摘要
本位之气虚与僭越之邪气相合称为“虚邪”。“虚邪”高度概括了正气与癌毒的邪正盛衰及正邪之间的虚实变化。T细胞是肿瘤特异性杀伤细胞,奠定了肿瘤免疫治疗的“中心法则”。肿瘤细胞通过降低其抗原性,导致T细胞无法有效识别肿瘤细胞而产生T细胞忽视,癌毒因之潜藏自身成为“伏毒”,为正虚毒伏。肿瘤微环境中异常的新生血管导致瘀血内结、间质重构致痰浊内停,渐成癥瘕积聚,排斥T细胞,使正失其位而致正虚。肿瘤抗原持续刺激T细胞,形成肿瘤细胞与适应性免疫之间的僵持状态,导致T细胞耗竭,为正虚邪恋。正虚与瘀毒癥积相互为用,所形成之虚毒,凶顽难消,且病势缠绵。治病必求于本。以肿瘤T细胞免疫分型结合临床辨证指导用药,是实现中医治疗肿瘤精准用药的重要基础之一。
Cancer is a kind of “deficiency pathogen” that represents the combination of qi deficiency and arrogated evil.The deficiency pathogen is the driving force of carcinogenesis that summarizes the “ebbs and flow” and “deficiency or excess” between healthy qi and cancerous toxin. T lymphocytes are tumor-specific killer cells.Therefore, tumor antigen recognition by T lymphocytes lies at the core of cancer immunotherapy.The tumor cells hide by lowering their antigenicity, hampering T cell function.Abnormal angiogenesis and stromal reprogramming in the tumor microenvironment are the basis of blood stasis, phlegm coagulation, and cancer growth.The reprogrammed microenvironment induces T cell exclusion by excluding effector T cells from the vicinity of cancer cells.Furthermore, continuous tumor antigen stimulation results in a cancer-host “stalemate.” The loss of effector T cell function can be defined as T cell exhaustion.Healthy qi deficiency and cancerous toxins reinforce each other to form the “deficiency pathogen, ” which is difficult to eliminate.Therefore, tumor treatment should focus on the root of the disease, and clinical treatment should be guided by a combination of T cell phenotype and syndrome differentiation.This may serve as an important basis for precise tumor treatment with traditional Chinese medicine.
作者
孙睿博
张清源
王浩
徐一华
孙学刚
丁霞
SUN Ruibo;ZHANG Qingyuan;WANG Hao;XU Yihua;SUN Xuegang;DING Xia(School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2022年第7期694-698,共5页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家自然科学基金重点项目(No.81630080)
国家自然科学基金面上项目(No.81774172,No.81974554)
广东省重点领域研发计划项目(No.2020B1111100011)。
关键词
虚邪
肿瘤微环境
精准医学
T细胞忽视
T细胞排斥
T细胞耗竭
deficiency pathogen
tumor microenvironment
precision medicine
T cell ignorance
T cell exclusion
T cell exhaustion
