中医药调节肿瘤免疫微环境治疗肝细胞癌研究进展  

Research Progress of Traditional Chinese Medicine Treating Hepatocellular Carcinoma by Regulating Tumor Immune Microenvironment

作　　者：邵明聪 张懿丹 李梓嫣 王丽娜 SHAO Mingcong;ZHANG Yidan;LI Ziyan;WANG Lina(Department of Traditional Chinese Medicine,Naval Medical University of Chinese People′s Liberation Army,Shanghai China 200433)

机构地区：[1]中国人民解放军海军军医大学中医系,上海200433

出　　处：《中医学报》2025年第3期474-480,共7页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81774244)。

摘　　要：中医药可作用于肿瘤免疫微环境中浸润的T细胞、B细胞、自然杀伤(natural killer,NK)细胞、肿瘤相关巨噬细胞(tumor-associated macrophage,TAM)、骨髓来源抑制细胞(myeloid-derived suppressor cell,MDSC)等免疫细胞,调节免疫系统功能,改善肿瘤免疫抑制状态,重塑肿瘤免疫微环境,从而缓解肝细胞癌患者临床症状,延长患者生存期。同时,中医药可抑制程序性死亡受体/配体-1、细胞毒T淋巴细胞抗原4(cytotoxic T lymphocyte antigen 4,CTLA4)、T细胞免疫球蛋白-3(T cell immunoglobulin-3,Tim3)等免疫检查点分子的过表达,直接或间接影响肿瘤免疫微环境,增强免疫治疗效果。但目前中医药治疗肝细胞癌仍存在一些局限,如中药的生物碱、多糖、糖苷等成分除抗肝细胞癌作用外,亦具有很强的生物毒性,某些药物毒性作用甚至可能强于抗肝癌作用,故需进一步明确中药有效作用成分及靶点,全面阐述中医药对肿瘤免疫微环境的整体调节机制,为中医药治疗肝癌提供新思路。Traditional Chinese medicine can act on immune cells infiltrated in the tumor immune microenvironment,such as T cells,B cells,natural killer(NK)cells,tumor-associated macrophage(TAM),myeloid-derived suppressor cell(MDSC),etc.,and regulate the function of the immune system,thereby alleviating the clinical symptoms of hepatocellular carcinoma patients and prolonging the survival of patients.At the same time,TCM can inhibit the overexpression of immune checkpoint molecules such as programmed death receptor/ligand-1,cytotoxic T lymphocyte antigen 4(CTLA4),and T cell immunoglobulin-3(Tim3),which can directly or indirectly affect the tumor,directly or indirectly affecting the tumor microenvironment and enhances the effect of immunotherapy.However,there are still some limitations in treatment of hepatocellular carcinoma with traditional Chinese medicine,such as alkaloids,polysaccharides,glycosides,and other components of traditional Chinese medicine have strong biotoxicity in addition to anti-hepatocellular carcinoma,and the toxicity of some drugs may even be stronger than the effect of anti-hepatocellular carcinoma.Therefore,it is necessary to further clarify the effective components and targets of traditional Chinese medicine,and to comprehensively elaborate the mechanism of traditional Chinese medicine in regulating the immune environment of tumors in a comprehensive way,so that new ideas can be provided for the treatment of hepatocellular carcinoma with traditional Chinese medicine,to provide new ideas for the treatment of liver cancer with Chinese medicine.

关 键 词：肝细胞癌 肿瘤免疫微环境 中医药 免疫治疗 

分 类 号：R273[医药卫生—中西医结合]