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巨细胞病毒与胶质母细胞瘤:生物学关联及治疗策略综述

英文原题:Cytomegalovirus and Glioblastoma: A Review of the Biological Associations and Therapeutic Strategies.

查看英文原题

Cytomegalovirus and Glioblastoma: A Review of the Biological Associations and Therapeutic Strategies.

PubMed 2022/09/04(内容时间) J Clin Med Q1 · IF 3.3(JCR 2025)

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中文摘要

胶质母细胞瘤是成人中枢神经系统中最常见且最具侵袭性的恶性肿瘤。巨细胞病毒(CMV)在胶质母细胞瘤的发病机制和治疗中起着至关重要的作用。

我们综述了CMV在胶质瘤中的流行病学、CMV相关癌变机制及其治疗策略,提供了进一步的临床实践见解。迄今为止,胶质母细胞瘤中的CMV感染率仍存在争议,而越来越多的研究表明感染率较高。CMV的癌变机制已在多个方面进行了研究,包括肿瘤调节、致癌特征、肿瘤微环境调控、上皮-间质转化以及整体免疫系统调控。在临床实践中,CMV相关脑病的发生率较高,针对CMV的治疗兼具抗CMV和抗肿瘤效应。作为主要的抗CMV治疗药物,缬更昔洛韦作为辅助治疗在新诊断和复发性胶质母细胞瘤中均显示出有前景的生存获益,无论手术情况和MGMT启动子甲基化状态如何。免疫治疗,包括DC疫苗和过继性CMV特异性T细胞,也正在研究中,初步结果令人鼓舞。关于CMV感染的意义和CMV的致癌机制仍存在疑问。

同时,研究已证明抗CMV治疗在胶质母细胞瘤中具有临床获益。因此,抗CMV治疗值得进一步认识和探索。

展开英文摘要原文

Glioblastoma is the most common and aggressive malignancy in the adult central nervous system. Cytomegalovirus (CMV) plays a crucial role in the pathogenesis and treatment of glioblastoma.

We reviewed the epidemiology of CMV in gliomas, the mechanism of CMV-related carcinogenesis, and its therapeutic strategies, offering further clinical practice insights. To date, the CMV infection rate in glioblastoma is controversial, while mounting studies have suggested a high infection rate. The carcinogenesis mechanism of CMV has been investigated in relation to various aspects, including oncomodulation, oncogenic features, tumor microenvironment regulation, epithelial-mesenchymal transition, and overall immune system regulation. In clinical practice, the incidence of CMV-associated encephalopathy is high, and CMV-targeting treatment bears both anti-CMV and anti-tumor effects.

As the major anti-CMV treatment, valganciclovir has demonstrated a promising survival benefit in both newly diagnosed and recurrent glioblastoma as an adjuvant therapy, regardless of surgery and the MGMT promoter methylation state.

Immunotherapy, including DC vaccines and adoptive CMV-specific T cells, is also under investigation, and preliminary results have been promising. There are still questions regarding the significance of CMV infection and the carcinogenic mechanism of CMV. Meanwhile, studies have demonstrated the clinical benefits of anti-CMV therapy in glioblastoma.

Therefore, anti-CMV therapies are worthy of further recognition and investigation.

论文信息

作者
Yang T、Liu D、Fang S、Ma W、Wang Y
单位
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.China
文献类型
综述
期刊
Journal of clinical medicine2022 Sep 4
原文标识
PubMed 36079151 · DOI 10.3390/jcm11175221