Expanding the armory for treating lymphoma: Targeting redox cellular status through thioredoxin reductase inhibition

Lymphoma refers to a group of cancers that arise from lymphocytes and is the most common form of hematological malignancy in adults. While the recent availability of specific chemotherapy regimes has resulted in good patient outcomes for some lymphoma subtypes, relapsed and refractory lymphoma is still a challenge that needs to be overcome. This review discusses how Nrf-2 regulated antioxidant systems such as the thioredoxin and glutathione systems are upregulated in lymphomas and have been linked with several signaling pathways involved in lymphoma development and progression, including the B cell receptor, the NF-κB, and the STAT3 signaling pathways. Thioredoxin reductase (TrxR) has been recognized as a potential anticancer target and, as a consequence, the synthesis of TrxR inhibitors, along with the discovery of inhibitors from natural resources and evaluation of their anti-cancer effects, is an ongoing active area of research. Targeting antioxidant systems, especially TrxR, may represent a new valid therapeutic approach for lymphoma, potentially in combination with existing therapies.