慢性应激促进肿瘤发展的机制及干预方式

Mechanism of chronic stress to promote tumor development and the intervention

慢性应激是机体在长期受到应激原刺激时所出现的一系列以神经内分泌为主的非特异性反应,它已被证实对肿瘤发展有显著的促进作用。慢性应激可以通过神经内分泌途径,分别激活下丘脑-垂体-肾上腺轴和交感-肾上腺髓质系统,促进儿茶酚胺及肾上腺皮质激素分泌,调节各级下游通路,也可以调节免疫细胞、免疫因子的分泌,抑制保护性免疫反应、诱发炎症,从而促使肿瘤细胞增殖及转移。一些药物及心理疗法可以缓解患者的应激状态、阻断神经信号传导的各级通路、调控免疫系统,或可成为干预肿瘤患者慢性应激的有效手段,为临床治疗提供可借鉴的干预思路。但由于缺乏相关临床试验,各种药物及心理疗法的临床干预效果暂无定论,仍需进一步研究证实。

Chronic stress is a serial of non-specific neuroendocrine reactions in the body when stimulated by stressors for a long time,which has been shown to have a significant effect on tumor development.Chronic stress can activate the hypothalamus-pituitary-adrenal axis and the sense-adrenal myelin system,promote catecholamine and adrenal corticosteroid secretion,regulate the downstream pathways at all levels,and modulate the secretion of immune cells and immune factors,inhibit protective immune response,and induce inflammation,thus promoting tumor cell proliferation and metastasis.Some drugs and psychotherapy can alleviate the patient’s stress state,block the nerve signal transmission at all levels of access,regulate the immune system,or can become an effective means to intervene in chronic stress in tumor patients for clinical treatment to provide reference for intervention ideas.However,due to lack of relevant clinical trials,the clinical intervention effect of various drugs and psychotherapy is uncertain and needs more studies to verify the effect.