RNA激活上調(diào)PTEN表達(dá)用于逆轉(zhuǎn)EGFR突變NSCLC患者TKI耐藥的研究
[Abstract]:Background: lung cancer is the most common malignant tumor in the world and the death rate is the first in malignant tumor. With the development of genomics and the development and application of targeted drugs, the first-line treatment of advanced non small cell lung cancer (non-small cell lung cancer, NSCLC) is changing from traditional chemotherapy to individualized molecular targeting therapy. The growth factor receptor (epidermal growth factor receptor, EGFR) tyrosine kinase inhibitor (tyrosine kinase inhibitors, TKI) has been widely used in the current treatment of NSCLC, especially in non smoking Asian women and those with EGFR mutations, which are particularly effective for EGFR-TKI treatment. G340, IPASS, NEJ0025, and so on, have proved EGFR-TKI as a first-line drug for the treatment of EGFR with sensitive mutations in late NSCLC patients, the effect is better than chemotherapy. However, some NSCLC patients have primary drug resistance to EGFR-TKI. In addition, the overwhelming majority of patients who are effective for EGFR-TKI treatment will also have acquired resistance within one year. Therefore, for patients with lung cancer receiving molecular targeted therapy, whether the treatment of EGFR-TKI is effective or not, it is difficult to escape the problem of resistance to the progression of the face disease and the relapse of the drug-resistant.EGFR-TKI, which has become the main bottleneck in the clinical application of the target therapy of NSCLC. Only the reason and mechanism of the drug resistance of EGFR-TKI can be found to be overcome. The drug resistance method makes more NSCLC patients benefit from molecular targeting therapy. According to current research, T790M mutation and MET amplification are the two most common mechanisms of acquired resistance. The two other 40% mechanisms for all acquired resistance to 60%. have not been fully elucidated, and more of them are tenmifying protein homologous 10. The deletion of the phosphatase (Phosphatase and tensin homolog deleted on chromosome ten, PTEN) the deletion of the tumor suppressor gene is the first tumor suppressor gene found with the activity of phosphatase so far. Its expression product plays an important role in the PI3K/Akt signaling pathway. It can inhibit the downstream signal pathway in the Akt. The study shows that PTEN is in a low expression state in a variety of malignant tumor cell lines (including lung, esophageal and liver cancer), and plays an important role in the development of tumor. The study of foreign Kokubo et al. Shows that the low expression of PTEN is associated with the acquired resistance of gefitinib. .Endoh et al's results also suggest that patients with high PTEN expression in gefitinib patients have a better prognosis, while EGFR mutations in patients with PTEN deletion and EGFR-TKI treatment are not effective in.Sos et al. Studies show that PTEN can lead to EGFR-TKI - resistant.Zhuang and others through X - ray exposure in 2009 by activating Akt The expression level of PTEN in H-157 lung cancer cells increased and the sensitivity of cancer cells to gefitinib was increased. All of these studies showed that PTEN played a significant role in the mechanism of T790M mutation and EGFR-TKI resistance other than MET amplification,.2006 Li et al. In the study of the gene expression regulation of dsRNA for the DNA promoter sequence. It was found that dsRNA, the target of the non CpG Island sequence of the promoter region, could cause a higher expression of some genes with lower levels of expression, and defined the phenomenon as RNA activation (RNAActivation, RNAa). He called the small RNA molecule with the RNA activation function as "small activated RNA" (small activating RNA, saRNA) and dried together. The effects of interfering, RNAi) on the expression of target genes, one is enhancement, one is inhibition, and the two are both effective, specific, and relatively easy to operate by the small fragment of double stranded RNA. The discovery of the.RNAa phenomenon provides a new strategy for the treatment of tumor gene therapy,.RNAa can specifically activate the cells. In the treatment of tumors, a gene with a lower level of expression is not required to consider whether a tumor has a specific oncogene or a new gene. Therefore, we can make a particular gene specific enhancement of a low expression more unique. We can use RNAa to activate tumor inhibition. Gene, apoptosis gene, and cell cycle inhibition gene were used to treat tumor.Li and others to analyze the promoter structure of p21Waf1/Cip1 (p21) and human cadherin E gene, and to screen out saRNA that can activate downstream gene transcription on the target site on the non CpG Island sequence of this sequence. He synthesized the saRNA of 21 nucleotides, and then The saRNA was transfected into a variety of extracorporeal tumor cells, such as prostate cancer, cervical cancer, human bladder cancer, and breast cancer. The results showed that the expression level of saRNA and the expression level of calcin E and p21 gene increased 2~13 times in different cells compared with the control group, and the growth of tumor cells was significantly inhibited. Although most of the studies are in vitro experiments, good results have been achieved, which indicates that RNAa technology has a very good development prospect in tumor gene therapy, the lack of.PTEN in cancer cells, low expression is closely related to the drug resistance of EGFR-TKI. At present, there is no related research on the use of RNA activation technology to increase the expression of PTEN in lung cancer. In this study, we selected PTEN as the target to design and synthesize the saRNA for the PTEN gene promoter, aiming at exploring the feasibility and effectiveness of RNAa up regulation of PTEN gene expression to overcome EGFR-TKI resistance and finding new ways and ideas for the treatment of EGFR-TKI after drug resistance. The first part of the study of the relationship between PTEN expression and TKI resistance in non-small cell lung cancer By analyzing the expression intensity of three cells of human non-small cell lung cancer (H-157, H-1355, H-1650), the expression intensity of pAkt and the effect of three kinds of cells on TKI, the effect of PTEN low expression or expression loss on the drug resistance of TKI was investigated and the possible mechanism of drug resistance was studied. Method: to make use of reverse transcriptase PCR and Western blot to H-157, three The expression intensity of PTEN was evaluated from RNA and protein levels. The growth curve of three cells before and after TKI treatment was plotted and the apoptosis was detected by flow cytometry. The effect of TKI on three kinds of cells was evaluated. The expression of pAkt in three lung cancer cells treated with TKI was detected by Western blot The mechanism of low expression of PTEN led to TKI resistance. Results: the expression of PTEN in H-1355 cells was the highest, and the expression intensity of H-157 cells was low, while the growth curve of PTEN protein expression in H-1650 cells was obviously down after TKI drug treatment, and the cells had obvious apoptosis (P0.05), and the growth curve of H-1650 cells was slightly down, and there was no obvious change in the growth curve of H-1650 cells. There was no obvious change in the growth curve of H-157 cells and no obvious cell apoptosis (P0.05): pAkt showed low expression in H-1355 cells after TKI treatment, and both H-157 and H-1650 showed high expression state. Conclusion: the resistance of TKI to PTEN expression intensity has certain relation to the normal lung cancer cells with.PTEN expression level. It is more sensitive to TKI therapy, but the effect of PTEN deletion or the decreased expression of PTEN on TKI is not obvious. Therefore, the low expression of PTEN or the lack of expression may be one of the mechanisms that lead to the resistance of lung cancer to TKI. The reason that the low expression of PTEN or the deletion of the expression causes the drug resistance of TKI may be related to the holding of the Akt/PI3K pathway controlled by the PTEN. The second part is aimed at the construction and screening of the small activation RNA of PTEN gene: designed and screened the saRNAo method with obvious activation function for the PTEN gene: according to the saRNA design principle reported in the existing literature, the 5 dsRNA is designed as the candidate saRNA, and the transfection of the Shanghai raw material company after chemical synthesis is not small. Cell lung cancer H-157 cells. The expression intensity of PTEN in the cells after transfection was detected by RT-PCR. The activation function was screened and then the functional saRNA was transfected into H-157 cells. The expression intensity of PTEN protein level was detected by Western blot, and the activation of saRNA was evaluated in lung tissue cells. 3 of the 5 candidate dsRNA we designed can increase the expression of PTEN in H-157 cells, one of which can increase the expression intensity of PTEN by more than 2 times. After transfection of the saRNA to human H-157 cells, the expression of PTEN can be enhanced from RNA and protein levels. Conclusion: RNA activation is also present in lung tissue cells, through the lung. The tumor cells transferred to the functional saRNA of PTEN, the expression of PTEN can be specifically up-regulated. Third part saRNA up-regulated the effect of PTEN expression on the drug resistance of lung cancer. By using the selected saRNA transfected human H-157 cells to up-regulation the expression of PTEN, whether the up regulation of PTEN expression can reverse the TKI drug resistance state. The functional saRNA was transfected into H-157 cells, and the expression intensity of PTEN was detected from RNA and protein levels by RT-PCR and Western blot methods. The expression of PTEN was up regulated by saRNA, and the sensitivity of H-157 cell to TKI drugs was evaluated through the detection of cell growth curve and apoptosis. TKI resistance was overcome. Results: after saRNA transfection to H-157 cells, the results of RT-PCR and Western blot showed that the expression level of PTEN was significantly higher than that of dsControl and mock groups (P0.05), which indicated that saRNA in the H-157 cells was activated to make the expression up. The growth curve showed that the transfection was 72 hours after transfection. The growth of the group cells was obviously inhibited, and there was significant difference with the other two groups (P0.05). Apoptosis results showed that the apoptosis rate of group saRNA was 17.82 + 2.37%, the apoptosis rate of group dsControl was 1.74+0.17%, and the apoptosis rate of mock group was 0.33+0.14% (P0.05). Conclusion: the low expression of PTEN is one of the mechanisms causing TKI resistance. The reason for the resistance is that the low expression of PTEN causes excessive phosphorylation of Akt, which causes the activation of Akt/PI3K pathway and causes resistance. Through the screening of functional saRNA, the expression level of PTEN can be up-regulated, thus increasing the sensitivity of lung cancer cells to TKI and reversing the drug resistance of TKI.
【學(xué)位授予單位】:山東大學(xué)
【學(xué)位級(jí)別】:博士
【學(xué)位授予年份】:2016
【分類號(hào)】:R734.2
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