中药挥发油抗白血病机制及问题探讨

白血病(leukemia)是一种发病率逐年增高的造血系统恶性增生性疾病,包括骨髓和淋巴系统。其病情复杂,是一种高度异质性的疾病,包括多种亚型,治疗难度大,预后欠佳。当前临床上常用于治疗白血病细胞分化诱导剂的有维甲酸及其衍生物、砷剂等,但他们治疗的临床范围多局限于粒系白血病,价格昂贵,而且仍有一定的毒副作用。随着分子遗传学、分子生物学、二代测序等技术的发展,对白血病的病因学、病理学的认识已有明显的提高,但是白血病具体的发病机制仍未能明确。随着分子靶向药物和嵌合抗原受体T细胞免疫疗法(chimeric antigen receptor T-cell immunotherapy,CAR-T)及造血干细胞移植的进一步推广,虽然使白血病的治疗进入了新领域,但是与传统化疗相比除了治疗成本高外,长期疗效还有待于进一步确认。经过多年的基础研究及临床研究发现,中药挥发油在治疗白血病领域取得了显著成就。中药挥发油不仅可以减轻化疗药物带来的毒副作用,而且能有效的延长或阻止白血病复发、抑制白血病细胞增殖和促进白血病细胞凋亡的优势。本文通过文献追踪法查阅了国内外相关文献,对中药挥发油抗白血病机制进行概述,分析了中药挥发油的特点及存在问题,并提出了改进的方向,为加快中药挥发油治疗白血病的研发和创新提供参考。

Anti-leukemia Mechanism and Problems of Volatile Oil from Traditional Chinese Medicine

Leukemia is a hematopoietic hyperplastic disease with an increasing incidence year by year, involving bone marrow and lymphatic system. The disease is complex and a highly heterogeneous disease, including a variety of subtypes, with difficulties in treatment and a poor prognosis. Currently, retinoic acid and its derivatives, arsenic are commonly used in clinical treatment as leukemia cell differentiation inducers. However, their clinical range of treatment is mostly restricted to granulocytic leukemia, with a high price and certain toxic and side effects. With the development of molecular genetics, molecular biology, second-generation sequencing and other technologies, the etiology and pathology of leukemia has been significantly studied, but the specific pathogenesis of leukemia has still been unclear. With the further promotion of molecular targeted drugs, chimeric antigen receptor T-cell immunotherapy (CAR-T) and hematopoietic stem cell transplantation, although the treatment of leukemia has entered a new field, compared with traditional chemotherapy, these therapies have high costs, and the long-term efficacy is yet to be further confirmed. After years of basic research and clinical research, traditional Chinese medicine(TCM) volatile oil in the treatment of leukemia has made remarkable achievements. Essential oil can alleviate the toxic and side effect of chemotherapy drugs, effectively prolong or prevent the relapse of leukemia, inhibit the proliferation of leukemia cells, and promote the apoptosis of leukemia cells. In this paper, the authors reviewed relevant domestic and foreign literatures by literature tracking method, summarized the anti-leukemia mechanism of essential oil of TCM, analyzed the characteristics and existing problems of essential oil of TCM, and proposed the improvement direction, in order to provide reference for accelerating the research and development and innovation of essential oil in the treatment of leukemia.