基于癌毒病机理论探讨外泌体对肿瘤及肿瘤微环境的交互作用

Effects of exosomes on tumor and tumor microenvironment based on the theory of cancer toxin pathogenesis

肿瘤外泌体为肿瘤微环境重要组成部分,可导致肿瘤侵袭转移,中医癌毒病机理论认为癌毒是肿瘤发生发展过程中产生的一种特异性致病因子。通过比较肿瘤外泌体和癌毒的概念、病理特性以及致病机制,发现二者有诸多共性。作用于肿瘤自身时,肿瘤外泌体可抑制免疫应答、增加肿瘤的侵袭转移能力、促使肿瘤耐药,一方面,与癌毒所呈现的耗损正气、走注流窜以及凶顽缠绵的致病特性相似。另一方面,作用于肿瘤微环境时,肿瘤外泌体在免疫微环境、炎性微环境、缺氧微环境以及酸性微环境等调控机制中发挥重要作用,同时癌毒可致正气亏虚,并常与瘀、热、痰湿胶结,两者所致病理状态具有一致性。综上,肿瘤外泌体是癌毒病机的重要生物学内容,癌毒病机理论符合现代医学对肿瘤外泌体的认识。通过深入探究癌毒与肿瘤外泌体对肿瘤及肿瘤微环境的交互作用,有助于理解两者的科学内涵,丰富中医癌毒病机理论,对进一步揭示肿瘤的致病机制以及提高癌症的临床治疗效果具有重要意义。

Exosomes belong to important parts of tumor microenvironment, leading to invasion and metastasis in cancer diseases. The theory of cancer toxin pathogenesis suggests that cancer toxin is a specific pathogenic factor and is responsible for the initiation and progression of carcinogenesis. It is found that tumor-derived exosomes and cancer toxin are sharing many similarities in the aspects of concepts, pathological characteristics as well as pathogenic mechanisms. On one hand, for the purpose of promoting tumor growth, exosomes inhibit the immune response, increase the metastatic ability as well as enhancing the drug resistance of tumors, while cancer toxin damages the healthy qi, moves with fluidity in human body, and lingers in the body with ferocity. On the other hand, for the purpose of sustaining tumor microenvironment, exosomes play an important role in the regulation of immune microenvironment, inflammatory microenvironment, hypoxic microenvironment, as well as acidic microenvironment, while cancer toxin causes deficiency of healthy qi, and is always associated with blood stasis, heat and phlegm dampness. Taken together, exosomes are important biological contents of the theory of cancer toxin pathogenesis, and the theory of cancer toxin pathogenesis conforms to cognition of exosomes in modern medicine. Exploring the interaction between cancer toxin and exosomes on tumor and tumor microenvironment is helpful to understand their innate scientific connotation, and enrich the pathogenesis theory of cancer toxin in Traditional Chinese medicine, exerting significant implications on further revealing the pathogenic mechanism of tumors and improving the clinical treatment effect of cancer.