Da Silva-De Abreu AJ, Menoni-Blanco BJ

Idioma: Español
Referencias bibliográficas: 46
Paginas: 23-30
Archivo PDF: 222.13 Kb.

RESUMEN

El mieloma múltiple (MM) es una neoplasia maligna con un desarrollo predominantemente intramedular; excepto en los estadíos más avanzados cuando puede tener compromiso extramedular, de manera que durante la mayor parte de su evolución se halla en íntima relación con el microambiente de la médula ósea, donde los plasmocitos tumorales (PT) y las células del estroma (CE) interactúan a través de una compleja red de mecanismos moleculares. Por mecanismos aún no del todo dilucidados, se ha demostrado que las vías moleculares implicadas en las interacciones entre los PT y las CE varían según las alteraciones moleculares tempranas en el desarrollo tumoral, pudiendo llegar a ser el microambiente responsable de la sobreexpresión de determinadas cascadas de señalización. Además de la amplia gama de interleucinas con acción autocrina y paracrina (p.ej. IL-6, IGF-1, VEGF, TNF), las moléculas de adhesión homotípica y heterotípica entre PT-CE (p.ej. VLA-4) y PT-proteínas de la matriz extracelular (PME) (p.ej. syndecan-1, MPC-1) intervienen en la resistencia al tratamiento, proliferación, angiogénesis, supresión de apoptosis y la reabsorción ósea. En el MM, los PT establecen una íntima relación con el microambiente de la médula ósea, donde logra establecer las circunstancias ideales para la progresión tumoral. Con el advenimiento de nuevas tecnologías y conocimientos en la fisiopatología molecular del MM, se han logrado establecer mejores estrategias terapéuticas que abordan de manera más eficiente y eficaz el desafío que representa esta enfermedad hasta los momentos considerada incurable.

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