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科学家如何用小苏打“饿死”癌细胞?

2016-09-25 07:01:30   法制网

十几元的小苏打,不贵,还能救命。

浙江大学附属第二医院在原发性肝细胞肝癌治疗上取得重大突破。宁波一位40多岁的女性肝癌晚期病人,黄疸超过正常值20多倍,肝部肿瘤巨大——外科医生宣布已经不能做切除手术了。“只能用新方法试试。”浙医二院放射介入科晁明教授团队经过4个多小时的手术,往菜瓜般大小的肿瘤中送进小苏打,再将输送养分的血管封闭。多次治疗后,经核磁共振检查,肿瘤已失去血液供应。

从2015年1月到现在,经过4次治疗,病人活得好好的。

今年8月,由浙江大学肿瘤研究所胡汛教授团队和晁明教授团队合作的原发性肝癌治疗的论文,登上国际生物和医学领域权威杂志《elife》,并得到了国际著名肿瘤学者的肯定。该论文介绍了“靶向肿瘤内乳酸阴离子和氢离子的动脉插管化疗栓塞术”,简称TILA-TACE。

胡汛从1982年开始从事肿瘤相关研究。走了很多弯路之后,他想到了从癌细胞的弱点入手:肿瘤虽是一种超级生物,但其也有弱点,那就是也需要物质和能量的代谢——肿瘤细胞也要“吃”东西才能生存和生长。

它们吃什么呢?研究人员把肿瘤细胞放在培养基中,逐一抽走里面的营养物质,当把葡萄糖抽走时,不出两天,肿瘤细胞都死光了。也就是说,癌细胞的主食是糖。剥夺葡萄糖,肿瘤细胞就会死亡。

但实际情况是,“断食”后肿瘤细胞不仅没死,反而还不断生长。

经过一系列筛查,研究人员锁定了乳酸。

肿瘤中有大量的乳酸,乳酸解离成乳酸阴离子和氢离子,成为肿瘤细胞的两位“帮手”,让其自身能够根据“食物”的多少决定“消耗”多少。两位“帮手”协同作用,使得肿瘤细胞在葡萄糖含量很少时,非常节约地利用葡萄糖;在没有葡萄糖的情况下进入“休眠”状态;当有葡萄糖供应时即刻恢复生长状态。

因此,若想有效“饿死”肿瘤细胞,还需同时破坏乳酸阴离子和氢离子的协同作用——用碳酸氢钠(小苏打)去除肿瘤内的氢离子,就可破坏乳酸根和氢离子的协同作用,从而快速有效地杀死处于葡萄糖饥饿或缺乏的肿瘤细胞。胡汛团队提出了这一治疗肿瘤的新理念,并于2012年在国际学术刊物《病理学杂志》上发表。

一项科研成果从实验室到临床之间,还隔着看不见的鸿沟。填平鸿沟的,正是晁明。两位教授的探索,开始于2012年。他们将动脉插管化疗栓塞术(cTACE)和小苏打结合的方法,应用在原发性癌细胞肝癌患者身上:注射碳酸氢钠,让癌细胞狠狠健个身,把储备消耗掉;然后,堵上血管,断了补给。

他们把这个疗法命名为TILA-TACE,意为靶向肿瘤内乳酸的TACE。这一合作,成功地将基础研究的发现快速转化成肿瘤临床治疗。

TILA-TACE改善了病人的生存质量,延长了病人的生命,代表了一个肿瘤治疗领域的重大突破。他们发表在了《eLife》论文显示:研究中,40位原发性肝癌病人在接受TILA-TACE治疗后,客观反应率100%。初步统计病人的累计中位生存期超过3年半。这个结果,让很多国内外同行难以置信——在此之前,晚期肝癌治疗,经过30年的努力,才突破了半年中位生存期。

更难能可贵的是,该治疗方案最核心的药物小苏打,随处可见。

责任编辑:李东舰 CN031
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