中医药调控内质网应激干预结直肠癌的研究进展

Research progress on traditional Chinese medicines regulating endoplasmic reticulum stress in the intervention of colorectal cancer

关键词:  结直肠癌  内质网应激  作用机制  中医药

Key words:  colorectal cancer  endoplasmic reticulum stress  mechanism  traditional Chinese medicine

摘要:

结直肠癌（CRC）是消化系统常见的恶性肿瘤，发病率和病死率常年居高不下，已成为全球性公共卫生挑战。CRC发病机制复杂，早期症状不典型，治疗困难且预后较差，现有的手术、放化疗等治疗手段均存在不同程度的短板，因此，寻找安全有效、毒副作用小的治疗方案是目前临床亟待解决的难题。内质网应激（ERS）与CRC的发生、癌细胞增殖、侵袭、迁移及耐药性密切相关，靶向调控ERS有望成为干预CRC病程的新策略。多项研究证实，中药活性成分凭借其多靶点、多通路、多层次的作用优势在CRC防治中应用广泛，成为近年来的研究热点。研究发现，中药活性成分如萜类、苯丙素类、多酚类、醌类、甾体类和生物碱类等可通过靶向调控ERS相关信号通路表达，诱导肿瘤细胞凋亡和自噬、阻滞癌细胞周期、调控上皮间质转化、提高化疗药物敏感性及抑制肿瘤细胞增殖、迁移等机制，发挥抗CRC的作用。文章旨在梳理近10年国内外关于中药活性成分调控ERS干预CRC的作用机制及价值，探讨当前研究中存在的不足，以期为CRC防治研究及新药研发提供思路与参考。

Abstract:

Colorectal cancer（CRC） is one of the most prevalent malignant tumors in the digestive system，with consistently high incidence and mortality rates，making it a significant global public health concern. The pathogenesis of CRC is highly complex，and its early symptoms are often nonspecific，which leads to delayed diagnosis and difficult treatment. Moreover，the overall prognosis remains unfavorable. Current therapeutic approaches，including surgical resection，radiotherapy，and chemotherapy，are associated with various limitations. Therefore，the development of safe，effective，and low-toxicity therapeutic strategies has become an urgent priority in clinical oncology. Accumulating evidence indicates that endoplasmic reticulum stress（ERS） plays a crucial role in the initiation and progression of CRC，as well as in tumor cell proliferation，invasion，metastasis，and drug resistance. Targeted modulation of ERS signaling pathways may offer a promising novel approach for the intervention of CRC. Multiple studies have confirmed that the active components of traditional Chinese medicine，owing to their advantages of multi-target，multi-pathway and multi-level actions，are widely utilized in the prevention and treatment of CRC，making them a prominent focus of recent research. Active ingredients of Chinese medicines，including terpenoids，phenylpropanoids，polyphenols，quinones，steroids and alkaloids，have been demonstrated to exert anti-CRC effects by modulating ERS-related signaling pathways. These mechanisms involve inducing tumor cell apoptosis and autophagy，arresting cancer cell cycles，regulating epithelial-mesenchymal transition，enhancing chemosensitivity，and inhibiting tumor cell proliferation and migration. This article aims to systematically review the mechanisms and therapeutic potential of TCM-mediated ERS regulation in CRC management，synthesizing domestic and international research over the past decade. It also addresses current research limitations，aiming to provide insights and references for the development of future CRC prevention strategies and novel therapeutic agents.