中医药调控糖酵解重塑肿瘤免疫微环境的研究进展

doi:10.12122/j.issn.1673-4254.2025.10.24

摘要/Abstract

摘要：

肿瘤微环境（TME）免疫抑制与糖酵解异常密切相关，肿瘤细胞通过“Warburg效应”获取代谢优势并抑制免疫应答。中医药通过多靶点调控糖酵解关键酶（如HK2、PKM2）、代谢信号通路（如PI3K/AKT/mTOR、HIF-1α）及非编码RNA，协同抑制乳酸积累、改善血管异常、解除免疫细胞代谢抑制。研究表明，中药单体和复方可增强免疫细胞浸润与功能，改善代谢微环境，并通过纳米递送系统提升治疗精准性。然而，中医药调控糖酵解-TME互作的动态机制尚未完全阐明，需借助单细胞测序等技术深入解析，并推进临床转化研究。未来应聚焦“代谢重编程-免疫激活”协同策略，为肿瘤免疫治疗提供新思路。

关键词: 中医药, 糖酵解, 肿瘤免疫微环境, 免疫逃逸, 代谢重编程, 免疫治疗

Abstract:

Immune suppression in the tumor microenvironment (TME) is closely related to abnormal glycolysis. Tumor cells gain metabolic advantages and suppress immune responses through the "Warburg effect". Traditional Chinese medicine (TCM) has been shown to regulate key glycolysis enzymes (such as HK2 and PKM2), metabolic signaling pathways (such as PI3K/AKT/mTOR, HIF-1α) and non-coding RNAs at multiple targets, thus synergistically inhibiting lactate accumulation, improving vascular abnormalities, and relieving metabolic inhibition of immune cells. Studies have shown that TCM monomers and formulas can promote immune cell infiltration and functions, improve metabolic microenvironment, and with the assistance by the nano-delivery system, enhance the precision of treatment. However, the dynamic mechanism of the interaction between TCM-regulated glycolysis and TME has not been fully elucidated, for which single-cell sequencing and other technologies provide important technical support to facilitate in-depth analysis and clinical translational research. Future studies should be focused on the synergistic strategy of "metabolic reprogramming-immune activation" to provide new insights into the mechanisms of tumor immunotherapy.

Key words: traditional Chinese medicine, glycolysis, tumor immune microenvironment, immune evasion, metabolic reprogramming, immunotherapy

贺松其, 刘洋, 秦梦晨, 何春雨, 江稳滔, 王一钦, 谭思蕊, 孙海燕, 孙海涛. 中医药调控糖酵解重塑肿瘤免疫微环境的研究进展[J]. 南方医科大学学报, 2025, 45(10): 2277-2284.

Songqi HE, Yang LIU, Mengchen QIN, Chunyu HE, Wentao JIANG, Yiqin WANG, Sirui TAN, Haiyan SUN, Haitao SUN. Traditional Chinese medicine for regulating glycolysis to remodel the tumor immune microenvironment: research progress and future prospects[J]. Journal of Southern Medical University, 2025, 45(10): 2277-2284.

图/表 2

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