中医药调控肿瘤相关巨噬细胞抗肺癌研究进展

Prevention and treatment of lung cancer by regulating tumor-associated macrophages with traditional Chinese medicine

肺癌是全世界常见的恶性肿瘤之一,其发病率和病死率逐年上升。在肿瘤微环境(tumor microenvironment,TME)中,肿瘤细胞与免疫细胞之间的相互作用将直接影响肿瘤的增殖、浸润和转移。肿瘤相关巨噬细胞(tumor-associated macrophages,TAMs)是TME的重要组成部分,对肺癌的恶性进展具有双重调控作用。其中,M2巨噬细胞的数量、活性及功能与肺癌患者预后不良相关,参与肿瘤的血管生成与免疫逃逸。中药及其活性成分已被证实可增强机体的抗肿瘤作用,降低化疗和放疗的毒性,延长癌症患者的生存期。该文旨在总结TAMs在肺癌发生和发展中的作用,依据中医“扶正祛邪”理论探讨中医药调控TAMs募集、极化表型、活性、相关因子和蛋白的表达以及相关信号通路防治肺癌的分子机制,以期为靶向TAMs的免疫治疗提供新思路。

Lung cancer is one of the common malignant tumors in the world, and its incidence and mortality is increasing year by year. Interactions between tumor cells and immune cells in the tumor microenvironment(TME) affect tumor proliferation, infiltration, and metastasis. Tumor-associated macrophages(TAMs) are prominent components of TME, and they have dual regulation effects on malignant progression of lung cancer. The number, activity, and function of M2 macrophages are related to the poor prognosis of lung cancer, and M2 macrophages participate in tumor angiogenesis and immune escape. It has been proved that traditional Chinese medicines(TCMs) and their active ingredients can enhance the antitumor effects, reduce the toxicity of chemotherapy and radiotherapy, and prolong the survival rates of patients with cancer. This paper summarized the role of TAMs in the lung cancer initiation and progression, explored the molecular mechanism of TCM in regulating the recruitment, polarization phenotype, activity, and expression of related factors and proteins of TAMs, and discussed related signal pathways in the prevention and treatment of lung cancer based on the TCM theory of "reinforcing healthy qi and eliminating pathogen". This paper is expected to provide new ideas for the immunotherapy of targeted TAMs.