从"肠道菌群-内质网应激"探讨"上下交损治其中"在非小细胞肺癌免疫治疗中的作用OA

Gut microbiota(GM)dysbiosis persistently activates endoplasmic reticulum stress(ERS)and unfolded pro-tein response(UPR)signaling pathways through aberrant microbial metabolites,thereby inducing effector T-cell exhaus-tion,impairing dendritic cell antigen presentation,and promoting the immunosuppressive phenotype of myeloid-derived suppressor cells.This process establishes a coordinated immune evasion network and represents a key mechanism underly-ing heterogeneous responses to immunotherapy in non-small cell lung cancer.The"GM-ERS-immune"axis provides an integrated framework linking microbial homeostasis disruption,metabolic imbalance,and tumor microenvironment remodel-ing.The traditional concept of"Treating the Middle When Upper and Lower Are Injured"emphasizes the pivotal role of the spleen and stomach in harmonizing lung and kidney functions.Its theoretical implications parallel the modern microbiota-metabolism-immunity regulatory network and offer a conceptual basis for targeting tumor-associated immunosuppression.Jianzhong therapy may enhance immunotherapeutic efficacy by reshaping GM composition,increasing short-chain fatty ac-id production,reducing aberrant bile acid accumulation,and suppressing maladaptive activation of key UPR pathways,thereby restoring immune cell function and potentiating immune checkpoint blockade.Future investigations should incorpo-rate comprehensive analyses of microbial metabolomic profiles,core UPR signaling nodes,and immune cell phenotypes to delin-eate multi-target synergistic mechanisms.Such efforts will facilitate the development of precision integrative strategies combin-ing traditional and modern medicine,ultimately improving overall clinical benefit from cancer immunotherapy.