自噬的中医属性及其在人体衰老和肿瘤发病中的意义  

TCM Nature of Autophagy and Its Meaning in Aging and Tumor

作　　者：靖林林[1] 龚先玲[2] 孙学刚[2] 

机构地区：[1]南方医科大学中西医结合医院、广东省广州市石榴岗路13号,510315 [2]南方医科大学中医药学院

出　　处：《中医杂志》2014年第22期1891-1893,共3页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81273621);高等学校博士点基金资助项目(20134433110007)

摘　　要：衰老过程中氧自由基(ROS)累积,导致免疫衰老及自噬缺陷,转化细胞免疫逃逸形成肿瘤。自噬是细胞生存机制,是气化功能的微观体现,脾肾虚弱自噬缺陷,是"因虚生癌"。肿瘤形成后,肿瘤细胞产生ROS诱导肿瘤相关成纤维细胞(CAFs)核因子κB的活化,产生细胞因子,形成慢性炎症;激活缺氧诱导因子1α形成假性缺氧,诱导CAFs自噬,形成反向瓦博格效应,为肿瘤细胞提供高能燃料,在CAFs和肿瘤细胞间建立代谢偶联,促进肿瘤生长转移,并加速衰老。自噬机制被肿瘤细胞"利用",耗损的精气反助癌毒,形成脾肾亏虚,是"因癌致虚"。通过健脾补肾调控细胞间质自噬及能量代谢障碍,是中医抗癌新策略。Deficiency of the spleen and kidneys will cause accumulation of reactive oxygen species （ROS） and lead to immunosenescence and autophagy during aging, then immune escape of transformed cell can form tumor. Au- tophagy is the survival mechanism of cells, and it is the microscopic embodiment of qi function. Thus, deficiency of the spleen and kidneys brings about autophagy defect and that is deficiency leading to tumor. After tumor formation, tumor cells will produce ROS and induce activation of nuclear factor kappa B （ NF-KB）, a kind of cancer-associated fibroblasts （CAFs）. Then cell factors are produced and chronic inflammation is formed. Hypoxia-inducible factor-1 c~ is activated to form pseudo hypoxia and CAFs autophagy is induced to form inverse Warburg effect to provide high- energy fuel for tumor cells and establish metabolic coupling between CAFs and tumor cells. The mechanism promotes tumor growth and metastasis and accelerates aging. Autophagic mechanism is used by tumor cells andconsumed vital essence will aid cancerous toxin to cause deficiency of the spleen and kidneys and that is cancer leading to deficiency. It is a new TCM anticancer strategy by strengthening the spleen and kidneys to regulate autophagy of intercellular sub- stance and dysfunction of energy metabolism.

关 键 词：肿瘤 自噬 衰老 脾肾虚弱 

分 类 号：R273[医药卫生—中西医结合]