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通讯作者:

邱文,E⁃mail:qiuwen@njmu.edu.cn

中图分类号:R392.12

文献标识码:A

文章编号:1007-4368(2021)12-1721-07

DOI:10.7655/NYDXBNS20211202

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参考文献 9
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参考文献 10
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参考文献 12
MAEDA Y,KAWANO Y,WADA Y,et,al.C5aR is frequently expressed in metastatic renal cell carcinoma and plays a crucial role in cell invasion via the ERK and PI3 kinase pathways[J].Oncol Rep,2015,33(4):1844-1850
参考文献 13
SALAZAR Y,ZHENG X,BRUNN D,et,al.Microenvironmental Th9 and Th17 lymphocytes induce metastatic spreading in lung cancer[J].J Clin Invest,2020,130(7):3560-3575
参考文献 14
NITTA H,MURAKAMI Y,WADA Y,et,al.Cancer cells release anaphylatoxin C5a from C5 by serine protease to enhance invasiveness[J].Oncol Rep,2014,32(4):1715-1719
参考文献 15
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目录contents

    摘要

    目的:探讨C5a对非小细胞肺癌(non⁃small cell lung cancer,NSCLC)细胞增殖和迁移的影响及其潜在的分子机制。 方法:RT⁃PCR和Western blot检测人正常支气管上皮细胞系BEAS⁃2B和3种NSCLC细胞系(H1703、PC9、H1299)中C5a受体 (C5aR)的表达;CCK⁃8 和划痕实验检测 C5a 对 PC9 细胞增殖和迁移的影响;Western blot 检查 C5a 刺激 PC9 细胞后蛋白激酶 Akt1、细胞外信号调节激酶1/2(extracellular signal⁃regulated kinase,ERK1/2)和蛋白激酶C⁃α(protein kinase C⁃α,PKC⁃α)表达及磷酸化水平;用Akt1抑制剂Perifosine和ERK1/2抑制剂U0126分别处理PC9细胞后再给予C5a刺激,Western blot检测Akt1和 ERK1/2的表达和磷酸化及其上下游调控关系,CCK⁃8和划痕实验检测Perifosine和U0126对细胞增殖和迁移的影响。结果: PC9细胞C5aR的表达水平显著高于其他细胞;C5a可明显促进PC9细胞的增殖和迁移能力;C5a刺激PC9细胞后,可显著增强 Akt1和ERK1/2的磷酸化;Akt1和ERK1/2抑制剂均能明显降低C5a刺激PC9细胞后引起的细胞增殖和迁移,且Akt1抑制剂不仅能减弱Akt1的磷酸化,还能减弱ERK1/2的磷酸化,而ERK1/2抑制剂则仅能阻断其自身的磷酸化。结论:C5a刺激NSCLC细胞后可能通过激活Akt1⁃ERK1/2通路促进细胞的增殖和迁移。

    Abstract

    Objective:This study aims to investigate the effect of C5a on the proliferation and migration of non⁃small cell lung cancer (NSCLC)cells and its potential molecular mechanism. Methods:The C5a receptor(C5aR)expression in the human normal bronchial epithelial cell line BEAS ⁃2B and three NSCLC cell lines(H1703,PC9,H1299)was examined by RT ⁃PCR and Western blot(WB) analysis. PC9 cell were stimulated with various concentrations of C5a,and cell proliferation and migration were examined by CCK ⁃8 and scratch test,respectively. The PC9 cells were treated with C5a,and then the expression and phosphorylation of Akt1,ERK1/2 and PKC ⁃α were examined by WB. PC9 cells were treated with Akt1 inhibitor(Perifosine)and ERK1/2 inhibitor(U0126),respectively, followed by C5a stimulation,and then WB was used to examine the expression and phosphorylation levels of Akt1 and ERK1/2 and their upstream and downstream regulatory relationships. The effects of Perifosine and U0126 on PC9 cell proliferation and migration were determined by CCK ⁃8 and scratch test,respectively. Results:The expression level of C5aR in PC9 cells was obviously higher than that of other cells. C5a could significantly promote the proliferation and migration of PC9 cells. In addition,the phosphorylation levels of both Akt1 and ERK1/2 were markedly enhanced in the PC9 cells induced by C5a,but the protein expression did not show significant change. Furthermore,Akt1 and ERK1/2 inhibitors markedly down ⁃ regulated the proliferation and migration of PC9 cells caused by C5a stimulation. Akt1 inhibitors not only attenuated Akt1 phosphorylation,but also attenuated ERK1/2 phosphorylation. ERK1/2 inhibitors only attenuated its own phosphorylation. Conclusion:C5a induces the proliferation and migration of NSCLC cells through activation of Akt1/ERK1/2 pathway.

    关键词

    非小细胞肺癌C5aAkt1ERK1/2增殖迁移

    Keywords

    NSCLCC5aAkt1ERK1/2proliferationmigration

  • 肺癌(亦称支气管肺癌)是一种发生于支气管黏膜上皮组织的恶性肿瘤,通常分为小细胞肺癌 (small cell lung cancer,SCLC)和非小细胞肺癌(non⁃ small cell lung cancer,NSCLC)两大类[1]。由于绝大多数肺癌患者属于NSCLC(约为85%),加上近年来NSCLC的发病率和病死率呈逐年升高的趋势[2],故深入探讨NSCLC的病因和发病机制具有十分重要的意义。

  • NSCLC的形成不仅与遗传和环境等因素有关[3],而且还与肿瘤局部微环境中的某些促炎因子(如TNF⁃α和IL⁃6)和补体(如C3a和C5a)的作用明显相关[4-5]。研究发现,补体C5a不仅可由补体系统3条途径激活时产生,还可由肿瘤组织本身产生[6]。肿瘤局部微环境中的补体C5a通过其C5a受体(C5aR) 作用于靶细胞,既能调节免疫应答,又能促进肿瘤的生长和转移[7]。NSCLC患者血浆和癌组织中C5a含量明显增多,并能促进NSCLC细胞的增殖[5]。本课题前期研究发现,体外用C5a刺激NSCLC细胞不仅能促进细胞的增殖还能增强细胞的迁移,但有关C5a促NSCLC细胞增殖和迁移的分子机制,目前尚不清楚。

  • 据报道,C5a诱导靶细胞的生物学效应通常与靶细胞内某些信号通路的活化有关,例如C5a可激活丝/苏氨酸蛋白激酶Akt1、细胞外信号调节激酶1/2 (extracellular signal⁃regulated kinase,ERK1/2)等[8-9]。已知,Akt1活化与多种肿瘤细胞的增殖和活化密切相关。Akt1可通过激活其下游分子如mTOR等促进肿瘤细胞的增殖、迁移以及肿瘤血管的形成[10]。此外,ERK1/2是MAPK家族中重要成员。作为高度保守的丝/苏氨酸蛋白激酶,ERK1/2可识别并磷酸化特定的底物蛋白,在细胞的增殖与分化等活动中发挥重要作用[10]。文献报道C5a可通过活化Akt1促进乳腺癌细胞的增殖[7]。此外,C5a还可通过激活ERK1/2增强肾癌细胞的增殖和侵袭能力[12]。但是,有关C5a作用于NSCLC细胞后信号通路的激活情况尚未见文献报道。

  • 本课题的前期研究已发现,用C5a刺激体外培养的NSCLC细胞后,NSCLC细胞的增殖和迁移能力均显著提高,且Akt1和ERK1/2的磷酸化水平也同步上调,故推测C5a刺激NSCLC细胞后,可能通过激活Akt1或ERK1/2信号分子促进细胞的增殖和迁移。鉴于此,本课题开展了以下实验,研究C5a激活Akt1和ERK1/2促进NSCLC细胞的增殖和迁移的作用与机制。

  • 1 材料和方法

  • 1.1 材料

  • 人正常支气管上皮细胞系BEAS ⁃ 2B和3种NSCLC细胞系(H1703、PC9、H1299)均由武汉大学中国典型培养物保藏中心提供。人C5a蛋白(R&D Systems公司,美国),抗C5aR抗体(武汉Abclonal公司),抗总Akt1(t ⁃ Akt1)、磷酸化Akt1(p ⁃ Akt1, Ser473)、总ERK1/2(t⁃ERK1/2)、磷酸化ERK1/2(p⁃ ERK1/2,Thr202/Tyr204)、总PKC⁃α(t⁃PKC⁃α)、磷酸化p⁃PKC⁃α(p⁃PKC⁃α,Thr638)的抗体(Cell Signaling Technology公司,美国)。HRP标记山羊抗兔和山羊抗鼠二抗(合肥Biosharp公司)。Perifosine (Akt1抑制剂)和U0126(ERK1/2抑制剂)(上海MCE公司)。胎牛血清(fetal bovine serum,FBS)(Wisent公司,加拿大)。DMEM(Gbico公司,美国)。CCK⁃8试剂盒(上海MCE公司)。

  • 1.2 方法

  • 1.2.1 BEAS⁃2B、H1703、PC9和H1299细胞系的培养

  • 将前述细胞系接种于含10%FBS的DMEM完全培养液中,置于37℃、5%CO2孵箱中培养48h。当细胞融合度达到90%时,按1∶3比例进行细胞传代,并继续培养。

  • 1.2.2 BEAS⁃2B、H1703、PC9和H1299细胞系C5aR表达的检查

  • RT⁃PCR:根据NCBI数据库找到目的基因CDS区,利用Premier 5软件进行引物设计,并交由通用生物系统有限公司合成。序列如下:C5aR(上游5′⁃ ACTACAGCCACGACAAACG⁃3′;下游5′⁃CCCTAAC⁃ CACGGACTCTTC ⁃3′),GAPDH(上游5′ ⁃CAAGGT⁃ CATCCATGACAACTTTG ⁃ 3′;下游5′ ⁃ GTCCAC⁃ CACCCTGTTGCTGTAG ⁃ 3′)。提取前述细胞总RNA,逆转录为cDNA,以此cDNA为模板,用Prime STAR@Max DNA Polymerase进行PCR反应,最终扩增产物行琼脂糖凝胶电泳,并拍照成像。

  • Western blot:将上述细胞裂解物离心3min,取30 μg蛋白行SDS⁃PAGE电泳,先用45V恒压浓缩,再用120V电泳2h,接着用0.3A湿转120min,待蛋白转印到PVDF膜上后再用脱脂奶粉溶液封闭2h,加入抗C5aR抗体4℃孵育过夜。漂洗后用HRP标记的二抗室温孵育1h,最后行ECL化学发光试剂检测。

  • 1.2.3 Western blot实验检测PC9 细胞中Akt1、 ERK1/2、PKC⁃α磷酸化水平

  • 收集C5a刺激PC9细胞后不同时间点的细胞蛋白,行Western blot检测Akt1、ERK1/2、PKC⁃α的表达和磷酸化水平,方法同前。用10 μmol/L Perifosine或U0126分别处理PC9细胞30min,然后加入50ng/mL C5a共同孵育3h,行Western blot检测Akt1和ERK1/2的表达和磷酸化。

  • 1.2.4 CCK⁃8实验检测PC9细胞的增殖

  • 将PC9细胞种植于96孔板,24h后换成无血清DMEM培养24h,接着用不同浓度的C5a刺激细胞48h,每孔加入10 μL的CCK⁃8溶液,在37℃孵育40~50min,用酶标仪测定450nm处的吸光度。同上将细胞接种至96孔板,分别用10 μmol/L Perifosine和U0126处理细胞30min,再用50ng/mL C5a刺激细胞48h,开展CCK⁃8实验检测细胞增殖水平。

  • 1.2.5 细胞划痕实验检测PC9细胞的迁移

  • 将PC9细胞接种于6孔板,24h后换成无血清DMEM培养12h。通过200 μL移液器吸头产生细胞单层的线性伤口,用PBS清洗脱落的细胞,加入含1%FBS的DMEM,同时加入不同浓度的C5a继续培养,并于24h和48h时观察细胞的迁移情况。同上将细胞接种至6孔板,进行细胞划痕,用10 μmol/L浓度的Perifosine和U0126分别处理细胞,30min后再用50ng/mL的C5a处理细胞24h和48h,观察其迁移情况。

  • 1.3 统计学方法

  • 所有实验均独立重复3次,所得定量数据以均数±标准误(x-±sx-)表示。采用SPSS 19.0统计软件进行统计学分析,多组间比较则采用单因素方差分析,Bonfferoni法进行两两比较,P< 0.05为差异有统计学意义。

  • 2 结果

  • 2.1 NSCLC细胞系中C5aR的表达情况

  • 首先检测了正常支气管上皮细胞(BEAS⁃2B)以及3种常见的NSCLC细胞系(H1703、PC9和H1299) 中C5aR的表达情况。结果显示,C5aR在PC9和H1703细胞中均有明显的表达,但以PC9细胞的表达水平最高(图1),故后续实验选择了PC9细胞系进行相关实验。

  • 2.2 C5a刺激PC9细胞后诱导细胞增殖和迁移及其刺激剂量的确定

  • 2.2.1 不同浓度C5a刺激PC9细胞后细胞增殖能力的变化

  • 在证实了PC9细胞高表达C5aR后,分别用0、 0.05、0.50、5.00,50.00、500.00ng/mL的C5a刺激PC9细胞,48h后行CCK⁃8实验检测细胞的增殖情况。结果发现,PC9细胞的增殖随着C5a刺激剂量的加大逐渐增强,当刺激剂量为50.00和500.00ng/mL时,细胞增殖最为显著(图2)。

  • 2.2.2 不同浓度C5a刺激PC9细胞后细胞迁移能力的改变

  • 分别用0、0.05、0.50、5.00、50.00、500.00ng/mL C5a刺激PC9细胞48h后,行划痕实验检测细胞的迁移情况。结果显示,C5a以剂量依赖性的方式促进细胞的迁移,其中以50.00和500.00ng/mL剂量的效果最为显著(图3)。由于50.00ng/mL和500.00ng/mL C5a刺激剂量之间细胞增殖和迁移水平无显著差异,故选择用50.00ng/mL剂量开展后续的实验。

  • 2.2.3 C5a促进PC9细胞Akt1和ERK1/2的磷酸化

  • 为了探讨C5a诱导PC9增殖和迁移的潜在机制,用C5a刺激PC9细胞,在不同时间点(0h、1h、2h、3h、6h、12h)检测增殖和迁移相关的信号分子Akt1、ERK1/2和PKC⁃α的表达与磷酸化情况。结果显示,C5a刺激PC9细胞后,显著增强Akt1和ERK1/2的磷酸化水平,且其峰值在3h左右,而PKC⁃α的表达和磷酸化均未见明显变化(图4)。

  • 图1 正常支气管上皮细胞BEAS ⁃2B和NSCLC细胞系H1703、PC9和H1299中C5aR的表达情况

  • Fig.1 The C5aR expression in the human normal bronchial epithelial cell line BEAS ⁃ 2B and three NSCLC cell lines (H1703,PC9and H1299)

  • 图2 CCK⁃8实验检测C5a刺激PC9细胞的增殖情况

  • Fig.2 C5a stimulates the proliferation of PC9cells by CCK⁃8experiment

  • 2.2.4 C5a通过Akt1⁃ERK1/2 通路诱导PC9 细胞增殖和迁移

  • 进一步探讨了Akt1和ERK1/2在C5a诱导PC9细胞增殖和迁移的作用。用Akt1抑制剂Perifosine和ERK1/2抑制剂U0126分别处理PC9细胞30min (设DMSO溶剂对照),接着用C5a刺激3h后,行Western blot检测Akt1和ERK1/2的表达和磷酸化。结果显示,Perifosine和U0126可分别阻断Akt1和ERK1/2的磷酸化,且均不影响其蛋白表达。此外, Perifosine能下调ERK1/2的磷酸化,而U0126对Akt1的磷酸化没有明显影响(图5),提示C5a刺激PC9细胞后Akt1和ERK1/2的活化可能存在一定的上下游关系,即C5a刺激PC9细胞后通过激活Akt1诱导ERK1/2的活化。CCK⁃8和细胞划痕实验进一步表明,抑制Akt1和ERK1/2可以显著减弱C5a上调的PC9细胞增殖和迁移(图6)。上述结果表明, C5a刺激PC9细胞后可通过激活Akt1⁃ERK1/2通路促进PC9细胞的增殖和迁移。

  • 图3 细胞划痕实验检测C5a刺激PC9细胞的迁移情况

  • Fig.3 C5a stimulates the migration of PC9cells by cell scratch test

  • 图4 C5a刺激PC9细胞后Akt1、ERK1/2和PKC⁃α的表达与磷酸化情况

  • Fig.4 The expression and phosphorylation of Akt1,ERK1/2and PKC⁃α in PC9cells treated with C5a

  • 图5 Akt1和ERK1/2抑制剂对C5a诱导PC9细胞中Akt1和ERK1/2表达和磷酸化的影响

  • Fig.5 Effects of Akt1and ERK1/2inhibitors on the expression and phosphorylation of Akt1and ERK1/2in PC9cells in⁃ duced by C5a

  • 图6 Akt1和ERK1/2抑制剂对C5a诱导PC9细胞增殖和迁移的影响

  • Fig.6 Effects of Akt1and ERK1/2inhibitors on the proliferation and migration of PC9cells induced by C5a

  • 3 讨论

  • NSCLC是最常见的肺部原发性恶性肿瘤。在我国,NSCLC已成为发病率和死亡率均排在首位的恶性肿瘤[1],但截至目前,有关NSCLC的病因和发病机制尚未完全明了,其可能与NSCLC肿瘤微环境中的某些促炎因子或补体成分(如C5a)的上调有一定关系[312]

  • 已知C5a是补体系统通过3条途径激活时形成的C5裂解片段。对于肿瘤生长而言,C5a既能作为趋化因子招募中性粒细胞和单核巨噬细胞等入侵肿瘤局部,释放更多的促炎因子,又能作为刺激物直接诱导肿瘤细胞的增殖[4]。NSCLC患者体内可检测到C5a水平显著升高,且患者体内升高的C5a不仅与其补体系统的活化相关,而且还可来源于NSCLC细胞本身[14]。本研究发现,体外用C5a刺激NSCLC细胞不仅能促进细胞的增殖,还能增强细胞的迁移,因此又进一步研究C5a刺激NSCLC细胞增殖和迁移可能涉及的分子机制。

  • 众所周知,肿瘤细胞的增殖和迁移与其胞内的信号通路的活化密切相关,但有关C5a刺激NSCLC细胞后能否开启某些信号通路,目前尚不清楚。据此,本实验用Western blot检测了一些信号分子的磷酸化(即活化)情况。结果发现,C5a刺激PC9细胞后其Akt1和ERK1/2的磷酸化显著增加。Akt1和ERK1/2抑制剂可明显下调由C5a刺激PC9细胞后诱导的细胞增殖和迁移,提示Akt1和ERK1/2均参与调控C5a诱导PC9细胞的增殖和迁移作用。值得一提的是,文献报道C5a也可作用于其他肿瘤细胞,并激活Akt1或ERK1/2。例如,Lu等[7] 报道C5a可通过活化Akt1调控补体应答基因⁃32(complement response gene⁃32,RGC⁃32)基因的表达,促进乳腺癌细胞的增殖;Maeda等[12] 研究发现,C5a在转移性肾细胞癌中高表达,并可通过激活ERK1/2促进癌细胞的侵袭。由此可见,多种肿瘤组织的肿瘤微环境中C5a含量均显著上调,上调的C5a可通过活化Akt1或ERK1/2促进肿瘤细胞的增殖和迁移。

  • 已有文献报道,生物碱Cyclovirobuxine D(CVB D)可以通过Akt1⁃ERK1/2信号通路抑制结直肠癌肿瘤发生[15],但C5a活化Akt1或ERK1/2是否存在相互作用,目前尚不知晓。因此又开展相应的实验,研究Akt1和ERK1/2之间是否存在上下游调控的关系。结果显示,在受C5a刺激的PC9细胞中, Perifosine能同时下调Akt1和ERK1/2的磷酸化,而U0126仅能抑制ERK1/2磷酸化,却对Akt1磷酸化水平没有明显的影响,提示C5a刺激PC9细胞后或许能通过激活Akt1诱导ERK1/2的活化。

  • 综上所述,本研究提示,C5a刺激NSCLC细胞后可能通过活化Akt1⁃ERK1/2通路促进NSCLC细胞的增殖和迁移,这为探究NSCLC的发病机制提供了新的思路和实验根据。

  • 参考文献

    • [1] O’DWYER E,HALPENNY D F,GINSBERG M S.Lung cancer screening in patients with previous malignancy:is this cohort at increased risk for malignancy?[J].Eur Radiol,2021,31(1):458-467

    • [2] 王梦玮,徐天蔚,王朝霞.PD⁃1/PD⁃L1免疫检查点抑制剂在肺癌临床研究中的进展[J].南京医科大学学报(自然科学版),2021,41(7):1084-1094

    • [3] EVISON M.The current treatment landscape in the UK for stage III NSCLC[J].Br J Cancer,2020,123(Suppl 1):3-9

    • [4] AJONA D,ORTIZ⁃ESPINOSA S,PIO R.Complement anaphylatoxins C3a and C5a:emerging roles in cancer progression and treatment[J].Semin Cell Dev Biol,2019,85:153-163

    • [5] ZHAO C,LI Y,QIU W,et,al.C5a induces A549 cell proliferation of non ⁃ small cell lung cancer via GDF15 gene activation mediated by GCN5 ⁃ dependent KLF5 acetylation[J].Oncogene,2018,37(35):4821-4837

    • [6] KOCHANEK D M,GHOUSE S M,KARBOWNICZEK M M,et,al.Complementing cancer metastasis[J].Front Immunol,2018,9:1629

    • [7] LU Y,HU X B.C5a stimulates the proliferation of breast cancer cells via Akt ⁃ dependent RGC ⁃ 32 gene activation [J].Oncol Rep,2014,32(6):2817-2823

    • [8] LI L,WEI T,LIU S,et,al.Complement C5 activation promotes type 2 diabetic kidney disease via activating STAT3 pathway and disrupting the gut ⁃kidney axis[J].J Cell Mol Med,2021,25(2):960-974

    • [9] LIM E J,KIM S,OH Y,et,al.Crosstalk between GBM cells and mesenchymal stemlike cells promotes the invasiveness of GBM through the C5a/p38/ZEB1 axis[J].Neuro Oncol,2020,22(10):1452-1462

    • [10] BI X,LV X,LIU D,et,al.METTL3⁃mediated maturation of miR ⁃ 126 ⁃ 5p promotes ovarian cancer progression via PTEN ⁃ mediated PI3K/Akt/mTOR pathway[J].Cancer Gene Ther,2021,28(3⁃4):335-349

    • [11] DEGIRMENCI U,WANG M,HU J.Targeting aberrant RAS/RAF/MEK/ERK signaling for cancer therapy[J].Cells,2020,9(1):198

    • [12] MAEDA Y,KAWANO Y,WADA Y,et,al.C5aR is frequently expressed in metastatic renal cell carcinoma and plays a crucial role in cell invasion via the ERK and PI3 kinase pathways[J].Oncol Rep,2015,33(4):1844-1850

    • [13] SALAZAR Y,ZHENG X,BRUNN D,et,al.Microenvironmental Th9 and Th17 lymphocytes induce metastatic spreading in lung cancer[J].J Clin Invest,2020,130(7):3560-3575

    • [14] NITTA H,MURAKAMI Y,WADA Y,et,al.Cancer cells release anaphylatoxin C5a from C5 by serine protease to enhance invasiveness[J].Oncol Rep,2014,32(4):1715-1719

    • [15] JIANG F,CHEN Y,REN S,et,al.Cyclovirobuxine D inhibits colorectal cancer tumorigenesis via the CTHRC1 ⁃ AKT/ERK⁃Snail signaling pathway[J].Int J Oncol,2020,57(1):183-196

  • 参考文献

    • [1] O’DWYER E,HALPENNY D F,GINSBERG M S.Lung cancer screening in patients with previous malignancy:is this cohort at increased risk for malignancy?[J].Eur Radiol,2021,31(1):458-467

    • [2] 王梦玮,徐天蔚,王朝霞.PD⁃1/PD⁃L1免疫检查点抑制剂在肺癌临床研究中的进展[J].南京医科大学学报(自然科学版),2021,41(7):1084-1094

    • [3] EVISON M.The current treatment landscape in the UK for stage III NSCLC[J].Br J Cancer,2020,123(Suppl 1):3-9

    • [4] AJONA D,ORTIZ⁃ESPINOSA S,PIO R.Complement anaphylatoxins C3a and C5a:emerging roles in cancer progression and treatment[J].Semin Cell Dev Biol,2019,85:153-163

    • [5] ZHAO C,LI Y,QIU W,et,al.C5a induces A549 cell proliferation of non ⁃ small cell lung cancer via GDF15 gene activation mediated by GCN5 ⁃ dependent KLF5 acetylation[J].Oncogene,2018,37(35):4821-4837

    • [6] KOCHANEK D M,GHOUSE S M,KARBOWNICZEK M M,et,al.Complementing cancer metastasis[J].Front Immunol,2018,9:1629

    • [7] LU Y,HU X B.C5a stimulates the proliferation of breast cancer cells via Akt ⁃ dependent RGC ⁃ 32 gene activation [J].Oncol Rep,2014,32(6):2817-2823

    • [8] LI L,WEI T,LIU S,et,al.Complement C5 activation promotes type 2 diabetic kidney disease via activating STAT3 pathway and disrupting the gut ⁃kidney axis[J].J Cell Mol Med,2021,25(2):960-974

    • [9] LIM E J,KIM S,OH Y,et,al.Crosstalk between GBM cells and mesenchymal stemlike cells promotes the invasiveness of GBM through the C5a/p38/ZEB1 axis[J].Neuro Oncol,2020,22(10):1452-1462

    • [10] BI X,LV X,LIU D,et,al.METTL3⁃mediated maturation of miR ⁃ 126 ⁃ 5p promotes ovarian cancer progression via PTEN ⁃ mediated PI3K/Akt/mTOR pathway[J].Cancer Gene Ther,2021,28(3⁃4):335-349

    • [11] DEGIRMENCI U,WANG M,HU J.Targeting aberrant RAS/RAF/MEK/ERK signaling for cancer therapy[J].Cells,2020,9(1):198

    • [12] MAEDA Y,KAWANO Y,WADA Y,et,al.C5aR is frequently expressed in metastatic renal cell carcinoma and plays a crucial role in cell invasion via the ERK and PI3 kinase pathways[J].Oncol Rep,2015,33(4):1844-1850

    • [13] SALAZAR Y,ZHENG X,BRUNN D,et,al.Microenvironmental Th9 and Th17 lymphocytes induce metastatic spreading in lung cancer[J].J Clin Invest,2020,130(7):3560-3575

    • [14] NITTA H,MURAKAMI Y,WADA Y,et,al.Cancer cells release anaphylatoxin C5a from C5 by serine protease to enhance invasiveness[J].Oncol Rep,2014,32(4):1715-1719

    • [15] JIANG F,CHEN Y,REN S,et,al.Cyclovirobuxine D inhibits colorectal cancer tumorigenesis via the CTHRC1 ⁃ AKT/ERK⁃Snail signaling pathway[J].Int J Oncol,2020,57(1):183-196