基于自噬中医药防治肺癌研究进展  

Research Progress of Prevention and Treatment of Lung Cancer with Chinese Medicine Based on Autophagy

作　　者：申宏 李亮[2] 范安安 刘海晔[2] SHEN Hong;LI Liang;FAN An′an;LIU Haiye(Tianjin University of Chinese Medicine,Tianjin China 300193;The Second Affiliated Hospital of Tianjin University of Chinese Medicine,Tianjin China 300150)

机构地区：[1]天津中医药大学,天津300193 [2]天津中医药大学第二附属医院,天津300150

出　　处：《中医学报》2021年第9期1904-1909,共6页Acta Chinese Medicine

基　　金：天津市教委基金项目(2019KJ069)。

摘　　要：自噬在肺癌病变的不同阶段具有不同的调控作用,一方面自噬对肿瘤细胞具有杀伤作用,另一方面在细胞缺氧、饥饿等应激条件下或自噬功能异常时,可促进肿瘤细胞的生长、增殖及侵袭。中医药能够有效干预Unc-51样激酶1(Unc-51 like autophagy activating kinase 1,ULK1)、微管相关蛋白轻链3 (microtubule-associated proteins light chain 3,LC3)、p62等自噬相关基因表达,同时调控PI3K/Akt/mTOR、丝裂原活化蛋白激酶(mitogen-activated protein kinase, MAPK)、磷酸腺苷蛋白激酶(AMP-activated protein kinase, AMPK)、信号转导与转录激活因子3(signal transducer and activator of transcription3,STAT3)等多条信号通路,并干预细胞器,多靶点、多环节调控自噬,防治肺癌。但现有研究尚处于表浅阶段,存在诸多局限,如多数临床试验设计简单,研究质量较低,对具体机制研究不足;中医药干预MAPK、AMPK、STAT3等信号通路调控自噬的实验研究较少,对相关蛋白靶点研究单一;缺少对调控自噬的中药复方的研究;实验研究以体外细胞水平居多,体内研究较少,缺乏临床应用证据。今后可在中医整体观念和辨证论治观念的指导下,深入研究自噬与肺癌发生、发展的关系,从自噬角度阐明中医药防治肺癌的相关机制,加强高质量、大样本、多中心的临床研究,为中医药防治肺癌提供更多客观有力的证据。Autophagy has different regulatory effects in different stages of lung cancer.On the one hand, autophagy can kill tumor cells.On the other hand, it can promote the growth, proliferation and invasion of tumor cells under stress conditions such as hypoxia and hunger or abnormal autophagy function.Chinese medicine can effectively interfere with the expression of autophagy related genes such as Unc-51 like autophagy activating kinase 1(ULK1),microtubule-associated proteins light chain 3(LC3),p62 and ATG6.At the same time, it regulates many signal pathways such as PI3 K/Akt/mTOR,mitogen-activated protein kinase(MAPK),AMP-activated protein kinase(AMPK),signal transducer and activator of transcription 3(STAT3),and intervenes in organelles, multi-target multi-link regulation of lung cancer autophagy process, prevention and treatment of lung cancer.However, the existing research is still in the superficial stage, and there are many limitations, such as the design of most clinical trials is simple, the research quality is low, and the research on the specific mechanism is insufficient;there are few experimental studies on the intervention of Chinese medicine in the regulation of autophagy by MAPK,AMPK,STAT3 and other signal pathways, and the research on related protein targets is single;lack of research on Chinese medicine compound for regulating autophagy;most of the experimental studies are in vitro cell experiments, few in vivo studies, and lack of clinical application evidence.In the future, under the guidance of the overall concept of Chinese medicine and the concept of syndrome differentiation and treatment, we can deeply study the relationship between autophagy and the occurrence and development of lung cancer, clarify the relevant mechanism of Chinese medicine in the prevention and treatment of lung cancer from the perspective of autophagy, and strengthen high-quality, large sample and multi-center clinical research, so as to provide more objective and powerful evidence for Chinese medicine in the prevention and tr

关 键 词：自噬 肺癌 中医药 

分 类 号：R273[医药卫生—中西医结合]