循環器ジャーナル69巻4号

2021年10月発行

特集 プレシジョン・メディシン時代における腫瘍循環器学の重要性 Ⅳ章　腫瘍循環器学　トピックス

ヒトiPS細胞技術を応用した抗がん剤の心毒性評価と個別化医療への展望

著者： 佐塚文乃¹ 諫田泰成¹

所属機関： ¹国立医薬品食品衛生研究所薬理部

ページ範囲：P.626 - P.633

Point
・国内外のバリデーション試験により，ヒトiPS細胞由来心筋細胞を用いて薬剤性のQT間隔延長および催不整脈リスク評価法が開発された．
・近年，がん治療の進歩により患者の生命予後が延長したこと，新たな作用機序を有する分子標的治療薬が登場をしたことなどにより，抗がん剤による不整脈，心筋障害などの循環器系有害事象が注目を集めている．
・筆者らは，抗がん剤による左心室機能障害に着目し，ヒトiPS細胞由来心筋細胞の動きを高解像度カメラで取得した画像の解析により，収縮・弛緩を評価できる新たなイメージング評価法を開発した．この評価法がドキソルビシンなどの抗がん剤による心毒性を評価可能であることを見いだし，現在，国際検証試験が進行中である．
・今後は，個別のヒトiPS細胞由来心筋細胞を作成し，個別の循環器データとの比較などによる検証を進めることで患者を層別化し，将来的にclinical trial in a dishへの活用が期待される．

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