. Furthermore, decreased expression of ARA70 and SRC-1 was observed when LNCaP cells were exposed to ST1 and ST2, which interfered with their ability to interact with AR.

Conclusion:

The observations suggest that suppression of AR transactivation by ST1 and ST2 may be mediated, in part, by inhibiting AR nuclear translocation and/or interfering with the interaction between AR and its coactivators ARA70 and SRC-1. Therefore, sesquiterpenoids could be developed as novel therapeutic agents for treating prostate cancer.