https://scholars.lib.ntu.edu.tw/handle/123456789/194577
Title: | 皮質醇同型受體表現對於急性淋巴型白血病化療反應之影響及其對策 | Authors: | 林凱信 | Keywords: | 急性淋巴性白血病;皮質醇同型受體;acute lymphoblastic leukemia;glucocorticoid receptor | Issue Date: | 2005 | Publisher: | 臺北市:國立臺灣大學醫學院小兒科 | Abstract: | 急性淋巴性白血病是兒童癌症中最常見的惡性疾病,需要進行多重藥物的化 學治療,其中皮質醇是急性淋巴性白血病化學治療藥物中的一個重要的基本藥 物。根據以往的報告,對皮質醇單獨治療反應不佳的病人,常伴隨有引導期化療 失敗和預後不好。但皮質醇如何影響治療成績的機制則還不清楚。皮質醇受體的 表現在許多研究報告中被證實與皮質醇的感受性有關,其中皮質醇同型受體 GRα、GRβ 被證實與皮質醇的作用與拮抗作用相關。本實驗收集了35 位新發病 急性淋巴性白血病病童的骨髓檢體,利用real time PCR 方法定量其白血病細胞 的GRα、GRβ 量。發現各危險群的急性淋巴性白血病童的GRα、GRβ 量與比率 並無差異。比較臨床上對皮質醇單獨治療反應、引導期化療反應、復發,發現 GRα、GRβ、GRα/GRβ 量高低對臨床治療反應的指標均無影響,這顯示皮質醇 同型受體可能不是影響治療成績的主要機制。 Acute leukemia is the most common childhood malignancy worldwide, and acute lymphoblastic leukemia (ALL) comprises the majority of pediatric leukemia. It is well known that the overall prognosis is dependent on the appropriate risk-specific chemotherapy. Glucocorticoids (GC) have long been the cornerstone of ALL chemotherapy. A better in vivo response to the initial 7 day prednisolone monotherapy had correlated to a significantly higher probability of both complete remission and long-term event free survival (EFS). Unsatisfactory response to GC has led to the failure of remission induction, and their survival is adversely affected. Glucocorticoid receptor(GR) expression has long been correlated with GC sensitivity in numerous experimental systems. Previous studies have suggested that GR-β is a dominant negative inhibitor, and down-regulation of GR-α or up-regulation of GR-β could result in GC resistance. Our aim is to determine which mRNA transcript is the one which accounts for GC resistance. We collected 35 bone marrow samples from fresh ALL patients. Our results show the relative expression of GRα、GRβ、GRα/GRβ shows no difference in the 3 risk groups. The relative expression of GRα、GRβ、GRα/GRβ shows no difference between the PGR and PPR patients of the 3 risk groups. Furthermore, when they were divided into two groups ( high and low) according to the median value of the GRα/GRβ ratio. The prednisolone response, induction remission rate and relapse rate show no difference in the two groups. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/22916 | Other Identifiers: | 932314B002206 | Rights: | 國立臺灣大學醫學院小兒科 |
Appears in Collections: | 醫學系 |
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932314B002206.pdf | 202.6 kB | Adobe PDF | View/Open |
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