Возможности тераностики в визуализации микроокружения опухоли и элиминации его иммуносупрессивных компонентов
https://doi.org/10.30895/1991-2919-2022-12-4-425-443
Резюме
Одним из перспективных направлений ядерной медицины является тераностика — использование радиофармпрепаратов для диагностики и лечения онкологических заболеваний, особое направление тераностики — иммунотераностика. Цель работы — обобщить возможности тераностики в визуализации микроокружения опухоли и элиминации его иммуносупрессивных компонентов. В статье представлены данные о составе и взаимодействии различных субпопуляций клеток в микроокружении опухоли, а также о роли стволовых опухолевых клеток в его формировании. Описаны дефекты сигнальных путей и потенциальные мишени для тераностики стволовых опухолевых клеток, а также механизм взаимодействия опухоли и иммунной системы в процессе канцерогенеза. Подробно разобраны подходы к оценке типа микроокружения с целью индивидуализации лечения и разработки рационального дизайна клинических исследований тераностических пар. Приведены собственные данные о характере распределения субпопуляций лимфоцитов и супрессорных клеток миелоидного происхождения у пациентов с метастатическими формами различных опухолей. Рассмотрены нюансы создания и использования различных молекул адресной доставки при разработке диагностических и терапевтических радиофармпрепаратов. Описаны наиболее перспективные диагностические и терапевтические изотопы с точки зрения возможности оценки микроокружения и воздействия на него. В статье освещены современные и перспективные методы предварительного таргетинга для снижения токсичности и повышения эффективности тераностики. Рассмотрены также достоинства и недостатки тераностики по сравнению с другими методами системного лечения метастатических форм опухолей. Обозначены пути преодоления недостатков тераностики.
Ключевые слова
Об авторах
О. Е. МолчановРоссия
Молчанов Олег Евгеньевич, д-р мед. наук
197758, Санкт-Петербург, п. Песочный, Ленинградская ул., д. 70
Д. Н. Майстренко
Россия
Майстренко Дмитрий Николаевич, д-р мед. наук
197758, Санкт-Петербург, п. Песочный, Ленинградская ул., д. 70
А. А. Станжевский
Россия
Станжевский Андрей Алексеевич, д-р мед. наук
197758, Санкт-Петербург, п. Песочный, Ленинградская ул., д. 70
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Молчанов О.Е., Майстренко Д.Н., Станжевский А.А. Возможности тераностики в визуализации микроокружения опухоли и элиминации его иммуносупрессивных компонентов. Ведомости Научного центра экспертизы средств медицинского применения. Регуляторные исследования и экспертиза лекарственных средств. 2022;12(4):425-443. https://doi.org/10.30895/1991-2919-2022-12-4-425-443
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Molchanov O.E., Maystrenko D.N., Stanzhevskiy A.A. Potential of Theranostics in Visualisation of the Tumour Microenvironment and Elimination of Its Immunosuppressive Components. Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products. Regulatory Research and Medicine Evaluation. 2022;12(4):425-443. (In Russ.) https://doi.org/10.30895/1991-2919-2022-12-4-425-443