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作 者:梁永杰 周平[2] Warangkhana WONGBA Juan GUARDIOLA Jerome WALKER 於峻[1,2]
机构地区:[1]美国肯塔基州路易维尔大学内科系 [2]复旦大学上海医学院生理与病理生理系,上海200032
出 处:《生理学报》2010年第3期191-195,共5页Acta Physiologica Sinica
摘 要:肺癌是主要医学难题之一,尽管分子生物学和药理学技术在进步,肺癌的治疗结果却不尽人意。临床上,炎症与肿瘤密切相关,炎症能够促进肿瘤的形成。从遗传角度讲,这两个过程受到同一个基因座的调控。越来越多的证据表明,神经和免疫两个系统存在交互作用,其中迷走神经起着重要作用。在临床及动物实验中分别观察到:切除迷走神经后肺部的肿瘤发生率增高,转移增加。表明迷走神经具有保护作用,能抑制肿瘤生长。气道感受器是生物感应器,能感受肺部炎症及肿瘤生长过程中的多种介质和细胞因子。这些信号通过迷走神经传递给脑,提供肿瘤生长的信息,随后产生一系列的反应调节炎症的广度和强度以及肿瘤生长速度。肿瘤细胞表达神经递质的受体,能提供底物与神经元直接相互作用。因此,免疫反应的神经调节既可以靶向炎症又可以靶向肿瘤。认识肺部神经如何监控肿瘤的生长并且产生神经免疫相互作用以调节肿瘤的进展及转移,将提高肺癌的治疗水平。Lung cancer is a major medical problem. Despite advances in molecular biology and pharmacology, the outcome of lung cancer treatment is unsatisfactory. Clinically, inflammation and cancer are closely associated, and, genetically, these two processes are regulated by the same gene loci. Inflammation promotes cancer formation. Increasing evidence shows that neuroimmune interaction involving inflammatory disease and the vagus nerves are crucial in the interaction. Airway sensory receptors are biosensors that detect the lung inflammatory process through various mediators and cytokines. This information is transmitted through vagal afferents to the brain and produces a host of responses that regulate the extent and intensity of inflammation. Tumor cells express receptors for neurotransmitters and provide a substrate for direct interaction with neurons. Thus, neural regulation of the immune response is targeted towards inflammation as well as tumors. The airway sensors can detect cancer-related cytokines, which provides a direct pathway to inform the brain of tumor growth. The knowledge of how these sensors may monitor tumor progression and provide neuroimmune interaction in the control of tumor development and metastasis will improve our treatment of lung cancer.
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