Glioblastoma tümörlerinde çoklu ilaç direnci.

In cellular perspective, neuronal and glial paradigms are two prevailing approaches for understanding both structure/function and pathology of central nervous system. Neuronal paradigm explains brain pathology mainly based on neurons, while glial paradigm put more emphasize to glial cells. Glioblastoma, one of the most common brain tumors, is unique due to its location, the shortness of median survival and the difficulty of efficient uptake in target tissue. Drug resistance mechanisms observed in the chemotherapy of glioblastoma are quite similar to the ones of other tumor types. These mechanisms can be investigated under two main groups: one is decreasing the sensitivity of tumor cells to chemotherapeutic agents (decreasing of drug uptake into cell by blood brain barrier and membrane transport proteins) and the other one is reducing the efficient concentration of the drug in target tissue (variabilities in detoxification proteins and hypoxia in the tumor microenvironment). Moreover, activation of oncogenes and abnormalities of expression of Bcl-2 protein family members are mediating players in the development of drug resistance in glioblastoma. In this review, the possible drug resistance mechanisms in glioblastoma were described in the light of recent literature by using systemic and integrative perspective. [ABSTRACT FROM AUTHOR]