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温和灸抑制结肠癌肝转移OACSTPCD

Mild Moxibustion Inhibiting Hepatic Metastasis of CRC

中文摘要英文摘要

程序性细胞死亡受体-1(programmed cell death receptor 1,PD-1)/程序性细胞死亡配体-1(programmed cell death lig-and 1,PD-L1)途径是结肠癌(colorectal cancer,CRC)免疫治疗的研究重点,但大部分CRC肝转移患者对PD-1 疗法无应答.CRC肝转移患者对抗PD-1 免疫疗法的抑制与CD8+T淋巴细胞缺失关系密切.肝髓系巨噬细胞通过Fas-FasL途径,促进CD8+T淋巴细胞中Caspases-3 裂解,诱导CD8+T淋巴细胞凋亡,抑制抗PD-1 免疫效应.因此,消除巨噬细胞的免疫抑制功能是恢复CD8+T淋巴细胞活性和抑制CRC肝转移的关键.温和灸可提升机体卫气,良性调节免疫细胞,提高CRC肝转移患者T淋巴细胞亚群、巨噬细胞、中性粒细胞及NK细胞水平,增强对CRC细胞的杀伤力和吞噬功能,及时杀灭游走脱落的CRC细胞,降低肝转移发生.基于此,温和灸可能通过降低免疫抑制性肝髓系巨噬细胞表达,抑制Fas-FasL信号传导,诱导CD8+T淋巴细胞富集与活化,增强CD8+T淋巴细胞活性,恢复CRC细胞对抗PD-1 疗法敏感性,最终抑制CRC肝转移.

The programmed cell death receptor 1(PD-1)/programmed cell death ligand 1(PD-L1)pathway is the research focus of immunotherapy for colorectal cancer(CRC),but most CRC patients with hepatic metastases have no response to PD-1 therapy,which is closely related to deficiency of CD8+T lymphocytes.Hepatic myeloid macrophages promote the cleavage of caspase-3 in CD8+T lymphocytes through Fas-FasL pathway,induce the apoptosis of CD8+T lymphocytes and inhibit the anti-PD-1 immune effect.Therefore,elimination of the immunosuppressive function of macrophages is the key to restore the activity of CD8+T lymphocytes and inhibit hepatic metastasis of CRC.Mild moxibustion can improve the body's defensive Qi,regulate immune cells,and increase the levels of T lymphocyte subsets,macrophages,neutrophils,and NK cells in patients with CRC hepatic metastasis,so as to enhance the lethality and phagocytic function for CRC cells as well as killing the drifting and shed CRC cells in time to reduce the occurrence of hepatic me-tastasis.Based on the above,mild moxibustion may reduce the expression of immunosuppressive liver myeloid macrophages,inhibit Fas-FasL signal transduction and induce the enrichment and activation of CD8+T lymphocytes as well as enhancing the activity of CD8+T lymphocytes,to restore the sensitivity of CRC cells to anti-PD-1 therapy and finally inhibit hepatic metastasis of CRC.

庄艺;孙建华;蒋诗媛;宋亚芳

南京中医药大学针灸推拿·养生康复学院,江苏 南京 210023南京中医药大学附属医院针灸康复科,江苏 南京 210029

中医学

结肠癌肝转移;温和灸;抗PD-1疗法;肝髓系巨噬细胞;CD8+T淋巴细胞

hepatic metastasis of CRC;mild moxibustion;anti-PD-1 therapy;hepatic myeloid macrophage;CD8+T lymphocyte

《中医学报》 2024 (006)

1182-1187 / 6

国家自然科学基金项目(82274630);江苏省中医药管理局项目(QN202101);重明鸟计划专项科研基金项目(HYCMP-2021005)

10.16368/j.issn.1674-8999.2024.06.197

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