Cheng Jun, Wang Rui, Chen Yonghua
Operating Room, Department of Anesthesiology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu 610041, China.
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Biomedicines. 2025 Mar 2;13(3):609. doi: 10.3390/biomedicines13030609.
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive primary malignancy, and recent technological advances in surgery have opened up more possibilities for surgical treatment. Emerging evidence highlights the critical roles of diverse immune and neural components in driving the aggressive behavior of PDAC. Recent studies have demonstrated that neural invasion, neural plasticity, and altered autonomic innervation contribute to pancreatic neuropathy in PDAC patients, while also elucidating the functional architecture of nerves innervating pancreatic draining lymph nodes. Research into the pathogenesis and therapeutic strategies for PDAC, particularly from the perspective of neuroimmune network interactions, represents a cutting-edge area of investigation. This review focuses on neuroimmune interactions, emphasizing the current understanding and future challenges in deciphering the reciprocal relationship between the nervous and immune systems in PDAC. Despite significant progress, key challenges remain, including the precise molecular mechanisms underlying neuroimmune crosstalk, the functional heterogeneity of neural and immune cell populations, and the development of targeted therapies that exploit these interactions. Understanding the molecular events governing pancreatic neuroimmune signaling axes will not only advance our knowledge of PDAC pathophysiology but also provide novel therapeutic targets. Translational efforts to bridge these findings into clinical applications, such as immunomodulatory therapies and neural-targeted interventions, hold promise for improving patient outcomes. This review underscores the need for further research to address unresolved questions and translate these insights into effective therapeutic strategies for PDAC.
胰腺导管腺癌（PDAC）是一种极具侵袭性的原发性恶性肿瘤，近年来手术技术的进步为手术治疗开辟了更多可能性。新出现的证据凸显了多种免疫和神经成分在驱动PDAC侵袭性方面的关键作用。最近的研究表明，神经侵袭、神经可塑性和自主神经支配改变导致了PDAC患者的胰腺神经病变，同时也阐明了支配胰腺引流淋巴结的神经功能结构。对PDAC发病机制和治疗策略的研究，特别是从神经免疫网络相互作用的角度来看，是一个前沿研究领域。本综述聚焦于神经免疫相互作用，强调目前对PDAC中神经和免疫系统之间相互关系的理解以及未来面临的挑战。尽管取得了重大进展，但关键挑战仍然存在，包括神经免疫串扰的精确分子机制、神经和免疫细胞群体的功能异质性，以及开发利用这些相互作用的靶向治疗方法。了解胰腺神经免疫信号轴的分子事件不仅将推进我们对PDAC病理生理学的认识，还将提供新的治疗靶点。将这些发现转化为临床应用的转化研究努力，如免疫调节疗法和神经靶向干预，有望改善患者预后。本综述强调需要进一步研究以解决未解决的问题，并将这些见解转化为PDAC的有效治疗策略。
