中医药调控肝癌免疫微环境的分子机制与临床治疗进展  

Molecular mechanisms and clinical advances of traditional Chinese medicine in regulating the immune microenvironment of liver cancer

作　　者：刘玉婷 商子梦 刘晓利 闫慧文 解宇晴 霍光远 杨志云 LIU Yu-ting;SHANG Zi-meng;LIU Xiao-li;YANG Zhi-yun(Beijing Ditan Hospital Affiliated to Capital Medical University(Beijing,100069),China.)

机构地区：[1]首都医科大学附属北京地坛医院,北京100069

出　　处：《中西医结合肝病杂志》2024年第12期1065-1068,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家重点研发计划(No.2024YFC3044700);国家自然科学基金面上项目(No.82274479);国家自然科学基金青年项目(No.82104781);北京市医院管理中心北京市卫健委卓越计划:病毒性乙型肝炎全程诊疗优化模式研究(No.BRWEP2024W10217010);北京市医院管理中心重点医学专业发展计划(No.ZYLX202127);北京市医院管理中心“登峰”人才培养计划(No.DFL20191803);首都卫生发展科研专项(No.2020-2-2173);高层次公共卫生技术人才建设项目(学科带头人-02-16);北京市青苗项目(No.QML0231801);首都医科大学基础-临床联合实验室:中医药防治传染性重症肝病研究与转化实验室(No.DTTP-202301)。

摘　　要：肝癌是全球癌症相关死亡的第三大原因,而免疫逃逸是造成肝癌免疫治疗应答不佳的主要原因。高效、精准的优化肝癌免疫治疗策略亟待被开发。中医药理论中的扶正祛邪理念与现代医学的肿瘤免疫治疗思路相契合,大量研究证实中医药在改善肝癌免疫微环境、增效减毒方面有显著效果。淫羊藿素、黄芪多糖等中药单体通过调控细胞周期、增强CD8+T细胞和NK细胞活性等途径改善免疫微环境,养阴扶正解毒方、大黄蛰虫丸等中药复方通过调控CD8+T细胞耗竭状态、增强NK细胞杀伤功能、调控巨噬细胞极化等途径以抑制免疫逃逸。中医药在联合治疗方案中显示出对免疫调节的积极影响,有望成为免疫治疗的重要手段。Liver cancer ranks as the third leading cause of cancer-related mortality globally,with immune evasion playing a pivotal role in the limited efficacy of immunotherapy in its treatment.The urgent need for effective and precise strategies to optimize immunotherapy for hepatocellular carcinoma(HCC)has garnered significant attention.The traditional Chinese medicine(TCM)concept of"supporting the healthy energy and eliminating pathogenic factors"closely aligns with the principles of modern tumor immunotherapy.Extensive research highlights the remarkable role of TCM in enhancing the immune microenvironment,boosting therapeutic efficacy,and reducing toxicity in HCC.Active compounds such as icariin and astragalus polysaccharides improve the immune microenvironment by modulating the cell cycle and enhancing CD8?T cell and natural killer(NK)cell activity.Moreover,TCM formulations,including Yangyin Fuzheng Jiedu Decoction and Dahuang Zhechong Pills,demonstrate immunomodulatory effects by mitigating CD8?T cell exhaustion,enhancing NK cell cytotoxicity,and regulating macrophage polarization,thus effectively suppressing immune evasion.When incorporated into combination therapies,TCM exhibits promising immunoregulatory potential,making it a compelling candidate for advancing immunotherapy in HCC.

关 键 词：中医药 肝癌 免疫调节 免疫微环境 

分 类 号：R273[医药卫生—中西医结合]