摘要
介绍肠道菌群推动消化系统肿瘤发生发展的病理机制,及其在消化系统肿瘤临床治疗方面的应用,以期望为相关的研究提供一定的参考。以“肠道菌群、消化系统肿瘤、胃肠道疾病、免疫治疗”为主要中文检索词,以“intestinal flora,microbiota,digestive system tumor,gastrointestinal disease,immunity therapy”为主要英文检索词,在PubMed、中国知识基础设施工程(CNKI)、万方数据库检索系统检索发表于2017-01-01-2021-05-01的相关文献,筛选出目标文献后进行整理分析并总结。结果发现,当肠道菌群失调时,其可通过免疫、基因毒副作用、有毒代谢产物、脑-肠轴等途径直接或间接推动消化道肿瘤的发生与发展。某些肠道细菌可抑制淋巴细胞的杀伤作用,介导炎症反应,增加定植部位的炎性因子。或者产生基因毒素,引起胃肠道细胞的异常增殖和死亡。一些由肠道细菌合成分泌的有毒代谢产物则可以通过损伤定植部位细胞的DNA来诱发细胞癌变。脑-肠轴途径则是通过两者之间相互影响、相互作用,共同参与消化系统肿瘤的发生、发展和预后。与此同时,肠道中的有益菌群比如双歧杆菌,又可以通过辅助化学药物、免疫检查点抑制剂等促进T细胞的活化增殖,增强这些药物对肿瘤细胞的杀伤能力。或是通过饮食疗法,通过构建科学健康的饮食结构,辅助消化道肿瘤的治疗。肠道菌群参与构成人体内复杂的生态系统,经过漫长的演化,这些细菌和其人类宿主之间已经形成了一种互利共生的关系。因此,充分利用肠道菌群治疗消化系统肿瘤等疾病,是一种较为理想的治疗方式,其对人体的损伤更小,值得更多的研究。合理膳食下的肠道菌群不仅可以提高某些化学药物对恶性细胞的抑制杀伤作用,还可以辅助免疫检查点抑制剂杀灭肿瘤细胞。
To introduce the pathological mechanism of intestinal flora which promote the occurrence and development of digestive system tumors,and its application in the clinical treatment of those diseases,and to provide some reference for future research.Using"intestinal flora,digestive system tumor,gastrointestinal diseases,immunotherapy"as the main search terms,a large number of relevant literatures published during the period of January 1,2017 to May 1,2021 were searched from PubMed,China Knowledge Infrastructure Project(CNKI),Wanfang and Database Retrieval System.Then the target literature was screened for analysis and summary.It turns out that when the intestinal flora was out of balance,it can directly or indirectly promote the occurrence and development of digestive tract tumors through immune reactions,genotoxic responses,toxic metabolites,brain-gut axis and other pathways.Certain intestinal bacteria can inhibit the killing effect of lymphocyte,mediate inflammatory responses,and increase inflammatory factors at their colonization sites,or produce genotoxins that cause abnormal proliferation and death of gastrointestinal cells.Some toxic metabolites synthesized and secreted by intestinal bacteria can induce cell carcinogenesis by damaging the DNA of cells at the colonization site.The brain-gut axis pathway,on the other hand,is involved in the occurrence,development and prognosis of digestive system tumors through the interaction between brain and gut.At the same time,beneficial flora in the intestine such as Bifidobacteria,can promote the activation and proliferation of T cells with chemical drugs and immune checkpoint inhibitors,enhancing the killing ability of these drugs on tumor cells.Also,the treatment of digestive tract tumors can be assisted by building a scientific and healthy diet structure through dietary therapy.The intestinal flora is involved in constituting a complex ecosystem in the human body,and after a long evolution,a mutually beneficial symbiotic relationship has been formed between these bacteria and their human hosts.Therefore,making full use of intestinal flora to treat diseases such as digestive tumors is a ideal therapy,which is less damaging to the human body and deserves more research.Intestinal flora under a proper diet can not only enhance the inhibitory effect and killing effect of certain chemical drugs on malignant cells,but also assist immune checkpoint inhibitors to kill tumor cells.
作者
罗新迪
吴燕
LUO Xin-di;WU yan(School of Medical Science,Jiangsu University,Jiangsu 212000,China)
出处
《社区医学杂志》
CAS
2022年第19期1117-1122,共6页
Journal Of Community Medicine
关键词
肠道菌群
消化道肿瘤
化学药物
免疫治疗
饮食
综述文献
intestinal flora
digestive tract tumor
chemical drugs
immunotherapy
diet
review literature
