腫瘤的基因療法

Gene Therapy for Cancer

施科念(Ko-Nien Shih) ； 黃文濤(Wen-Tao Huang) ； 張宗良(Chung-Liang Chang)

《台灣醫學》 16卷3期 (2012/05) Pp. 308-319

https://doi.org/10.6320/FJM.2012.16(3).11

摘要

目前的癌症治療在傳統的醫學上仍是以手術、放射治療和化學治療為主要方法，但很明顯的是這些療法都有不同程度的副作用伴隨，例如麻醉風險、術後感染、噁心、嘔吐、掉髮、造血不良、肝腎毒性等，種種急性或慢性的副作用，造成病患對於癌症治療產生莫大的恐懼。隨著近代分子生物學與生物科技的進步，對於癌症的成因與發展已慢慢的被研究出來，對於癌症治療的評估不再只侷限於其大小位置、淋巴轉移、癌組織型態，而是更深入的瞭解其基因運作的調控缺失與免疫系統之間的相互作用，因此新的癌症醫療思維『癌症基因治療』就此展開，經過了將近二十年基因治療的研究，不管是民間或政府都投入了龐大的經費，雖然經歷了許多的挫折（例如使患者罹患白血病、具有嚴重肝、腎毒性或產生病毒血症導致患者死亡），但也獲得了許多新穎的相關知識。本文將對基因療法的原理技術與應用在腫瘤治療的方式，以簡單的圖示與文字介紹，文中包括：以小片段干擾RNA抑制致癌基因的表現、細胞凋亡誘導基因、自殺基因、抗血管生成因子、免疫治療與溶瘤病毒的相關應用，以期讓每位讀者在此領域有更進一步的瞭解。

關鍵字

基因療法 ； 腫瘤 ； 小片段干擾RNA ； 細胞凋亡誘導基因 ； 自殺基因 ； 免疫調控

並列摘要

Current therapy of cancer is still based mainly on surgery, radiation therapy and chemotherapy, but it is obviously that these therapies have many side effects, such as anesthesia risk, postoperative infection, nausea, vomiting, hair loss, induction of leukemia, liver and kidney toxicity. These various acute or chronic side effects make cancer patients have a fear of traditional cancer therapy. With recent advances in modern molecular biology and biotechnology, the causes of oncogenesis have gradually been understood. The treatment of cancer is no longer confined to its size or location, lymph node metastasis, cancer types, but a better understanding of the regulation of genes in oncogenesis and the interaction between the immune system and cancer cells. The new thinking about cancer and treatment brings up the new term「cancer gene therapy」. After nearly two decades of research in gene therapy, either private industry or government has invested huge funds in the area. While there were a lot of frustration (for example, patients suffering from leukemia, a serious liver and kidney toxicity or produced viremia leads to patient's death), a lot of new knowledge have been received. This article will briefly introduce the principle and techniques of gene therapy used in the current cancer treatment, and let reader have a better understanding in this area.

並列關鍵字

gene therapy ； tumor ； siRNA ； apoptosis-inducing gene ； suicide gene ； immunomodulation