2022 年第 3 期 第 17 卷

外泌体在乳腺癌内分泌耐药方面的研究现状及中药干预可能的作用机制探讨

Research status of exosomes in endocrine drug resistance of breast cancer and discussion on the possible mechanism of traditional Chinese medicine intervention

作者：崔永佳卢雯平吴晓晴

英文作者：Cui Yongjia Lu Wenping Wu Xiaoqing

单位：中国中医科学院广安门医院肿瘤科，北京100053

英文单位：Department of Oncology Guang′anmen Hospital China Academy of Chinese Medical Sciences Beijing 100053 China

关键词：乳腺癌；内分泌耐药；外泌体；疏肝益肾方

英文关键词：Breastcancer;Endocrinedrugresistance;Exosomes;ShuganYishenformula

• 摘要：

• 女性乳腺癌新发病例现已位居全球癌症发病率的首位。以雌激素受体表达为特征的乳腺癌约占所有新病例的70%，约30%的患者因内分泌治疗耐药出现复发或转移，这给临床治疗带来巨大挑战。外泌体是介导肿瘤微环境中细胞间通讯的纳米级囊泡，包含着非编码RNA、蛋白质等物质，其不仅可以通过改变雌激素受体的表达水平或激活非配体依赖的雌激素受体信号通路驱动乳腺癌内分泌耐药，而且可作为内分泌治疗反应的标志物。外泌体作为天然载体，可递送药物而实现精准治疗。同时，阻断细胞间外泌体的信息交流可逆转乳腺癌内分泌耐药。基于外泌体在乳腺癌内分泌耐药中信息传递的重要角色，我们研究证明了疏肝益肾方负载的外泌体可以逆转乳腺癌内分泌耐药，这为中医药治疗乳腺癌内分泌耐药提供了新的依据。

• The number of new cases of breast cancer in women now leads the world in cancer incidence. Breast cancer characterized by estrogen receptor expression accounts for about 70% of all new cases, and 30% patients experience recurrence or metastasis due to endocrine drug resistance, which poses a huge challenge to clinical treatment. Exosomes are nanoscale vesicles that mediate cell-to-cell communication in the tumor microenvironment, containing non-coding RNA, proteins, and other substances. Exosomes can not only drive breast cancer endocrine drug resistance by changing the expression of estrogen receptor or activating the non ligand dependent estrogen receptor signaling pathways, but also can be used as a marker of endocrine therapy response. As a natural carrier, exosomes can deliver drugs for precise treatment, and reverse the endocrine drug resistance of breast cancer by blocking the information exchange of exosomes between cells. Based on the important role of exosomes in information transmission in endocrine drug resistance of breast cancer, our study has proved that exosomes loaded in Shugan Yishen formula can reverse the endocrine drug resistance of breast cancer, which provides a new basis for traditional Chinese medicine in the treatment of endocrine drug resistance of breast cancer.