肿瘤药学2026，Vol.16Issue(3)：264-271,8.DOI:10.3969/j.issn.2095-1264.2026.03.02
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
Mechanistic insights into"Treating the Middle When Upper and Lower Are Injured"in non-small cell lung cancer immunotherapy:gut microbiota-endoplasmic reticulum stress axis perspective
摘要
Abstract
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.关键词
非小细胞肺癌/肠道菌群/免疫治疗/上下交损治其中/建中法/内质网应激Key words
Non-small cell lung cancer/Immunotherapy/Treating the Middle When the Upper and the Lower Both In-jured/Jianzhong therapy/Gut microbiota/Endoplasmic reticulum stress分类
医药卫生引用本文复制引用
黄江南,沈春,陈子怡,孙银辉,杨晓,刘华,王理槐..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[J].肿瘤药学,2026,16(3):264-271,8.基金项目
湖南省中医肿瘤临床医学研究中心平台项目(2021SK4023) （2021SK4023）
湖南省自然科学基金项目(2025JJ80929、2025JJ90017) （2025JJ80929、2025JJ90017）
湖南中医药大学研究生创新项目(20225CX158). （20225CX158）
