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糖皮质激素是儿童急性淋巴细胞白血病治疗中的核心药物,对其耐药会直接影响预后。目前就其耐药机制的研究主要是针对细胞凋亡通路的各个环节,包括受体前机制,糖皮质激素受体基因表达、自我诱导功能及受体相关蛋白的缺陷,糖皮质激素目标基因的缺陷及凋亡效应通路受抑制。此外还包括一些其他机制,如急性淋巴细胞白血病细胞基因的表达模式,细胞内氧化还原状态的调节剂──谷胱甘肽水平等。
Glucocorticoids are the core drugs in the treatment of childhood acute lymphoblastic leukemia, the resistance of which will directly affect the prognosis. At present, the research of its drug resistance mechanism mainly focuses on the various aspects of the apoptosis pathway, including the pre-receptor mechanism, the gene expression of the glucocorticoid receptor, the self-induced function and the defect of the receptor-related protein, the expression of the glucocorticoid target gene Defects and apoptotic pathways are inhibited. In addition, some other mechanisms are also included, such as the expression pattern of acute lymphoblastic leukemia cell genes and the glutathione level regulator of intracellular redox state.