Lissoni Paolo
Institute of Biological Medicine, Milan, Italy.
Methods Mol Biol. 2012;934:183-92. doi: 10.1007/978-1-62703-071-7_10.
The recent discoveries in the oncological researches have demonstrated that the prognosis of the neoplastic diseases depends on not only the biological characteristics of tumors, including oncogene expression and growth factor receptor activity, but also on the immune status of cancer patients. This is because the well-documented importance of the anticancer immunity in the initiation of the tumor that is mainly modulated by lymphocytes. In addition, the knowledge on the interactions between the immune and neuroendocrine systems has demonstrated that the immune responses are physiologically under a psychoneuroendocrine control. In particular, it has been confirmed that the activation of the brain opioid tone may suppress the generation of an effective anticancer immunity, whereas it is stimulated by other neuroendocrine structure, namely the pineal gland, through the release of at least two indole hormones with anticancer activity, melatonin and 5-methoxytryptamine, exerting both antiproliferative and immunostimulatory effects. By investigating the immune and neuroendocrine functions in cancer patients, it has been observed that cancer progression is associated with a progressive decline in the pineal function, which would constitute the main cancer-related endocrine deficiency, and the occurrence of the irreversible immune alterations. The most prognostically important factors would consist of a diminished endogenous production of anticancer cytokines, such as IL-2 and IL-12, as well as an abnormally enhanced secretion of cytokines provided by suppressive effect on the anticancer immunity, namely IL-14, TGF-beta, and IL-6. The psychoneuroimmunotherapeutic approach in the treatment of cancer would simply consist of the corrections of the various endocrine and immune cancer-related alterations in an attempt to re-establish the neuroimmune condition of the health status.
肿瘤学研究中的最新发现表明，肿瘤性疾病的预后不仅取决于肿瘤的生物学特性，包括癌基因表达和生长因子受体活性，还取决于癌症患者的免疫状态。这是因为抗癌免疫在肿瘤发生过程中的重要作用已得到充分证明，而抗癌免疫主要由淋巴细胞调节。此外，关于免疫和神经内分泌系统之间相互作用的知识表明，免疫反应在生理上受心理神经内分泌控制。特别是，已经证实脑阿片类物质张力的激活可能会抑制有效的抗癌免疫的产生，而它会受到其他神经内分泌结构（即松果体）的刺激，通过释放至少两种具有抗癌活性的吲哚激素，褪黑素和5-甲氧基色胺，发挥抗增殖和免疫刺激作用。通过研究癌症患者的免疫和神经内分泌功能，已观察到癌症进展与松果体功能的逐渐下降有关，这将构成主要的癌症相关内分泌缺陷，以及不可逆转的免疫改变的发生。预后最重要的因素包括内源性抗癌细胞因子（如IL-2和IL-12）的产生减少，以及对抗癌免疫具有抑制作用的细胞因子（即IL-14、TGF-β和IL-6）的异常分泌增加。癌症治疗中的心理神经免疫治疗方法简单地包括纠正各种与癌症相关的内分泌和免疫改变，试图重新建立健康状态的神经免疫状况。
