研究概要
大多数癌症患者是同时患有其他几种慢性疾病的老年人,而肿瘤及其最常见的伴随疾病——心血管代谢疾病、2型糖尿病和抑郁症——都由一个共同的免疫抑制性炎症环境所维持。
中文摘要
大多数癌症患者是同时患有多种其他慢性疾病的老年人,而肿瘤及其最常见的伴随疾病——心血管代谢疾病、2型糖尿病和抑郁症——均由一个共同的免疫抑制性炎症微环境所维持。在此背景下,许多肿瘤在免疫学上呈“冷”状态:细胞毒性T细胞和自然杀伤(NK)细胞浸润不良,调节性T细胞(Tregs)和M2巨噬细胞富集,并嵌入一个慢性炎症的“土壤”中,而该土壤同时也驱动着这些合并症。在此,我们提出一个机制性假说:两种低损伤手段联合应用,可在该宿主中重新唤醒抗肿瘤免疫,同时保留根治性治疗所消耗的生理储备。微创冷冻消融原位破坏肿瘤,释放肿瘤抗原及损伤相关分子模式(钙网蛋白、ATP、HMGB1),驱动免疫原性细胞死亡、树突状细胞成熟和CD8+ T细胞致敏;多靶点中药(TCM)作用于同一炎症基质——抑制NF-κB、IL-6和TNF-α信号,降低乳酸,减少调节性T细胞和M2优势——从而重塑肿瘤微环境。我们提出,二者的汇聚将“冷”微环境转为“热”微环境,并且由于所靶向的基质是共享的,可产生一对多的获益,从肿瘤延伸至其炎症性合并症。我们将这一假设置于三阶段肿瘤绿色治疗框架之内——霸道(Dominant Control)、王道(Supportive Integration)与地道(Harmonisation and Maintenance)——该框架根据肿瘤急迫程度和宿主禀赋,依次安排局部免疫原性减瘤、全身免疫支持与微环境调和,并将中医证型映射到可测量的免疫和炎症读数(中性粒细胞与淋巴细胞比值、CRP、IL-6/TNF-α)上,这些读数可作为生物标志物。我们界定该宿主的免疫表型,明确哪些患者应接受和不应接受该方法,坦承其局限性——草药-药物相互作用、产品质量以及随机数据的稀缺——并预先设定一项两阶段前瞻性试验以及将驳斥该假设每一要素的观察结果。其核心的可证伪主张是:冷冻消融联合多靶点中医可重新唤醒抗肿瘤免疫并减少总治疗负担,包括多重用药,同时不损害生存或生活质量。
展开英文摘要原文
Most patients with cancer are older adults living with several other chronic illnesses, and both the tumour and its commonest companions-cardiometabolic disease, type 2 diabetes and depression-are sustained by a shared, immunosuppressive inflammatory milieu. In this setting many tumours are immunologically "cold": poorly infiltrated by cytotoxic T and natural killer (NK) cells, enriched for regulatory T cells (Tregs) and M2 macrophages, and embedded in a chronically inflamed "soil" that also drives the comorbidities. Here we advance a mechanistic hypothesis: that two low-harm modalities applied together can reawaken antitumour immunity in this host while sparing the physiological reserve that radical treatment consumes. Minimally invasive cryoablation destroys tumour in situ and releases tumour antigens together with damage-associated molecular patterns (calreticulin, ATP, HMGB1), driving immunogenic cell death, dendritic-cell maturation and CD8+ T-cell priming; multi-target Traditional Chinese Medicine (TCM) acts on the same inflammatory substrate-dampening NF-κB, IL-6 and TNF-α signalling, lowering lactate, and reducing regulatory-T-cell and M2 dominance-to remodel the tumour microenvironment. We propose that their convergence turns a "cold" microenvironment "hot" and, because the targeted substrate is shared, yields a one-to-many benefit that extends from the tumour to its inflammatory comorbidities. We situate this hypothesis within the three-stage Tumour Green Therapy framework-Dominant Control ( bà dào , ), Supportive Integration ( wáng dào , ) and Harmonisation and Maintenance ( dì dào , )-which sequences local immunogenic debulking, systemic immune support and microenvironmental harmonisation according to tumour urgency and host constitution, and maps TCM syndrome patterns onto measurable immune and inflammatory readouts (neutrophil-to-lymphocyte ratio, CRP, IL-6/TNF-α) that could serve as biomarkers. We define the immunological phenotype of this host, specify which patients should and should not receive the approach, remain candid about its limitations-herb-drug interactions, product quality and the scarcity of randomised data-and pre-specify both a two-stage prospective test and the observations that would refute each element of the hypothesis. Its central, falsifiable claim is that cryoablation plus multi-target TCM reawakens antitumour immunity and reduces total treatment burden, including polypharmacy, without compromising survival or quality of life.
论文信息
- 作者
- Liu L、Chen H、Wang J、Yang J、Zhou Y、Luo B、Zhou Y、Hu K
- 单位
- School of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China.China
- 文献类型
- 综述
- 期刊
- Frontiers in immunology2026