中医药调控肿瘤相关巨噬细胞在结直肠癌中的研究进展

Traditional Chinese Medicine Regulates Tumor-associated Macrophages in Colorectal Cancer： A Review

摘要:

结直肠癌（CRC）是常见的消化道恶性肿瘤之一，具有腹痛、便质改变、便血及体质量减轻等临床表现，发病率和死亡率呈逐年上升趋势，其发生、发展依赖于多种机制，其中肿瘤微环境（TME）和肿瘤相关巨噬细胞（TAMs）越来越受到重视。肿瘤相关巨噬细胞通过促血管新生、免疫逃逸等方式，影响肿瘤的发生发展并与肿瘤预后息息相关。近年来，中医药已被广泛研究并应用于癌症领域，研究发现中医药主要通过抑制癌细胞增殖、转移和血管生成，促进癌细胞凋亡、诱导肿瘤细胞自噬等和影响免疫功能等途径发挥抗结直肠癌的作用。中医药作为有效治疗手段之一，不仅能够调节TAMs起到抑制肿瘤生长的作用，且其中的有效成分及作用靶点可能会成为免疫治疗领域的新研究方向。因此，该文阐述了肿瘤相关巨噬细胞及其在结直肠癌进展中的作用，并梳理和总结不同种类的中药单体、中药复方及中药新型制剂等抗结直肠癌的分子靶标与作用机制，为中医药在结直肠癌临床治疗提供机制参考，为探索中医药防治结直肠癌及其相关疾病提供新的思路和方向。

Abstract:

Colorectal cancer （CRC）， a most common malignant tumor of the digestive tract， is often manifested by abdominal pain， changes in stool quality， blood in the stool， and weight loss， with rising morbidity and mortality year by year. The onset and development of CRC involve a variety of mechanisms， in which tumor microenvironment （TME） and tumor-associated macrophages （TAMs） have received increasing attention. TAMs influence the tumor development via immune escape and angiogenesis promotion and are associated with the prognosis of tumors. In recent years， traditional Chinese medicine （TCM） has been widely researched and applied in the treatment of cancers. Studies have discovered that TCM mainly exerts the therapeutic effects on CRC by inhibiting the proliferation， metastasis， and angiogenesis， promoting the apoptosis， and inducing autophagy of tumor cells and boosting the immune function. TCM as an effective treatment approach can regulate TAMs to inhibit tumor growth. Moreover， the active components and targets of TCM can be taken as new research directions of immunotherapy. This review describes TAMs and their roles in CRC progression and summarizes the molecular targets and mechanisms of different active components， compound prescriptions， and novel preparations of TCM against CRC， aiming to provide a mechanism reference for the clinical treatment of CRC with TCM and give new insights into the in-depth research on the prevention and treatment of CRC-related diseases with TCM.