肠促胰岛素和SGLT-2抑制剂在糖尿病神经内分泌肿瘤患者中的应用:最新进展和未来方向

IF 6.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Rosaria M Ruggeri, Erika Maria Grossrubatscher, Eleonora Ciocca, Iderina Hasballa, Simona Jaafar, Monica Oldani, Manila Rubino, Flaminia Russo, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano
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引用次数: 0

摘要

神经内分泌肿瘤(NET)通常与血糖紊乱有关,如糖尿病前期或糖尿病,这可能是由手术或药物治疗或肿瘤本身激素分泌过多引起的。此外,已有的糖尿病是NET发展的已知危险因素,代谢控制和抗糖尿病治疗可能影响肿瘤进展。糖尿病和NET之间复杂的相互作用,共享几个分子途径,激发了人们对抗糖尿病药物抗癌作用的兴趣。随着新的降糖药不断涌现,包括钠-葡萄糖共转运体-2 (SGLT2)抑制剂和以肠促胰岛素为基础的疗法,如二肽基肽酶-4 (DPP-4)抑制剂、胰高血糖素样肽-1受体(GLP- 1r)激动剂和双GIP/GLP- 1r激动剂,这一点尤为重要。本文通过对临床前和临床研究的综合分析,探讨了这些新的药物选择对NET发展和进展的影响,目的是评估将这些药物引入治疗NET患者的安全性和可行性。我们对在线数据库进行了全面搜索,包括PubMed、ISI Web of Science和Scopus,以评估肠促胰岛素和SGLT2抑制剂对NET患者的治疗效果和潜在作用机制。这些新型抗糖尿病药物显示出有希望的抗癌特性,可能抑制肿瘤细胞增殖和诱导细胞凋亡,尽管对某些癌症风险的担忧仍然存在。根据目前的证据,基于肠促胰岛素的治疗的益处超过任何潜在的癌症风险,导致针对NET患者糖尿病的定制管理算法的提出,考虑到糖尿病的病因、合并症和预期寿命。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incretins and SGLT-2 inhibitors in diabetic patients with neuroendocrine tumors: current updates and future directions.

Neuroendocrine tumors (NET) are frequently associated with glycemic disorders, such as prediabetes or diabetes, which may result from either surgical or medical treatments or hormonal hypersecretion by the tumor itself. Moreover, pre-existing diabetes is a known risk factor for NET development, with metabolic control and antidiabetic therapies potentially influencing tumor progression. The complex interplay between diabetes and NET, which share several molecular pathways, has spurred interest in the anti-cancer effects of antidiabetic medications. This is particularly relevant as new antidiabetic drugs continue to emerge, including sodium-glucose cotransporter-2 (SGLT2) inhibitors and incretin-based therapies, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor (GLP-1R) agonists and dual GIP/GLP- 1 R agonists. This review explores the impact of these novel pharmacological options on NET development and progression through a comprehensive analysis of pre-clinical and clinical studies, with the purpose to evaluate safety and feasibility of introducing these drugs in the treatment of NETs patients. We conducted a comprehensive search of online databases, including PubMed, ISI Web of Science, and Scopus, for studies assessing the therapeutic effects and potential mechanisms of action of incretins and SGLT2 inhibitors in patients with NET. These novel antidiabetic drugs exhibit promising anticancer properties, potentially inhibiting tumor cell proliferation and inducing apoptosis, though concerns about certain cancer risks remain. Based on current evidence, the benefits of incretin-based therapies outweigh any potential cancer risks, leading to the proposal of tailored management algorithms for diabetes in NET patients, factoring in the diabetes aetiology, comorbidities, and life expectancy.

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来源期刊
Reviews in Endocrine & Metabolic Disorders
Reviews in Endocrine & Metabolic Disorders 医学-内分泌学与代谢
CiteScore
14.70
自引率
1.20%
发文量
75
审稿时长
>12 weeks
期刊介绍: Reviews in Endocrine and Metabolic Disorders is an international journal dedicated to the field of endocrinology and metabolism. It aims to provide the latest advancements in this rapidly advancing field to students, clinicians, and researchers. Unlike other journals, each quarterly issue of this review journal focuses on a specific topic and features ten to twelve articles written by world leaders in the field. These articles provide brief overviews of the latest developments, offering insights into both the basic aspects of the disease and its clinical implications. This format allows individuals in all areas of the field, including students, academic clinicians, and practicing clinicians, to understand the disease process and apply their knowledge to their specific areas of interest. The journal also includes selected readings and other essential references to encourage further in-depth exploration of specific topics.
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