外泌体在大肠癌中的研究进展

Exosomes in Colorectal Cancer

大肠癌是发病率最高的消化道恶性肿瘤之一,总体5年生存率不高,且近年来随着饮食结构等的改变,大肠癌在我国发病率逐年上升,严重威胁着人类生命健康,故研究大肠癌发生、发展的机制及有效防治方法有重大意义。外泌体是一类由细胞分泌的直径约30~100 nm的有被小泡,表面携带特定分子,可通过受体-配体结合方式或通过内吞作用被内在化,或与靶细胞膜融合,将囊泡中的物质释放至靶细胞胞液中,诱导靶细胞生理状态发生改变,在细胞与细胞间的交流中发挥重要作用。在肿瘤组织中,外泌体作为肿瘤微环境的重要组成部分,可通过促进肿瘤新生血管形成、促使结直肠癌细胞上皮-间质转化、引导肿瘤细胞器官特异性转移、诱导结直肠癌细胞耐药及参与抗肿瘤免疫效应等影响结直肠癌的发展,对结直肠癌外泌体进行深入研究,有利于寻找防治结直肠癌的有效方法。同时,由于外泌体自身通常包含多种特异性分子,有望作为理想的肿瘤标志物用于结直肠癌的诊断及预后判断。中医药治疗以＂整体观念＂和＂辨证论治＂为基本原则,可通过多环节、多途径、多靶点起效,在降低大肠癌的复发转移率、改善大肠癌患者预后方面发挥着重要作用,已成为我国大肠癌综合治疗的重要组成部分。外泌体对大肠癌发生、发展过程影响的广泛性,与中医药防治大肠癌的多环节、多途径、多靶点性相契合,以其为切入点,或许可更全面地研究中医药防治大肠癌的作用机制。

Colorectal cancer has the highest incidence among malignant digestive tract tumors,with a low survival rate in five years. In recent years,with the changes in diet structure,its incidence has increased in China year by year,and become a serious threat to human health. Therefore,it is of great significance to study its occurrence and development mechanisms and effective prevention and treatment methods. Exosomes are a type of secretory vesicles with a diameter of about 30-100 nm secreted by cells,and carry specific molecules on surface.They can be internalized through receptor-ligand binding or endocytosis,or fused with the target cell membrane,then release substances into target cells,and induce target cells to change their physiological state,so as to play an important role in intercellular exchanges. In tumor tissues,exosomes,as an important component in tumor microenvironment,can promote colorectal cancer epithelial-mesenchymal transition,guide specific metastasis of tumor cells among organs,induce drug resistance of colorectal cancer cells,and participate in the anti-tumor immunity effect by promoting tumor angiogenesis. Therefore,further study of exosomes in colorectal cancer is conducive to finding the effective methods to prevent and treat colorectal cancer. Meanwhile,because exosomes usually contain a variety of specific molecules,they are expected to be ideal tumor markers in the diagnosis and prognosis of colorectal cancer. Traditional Chinese medicine（ TCM） therapy takes ‘overall concept ＇ and‘treatment based on syndrome differentiation＇as the basic principle,take effect through multiple links,multiple channels and multiple targets,plays an important role in reducing the recurrence and metastasis rate of colorectal cancer and improving the prognosis of patients with colorectal cancer,and has become an important component of the comprehensive therapy of colorectal cancer. Exosomes widely affects the occurrence and development of colorectal cancer,which is consistent with TCM therapy for colorectal cancer in multiple links,multiple pathways and multi-targets. From this perspective,a more comprehensive study may be made on the mechanisms of TCM for the prevention and treatment of colorectal cancer.