Lian Jing, Lin Dongxin, Huang Yuchan, Chen Xiaohui, Chen Lian, Zhang Fan, Tang Peiling, Xie Jinling, Hou Xiaotao, Du Zhengcai, Deng Jiagang, Hao Erwei, Liu Junhui
Guangxi Key Laboratory of Efficacy Study on Chinese Materia Medica, Guangxi University of Chinese Medicine, Nanning, China.
Faculty of pharmacy, Guangxi University of Chinese Medicine, Nanning, China.
Chin Med. 2023 Sep 23;18(1):124. doi: 10.1186/s13020-023-00834-5.
Tumours do not exist in isolation from the organism; their growth, proliferation, motility, and immunosuppressive response are intricately connected to the tumour's microenvironment. As tumour cells and the microenvironment coevolve, an inflammatory microenvironment ensues, propelling the phenomenon of inflammation-cancer transformation-an idea proposed by modern medicine. This review aims to encapsulate the array of representative factors within the tumour's inflammatory microenvironment, such as interleukins (IL-6, IL-10, IL-17, IL-1β), transforming growth factor-beta (TGF-β), interferon-gamma (IFN-γ), tumour necrosis factor-alpha (TNF-α), vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs). Moreover, drawing upon research in traditional Chinese medicine (TCM) and pharmacology, we explore the delicate interplay between these factors and tumour-associated inflammatory cells: tumour-associated macrophages (TAMs), myeloid-derived suppressor cells (MDSCs), tumour-associated neutrophils (TANs) and dendritic cells (DCs). By analyzing the tumour-promoting effects of these entities, we delve into the connotations of Academician Tong Xiao-lin's novel model of "state-target differentiation" and its application in the diagnosis and treatment of tumours. Our aim is to enhance the precision and targeting of tumour treatment in clinical practice. Delving deeper into our understanding of tumour pathogenesis through the lens of modern medicine, we discern the key etiology and pathogenesis throughout the entire developmental stage of tumours, unveiling the evolutionary patterns of Chinese Medicine (CM) states: heat state → phlegm state → stagnation state → deficiency state. Building upon this foundation, we devised a state-regulating formula. Simultaneously, drawing on pharmacological research in traditional Chinese medicine (TCM), we meticulously identified a range of targeted drugs that effectively modulate the aforementioned tumour-related mediators. This comprehensive strategy-a harmonious integration of state identification, target recognition, and simultaneous regulation-aims to elevate clinical efficacy. The fusion of TCM with Western medicine in tumour treatment introduces novel dimensions to the precise and refined application of TCM in clinical practice.
肿瘤并非孤立于机体而存在;其生长、增殖、运动及免疫抑制反应与肿瘤微环境密切相关。随着肿瘤细胞与微环境共同进化,会形成炎性微环境,从而推动炎症 - 癌症转化现象的发生——这是现代医学提出的观点。本综述旨在概括肿瘤炎性微环境中的一系列代表性因子,如白细胞介素(IL - 6、IL - 10、IL - 17、IL - 1β)、转化生长因子 - β(TGF - β)、干扰素 - γ(IFN - γ)、肿瘤坏死因子 - α(TNF - α)、血管内皮生长因子(VEGF)和基质金属蛋白酶(MMPs)。此外,借鉴中医及药理学研究,我们探究了这些因子与肿瘤相关炎性细胞之间的微妙相互作用:肿瘤相关巨噬细胞(TAM)、髓源性抑制细胞(MDSC)、肿瘤相关中性粒细胞(TAN)和树突状细胞(DC)。通过分析这些实体的促肿瘤作用,我们深入探讨了仝小林院士“态靶辨治”新模式的内涵及其在肿瘤诊治中的应用。我们的目标是提高临床肿瘤治疗的精准性和靶向性。通过现代医学视角深入理解肿瘤发病机制,我们识别出肿瘤整个发育阶段的关键病因及发病机制,揭示了中医“态”的演变模式:热态→痰态→瘀态→虚态。在此基础上,我们制定了调态方剂。同时,借鉴中药药理学研究,我们精心筛选出一系列能有效调节上述肿瘤相关介质的靶向药物。这种综合策略——态辨、靶识与同治的和谐统一——旨在提高临床疗效。中医与西医在肿瘤治疗中的融合为中医在临床实践中的精准应用开辟了新维度。