Liu Ming-Xin, Xie Xue-Mei, Li Qiang, Xu Chuan
Medical School of the University of Electronic Science and Technology of China, Chengdu 610054, China.
Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Jan;52(1):39-44. doi: 10.12182/20210160203.
Chronic stress activates the typical neuroendocrine system, hypothalamus pituitary adrenal axis and sympathetic nervous system, and leads to a sustained non-specific adaptive response. It has been proved that chronic stress can promote tumor initiation and induce tumor evolution, especially in immune function and remodeling of tumor microenvironment. However, due to the complex mechanism of chronic stress and the great difference in individual tolerance, the research evidence of chronic stress in tumor genesis and progression is still unclear. Therefore, in this paper, we review the research on the relationship between chronic stress and tumor initiation and evolution, focusing on the molecular mechanism of chronic stress promoting tumor occurrence and development, inhibiting immune response and remodeling tumor immune microenvironment, and exploring the stress management program of healthy people and cancer patients, so as to provide clues for exploring new strategies of cancer prevention and treatment. In our opinion, targeting the cAMP/PKA/CREB signaling pathway to reverse tumor treatment strategy, the relationship between the tumor and stress, inflammation, immunity, the suppressor activity of β receptor antagonist and its mechanism as well as associated with different treatment options, still need to be further explored. A healthy lifestyle, positive life attitudes and professional stress management guidance are essential for the prevention and treatment of cancer.
慢性应激会激活典型的神经内分泌系统、下丘脑-垂体-肾上腺轴和交感神经系统，并导致持续的非特异性适应性反应。业已证明，慢性应激可促进肿瘤发生并诱导肿瘤进展，尤其是在免疫功能和肿瘤微环境重塑方面。然而，由于慢性应激的机制复杂且个体耐受性差异很大，慢性应激在肿瘤发生和进展中的研究证据仍不明确。因此，在本文中，我们综述了慢性应激与肿瘤发生和进展之间关系的研究，重点关注慢性应激促进肿瘤发生发展、抑制免疫反应和重塑肿瘤免疫微环境的分子机制，并探讨健康人和癌症患者的应激管理方案，以便为探索癌症防治新策略提供线索。我们认为，针对环磷酸腺苷/蛋白激酶A/环磷腺苷反应元件结合蛋白（cAMP/PKA/CREB）信号通路来逆转肿瘤治疗策略、肿瘤与应激、炎症、免疫的关系、β受体拮抗剂的抑制活性及其机制以及与不同治疗方案的关联等，仍有待进一步探索。健康的生活方式、积极的生活态度和专业的应激管理指导对于癌症的防治至关重要。
