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谷氨酰胺与白血病研究:进展与临床前景

Glutamine and leukemia research: progress and clinical prospects.

作者信息

Wang Zexin, Liu Miao, Yang Qiang

机构信息

Mianyang Central Hospital, Fucheng District, Mianyang, 621000, Sichuan, China.

出版信息

Discov Oncol. 2024 Aug 31;15(1):391. doi: 10.1007/s12672-024-01245-0.

Abstract

Leukemia is an abnormal proliferation of white blood cells that occurs in bone marrow and expands through the blood. It arises from dysregulated differentiation, uncontrolled growth, and inhibition of apoptosis. Glutamine (GLN) is a "conditionally essential" amino acid that promotes growth and proliferation of leukemic cells. Recently, details about the role of GLN and its metabolism in the diagnosis and treatment of acute myeloid, chronic lymphocytic, and acute lymphoblastic leukemia have emerged. The uptake of GLN by leukemia cells and the dynamic changes of glutamine-related indexes in leukemia patients may be able to assist in determining whether the condition of leukemia is in a state of progression, remission or relapse. Utilizing the possible differences in GLN metabolism in different subtypes of leukemia may help to differentiate between different subtypes of leukemia, thus providing a basis for accurate diagnosis. Targeting GLN metabolism in leukemia requires simultaneous blockade of multiple metabolic pathways without interfering with the normal cellular and immune functions of the body to achieve effective leukemia therapy. The present review summarizes recent advances, possible applications, and clinical perspectives of GLN metabolism in leukemia. In particular, it focuses on the prospects of GLN metabolism in the diagnosis and treatment of acute myeloid leukemia. The review provides new directions and hints at potential roles for future clinical treatments and studies.

摘要

白血病是一种发生于骨髓并通过血液扩散的白细胞异常增殖疾病。它源于分化失调、生长失控以及细胞凋亡抑制。谷氨酰胺(GLN)是一种“条件必需”氨基酸,可促进白血病细胞的生长和增殖。最近,有关谷氨酰胺及其代谢在急性髓系白血病、慢性淋巴细胞白血病和急性淋巴细胞白血病的诊断与治疗中的作用的细节已逐渐明晰。白血病细胞对谷氨酰胺的摄取以及白血病患者体内谷氨酰胺相关指标的动态变化或许能够辅助判断白血病病情处于进展、缓解还是复发状态。利用不同亚型白血病中谷氨酰胺代谢的可能差异可能有助于区分不同亚型的白血病,从而为准确诊断提供依据。针对白血病中的谷氨酰胺代谢进行靶向治疗需要同时阻断多条代谢途径,且不干扰机体正常的细胞和免疫功能,以实现有效的白血病治疗。本综述总结了谷氨酰胺代谢在白血病方面的最新进展、可能的应用及临床前景。特别关注了谷氨酰胺代谢在急性髓系白血病诊断和治疗中的前景。该综述为未来的临床治疗和研究提供了新方向及潜在作用的提示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3d8/11365919/af9d71382dc8/12672_2024_1245_Fig1_HTML.jpg

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