1)湖南师范大学医学院生理学教研室,长沙 410081;2)南华大学衡阳医学院基础医学院生理学教研室,神经科学研究所,神经变性与认知障碍衡阳市重点实验室,衡阳 421001;3)长沙优龙机器人有限公司,长沙 410221;4)湖南师范大学医学院护理系,长沙 410081
湖南省自然科学基金(2023JJ30426)资助项目。
1)Department of Physiology, Medical College of Hunan Normal University, Changsha 410081, China;2)Department of Physiology, Institute of Neuroscience Research, Hengyang Key Laboratory of Neurodegeneration and Cognitive Impairment, University of South China, Hengyang 421001, China;3)Changsha Youlong Robot Co., Ltd., Changsha 410221, China;4)Department of Nursing, School of Medicine, Hunan Normal University, Changsha 410081, China
This work was supported by a grant from Hunan Provincial Natural Science Foundation General Project (2023JJ30426).
三阴性乳腺癌(triple negative breast cancer,TNBC)是一种特殊乳腺癌亚型,由于其耐药性强、侵袭性高、转移能力强、易复发及预后差等临床特点,导致临床治疗手段不足。CRISPR/Cas基因编辑系统的发展,极大促进了对基因组结构和功能的理解,为研究疾病的发生发展提供了简单又有前途的工具。本综述描述了新兴的CRISPR/Cas技术及其对TNBC的新见解,展示了其临床应用的未来前景,并提出CRISPR技术与其他技术相结合,如三维体外细胞培养系统、单细胞测序和人工智能等,可早期诊断和精确治疗TNBC患者,从而达到精准医疗的目的。
Triple-negative breast cancer (TNBC) represents a distinctive subtype, characterized by the absence of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). Due to its high inter-tumor and intra-tumor heterogeneity, TNBC poses significant chanllenges for personalized diagnosis and treatment. The advant of clustered regular interspaced short palindromic repeats (CRISPR) technology has profoundly enhanced our understanding of the structure and function of the TNBC genome, providing a powerfal tool for investigating the occurrence and development of diseases. This review focuses on the application of CRISPR/Cas technology in the personalized diagnosis and treatment of TNBC. We begin by discussing the unique attributes of TNBC and the limitations of current diagnostic and treatment approaches: conventional diagnostic methods provide limited insights into TNBC, while traditional chemotherapy drugs are aften associated with low efficacy and severe side effects. The CRISPR/Cas system, which activates Cas enzymes through complementary guide RNAs (gRNAs) to selectively degrad specific nucleic acids, has emerged as a robust tool for TNBC research. This technology enables precise gene editing, allowing for a deepor understanding of TNBC heterogeneity by marking and tracking diverse cell clones. Additionally, CRISPR facilitates high-throughput screening to promptly identify genes involved in TNBC growth, metastasis, and drug resistance, thus revecling new therapeutic targets and strategies. In TNBC diagnostics, CRISPR/Cas was applied to develop molecular diagnostic systems based on Cas9, Cas12, and Cas13, each employing distinct detection principles. These systems can sensitively and specifically detect a variety of TNBC biomarkers, including cell-specific DNA/RNA and circulating tumor DNA (ctDNA). In the realm of precision therapy, CRISPR/Cas has been utilized to identify key genes implicated in TNBC progression and treatment resistance. CRISPR based screening has uncovered potential therapeutic targets, while its gene-editing capabilities have tacilitated the development of combination therapies with traditional chemotherapy drugs, enhancing their efficacy. Despite its promise, the clinical translation of CRISPR/Cas technology remains in its early stages. Several clinical trials cure underway to assess its safety and efficacy in the treatment of various genetic diseases and cancers. Challenges such as off-target effects, editing efficiency, and delivery methods remain to be addreised. The integration of CRISPR/Cas with other technologies, such as 3D cell culture systems, human induced pluripotent stem cells (hiPSCs), and artificial intelligence (AI), is expected to further advance precision medicine for TNBC. These technological convergences can offer deeper insights into disease mechanisms and facilitate the development of personalized treatment strategies. In conclusion, the CRISPR/Cas system holds immense potential in the precise diagnosis and treatment of TNBC. As the technology progresses and becomes more costs effective, its clinical relevance will grow, and the translation of CRISPR/Cas system data into clinical applications will pave the way for optimal diagnosis and treatment strategies for TNBC patients. However, technical hurdles and ethical considerations require ongoing research and regulation to ensure safety and efficacy.
林惠玲,欧阳雨欣,唐宛莹,胡密,彭茂,何平平,欧阳新平. CRISPR/Cas系统在三阴性乳腺癌精准医疗中的应用[J].生物化学与生物物理进展,2025,52(2):279-289
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