线粒体凋亡在胃癌中的调控机制及中医药干预研究进展

Regulatory Mechanism of Mitochondrial Apoptosis in Gastric Cancer and Intervention of Traditional Chinese Medicine:A Review

胃癌(GC)是世界上最常见癌症之一,其症状隐匿不显,发病机制复杂且尚未明确,具有高发病率、高死亡率、预后不良等特点。线粒体凋亡作为经典细胞凋亡途径之一,在GC逃避细胞凋亡中被广泛描述,可通过氧化应激、细胞周期、线粒体膜电位、线粒体易位等机制介导线粒体凋亡参与GC增殖、侵袭及转移等过程,同时也是中医药(TCM)干预恢复GC线粒体功能的潜在靶点之一。TCM基于“中医脾-线粒体相关”理论,阐述脾虚失荣、癌毒内结是线粒体凋亡之根本,确立以“健脾复其本、抗癌解毒攻其根”为基本治疗原则,通过抑制氧化应激、促进细胞周期停滞、下调线粒体膜电位等多种途径促进线粒体凋亡,改善GC能量代谢障碍、恢复线粒体结构及功能,有效干预GC的发生发展,具有不良反应小、耐药性低的独特优势。但线粒体凋亡在GC中的作用机制及TCM干预线粒体凋亡治疗GC的作用靶点尚缺乏系统性评述。因此,该文从线粒体凋亡对GC的发生发展的影响及TCM干预线粒体凋亡治疗GC的作用进行系统性整理、归纳,以期为GC的治疗及进一步的研究提供一定的文献及理论参考依据。

Gastric cancer(GC)is one of the most common cancers in the world,with hidden symptoms,complex pathogenesis,high morbidity,high mortality,and poor prognosis.As one of the classical apoptosis pathways,mitochondrial apoptosis has been widely described in the apoptosis escape by GC cells.Mitochondrial apoptosis can regulate the proliferation,invasion,and metastasis of GC cells via oxidative stress,cell cycle,mitochondrial membrane potential,mitochondrial translocation and other mechanisms,and it is one of the potential targets of traditional Chinese medicine(TCM)intervention to restore the mitochondrial function in GC.The theory of spleen-mitochondria in correlation explains that spleen deficiency and cancer toxin are the root causes of mitochondrial apoptosis.Accordingly,the TCM treatment should follow the basic principle of invigorating spleen to restore healthy Qi and removing cancer toxin to eliminate the root cause.Mitochondrial apoptosis can be promoted by inhibiting oxidative stress,promoting cell cycle arrest,and reducing mitochondrial membrane potential.This therapy can improve the energy metabolism,restore the mitochondrial structure and function,and prevent the occurrence and development of GC,with mild side effects and low drug resistance.However,the mechanism of mitochondrial apoptosis in GC and the target of TCM intervention in GC have not been systematically reviewed.Therefore,this paper systematically summarized the effects of mitochondrial apoptosis on the occurrence and development of GC and the role of TCM in the treatment of GC by intervening in mitochondrial apoptosis,aiming to provide a theoretical reference for the treatment and further research of GC.