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上海中医药大学,上海 201203
Received:16 April 2021,
Published Online:06 July 2021,
Published:05 September 2021
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颜彬,周钱梅.肿瘤相关巨噬细胞参与化疗耐药及中医药干预研究进展[J].中国实验方剂学杂志,2021,27(17):193-202.
YAN Bin,ZHOU Qian-mei.Role of Tumor Associated Macrophages in Chemotherapy Resistance and Intervention with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(17):193-202.
颜彬,周钱梅.肿瘤相关巨噬细胞参与化疗耐药及中医药干预研究进展[J].中国实验方剂学杂志,2021,27(17):193-202. DOI: 10.13422/j.cnki.syfjx.20211793.
YAN Bin,ZHOU Qian-mei.Role of Tumor Associated Macrophages in Chemotherapy Resistance and Intervention with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(17):193-202. DOI: 10.13422/j.cnki.syfjx.20211793.
肿瘤发病率逐年上升,化疗作为主要治疗手段之一,在临床实际应用上却面临着严重的耐药问题。肿瘤相关巨噬细胞(TAMs)是导致肿瘤化疗耐药的关键因素。TAMs是肿瘤微环境中数量最多的炎症细胞群,广泛分布于上皮组织,如大肠、胃等组织的免疫环境中,与乳腺癌、结直肠癌等多种常见肿瘤疾病关系密切。TAMs分为2种表型,其中M2型TAMs为促瘤表型,通过免疫逃逸、促血管新生等方式,影响肿瘤发生发展全过程,促进肿瘤耐药。同时,临床常见的化疗药物会增加TAMs的招募,分泌细胞因子,导致巨噬细胞向M2型过度极化,引起促肿瘤耐药的进程。化疗耐药分子机制复杂,是化疗领域急需解决的问题。中医药在抗肿瘤药物耐药性方面有着安全性高、多靶点、多途径等独特优势。现研究发现,中医药可以改善肿瘤微环境,从多种途径调控TAMs,进而调节肿瘤发展,改善耐药。该文将系统梳理近些年来有关文献,从TAMs通过调节免疫微环境、与肿瘤干细胞相互作用等方式促进耐药及化疗药物对于耐药的推动作用两方面,总结TAMs化疗耐药机制,并结合中药调节TAMs的细胞因子和相关蛋白、活性、极化方向等相关机制,阐明中药有效成分在耐药干预方面的新进展,以期为深入研究化疗耐药的生物学机制及其中药靶向干预提供参考。
The tumor incidence goes up with every passing year. Chemotherapy, as one of the main treatment methods, is faced with a major challenge of drug resistance in clinical practice. Tumor-associated macrophages (TAMs) are the key factors inducing chemotherapy resistance of tumors. TAMs are inflammatory cells with the largest number in the tumor microenvironment, which are widely distributed in such epithelial tissues as large intestine and stomach in the immune environment and closely associated with multiple common cancers like breast cancer and colorectal cancer. TAMs can be divided into two phenotypes, with M2-polarized TAMs into the tumor-promoting phenotype that affects the oncogenesis and progression and promotes drug resistance via immune escape, angiogenesis and other ways. At the same time, the frequently utilized chemotherapeutic agents will increase the recruitment of TAMs and trigger the secretion of cytokines, leading to the excessive polarization of macrophages to M2 type, followed by tumor drug resistance. The molecular mechanism of chemotherapy resistance is complex, which is becoming an urgent problem in the field of chemotherapy. Traditional Chinese medicine (TCM) has exhibited unique advantages in resisting tumor drug resistance. It has been proved efficient and safe in improving tumor microenvironment and regulating TAMs by acting on multiple targets via multiple ways, thus adjusting tumor progression and improving drug resistance. Based on related articles published in recent years, this paper reviewed the drug resistance-promoting effect of TAMs via regulating the immune microenvironment and interacting with tumor stem cells and the driving effect of chemotherapeutic agents on drug resistance to figure out the role of TAMs in chemotherapy resistance. Besides, it summarized the mechanisms of TCM in regulating related cytokines, proteins, activity, and the polarization direction of TAMs to expound the effective components of TCM in the intervention of drug resistance. The aim of this paper was to provide reference for further research on the biological mechanism of chemotherapy resistance and its targeted intervention with TCM.
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