ABSTRACT
Pulmonary toxicity is a serious side effect of some specific anticancer drugs. Bleomycin is a well-known anticancer drug that triggers severe reactions in the lungs. It is an approved drug that may be prescribed for the treatment of testicular cancers, Hodgkin's and non-Hodgkin's lymphomas, ovarian cancer, head and neck cancers, and cervical cancer. A large number of experimental studies and clinical findings show that bleomycin can concentrate in lung tissue, leading to massive oxidative stress, alveolar epithelial cell death, the proliferation of fibroblasts, and finally the infiltration of immune cells. Chronic release of pro-inflammatory and pro-fibrotic molecules by immune cells and fibroblasts leads to pneumonitis and fibrosis. Both fibrosis and pneumonitis are serious concerns for patients who receive bleomycin and may lead to death. Therefore, the management of lung toxicity following cancer therapy with bleomycin is a critical issue. This review explains the cellular and molecular mechanisms of pulmonary injury following treatment with bleomycin. Furthermore, we review therapeutic targets and possible promising strategies for ameliorating bleomycin-induced lung injury.
Subject(s)
Bleomycin , Pulmonary Fibrosis , Bleomycin/adverse effects , Humans , Pulmonary Fibrosis/chemically induced , Pulmonary Fibrosis/pathology , Pulmonary Fibrosis/drug therapy , Animals , Oxidative Stress/drug effects , Lung/pathology , Lung/drug effects , Antibiotics, Antineoplastic/adverse effectsABSTRACT
Chemoresistance has remained a significant concern in tumor recurrence and elevated cancer-related mortalities. A deep insight into mechanisms by which cancerous cells resist administered drugs can pave the way to overcome chemotherapy-induced cell death and develop novel procedures to rescue patients. Regarding accumulated data, stem cell-derived exosomal microRNAs (miRNAs) can be deemed a novel and promising method to overcome chemoresistance. It seems exosomal miRNAs play a dual role in the cancer microenvironment. On the one hand, as a messenger, they are transferred between donor and recipient cells contributing to cancer chemoresistance. On the other hand, stem cell-derived exosomal miRNA significantly restrains tumorigenesis and inhibits or alleviates drug resistance in the tumor niche. Hence, our purpose in this review evaluating the roles of stem cells-derived exosomal microRNAs in overcoming chemoresistance in tumors.