The Effectiveness of Traditional Chinese Medicine in Treating Malignancies via Regulatory Cell Death Pathways and the Tumor Immune Microenvironment: A Review of Recent Advances.

The American journal of Chinese medicine Pub Date : 2024-01-01 Epub Date: 2024-02-07 DOI:10.1142/S0192415X2450006X
Jingya Fu, Xiaoxia Xie, Huimin Yao, Haijuan Xiao, Zhuoqun Li, Zhenzhi Wang, Ran Ju, Yan Zhao, Zhijun Liu, Nana Zhang
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Abstract

Traditional Chinese Medicine (TCM) has achieved high clinical efficacy in treating malignancies in recent years and is thus gradually becoming an important therapy for patients with advanced tumor for its benefits in reducing side effects and improving patients' immune status. However, it has not been internationally recognized for cancer treatment because TCM's anti-tumor mechanism is not fully elucidated, limiting its clinical application and international promotion. This review traced the mechanism of the TCM-mediated tumor cell death pathway and its effect on remodeling the tumor immune microenvironment, its direct impact on the microenvironment, its anti-tumor effect in combination with immunotherapy, and the current status of clinical application of TCM on tumor treatment. TCM can induce tumor cell death in many regulatory cell death (RCD) pathways, including apoptosis, autophagy, pyroptosis, necroptosis, and ferroptosis. In addition, TCM-induced cell death could increase the immune cells' infiltration with an anti-tumor effect in the tumor tissue and elevate the proportion of these cells in the spleen or peripheral blood, enhancing the anti-tumor capacity of the tumor-bearing host. Moreover, TCM can directly affect immune function by increasing the population or activating the sub-type immune cells with an anti-tumor role. It was concluded that TCM could induce a pan-tumor death modality, remodeling the local TIME differently. It can also improve the systemic immune status of tumor-bearing hosts. This review aims to establish a theoretical basis for the clinical application of TCM in tumor treatment and to provide a reference for TCM's potential in combination with immunotherapy in cancer treatment.

中医药通过调控细胞死亡途径和肿瘤免疫微环境治疗恶性肿瘤的疗效:最新进展综述》。
近年来,中医药在治疗恶性肿瘤方面取得了较高的临床疗效,并因其在减轻副作用、改善患者免疫状态等方面的优势,逐渐成为晚期肿瘤患者的重要治疗手段。然而,由于中医药抗肿瘤机制尚未完全阐明,其在肿瘤治疗方面尚未得到国际认可,限制了其临床应用和国际推广。本综述追溯了中药介导肿瘤细胞死亡途径的机制及其对肿瘤免疫微环境的重塑作用、中药对肿瘤微环境的直接影响、中药联合免疫治疗的抗肿瘤作用以及中药治疗肿瘤的临床应用现状。中药可通过多种调节性细胞死亡(RCD)途径诱导肿瘤细胞死亡,包括凋亡、自噬、热凋亡、坏死和铁凋亡。此外,中药诱导的细胞死亡可增加肿瘤组织中具有抗肿瘤作用的免疫细胞浸润,并提高这些细胞在脾脏或外周血中的比例,增强肿瘤宿主的抗肿瘤能力。此外,中药还能直接影响免疫功能,增加或激活具有抗肿瘤作用的亚型免疫细胞的数量。研究认为,中药可诱导泛肿瘤死亡模式,对局部TIME进行不同程度的重塑。它还能改善肿瘤宿主的全身免疫状态。本综述旨在为中药在肿瘤治疗中的临床应用建立理论基础,并为中药与免疫疗法在肿瘤治疗中的结合潜力提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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