PI3K/Akt通路与肿瘤治疗

磷酸肌醇3激酶/蛋白激酶B (phosphoinositide 3kinase /protein kinase B,PI3K/Akt)信号通路参与很多重要生物学过程的调控，但其过度激活可导致肿瘤的发生。在正常组织中PI3K/Akt信号转导途径处于活化状态，但是该通路如果被过度激活则可通过下调肿瘤抑制蛋白p53、刺激蛋     

PDK／Akt通路与肿瘤治疗

磷酸肌醇-3激酶／蛋白激酶B（phosphoinositide 3-kinase／protein kinaseB，P13K／Akt）信号通路参与很多重要生物学过程的调控，但其过度激活可导致肿瘤的发生。在正常组织中P13K／Akt信号转导途径处于活化状态，但是该通路如果被过度激活则可通过下调肿瘤抑制蛋白p53、刺激蛋白质合成、抑制细胞凋亡等导致肿瘤细胞的无限增殖，成为肿瘤预后不好的标志，因此抑制该通路的激活有利于肿瘤治疗。目前已发现肿瘤抑制基因PTEN、PHLPP和蛋白磷酸酶2A等均可通过不同的机制抑制该通路的激活。同时，针对该通路的抑制剂作为抗肿瘤药物得到了广泛研究并在临床上取得了预期的进展，如wtPTEN的转基因研究、P13K抑制剂LY294002和渥曼青霉素、PDK-1抑制剂星孢菌素和塞来昔布、Akt抑制剂哌立福新、雷帕霉素靶蛋白（mTOR）抑制剂西罗莫司等，期望这些抑制剂能达到靶向治疗肿瘤的目的。     

ＰＩ３Ｋ／Ａｋｔ信号传导通路及其在结直肠癌中的研究进展

结直肠癌是常见的恶性肿瘤之一,近十年来,结直肠癌在我国的发病率呈逐年上升的趋势。已有研究表明,ＰＩ３Ｋ／Ａｋｔ信号传导通路是与细胞增殖和细胞凋亡关系最密切的信号传导通路之一。随着ＰＩ３Ｋ／ＡＫｔ信号通路在结直肠癌发生、发展中的研究不断深入,该通路对结直肠癌发生、发展及治疗药物的研发具有十分重要的价值。本文就ＰＩ３Ｋ／Ａｋｔ信号传导通路在结直肠癌发生、发展和治疗中的作用以及机制的研究进展作一综述。     

ICAM-3-induced cancer cell proliferation through the PI3K/Akt pathway

ICAM-3 interacts with LFA1, and is involved in the intercellular adhesion of leukocytes as well as in the mainenance of cell survival. It has also been suggested to induce cancer cell proliferation but the precise signaling pathway is unclear. The aim of this study was to determine the ICAM-3-activated downstream pathway in H1299 lung cancer cells. The level of ICAM-3-induced cell growth was examined using BrdU incorporation, which is a colony-forming assay, FACS analysis, and cell counting. The results showed that ICAM-3 expression induces cancer cell proliferation. In addition, FAK, Akt, PDK1, GSK-3beta, BAD, and PTEN were phosphorylated by ICAM-3-overexpression, resulting in enhanced cell proliferation. In conclusion, ICAM-3 expression induces cancer cell proliferation, and an increase in ICAM-3 expression can contribute to cancer progression.     

Drug discovery approaches targeting the PI3K/Akt pathway in cancer

The abnormal activation of the phosphatidylinositol 3-kinase (PI3K)/Akt pathway has been validated by epidemiological and experimental studies as an essential step toward the initiation and maintenance of human tumors. Notable in this regard are the prevalent somatic genetic alterations leading to the inactivation of the tumor suppressor gene PTEN and gain-of-function mutations targeting PIK3CA--the gene encoding the catalytic phosphosinositide-3 kinase subunit p110 alpha. A number of the intracellular components of this pathway have been targeted as anticancer drug discovery activities leading to the current panoply of clinical trials of inhibitors of PI3K, Akt and HSP90 in man. This review summarizes current preclinical knowledge of modulators of the PI3K/Akt pathway in which drug discovery and development activities have been advanced focusing on both the relevant clinical stage inhibitors and other disclosed tool compounds targeting PI3K, PDK1, Akt and HSP90.     

磷脂酰肌醇3激酶-蛋白质丝氨酸苏氨酸激酶途径与肿瘤的关系

磷脂酰肌醇3激酶（PI3K）-蛋白质丝氨酸苏氨酸激酶（Akt）途径是细胞内重要的信号传导途径,在细胞增殖分化中起重要作用。PI3K-Akt途径的失调控对于多种肿瘤的发生是一种刺激信号,途径中任何激酶表达的异常都可能诱导肿瘤的发生。现综述PI3K-Akt途径中PI3K、Akt、磷脂酰肌醇依赖性蛋白激酶（PDK）、与张力蛋白同源的第10号染色体上丢失的磷酸酶基因（PTEN）在肿瘤发生发展中的作用。     

Inhibiting the PI3K/Akt pathway reversed progestin resistance in endometrial cancer

Progestin resistance is the main obstacle to successful conservative therapy in young endometrial cancer patients. To investigate the molecular events that lead to progestin resistance and to find a possible way to reverse progestin resistance in endometrial cancer, we established a progestin-resistant Ishikawa cell line by long-term progestin treatment to downregulate progesterone receptor (PR) expression. Both medoxyprogesterone acetate (MPA) and LY294002, a phosphatidylinositol 3-kinase (PI3K) inhibitor, were assayed for their effects on the proliferation of progestin-sensitive and progestin-resistant cancer cells, respectively. The MPA inhibited the PI3K/Akt pathway and suppressed cell proliferation in progestin-sensitive Ishikawa cells, but activated the PI3K/Akt pathway and had no effect on cell proliferation in progestin-resistant Ishikawa cells or HEC-1A cells. Inhibiting the PI3K/Akt pathway by LY294002 upregulated PR expression and diminished cell growth, especially in progestin-resistant endometrial cancer cells. In vivo endometrial cancer xenograft studies in nude mice also showed that inhibiting the PI3K/Akt pathway reversed progestin resistance in endometrial cancer. Our results indicate that activation of the PI3K/Akt pathway by progestin without PR mediation plays an important role in progestin resistance to endometrial cancer cells. In addition, inhibiting the PI3K/Akt pathway might reverse progestin resistance in endometrial cancer.     

PI3K/Akt/mTOR信号通路抑制剂在乳腺癌中的研究进展

目的:总结PI3K/Akt/mTOR信号通路靶向治疗在乳腺癌中的研究进展.方法:以“PI3K/Akt/mTOR、信号通路和乳腺癌”等为关键词,检索2000-01-2011-06 PubMed、Ovid和Springer等数据库的相关文献.纳入标准:1)关于PI3K/Akt/mTOR信号通路的组成、功能特点;2)PI3K/Akt/mTOR信号通路与乳腺癌的关系研究;3)以PI3K/Akt/mTOR信号通路中关键分子为靶点的乳腺癌治疗.根据纳入标准,符合分析的文献40篇.结果:信号转导通路的异常是肿瘤发生、发展的重要步骤,PI3K/Akt/mTOR信号通路与人类多种肿瘤密切相关,其在肿瘤细胞的增殖、存活、抵抗凋亡、血管发生和转移以及对放化疗抵抗中发挥了重要作用.乳腺癌中常见PI3K/Akt/mTOR信号通路的异常激活,以此通路为靶点的药物已成为乳腺癌治疗的研究热点.结论:靶向PI3K/Akt/mTOR通路中关键分子的众多药物在乳腺癌开展了一系列相关的临床试验研究,一部分显示出较好的安全性和有效性.随着对PI3K/Akt/mTOR通路的分子生物学机制的深入研究,期待靶向此通路的抑制剂将会在乳腺癌治疗中发挥巨大的作用,进一步提高乳腺癌患者的疗效和改善预后.     

PI3K/Akt/mTOR inhibitors in breast cancer

Activation of the phosphoinositide 3 kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway is common in breast cancer. There is preclinical data to support inhibition of the pathway, and phase I to III trials involving inhibitors of the pathway have been or are being conducted in solid tumors and breast cancer. Everolimus, an mTOR inhibitor, is currently approved for the treatment of hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. In this review, we summarise the efficacy and toxicity findings from the randomised clinical trials, with simplified guidelines on the management of potential adverse effects. Education of healthcare professionals and patients is critical for safety and compliance. While there is some clinical evidence of activity of mTOR inhibition in HR-positive and HER2-positive breast cancers, the benefits may be more pronounced in selected subsets rather than in the overall population. Further development of predictive biomarkers will be useful in the selection of patients who will benefit from inhibition of the PI3K/Akt/mTOR (PAM) pathway.KEYWORDS : Breast cancer, phosphoinositide 3 kinase (PI3K)/Akt/ mammalian target of rapamycin (mTOR), everolimus     

Targeting the PI3K/Akt/mTOR pathway in hepatocellular carcinoma

Despite recent advances in the understanding of the biologic basis of hepatocellular carcinoma (HCC) development, the clinical management of the disease remains a major challenge. Deregulation of the PI3K/Akt/mTOR pathway, which is a prototypic survival pathway, is increasingly implicated in HCC carcinogenesis. In this article, we detailed the role of this pathway in the pathogenesis of HCC and provide an update on the preclinical and clinical development of various agents targeting this key survival/proliferation pathway, which include various PI3K inhibitors, Akt inhibitors and mTOR inhibitors for HCC. In addition, we highlighted the therapeutic potential of combination strategy for mTOR inhibitors with conventional chemotherapy, in particular, antimicrotubule agents, other molecular targeting agents, as well as radiotherapy.     

抑制PI3K/Akt信号转导通路提高化疗效果的实验研究

目的:探讨通过抑制PI3K/Akt信号转导通路提高抗癌药物对恶性肿瘤细胞的杀伤作用。方法:采用噻唑蓝(MTT)比色法检测塞莱昔布、顺铂及多西紫杉醇单独或联合PI3K抑制剂LY294002对人宫颈癌HeLa细胞和人乳腺癌MCF7细胞的抑制率;采用流式细胞技术检测药物单独或联合作用对HeLa细胞和MCF7细胞凋亡的影响。结果:①联合LY294002能够显著提高塞莱昔布、顺铂及多西紫杉醇对HeLa细胞和MCF7细胞抑制率(P<0.05)。②LY294002与塞莱昔布、顺铂及多西紫杉醇的协同治疗指数均小于1,具有协同治疗作用。③联合LY294002能够增加HeLa细胞和MCF7细胞的凋亡水平。结论:抑制PI3K/Akt信号转导通路能够显著提高塞莱昔布、顺铂及多西紫杉醇对HeLa细胞和MCF7细胞的杀伤作用。     

Effects of AFP-activated PI3K/Akt signaling pathway on cell proliferation of liver cancer

This study aims to investigate effects of alpha-fetoprotein (AFP)-activated phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway on hepatocellular carcinoma cell proliferation. Active cirrhosis patients after hepatitis B infection (n?=?20) and viral hepatitis patients with hepatocellular carcinoma (HCC) (n?=?20) were selected as the subjects of the present study. Another 20 healthy subjects were selected as the control group. The serum AFP expression and liver tissue PI3K and Akt gene mRNA expression were detected. The hepatoma cell model HepG2 which had a stable expression of AFP gene was used. Real-time quantitative PCR and Western blot and other methods were used to analyze the intracellular PI3K and Akt protein levels. Compared with control group and cirrhosis group, the serum AFP levels in HCC group significantly increased, and the tissue PI3K and Akt mRNA expression also significantly increased. HepG2 cells were intervened using AFP, in which the PIK and Akt protein expression significantly increased. After intervention by use of AFP monoclonal antibodies or LY294002 inhibitor, the PIK and Akt protein expression in HepG2 cell was significantly decreased (P?<?0.05). AFP can promote the proliferation of hepatoma cells via activation of PI3K/Akt signaling pathway.     

Deciphering the role of PI3K/Akt/mTOR pathway in breast cancer biology and pathogenesis

The phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway mediates multiple cellular functions critical to tumor initiation, progression, and outcomes, including growth and proliferation, metabolism, motility, migration, invasion, angiogenesis, survival, and autophagy. Tight regulation of this pathway is paramount to ensure that multiple cellular inputs are integrated for appropriate cellular outcomes. Frequent deregulation and aberrations of this pathway have been implicated in breast cancer development and progression. This review focuses on the biology of this pathway and its role in breast cancer pathogenesis. The role of therapies directed at targeting mTOR in the PI3K/Akt/mTOR pathway, which are currently being evaluated in clinical trials, will also be reviewed.     

Chemoresistance in breast cancer: PI3K/Akt pathway inhibitors vs the current chemotherapy

Breast cancer is the most prevalent type of cancer among women. Several types of drugs, targeting the specific proteins expressed on the breast cancer cell surface (such as receptor tyrosine kinases and immune checkpoint regulators) and proteins involved in cell cycle and motility (including cyclin-dependent kinases, DNA stabilisers, and cytoskeleton modulators) are approved for different subtypes of breast cancer. However, breast cancer also has a poor response to conventional chemotherapy due to intrinsic and acquired resistance, and an Akt fingerprint is detectable in most drug-resistant cases. Overactivation of Akt and its upstream and downstream regulators in resistant breast cancer cells is considered a major potential target for novel anti-cancer therapies, suggesting that Akt signalling acts as a cellular mechanism against chemotherapy. The present review has shown that sustained activation of Akt results in resistance to different types of chemotherapy. Akt signalling plays a cellular defence role against chemotherapy and (1) enhances multi-drug resistance, (2) increases reactive oxygen species at breast tumor microenvironment, (3) enhances anaerobic metabolism, (4) inhibits the tricarboxylic cycle, (5) promotes PD-L1 upregulation, (6) inhibits apoptosis, (7) increases glucose uptake, and more importantly (8) recruits and interconnects the plasma membrane, nucleus, endoplasmic reticulum, and mitochondria to hijack breast cancer cells and rescue these cells from chemotherapy. Therefore, Akt signalling is considered a cellular defence mechanism employed against chemotherapeutic effects. In addition, interfering roles of PI3K/Akt signalling on the current cytotoxic and molecularly targeted therapy as well as immunotherapy of breast cancer are discussed with a clinical approach. Although, alpelisib, a PIK3CA inhibitor, is the only PI3K/Akt pathway inhibitor approved for breast cancer, we also highlight well-evaluated inhibitors of PI3K/Akt signalling based on different subtypes of breast cancer, which are under clinical trials whether as monotherapy or in combination with other types of chemotherapy.     

PI3K/Akt信号通路与肿瘤血管新生的研究进展

PI3K/Akt信号通路在多种细胞中活化,参与细胞的增殖、分化、凋亡、血管新生等病理、生理过程。血管的生成需要PI3K/Akt信号通路的激活,PI3K/Akt活化后可以广泛诱导鸡胚尿囊膜血管的生成。PI3K/Akt信号通路与其下游信号分子mTOR及多种促血管新生因子,如VEGF、HIF等相互作用,从而促进肿瘤血管新生。PI3K/Akt信号通路抑制剂能够抑制其血管新生作用,因此靶向PI3K/Akt信号通路为恶性肿瘤靶向治疗提供了新方法。     

CUEDC2通过活化 PI3K／Akt 信号通路促进乳腺癌细胞的生长

目的：探讨 CUE 结构域2（CUE domain －containing 2,CUEDC2）蛋白在人乳腺癌细胞中的生物学作用。方法：人乳腺肿瘤细胞 MCF －7转染的 Myc －CUEDC2真核表达载体,提取转染细胞的总蛋白检测磷酸化 Akt 和总 Akt 的表达变化。利用 CCK －8检测过表达 CUEDC2后 MCF －7细胞的生长。结果：CUEDC2能够活化 Akt,使磷酸化 Akt 表达增加,能够促进人乳腺癌细胞生长。结论：当乳腺癌中 CUEDC2表达增高时,能够引起 PI3K／Akt 信号通路活化,促进肿瘤细胞生长。     

IL 6经PI3K/Akt通路诱导卵巢癌细胞对他莫西芬耐药

目的:探讨IL-6诱导卵巢癌细胞对他莫西芬(tamoxifen,TAM)耐药的分子机制.方法:构建内源性过表达IL-6的人卵巢癌A2780细胞系和内源性抑制IL-6表达的人卵巢癌CAOV-3细胞,50 ng/ml外源性IL-6预处理A2780细胞(A2780/preIL-6细胞),Western blotting检测内/外源IL-6对卵巢癌细胞ERα Ser167位磷酸化水平的影响;IL-6与PI3K抑制剂Wort-mannin单独或联合作用于A2780细胞,Western blotting检测其对A2780细胞Akt磷酸化和ERα磷酸化的影响;MTT法检测Wortmannin和内/外源IL-6对A2780细胞TAM敏感性的影响;荧光素酶报告基因检测卵巢癌细胞ERα的转录活性,并分析其可能涉及的信号通路.结果:外源性及内源性过表达IL-6可明显促进A2780细胞ERα Ser167位点磷酸化水平(均P＜0.01),而内源性抑制IL-6表达则可降低CAOV-3细胞ERα Ser167位点的磷酸化水平(P＜0.01);Wortmannin可阻断IL-6诱导的A2780细胞对TAM的耐药及ERα的磷酸化(P ＜0.05);IL-6可促进细胞ERα的转录活性(P＜0.01),而Wortmannin并不能阻断IL-6对ERα的转录活性的影响(P＞0.05).结论:IL-6可经PI3 K/Akt通路引起ERα磷酸化从而活化ER信号通路,进而诱导卵巢癌细胞对TAM耐药.     

基于SNP芯片研究PI3K/Akt/mTOR通路上自噬相关基因SNPs与胃癌的关联

目的： 探讨与胃癌发生相关的PI3K/Akt/mTOR通路上新的与自噬相关基因单核苷酸多态性位点（SNPs），为寻找有价值的胃癌发生相关的分子标志物提供新的依据。方法： 采用1：1配对病例-对照研究的方法。通过KEGG pathway网站和Gene Ontology、Ensemble数据库及HaploView、STRING、Cytoscape软件联合SNP芯片筛选目标SNPs，采用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF-MS）对筛检出来的SNPs位点在来自福建省仙游县的622例胃癌患者和622例健康人群基因组中进行验证。结果： SNP芯片及生物信息学分析筛选出IRS1 rs10205233、PIK3CD rs3934934、PIK3R1 rs706711、PIK3R1 rs706714和AKT1 rs35285446为候选位点。扩大样本验证发现IRS1 rs10205233的多态性变异（C > T）显著降低了胃癌的发病风险[共显性模型、显性模型的OR（95% CI）分别为0.761（0.595，0.975）、0.764（0.601，0.973）]。进一步分层分析，该位点显性模型、隐形模型、共显性模型以及等位基因在贲门癌和非贲门癌人群中均未见统计学差异（P > 0.05）。并未见其他位点与患胃癌风险的关联有统计学意义。对PIK3R1基因2个位点（rs706711、rs706714）的单体型分析也未见统计学差异。结论： IRS1 rs10205233位点与福建省胃癌高发区仙游县的胃癌发生存在关联，T等位基因可能是胃癌发生的一个遗传保护因素。